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Manna A, Dall’Amico L, Tizzoni M, Karsai M, Perra N. Generalized contact matrices allow integrating socioeconomic variables into epidemic models. SCIENCE ADVANCES 2024; 10:eadk4606. [PMID: 39392883 PMCID: PMC11468902 DOI: 10.1126/sciadv.adk4606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/09/2024] [Indexed: 10/13/2024]
Abstract
Variables related to socioeconomic status (SES), including income, ethnicity, and education, shape contact structures and affect the spread of infectious diseases. However, these factors are often overlooked in epidemic models, which typically stratify social contacts by age and interaction contexts. Here, we introduce and study generalized contact matrices that stratify contacts across multiple dimensions. We demonstrate a lower-bound theorem proving that disregarding additional dimensions, besides age and context, might lead to an underestimation of the basic reproductive number. By using SES variables in both synthetic and empirical data, we illustrate how generalized contact matrices enhance epidemic models, capturing variations in behaviors such as heterogeneous levels of adherence to nonpharmaceutical interventions among demographic groups. Moreover, we highlight the importance of integrating SES traits into epidemic models, as neglecting them might lead to substantial misrepresentation of epidemic outcomes and dynamics. Our research contributes to the efforts aiming at incorporating socioeconomic and other dimensions into epidemic modeling.
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Affiliation(s)
- Adriana Manna
- Department of Network and Data Science, Central European University, Vienna, Austria
| | | | - Michele Tizzoni
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | - Márton Karsai
- Department of Network and Data Science, Central European University, Vienna, Austria
- National Laboratory for Health Security, HUN-REN Rényi Institute of Mathematics, Budapest, Hungary
| | - Nicola Perra
- School of Mathematical Sciences, Queen Mary University of London, London, UK
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Albrecht S, Broderick D, Dost K, Cheung I, Nghiem N, Wu M, Zhu J, Poonawala-Lohani N, Jamison S, Rasanathan D, Huang S, Trenholme A, Stanley A, Lawrence S, Marsh S, Castelino L, Paynter J, Turner N, McIntyre P, Riddle P, Grant C, Dobbie G, Wicker JS. Forecasting severe respiratory disease hospitalizations using machine learning algorithms. BMC Med Inform Decis Mak 2024; 24:293. [PMID: 39379946 PMCID: PMC11462891 DOI: 10.1186/s12911-024-02702-0] [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: 06/15/2024] [Accepted: 09/30/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Forecasting models predicting trends in hospitalization rates have the potential to inform hospital management during seasonal epidemics of respiratory diseases and the associated surges caused by acute hospital admissions. Hospital bed requirements for elective surgery could be better planned if it were possible to foresee upcoming peaks in severe respiratory illness admissions. Forecasting models can also guide the use of intervention strategies to decrease the spread of respiratory pathogens and thus prevent local health system overload. In this study, we explore the capability of forecasting models to predict the number of hospital admissions in Auckland, New Zealand, within a three-week time horizon. Furthermore, we evaluate probabilistic forecasts and the impact on model performance when integrating laboratory data describing the circulation of respiratory viruses. METHODS The dataset used for this exploration results from active hospital surveillance, in which the World Health Organization Severe Acute Respiratory Infection (SARI) case definition was consistently used. This research nurse-led surveillance has been implemented in two public hospitals in Auckland and provides a systematic laboratory testing of SARI patients for nine respiratory viruses, including influenza, respiratory syncytial virus, and rhinovirus. The forecasting strategies used comprise automatic machine learning, one of the most recent generative pre-trained transformers, and established artificial neural network algorithms capable of univariate and multivariate forecasting. RESULTS We found that machine learning models compute more accurate forecasts in comparison to naïve seasonal models. Furthermore, we analyzed the impact of reducing the temporal resolution of forecasts, which decreased the model error of point forecasts and made probabilistic forecasting more reliable. An additional analysis that used the laboratory data revealed strong season-to-season variations in the incidence of respiratory viruses and how this correlates with total hospitalization cases. These variations could explain why it was not possible to improve forecasts by integrating this data. CONCLUSIONS Active SARI surveillance and consistent data collection over time enable these data to be used to predict hospital bed utilization. These findings show the potential of machine learning as support for informing systems for proactive hospital management.
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Affiliation(s)
- Steffen Albrecht
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand.
| | - David Broderick
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Katharina Dost
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Isabella Cheung
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Nhung Nghiem
- Australian National University, 131 Garran Rd, Acton, Canberra ACT, 2601, Australia
| | - Milton Wu
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Johnny Zhu
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | | | - Sarah Jamison
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | | | - Sue Huang
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand
| | - Adrian Trenholme
- Health New Zealand Counties Manukau, Middlemore Hospital, 100 Hospital Road, Auckland, 2025, New Zealand
| | - Alicia Stanley
- Health New Zealand Te Toka Tumai Auckland, Auckland City Hospital, 2 Park Road, Auckland, 1023, New Zealand
| | - Shirley Lawrence
- Health New Zealand Counties Manukau, Middlemore Hospital, 100 Hospital Road, Auckland, 2025, New Zealand
| | - Samantha Marsh
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | | | - Janine Paynter
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Nikki Turner
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Peter McIntyre
- University of Otago, 362 Leith Street, Dunedin, 9016, New Zealand
| | - Patricia Riddle
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand
| | - Cameron Grant
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand.
| | - Gillian Dobbie
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand.
| | - Jörg Simon Wicker
- University of Auckland, 20 Symonds Street, Auckland, 1010, New Zealand.
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Kausto J, Airaksinen J, Oksanen T, Vahtera J, Kivimäki M, Ervasti J. COVID-19-induced changes in the workplace, psychosocial work environment and employee well-being: a longitudinal study. Occup Med (Lond) 2024:kqae079. [PMID: 39312483 DOI: 10.1093/occmed/kqae079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND In many workplaces, the coronavirus disease 2019 pandemic changed work arrangements, but there is scarce longitudinal evidence on whether psychosocial work environment and employee well-being were affected. AIMS To examine the psychosocial work environment and employee well-being before, during and after the pandemic in relation to pandemic-induced changes (working from home, change to other tasks and team reorganization). METHODS Survey data from a cohort of 20 944 public sector employees in Finland were collected before (2016-2018), during (2020) and after the pandemic (2022). Multilevel linear and logistic regression was used to examine group differences between the before-during and during-after periods of the pandemic. RESULTS Working from home was associated with a small but favourable change in worktime control, organizational justice and social capital (scale 1-5) during the pandemic and after the pandemic (marginal mean difference ranging from 0.02 to 0.09 with 95% confidence intervals [CIs] from 0.01 to 0.10). There was a post-pandemic increase in work time control, even among participants with a transfer into other tasks (0.11, 95% CI 0.07, 0.14) or team reorganization (0.06, 95% CI 0.02, 0.10). The decline in self-rated work ability (scale 0-10) before and during the pandemic was greater in those transferred into other tasks (-0.10, 95% CI -0.13, -0.06) than in those not (-0.05, 95% CI -0.06, -0.04). CONCLUSIONS Working from home during the pandemic was accompanied by small favourable changes in the psychosocial work environment during the pandemic, whereas transition to different tasks was associated with a decline in self-rated work ability.
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Affiliation(s)
- J Kausto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Airaksinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - T Oksanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - J Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
| | - M Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland
- Clinicum, University of Helsinki, Helsinki, Finland
- UCL Brain Sciences, University College London, London, UK
| | - J Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
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Yin Z, Dong Y, Wang Q, Ma Y, Gao Z, Ling Z, Aihaiti X, Abudusaimaiti X, Qiu R, Chen Z, Wushouer F. Spatial-temporal evolution patterns of influenza incidence in Xinjiang Prefecture from 2014 to 2023 based on GIS. Sci Rep 2024; 14:21496. [PMID: 39277661 PMCID: PMC11401927 DOI: 10.1038/s41598-024-72618-2] [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: 05/10/2024] [Accepted: 09/09/2024] [Indexed: 09/17/2024] Open
Abstract
Using GIS technology, this study investigated the spatiotemporal distribution pattern of influenza incidence in Xinjiang from 2014 to 2023 based on influenza surveillance data. The study revealed a noticeable fluctuation trend in influenza incidence rates in Xinjiang, particularly notable spikes observed in 2019 and 2023. The results of the 3-year moving average showed a significant long-term upward trend in influenza incidence rates, confirmed by Theil-Sen method (MAD = 2.202, p < 0.01). Global spatial autocorrelation analysis indicated significant positive spatial autocorrelation in influenza incidence rates from 2016 and from 2018 to 2023 (Moran's I > 0, P < 0.05). Local spatial autocorrelation analysis further revealed clustering patterns in different regions, with high-high clustering and low-high clustering predominating in northern Xinjiang, and low-low clustering predominating in southern Xinjiang. Hotspot analysis indicated a progressive rise in the number of influenza incidence hotspots, primarily concentrated in northern Xinjiang, particularly in Urumqi, Ili Kazakh Autonomous Prefecture, and Hotan Prefecture. Standard deviation ellipse analysis and the trajectory of influenza incidence gravity center migration showed that the transmission range of influenza in Xinjiang has been expanding, with the epidemic center gradually moving northward. The spatiotemporal heterogeneity of influenza incidence in Xinjiang highlights the need for differentiated and precise influenza prevention and control strategies in different regions to address the changing trends in influenza prevalence.
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Affiliation(s)
- Zhe Yin
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Yan Dong
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Qi Wang
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Yuanyuan Ma
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Zhenguo Gao
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Zhang Ling
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Xiapikatijiang Aihaiti
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Xiayidanmu Abudusaimaiti
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Ruiying Qiu
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Zihan Chen
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China
| | - Fuerhati Wushouer
- Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, No. 380, Jianquan First Street, Tianshan District, Ürümqi, 830002, Xinjiang Uygur Autonomous Region, China.
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Narita M, Yamamoto M, Sakurai K, Mori C. Associations of parental education with children's infectious diseases and their mediating factors: the Japan Environment and Children's Study (JECS). J Epidemiol 2024:JE20240192. [PMID: 39245579 DOI: 10.2188/jea.je20240192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Abstract
BackgroundParents' educational background is presumed to influence the incidence of vaccine-preventable diseases in children through their decisions about vaccinations and other family lifestyle choices. Regarding voluntary vaccination, a household's economic situation may also be associated with non-vaccination. Therefore, this study investigated the association between parental education and vaccine-preventable diseases (varicella, mumps, influenza [flu], pertussis, measles, and rubella) in children, which currently remains elusive.MethodsWe used datasets from the Japan Environment and Children's Study, which included 104,062 fetal records; our study population comprised 80,930 children up to the age of three years. The associations between parental educational background and children's infectious diseases were examined using binomial logistic regression analysis. The mediating effects of household income, vaccination, and smoking were examined using a path analysis.ResultsFor varicella, mumps, and influenza covered by voluntary vaccination, a higher education level of the father was associated with a lower incidence of infection. The association between mothers' education and children's infection was limited. There were both income-mediated and non-income-mediated pathways between parental education and voluntary vaccination. For pertussis, measles, and rubella, which are covered by routine vaccines, there was no association between parental education and the child's infection.ConclusionAn association between parental education and childhood infections was observed. Additionally, providing financial support for vaccination and communicating the benefits of vaccination in a way that parents at all levels of education can understand will help reduce the incidence of infectious diseases among children.
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Affiliation(s)
- Masami Narita
- Department of Sustainable Health Science, Graduate School of Medical and Pharmaceutical Sciences, Chiba University
- Department of Recruit and Career Development, Ono Pharmaceutical Co
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University
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Corchis-Scott R, Beach M, Geng Q, Podadera A, Corchis-Scott O, Norton J, Busch A, Faust RA, McFarlane S, Withington S, Irwin B, Aloosh M, Ng KKS, McKay RM. Wastewater Surveillance to Confirm Differences in Influenza A Infection between Michigan, USA, and Ontario, Canada, September 2022-March 2023. Emerg Infect Dis 2024; 30:1580-1588. [PMID: 39043398 PMCID: PMC11286066 DOI: 10.3201/eid3008.240225] [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] [Indexed: 07/25/2024] Open
Abstract
Wastewater surveillance is an effective way to track the prevalence of infectious agents within a community and, potentially, the spread of pathogens between jurisdictions. We conducted a retrospective wastewater surveillance study of the 2022-23 influenza season in 2 communities, Detroit, Michigan, USA, and Windsor-Essex, Ontario, Canada, that form North America's largest cross-border conurbation. We observed a positive relationship between influenza-related hospitalizations and the influenza A virus (IAV) wastewater signal in Windsor-Essex (ρ = 0.785; p<0.001) and an association between influenza-related hospitalizations in Michigan and the IAV wastewater signal for Detroit (ρ = 0.769; p<0.001). Time-lagged cross correlation and qualitative examination of wastewater signal in the monitored sewersheds showed the peak of the IAV season in Detroit was delayed behind Windsor-Essex by 3 weeks. Wastewater surveillance for IAV reflects regional differences in infection dynamics which may be influenced by many factors, including the timing of vaccine administration between jurisdictions.
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Gaddy H, Ingholt MM. Did the 1918 influenza pandemic cause a 1920 baby boom? Demographic evidence from neutral Europe. POPULATION STUDIES 2024; 78:269-287. [PMID: 37011659 DOI: 10.1080/00324728.2023.2192041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/22/2022] [Indexed: 04/05/2023]
Abstract
In 1919-20, the European countries that were neutral in the First World War saw a small baby bust followed by a small baby boom. The sparse literature on this topic attributes the 1919 bust to individuals postponing conceptions during the peak of the 1918-20 influenza pandemic and the 1920 boom to recuperation of those conceptions. Using data from six large neutral countries of Europe, we present novel evidence contradicting that narrative. In fact, the subnational populations and maternal birth cohorts whose fertility was initially hit hardest by the pandemic were still experiencing below-average fertility in 1920. Demographic evidence, economic evidence, and a review of post-pandemic fertility trends outside Europe suggest that the 1920 baby boom in neutral Europe was caused by the end of the First World War, not by the end of the pandemic.
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Richmond-Rakerd LS, Iyer MT, D'Souza S, Khalifeh L, Caspi A, Moffitt TE, Milne BJ. Associations of hospital-treated infections with subsequent dementia: nationwide 30-year analysis. NATURE AGING 2024; 4:783-790. [PMID: 38714911 DOI: 10.1038/s43587-024-00621-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/02/2024] [Indexed: 05/22/2024]
Abstract
Infections, which can prompt neuroinflammation, may be a risk factor for dementia1-5. More information is needed concerning associations across different infections and different dementias, and from longitudinal studies with long follow-ups. This New Zealand-based population register study tested whether infections antedate dementia across three decades. We identified individuals born between 1929 and 1968 and followed them from 1989 to 2019 (n = 1,742,406, baseline age = 21-60 years). Infection diagnoses were ascertained from public hospital records. Dementia diagnoses were ascertained from public hospital, mortality and pharmaceutical records. Relative to individuals without an infection, those with an infection were at increased risk of dementia (hazard ratio 2.93, 95% confidence interval 2.68-3.20). Associations were evident for dementia diagnoses made up to 25-30 years after infection diagnoses. Associations held after accounting for preexisting physical diseases, mental disorders and socioeconomic deprivation. Associations were evident for viral, bacterial, parasitic and other infections, and for Alzheimer's disease and other dementias, including vascular dementia. Preventing infections might reduce the burden of neurodegenerative conditions.
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Affiliation(s)
| | - Monica T Iyer
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Aetion,Inc, New York, NY, USA
| | - Stephanie D'Souza
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Lara Khalifeh
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Promenta Center, University of Oslo, Oslo, Norway
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Promenta Center, University of Oslo, Oslo, Norway
| | - Barry J Milne
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
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Bekker-Nielsen Dunbar M, Held L. The COVID-19 vaccination campaign in Switzerland and its impact on disease spread. Epidemics 2024; 47:100745. [PMID: 38593727 DOI: 10.1016/j.epidem.2024.100745] [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: 04/06/2023] [Revised: 12/05/2023] [Accepted: 01/23/2024] [Indexed: 04/11/2024] Open
Abstract
We analyse infectious disease case surveillance data to estimate COVID-19 spread and gain an understanding of the impact of introducing vaccines to counter the disease in Switzerland. The data used in this work is extensive and detailed and includes information on weekly number of cases and vaccination rates by age and region. Our approach takes into account waning immunity. The statistical analysis allows us to determine the effects of choosing alternative vaccination strategies. Our results indicate greater uptake of vaccine would have led to fewer cases with a particularly large effect on undervaccinated regions. An alternative distribution scheme not targeting specific age groups also leads to fewer cases overall but could lead to more cases among the elderly (a potentially vulnerable population) during the early stage of prophylaxis rollout.
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Affiliation(s)
| | - L Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
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Manna A, Koltai J, Karsai M. Importance of social inequalities to contact patterns, vaccine uptake, and epidemic dynamics. Nat Commun 2024; 15:4137. [PMID: 38755162 PMCID: PMC11099065 DOI: 10.1038/s41467-024-48332-y] [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: 09/05/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals' socio-demographic and economic characteristics crucially shape the spread of an epidemic by largely determining the exposure level to the virus and the severity of the disease for those who got infected. While the complex interplay between individual characteristics and epidemic dynamics is widely recognised, traditional mathematical models often overlook these factors. In this study, we examine two important aspects of human behaviour relevant to epidemics: contact patterns and vaccination uptake. Using data collected during the COVID-19 pandemic in Hungary, we first identify the dimensions along which individuals exhibit the greatest variation in their contact patterns and vaccination uptake. We find that generally higher socio-economic groups of the population have a higher number of contacts and a higher vaccination uptake with respect to disadvantaged groups. Subsequently, we propose a data-driven epidemiological model that incorporates these behavioural differences. Finally, we apply our model to analyse the fourth wave of COVID-19 in Hungary, providing valuable insights into real-world scenarios. By bridging the gap between individual characteristics and epidemic spread, our research contributes to a more comprehensive understanding of disease dynamics and informs effective public health strategies.
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Affiliation(s)
- Adriana Manna
- Department of Network and Data Science, Central European University, Quellenstraße 51, Vienna, 1100, Austria
| | - Júlia Koltai
- National Laboratory for Health Security, HUN-REN Centre for Social Sciences, Tóth Kálmán utca 4, Budapest, 1097, Hungary
- Department of Social Research Methodology, Faculty of Social Sciences, Eötvös Loránd University, Pázmány Péter sétány 1/A, Budapest, 1117, Hungary
| | - Márton Karsai
- Department of Network and Data Science, Central European University, Quellenstraße 51, Vienna, 1100, Austria.
- National Laboratory for Health Security, HUN-REN Rényi Institute of Mathematics, Reáltanoda utca 13-15, Budapest, 1053, Hungary.
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Yasopa O, Homkham N, Chompook P. Factors affecting the number of influenza patients before and during COVID-19 pandemic, Thailand. PLoS One 2024; 19:e0303382. [PMID: 38728241 PMCID: PMC11086856 DOI: 10.1371/journal.pone.0303382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
This study was aimed to explore the association between potential factors including public health and social measures and the number of influenza patients in Thailand between 2014-2021. Secondary data from relevant agencies were collected. Generalized Estimating Equation (GEE) and regression coefficient (β) were performed at a significance level of 0.05. We found factors associated with number of influenza patients during the time prior to COVID-19 pandemic were monthly income per household (Adjusted β = -0.02; 95% CI: -0.03, -0.01), population density (Adjusted β = 1.00; 95% CI: 0.82, 1.18), rainy season (Adjusted β = 137.15; 95% CI: 86.17, 188.13) and winter time (Adjusted β = 56.46; 95% CI: 3.21, 109.71). During the time of COVID-19 pandemic, population density (Adjusted β = 0.20; 95% CI: 0.15, 0.26), rainy season (Adjusted β = -164.23; 95% CI: -229.93, -98.52), winter time (Adjusted β = 61.06; 95% CI: 0.71, 121.41), public health control measures (prohibition of entering to into an area with high number of COVID-19 infections (Adjusted β = -169.34; 95% CI: -233.52, -105.16), and restriction of travelling also reduced the number of influenza patients (Adjusted β = -66.88; 95% CI: -125.15, -8.62) were associated with number of influenza patients. This study commends strategies in monitoring influenza patients to focus on the areas with low income, high population density, and in specific seasons. Public health and social measures which can be implemented are prohibition of entering to risk-areas (lock down), and restriction of travelling across provinces which their effectiveness in reducing influenza infections.
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Affiliation(s)
- Oiythip Yasopa
- Department of Disease Control, Division of Epidemiology, Ministry of Public Health, Nonthaburi, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand
| | - Pornthip Chompook
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand
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12
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Myers C, Bennett K, Cahir C. Lessons learned from COVID-19: improving breast cancer care post-pandemic from the patient perspective. Support Care Cancer 2024; 32:338. [PMID: 38730019 PMCID: PMC11087304 DOI: 10.1007/s00520-024-08540-0] [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: 10/27/2023] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Since the onset of the pandemic, breast cancer (BC) services have been disrupted in most countries. The purpose of this qualitative study is to explore the unmet needs, patient-priorities, and recommendations for improving BC healthcare post-pandemic for women with BC and to understand how they may vary based on social determinants of health (SDH), in particular socio-economic status (SES). METHODS Thirty-seven women, who were purposively sampled based on SDH and previously interviewed about the impact of COVID-19 on BC, were invited to take part in follow-up semi-structured qualitative interviews in early 2023. The interviews explored their perspectives of BC care since the easing of COVID-19 government restrictions, including unmet needs, patient-priorities, and recommendations specific to BC care. Thematic analysis was conducted to synthesize each topic narratively with corresponding sub-themes. Additionally, variation by SDH was analyzed within each sub-theme. RESULTS Twenty-eight women (mean age = 61.7 years, standard deviation (SD) = 12.3) participated in interviews (response rate = 76%). Thirty-nine percent (n = 11) of women were categorized as high-SES, while 61% (n = 17) of women were categorized as low-SES. Women expressed unmet needs in their BC care including routine care and mental and physical well-being care, as well as a lack of financial support to access BC care. Patient priorities included the following: developing cohesion between different aspects of BC care; communication with and between healthcare professionals; and patient empowerment within BC care. Recommendations moving forward post-pandemic included improving the transition from active to post-treatment, enhancing support resources, and implementing telemedicine where appropriate. Overall, women of low-SES experienced more severe unmet needs, which in turn resulted in varied patient priorities and recommendations. CONCLUSION As health systems are recovering from the COVID-19 pandemic, the emphasis should be on restoring access to BC care and improving the quality of BC care, with a particular consideration given to those women from low-SES, to reduce health inequalities post-pandemic.
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Affiliation(s)
- Charlotte Myers
- School of Population Health, RCSI University of Medicine and Health Sciences, 123 St Stephen's, Green, Dublin, D02 YN77, Ireland.
| | - Kathleen Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Caitriona Cahir
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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13
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Chirila S, Hangan T, Gurgas L, Costache MG, Vlad MA, Nitu BF, Bittar SM, Craciun A, Condur L, Bjørklund G. Pharmacy-Based Influenza Vaccination: A Study of Patient Acceptance in Romania. Risk Manag Healthc Policy 2024; 17:1005-1013. [PMID: 38690537 PMCID: PMC11059623 DOI: 10.2147/rmhp.s459369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Background This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration. Material and Method The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations. Results Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability. Conclusion Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies' potential in achieving broader vaccination goals.
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Affiliation(s)
- Sergiu Chirila
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Tony Hangan
- Department of Dermatology, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Leonard Gurgas
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | | | | | | | - Sara Melek Bittar
- Department of Dermatology, County Clinical Emergency Hospital of Constanta, Constanta, Romania
| | - Aurora Craciun
- Department of Biochemistry, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Laura Condur
- Department of Family Medicine, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
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14
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Goodfellow L, van Leeuwen E, Eggo RM. COVID-19 inequalities in England: a mathematical modelling study of transmission risk and clinical vulnerability by socioeconomic status. BMC Med 2024; 22:162. [PMID: 38616257 PMCID: PMC11380352 DOI: 10.1186/s12916-024-03387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/10/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in major inequalities in infection and disease burden between areas of varying socioeconomic deprivation in many countries, including England. Areas of higher deprivation tend to have a different population structure-generally younger-which can increase viral transmission due to higher contact rates in school-going children and working-age adults. Higher deprivation is also associated with a higher presence of chronic comorbidities, which were convincingly demonstrated to be risk factors for severe COVID-19 disease. These two major factors need to be combined to better understand and quantify their relative importance in the observed COVID-19 inequalities. METHODS We used UK Census data on health status and demography stratified by decile of the Index of Multiple Deprivation (IMD), which is a measure of socioeconomic deprivation. We calculated epidemiological impact using an age-stratified COVID-19 transmission model, which incorporated different contact patterns and clinical health profiles by decile. To separate the contribution of each factor, we considered a scenario where the clinical health profile of all deciles was at the level of the least deprived. We also considered the effectiveness of school closures and vaccination of over 65-year-olds in each decile. RESULTS In the modelled epidemics in urban areas, the most deprived decile experienced 9% more infections, 13% more clinical cases, and a 97% larger peak clinical size than the least deprived; we found similar inequalities in rural areas. Twenty-one per cent of clinical cases and 16% of deaths in England observed under the model assumptions would not occur if all deciles experienced the clinical health profile of the least deprived decile. We found that more deaths were prevented in more affluent areas during school closures and vaccination rollouts. CONCLUSIONS This study demonstrates that both clinical and demographic factors synergise to generate health inequalities in COVID-19, that improving the clinical health profile of populations would increase health equity, and that some interventions can increase health inequalities.
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Affiliation(s)
- Lucy Goodfellow
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC14 7HT, UK.
| | - Edwin van Leeuwen
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC14 7HT, UK
- Modelling and Economics Unit and NIHR Health Protection Research Unit in Modelling and Health Economics, UK Health Security Agency, London, NW9 5EQ, UK
| | - Rosalind M Eggo
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC14 7HT, UK
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15
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Bann D, Wright L, Hughes A, Chaturvedi N. Socioeconomic inequalities in cardiovascular disease: a causal perspective. Nat Rev Cardiol 2024; 21:238-249. [PMID: 37821646 DOI: 10.1038/s41569-023-00941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
Socioeconomic inequalities in cardiovascular disease (CVD) persist in high-income countries despite marked overall declines in CVD-related morbidity and mortality. After decades of research, the field has struggled to unequivocally answer a crucial question: is the association between low socioeconomic position (SEP) and the development of CVD causal? We review relevant evidence from various study designs and disciplinary perspectives. Traditional observational, family-based and Mendelian randomization studies support the widely accepted view that low SEP causally influences CVD. However, results from quasi-experimental and experimental studies are both limited and equivocal. While more experimental and quasi-experimental studies are needed to aid causal understanding and inform policy, high-quality descriptive studies are also required to document inequalities, investigate their contextual dependence and consider SEP throughout the lifespan; no simple hierarchy of evidence exists for an exposure as complex as SEP. The COVID-19 pandemic illustrates the context-dependent nature of CVD inequalities, with the generation of potentially new causal pathways linking SEP and CVD. The linked goals of understanding the causal nature of SEP and CVD associations, their contextual dependence, and their remediation by policy interventions necessitate a detailed understanding of society, its change over time and the phenotypes of CVD. Interdisciplinary research is therefore key to advancing both causal understanding and policy translation.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK.
| | - Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | - Alun Hughes
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
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16
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El Labban M, Farah W, Mansour P, Eid K, Odeyemi YE. Influenza-Associated Outcomes and Healthcare Utilization by Race and Ethnicity in the USA: a Retrospective Cohort Study Using the National Inpatient Sample Database. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01971-9. [PMID: 38536630 DOI: 10.1007/s40615-024-01971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The influenza virus continues to be a public health concern every season. We aimed to evaluate influenza-associated outcomes and healthcare utilization by race and ethnicity. METHODS We conducted a retrospective cohort study using the National Inpatient Sample across 2019 and 2020. Influenza pneumonia was selected as the principal diagnosis. Outcomes included mortality, use of respiratory support ventilation, length of stay, and total hospitalization charge. Regression models were adjusted for age, gender, Charlson Comorbidity Index, hospitals' region, bed size, teaching status, insurance status, and median income. RESULTS We identified 73,098 individuals hospitalized with influenza pneumonia; 39,807 and 33,291 were admitted in 2019 and 2020, respectively. The sample included 49,829 (68%) White, 11,356 (15.5%) Black, 7526 (10%) Hispanic, 1860 (2.5%) Asian/Pacific, and 617 (0.84%) Native American patients. In-hospital mortality rates and respiratory support (non-invasive ventilation and invasive mechanical ventilation) in 2019 and 2020 were not significantly different across all the races. In 2019 and 2020, the adjusted odds ratios of in-patient mortality were not significantly different. Asians had higher odds of receiving NIV in 2019 but not in 2020 compared to White patients (adjusted odds ratio (aOR) 1.67, p value 0.04). The adjusted odds ratios for receiving IMV were not significantly different between the races in 2019 and 2020. CONCLUSIONS This study contributes valuable insight into influenza-associated outcomes and healthcare utilization patterns among diverse racial and ethnic groups. Disparities in healthcare utilization were observed among younger (< 65 years) individuals of Black and Hispanic ethnicity.
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Affiliation(s)
- Mohamad El Labban
- Department of Internal Medicine, Mayo Clinic Health System, Mankato, MN, 56001, USA.
| | - Wigdan Farah
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Perla Mansour
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Karine Eid
- School of Medicine, American University of Beirut, Beirut, Lebanon
| | - Yewande E Odeyemi
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55905, USA
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17
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Zhang L, Li Y, Ma N, Zhao Y, Zhao Y. Heterogeneity of influenza infection at precise scale in Yinchuan, Northwest China, 2012-2022: evidence from Joinpoint regression and spatiotemporal analysis. Sci Rep 2024; 14:3079. [PMID: 38321190 PMCID: PMC10847441 DOI: 10.1038/s41598-024-53767-w] [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: 08/15/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024] Open
Abstract
Identifying high-risk regions and turning points of influenza with a precise spatiotemporal scale may provide effective prevention strategies. In this study, epidemiological characteristics and spatiotemporal clustering analysis at the township level were performed. A descriptive study and a Joinpoint regression analysis were used to explore the epidemiological characteristics and the time trend of influenza. Spatiotemporal autocorrelation and clustering analyses were carried out to explore the spatiotemporal distribution characteristics and aggregation. Furthermore, the hotspot regions were analyzed by spatiotemporal scan analysis. A total of 4025 influenza cases were reported in Yinchuan showing an overall increasing trend. The tendency of influenza in Yinchuan consisted of three stages: increased from 2012 to the first peak in 2019 (32.62/100,000) with a slight decrease in 2016; during 2019 and 2020, the trend was downwards; then it increased sharply again and reached another peak in 2022. The Joinpoint regression analysis found that there were three turning points from January 2012 to December 2022, namely January 2020, April 2020, and February 2022. The children under ten displayed an upward trend and were statistically significant. The trend surface analysis indicated that there was a shifting trend from northern to central and southern. A significant positive spatial auto-correlation was observed at the township level and four high-incidence clusters of influenza were detected. These results suggested that children under 10 years old deserve more attention and the spatiotemporal distribution of high-risk regions of influenza in Yinchuan varies every year at the township level. Thus, more monitoring and resource allocation should be prone to the four high-incidence clusters, which may benefit the public health authorities to carry out the vaccination and health promotion timely.
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Affiliation(s)
- Lu Zhang
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, China
| | - Yan Li
- Yinchuan Center for Diseases Prevention and Control, Yinchuan, 750004, Ningxia, China
| | - Ning Ma
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, China
| | - Yi Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, China
| | - Yu Zhao
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
- Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia, China.
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18
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Doran Á, Colvin CL, McLaughlin E. What can we learn from historical pandemics? A systematic review of the literature. Soc Sci Med 2024; 342:116534. [PMID: 38184966 DOI: 10.1016/j.socscimed.2023.116534] [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: 06/09/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
What are the insights from historical pandemics for policymaking today? We carry out a systematic review of the literature on the impact of pandemics that occurred since the Industrial Revolution and prior to Covid-19. Our literature searches were conducted between June 2020 and September 2023, with the final review encompassing 169 research papers selected for their relevance to understanding either the demographic or economic impact of pandemics. We include literature from across disciplines to maximise our knowledge base, finding many relevant articles in journals which would not normally be on the radar of social scientists. Our review identifies two gaps in the literature: (1) the need to study pandemics and their effects more collectively rather than looking at them in isolation; and (2) the need for more study of pandemics besides 1918 Spanish Influenza, especially milder pandemic episodes. These gaps are a consequence of academics working in silos, failing to draw on the skills and knowledge offered by other disciplines. Synthesising existing knowledge on pandemics in one place provides a basis upon which to identify the lessons in preparing for future catastrophic disease events.
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Affiliation(s)
- Áine Doran
- Department of Accounting, Finance and Economics, Ulster University, 2-24 York Street, Belfast, BT15 1AP, UK.
| | - Christopher L Colvin
- Department of Economics, Queen's University Belfast, Riddel Hall, 185 Stranmillis Road, Belfast, BT9 5EE, UK.
| | - Eoin McLaughlin
- Department of Accounting, Finance and Economics, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
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19
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Basco S, Domènech J, Rosés JR. Socioeconomic mortality differences during the Great Influenza in Spain. ECONOMICS AND HUMAN BIOLOGY 2024; 52:101318. [PMID: 38070226 DOI: 10.1016/j.ehb.2023.101318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 09/21/2023] [Accepted: 11/18/2023] [Indexed: 02/10/2024]
Abstract
Despite being one of the deadliest viruses in history, there is limited information on the socioeconomic factors that affected mortality rates during the Great Influenza Pandemic. In this study, we use occupation-province level data to investigate the relationship between influenza excess mortality rates and occupation-related status in Spain. We obtain three main results. Firstly, individuals in low-income occupations experienced the highest excess mortality, pointing to a notable income gradient. Secondly, professions that involved more social interaction were associated with a higher excess of mortality, regardless of income. Finally, we observe a substantial rural mortality penalty, even after controlling for income-related occupational groups. Based on this evidence, it seems that the high number of deaths was caused by not self-isolating. Some individuals did not quarantine themselves because they could not afford to miss work. In rural areas, home confinement was likely more limited because their inhabitants did not have immediate access to information about the pandemic or fully understand its impact due to their limited experience handling influenza outbreaks.
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Affiliation(s)
- Sergi Basco
- Departament d'Economia, Universitat de Barcelona, Spain.
| | - Jordi Domènech
- Department of Social Sciences, Universidad Carlos III de Madrid, Spain.
| | - Joan R Rosés
- Historical Economic Demography Group, Department of Economic History, London School of Economics and CEPR, United Kingdom.
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20
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Nii-Trebi NI, Mughogho TS, Abdulai A, Tetteh F, Ofosu PM, Osei MM, Yalley AK. Dynamics of viral disease outbreaks: A hundred years (1918/19-2019/20) in retrospect - Loses, lessons and emerging issues. Rev Med Virol 2023; 33:e2475. [PMID: 37602770 DOI: 10.1002/rmv.2475] [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: 05/05/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
Infectious diseases continue to be the leading cause of morbidity and mortality, and a formidable obstacle to the development and well-being of people worldwide. Viruses account for more than half of infectious disease outbreaks that have plagued the world. The past century (1918/19-2019/20) has witnessed some of the worst viral disease outbreaks the world has recorded, with overwhelming impact especially in low- and middle-income countries (LMIC). The frequency of viral disease outbreak appears to be increasing. Generally, although infectious diseases have afflicted the world for centuries and humankind has had opportunities to examine the nature of their emergence and mode of spread, almost every new outbreak poses a formidable challenge to humankind, beating the existing pandemic preparedness systems, if any, and causing significant losses. These underscore inadequacy in our understanding of the dynamics and preparedness against viral disease outbreaks that lead to epidemics and pandemics. Despite these challenges, the past 100 years of increasing frequencies of viral disease outbreaks have engendered significant improvements in response to epidemics and pandemics, and offered lessons to inform preparedness. Hence, the increasing frequency of emergence of viral outbreaks and the challenges these outbreaks pose to humankind, call for the continued search for effective ways to tackle viral disease outbreaks in real time. Through a PRISMA-based approach, this systematic review examines the outbreak of viral diseases in retrospect to decipher the outbreak patterns, losses inflicted on humanity and highlights lessons these offer for meaningful preparation against future viral disease outbreaks and pandemics.
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Affiliation(s)
- Nicholas I Nii-Trebi
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | | | - Anisa Abdulai
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Francis Tetteh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Priscilla M Ofosu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
| | - Mary-Magdalene Osei
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Akua K Yalley
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana
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21
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Yang Y, Lian J, Jia X, Wang T, Fan J, Yang C, Wang Y, Bao J. Spatial distribution and driving factors of the associations between temperature and influenza-like illness in the United States: a time-stratified case-crossover study. BMC Public Health 2023; 23:1403. [PMID: 37474889 PMCID: PMC10360314 DOI: 10.1186/s12889-023-16240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Several previous studies investigated the associations between temperature and influenza in a single city or region without a national picture. The attributable risk of influenza due to temperature and the corresponding driving factors were unclear. This study aimed to evaluate the spatial distribution characteristics of attributable risk of Influenza-like illness (ILI) caused by adverse temperatures and explore the related driving factors in the United States. METHODS ILI, meteorological factors, and PM2.5 of 48 states in the United States were collected during 2011-2019. The time-stratified case-crossover design with a distributed lag non-linear model was carried out to evaluate the association between temperature and ILI at the state level. The multivariate meta-analysis was performed to obtain the combined effects at the national level. The attributable fraction (AF) was calculated to assess the ILI burden ascribed to adverse temperatures. The ordinary least square model (OLS), spatial lag model (SLM), and spatial error model (SEM) were utilized to identify driving factors. RESULTS A total of 7,716,115 ILI cases were included in this study. Overall, the temperature was negatively associated with ILI risk, and lower temperature gave rise to a higher risk of ILI. AF ascribed to adverse temperatures differed across states, from 49.44% (95% eCI: 36.47% ~ 58.68%) in Montana to 6.51% (95% eCI: -6.49% ~ 16.46%) in Wisconsin. At the national level, 29.08% (95% eCI: 27.60% ~ 30.24%) of ILI was attributable to cold. Per 10,000 dollars increase in per-capita income was associated with the increment in AF (OLS: β = -6.110, P = 0.021; SLM: β = -5.496, P = 0.022; SEM: β = -6.150, P = 0.022). CONCLUSION The cold could enhance the risk of ILI and result in a considerable proportion of ILI disease burden. The ILI burden attributed to cold varied across states and was higher in those states with lower economic status. Targeted prevention programs should be considered to lower the burden of influenza.
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Affiliation(s)
- Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Jiao Lian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Tianrun Wang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Jingwen Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Chaojun Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yuping Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Junzhe Bao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China.
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22
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Kalankesh LR, Rezaei Z, Mohammadpour A, Taghavi M. COVID-19 pandemic and socio-environmental inequality: A narrative review. Health Sci Rep 2023; 6:e1372. [PMID: 37388271 PMCID: PMC10300242 DOI: 10.1002/hsr2.1372] [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: 01/18/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 07/01/2023] Open
Abstract
Background and Aims The COVID-19 pandemic has provided preliminary evidence of the existence of health, social, and environmental inequalities. This inequality encompasses inadequate access to safe water, clean air, and wastewater management, as well as limited socioeconomic and educational opportunities. These issues have not received sufficient attention during the pandemic. The purpose of this narrative review is to provide a comprehensive summary and analysis of the existing literature on a specific topic, ultimately leading to a conclusion based on the evidence presented. Methods The search methodology for this study involved conducting comprehensive searches of scientific databases, including PubMed, ScienceDirect, LILACS, and Google Scholar, from 2019 to 2023. The study focused on a specific theme and its relevant aspects related to global environmental health and society. Keywords such as COVID-19, inequities, and environmental health were used for searching. Additionally, the Boolean operator "AND" was used to combine these descriptors. Results Unequal exposure to air pollution has been reported in Africa, as well as in large parts of Asia and Latin America, according to the data that has been obtained. The pandemic has also resulted in a surge in healthcare waste generation, exacerbating the environmental impact of solid waste. Furthermore, there is evidence indicating significant disparities in the severe lack of access to sanitation services between developing nations and low-income regions. The issues related to water availability, accessibility, and quality are subject to debate. It has been reported that SARS-CoV-2 is present not only in untreated/raw water, but also in water bodies that act as reservoirs. Moreover, insufficient education, poverty, and low household income have been identified as the most significant risk factors for COVID-19 infection and mortality. Conclusion It is evident that addressing socio-environmental inequality and striving to narrow the gap by prioritizing vulnerable populations are imperative.
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Affiliation(s)
- Laleh R. Kalankesh
- Social Determinants of Health Research CenterGonabad University of Medical SciencesGonabadIran
| | - Zahed Rezaei
- Social Determinants of Health Research CenterGonabad University of Medical SciencesGonabadIran
| | - Ali Mohammadpour
- Social Determinants of Health Research CenterGonabad University of Medical SciencesGonabadIran
| | - Mahmoud Taghavi
- Social Determinants of Health Research CenterGonabad University of Medical SciencesGonabadIran
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23
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Matthes KL, Le Vu M, Bhattacharyya U, Galliker A, Kordi M, Floris J, Staub K. Reinfections and Cross-Protection in the 1918/19 Influenza Pandemic: Revisiting a Survey Among Male and Female Factory Workers. Int J Public Health 2023; 68:1605777. [PMID: 37180611 PMCID: PMC10169597 DOI: 10.3389/ijph.2023.1605777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Objectives: The COVID-19 pandemic highlights questions regarding reinfections and immunity resulting from vaccination and/or previous illness. Studies addressing related questions for historical pandemics are limited. Methods: We revisit an unnoticed archival source on the 1918/19 influenza pandemic. We analysed individual responses to a medical survey completed by an entire factory workforce in Western Switzerland in 1919. Results: Among the total of n = 820 factory workers, 50.2% reported influenza-related illness during the pandemic, the majority of whom reported severe illness. Among male workers 47.4% reported an illness vs. 58.5% of female workers, although this might be explained by varied age distribution for each sex (median age was 31 years old for men, vs. 22 years old for females). Among those who reported illness, 15.3% reported reinfections. Reinfection rates increased across the three pandemic waves. The majority of subsequent infections were reported to be as severe as the first infection, if not more. Illness during the first wave, in the summer of 1918, was associated with a 35.9% (95%CI, 15.7-51.1) protective effect against reinfections during later waves. Conclusion: Our study draws attention to a forgotten constant between multi-wave pandemics triggered by respiratory viruses: Reinfection and cross-protection have been and continue to be a key topic for health authorities and physicians in pandemics, becoming increasingly important as the number of waves increases.
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Affiliation(s)
- Katarina L. Matthes
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Mathilde Le Vu
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | | | - Antonia Galliker
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Maryam Kordi
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Joël Floris
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
| | - Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zürich, Switzerland
- Swiss School of Public Health (SSPH+), Zurich, Switzerland
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Wu Y, Li S, Xu R, Chen G, Yue X, Yu P, Ye T, Wen B, de Sousa Zanotti Stagliorio Coêlho M, Saldiva PHN, Guo Y. Wildfire-related PM 2.5 and health economic loss of mortality in Brazil. ENVIRONMENT INTERNATIONAL 2023; 174:107906. [PMID: 37030285 DOI: 10.1016/j.envint.2023.107906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/19/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Wildfire imposes a high mortality burden on Brazil. However, there is a limited assessment of the health economic losses attributable to wildfire-related fine particulate matter (PM2.5). METHODS We collected daily time-series data on all-cause, cardiovascular, and respiratory mortality from 510 immediate regions in Brazil during 2000-2016. The chemical transport model GEOS-Chem driven with Global Fire Emissions Database (GFED), in combination with ground monitored data and machine learning was used to estimate wildfire-related PM2.5 data at a resolution of 0.25° × 0.25°. A time-series design was applied in each immediate region to assess the association between economic losses due to mortality and wildfire-related PM2.5 and the estimates were pooled at the national level using a random-effect meta-analysis. We used a meta-regression model to explore the modification effect of GDP and its sectors (agriculture, industry, and service) on economic losses. RESULTS During 2000-2016, a total of US$81.08 billion economic losses (US$5.07 billion per year) due to mortality were attributable to wildfire-related PM2.5 in Brazil, accounting for 0.68% of economic losses and equivalent to approximately 0.14% of Brazil's GDP. The attributable fraction (AF) of economic losses due to wildfire-related PM2.5 was positively associated with the proportion of GDP from agriculture, while negatively associated with the proportion of GDP from service. CONCLUSION Substantial economic losses due to mortality were associated with wildfires, which could be influenced by the agriculture and services share of GDP per capita. Our estimates of the economic losses of mortality could be used to determine optimal levels of investment and resources to mitigate the adverse health impacts of wildfires.
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Affiliation(s)
- Yao Wu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | | | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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Jones EJ, Ayling K, Wiley CR, Geraghty AW, Greer AL, Holt-Lunstad J, Prather AA, Schreier HM, Silver RC, Sneed RS, Marsland AL, Pressman SD, Vedhara K. Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health. POLICY INSIGHTS FROM THE BEHAVIORAL AND BRAIN SCIENCES 2023; 10:33-40. [PMID: 36942265 PMCID: PMC10018248 DOI: 10.1177/23727322221145308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known prepandemic as well as contemporary research conducted during the pandemic. This focuses on the negative impact of the pandemic on psychosocial health and how this in turn has likely consequences for critically relevant viral and vaccination outcomes. We end by looking forward, highlighting the potential of psychosocial interventions that could be leveraged to support all people in navigating a postpandemic world and how a biopsychosocial approach to health could be incorporated into public health responses to future pandemics.
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Affiliation(s)
- Emily J. Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kieran Ayling
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Cameron R. Wiley
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Adam W.A. Geraghty
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Amy L. Greer
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | | | - Aric A. Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Hannah M.C. Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Roxane Cohen Silver
- Department of Psychological Science, Department of Medicine, Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Rodlescia S. Sneed
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah D. Pressman
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Kavita Vedhara
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
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Social and demographic patterns of influenza vaccination coverage in Norway, influenza seasons 2014/15 to 2020/21. Vaccine 2023; 41:1239-1246. [PMID: 36639272 DOI: 10.1016/j.vaccine.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/12/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
AIMS To examine influenza vaccination coverage among risk groups (RG) and health care workers (HCW), and study social and demographic patterns of vaccination coverage over time. METHODS Vaccination coverage was estimated by self-report in a nationally representative telephone survey among 14919 individuals aged 18-79 years over seven influenza seasons from 2014/15 to 2020/21. We explored whether belonging to an influenza RG (being >=65 years of age and/or having >=1 medical risk factor), being a HCW or educational attainment was associated with vaccination status using logistic regression. RESULTS Vaccination coverage increased from 27 % to 66 % among individuals 65-79 years, from 13 % to 33 % among individuals 18-64 years with >=1 risk factor, and from 9 % to 51 % among HCWs during the study period. Being older, having a risk factor or being a HCW were significantly associated with higher coverage in all multivariable logistic regression analyses. Higher education was also consistently associated with higher coverage, but the difference did not reach significance in all influenza seasons. Educational attainment was not significantly associated with coverage while coverage was at its lowest (2014/15-2017/18), but as coverage increased, so did the differences. Individuals with intermediate or lower education were less likely to report vaccination than those with higher education in season 2018/19, OR = 0.61 (95 % CI 0.46-0.80) and OR = 0.58 (95 % CI 0.41-0.83), respectively, and in season 2019/20, OR = 0.69 (95 % CI 0.55-0.88) and OR = 0.71 (95 % CI 0.53-0.95), respectively. When the vaccine was funded in the COVID-19 pandemic winter of 2020/21, educational differences diminished again and were no longer significant. CONCLUSIONS We observed widening educational differences in influenza vaccination coverage as coverage increased from 2014/15 to 2019/20. When influenza vaccination was funded in 2020/21, differences in coverage by educational attainment diminished. These findings indicate that economic barriers influence influenza vaccination decisions among risk groups in Norway.
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The Spanish flu and the health system: Considerations from the city of Parma, 1918. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.47.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Amanya G, Elyanu P, Migisha R, Kadobera D, Ario AR, Harris JR. Individual and household risk factors for COVID-19 infection among household members of COVID-19 patients in home-based care in western Uganda, 2020. IJID REGIONS 2022; 5:183-190. [PMID: 36407852 PMCID: PMC9650255 DOI: 10.1016/j.ijregi.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To investigate factors associated with COVID-19 among household members of patients in home-based care (HBC) in western Uganda. METHODS We conducted a case-control and cohort study. Cases were reverse transcriptase-polymerase chain reaction-confirmed SARS-CoV-2 diagnosed 1-30 November 2020 among persons in HBC in Kasese or Kabarole districts. We compared 78 case-households (≥1 secondary case) with 59 control-households (no secondary cases). The cohort included all case-household members. Data were captured by in-person questionnaire. We used bivariate regression to calculate odds and risk ratios. RESULTS Case-households were larger than control-households (mean 5.8 vs 4.3 members, P<0.0001). Having ≥1 household member per room (adjusted odds ratio (aOR)=4.5, 95% CI 2.0-9.9), symptom development (aOR=2.3, 95% CI 1.1-5.0), or interaction with primary case-patient (aOR=4.6, 95% CI 1.4-14.7) increased odds of case-household status. Households assessed for suitability for HBC reduced odds of case-household status (aOR=0.4, 95% CI=0.2-0.8). Interacting with a primary case-patient increased the risk of individual infection among household members (adjusted risk ratio=1.7, 95% CI 1.1-2.8). CONCLUSION Household and individual factors influence secondary infection risk in HBC. Decisions about HBC should be made with these in mind.
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Key Words
- ABHR, Alcohol Based Hand Rub
- AFENET, The African Field Epidemiology Network
- CDC, Centers for Diseases Control and Prevention
- COVID-19
- COVID-19, Corono Virus Disease 2019
- HBC, Home Based Care
- HH, Household
- MoH, Ministry of Health
- PEPFAR, President's Emergency Plan for AIDS Relief
- RT-PCR, Reverse Tanscription Polymerase Chain Reaction
- SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2
- SES, Social Economic Status
- Screening
- TB, Tuberculosis
- Uganda
- home-based care (HBC)
- household contacts
- pandemic
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Affiliation(s)
- Geofrey Amanya
- Uganda Public Health Fellowship Program, Infectious Diseases Institute
| | | | - Richard Migisha
- National Institute of Public Health, Ministry of Health, Kampala, Uganda
| | - Daniel Kadobera
- National Institute of Public Health, Ministry of Health, Kampala, Uganda
| | - Alex Riolexus Ario
- National Institute of Public Health, Ministry of Health, Kampala, Uganda
| | - Julie R. Harris
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Kampala, Uganda
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Makovski TT, Ghattas J, Monnier Besnard S, Ambrozova M, Vasinova B, Feteira-Santos R, Bezzegh P, Ponce Bollmann F, Cottam J, Haneef R, Devleesschauwer B, Speybroeck N, Nogueira P, Forjaz MJ, Coste J, Carcaillon-Bentata L. Aetiological and prognostic roles of frailty, multimorbidity and socioeconomic characteristics in the development of SARS-CoV-2 health outcomes: protocol for systematic reviews of population-based studies. BMJ Open 2022; 12:e063573. [PMID: 36414309 PMCID: PMC9684277 DOI: 10.1136/bmjopen-2022-063573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/27/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION There is growing evidence that the impact of COVID-19 crisis may be stronger for individuals with multimorbidity, frailty and lower socioeconomic status. Existing reviews focus on few, mainly short-term effects of COVID-19 illness and patients with single chronic disease. Information is also largely missing for population representative samples.Applying population-based approach, the systematic reviews will have two objectives: (1) to evaluate the aetiological roles of frailty, multimorbidity and socioeconomic status on SARS-CoV-2 infection probability, hospitalisation, intensive care unit (ICU) admission, mechanical ventilation and COVID-19 related mortality among general population and (2) to investigate the prognostic roles of frailty, multimorbidity and socioeconomic characteristics on the risk of hospitalisation, ICU admission, mechanical ventilation, COVID-19 mortality, functioning, quality of life, disability, mental health and work absence. METHODS AND ANALYSIS For this ongoing work, four databases were searched: PubMed, Embase, WHO COVID-19 Global literature on coronavirus disease and PsycINFO, for the period between January 2020 and April 7 2021. Peer-reviewed published literature in English and all types of population-based studies will be considered. Studies using standard tools to assess multimorbidity such as disease count, comorbidity indices or disease combinations will be retained, as well as studies with standard scales and scores for frailty or measurement of a socioeconomic gradient. Initial search included 10 139 articles, 411 for full-text reading. Results will be summarised by risk factor, objective and outcome. The feasibility of meta-analysis will be determined by the findings and will aim to better understand uncertainties of the results. Quality of studies will be assessed using standardised scales. ETHICS AND DISSEMINATION The study will be based on published evidence, and it is exempt from the ethical approval. This work is part of the Population Health Information Research Infrastructure (PHIRI) project. Dissemination of the results will imply conference presentation, submission for scientific publication and PHIRI project report. PROSPERO REGISTRATION NUMBER CRD42021249444.
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Affiliation(s)
- Tatjana T Makovski
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Jinane Ghattas
- Institut de recherche santé et société (IRSS), Université catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium
| | - Stephanie Monnier Besnard
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Monika Ambrozova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Barbora Vasinova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Peter Bezzegh
- Directorate for Project Management, National Directorate General for Hospitals, Budapest, Hungary
| | | | - James Cottam
- Department of Epidemiology and Public Health, Sciensano, Brussel, Belgium
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Romana Haneef
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussel, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Niko Speybroeck
- Institut de recherche santé et société (IRSS), Université catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium
| | - Paulo Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Maria João Forjaz
- National Center of Epidemiology, Instituto de Salud Carlos III, REDISSEC and RICAPPS, Madrid, Spain
| | - Joel Coste
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
| | - Laure Carcaillon-Bentata
- Department of non-communicable diseases and injuries, Santé publique France, Saint-Maurice, Île-de-France, France
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Trained Immunity as a Prospective Tool against Emerging Respiratory Pathogens. Vaccines (Basel) 2022; 10:vaccines10111932. [DOI: 10.3390/vaccines10111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
Although parental vaccines offer long-term protection against homologous strains, they rely exclusively on adaptive immune memory to produce neutralizing antibodies that are ineffective against emerging viral variants. Growing evidence highlights the multifaceted functions of trained immunity to elicit a rapid and enhanced innate response against unrelated stimuli or pathogens to subsequent triggers. This review discusses the protective role of trained immunity against respiratory pathogens and the experimental models essential for evaluating novel inducers of trained immunity. The review further elaborates on the potential of trained immunity to leverage protection against pathogens via the molecular patterns of antigens by pathogen recognition receptors (PPRs) on innate immune cells. The review also focuses on integrating trained innate memory with adaptive memory to shape next-generation vaccines by coupling each one’s unique characteristics.
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McGowan VJ, Bambra C. COVID-19 mortality and deprivation: pandemic, syndemic, and endemic health inequalities. Lancet Public Health 2022; 7:e966-e975. [PMID: 36334610 PMCID: PMC9629845 DOI: 10.1016/s2468-2667(22)00223-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022]
Abstract
COVID-19 has exacerbated endemic health inequalities resulting in a syndemic pandemic of higher mortality and morbidity rates among the most socially disadvantaged. We did a scoping review to identify and synthesise published evidence on geographical inequalities in COVID-19 mortality rates globally. We included peer-reviewed studies, from any country, written in English that showed any area-level (eg, neighbourhood, town, city, municipality, or region) inequalities in mortality by socioeconomic deprivation (ie, measured via indices of multiple deprivation: the percentage of people living in poverty or proxy factors including the Gini coefficient, employment rates, or housing tenure). 95 papers from five WHO global regions were included in the final synthesis. A large majority of the studies (n=86) found that COVID-19 mortality rates were higher in areas of socioeconomic disadvantage than in affluent areas. The subsequent discussion reflects on how the unequal nature of the pandemic has resulted from a syndemic of COVID-19 and endemic inequalities in chronic disease burden.
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Affiliation(s)
- Victoria J McGowan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; Fuse-The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; Fuse-The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK.
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Kirankaya A, Ozel A, Gayret OB, Atici A, Tenekecigil A, Erol M. Assessment of Serum Zinc and Selenium Levels in Children with COVID-19. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1756714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Objective Zinc and selenium levels are being investigated with increasing frequency in adult patients with coronavirus disease 2019 (COVID-19). However, levels of zinc and selenium in children with COVID-19 have not been adequately studied to date.
Methods This prospective, observational study was conducted on 146 pediatric patients diagnosed with COVID-19 and 49 healthy controls between 2020 and 2021. Normal serum zinc reference values were 0.60 to 1.20 µg/mL for children 0 to 10 years old and 0.66 to 1.10 µg/mL for children ≥11 years old. The normal range for serum selenium concentration was considered between 70 and 150 µg/L. Deficiencies were defined for values below the reference range.
Results Zinc and selenium levels were significantly lower in the COVID-19 (+) group compared with the controls (zinc: 0.7 ± 0.2 vs 0.9 ± 0.2 µg/mL, p < 0.001; selenium: 57.1 ± 9.1 vs 66.5 ± 11.4 µg/L, p < 0.01, respectively). Also, zinc and selenium levels were found to be statistically significantly lower in the hospitalized group compared with the outpatient group (zinc: 0.6 ± 0.2 vs 0.8 ± 0.2 µg/mL, p < 0.001; selenium: 52.1 ± 9.6 vs 58.8 ± 8.3 µg/L, p < 0.001). In the receiver operating characteristic curve analysis, selenium levels with a cutoff value of 55.50 µg/L, with 75% sensitivity and 70% specificity, and zinc levels with a cutoff value of 0.7 µg/mL, with 56% sensitivity and 53% specificity, predicted hospitalization.
Conclusion Our data showed that serum zinc and selenium levels were significantly lower in patients with COVID-19 compared with healthy control group. Also, zinc and selenium levels were found to be lower in the hospitalized group compared with the outpatient COVID-19 group.
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Affiliation(s)
- Aysegul Kirankaya
- Department of Biochemistry, Health Science University, Bagcılar Research and Education Hospital, Istanbul, Turkey
| | - Abdulrahman Ozel
- Department of Pediatrics, Health Science University, Bagcılar Research and Education Hospital, Istanbul, Turkey
| | - Ozlem Bostan Gayret
- Department of Pediatrics, Health Science University, Bagcılar Research and Education Hospital, Istanbul, Turkey
| | - Adem Atici
- Department of Cardiology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Aslihan Tenekecigil
- Department of Medical Biochemistry, Gazi University of Medicine, Ankara, Turkey
| | - Meltem Erol
- Department of Pediatrics, Health Science University, Bagcılar Research and Education Hospital, Istanbul, Turkey
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Fung SG, Fakhraei R, Condran G, Regan AK, Dimanlig-Cruz S, Ricci C, Foo D, Sarna M, Török E, Fell DB. Neuropsychiatric outcomes in offspring after fetal exposure to maternal influenza infection during pregnancy: A systematic review. Reprod Toxicol 2022; 113:155-169. [PMID: 36100136 DOI: 10.1016/j.reprotox.2022.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 01/15/2023]
Abstract
Increasing evidence suggests that influenza infection in pregnancy may disrupt fetal neurodevelopment. The impact of maternal influenza infection on offspring neuropsychiatric health has not been comprehensively reviewed. We systematically reviewed comparative studies evaluating associations between maternal influenza infection and neuropsychiatric health outcomes in offspring. We searched MEDLINE, EMBASE, CINAHL, and Web of Science for articles published until January 7, 2022. Included were English studies evaluating neuropsychiatric outcomes in offspring aged > 6 months born to women with and without influenza during pregnancy, defined as clinical or laboratory-confirmed influenza illness, or being pregnant during pandemics/epidemics. Of 12,010 records screened, 42 studies were included. Heterogeneity in study design, exposures, and outcome definitions precluded meta-analyses. Four of 14 studies assessing schizophrenia reported adjusted ratio estimates from 0.5 to 8.2; most 95% CIs contained the null value; study quality was high in three of four. Two studies reported an increased risk of schizophrenia with influenza exposure any time during pregnancy (adjusted incidence rate ratio 8.2, 95% CI: 1.4-48.8; adjusted odds ratio 1.3, 95% CI: 1.2-1.5); another reported a reduced risk with first-trimester exposure (adjusted risk ratio 0.5, 95% CI: 0.3-0.9). Seven studies of autism spectrum disorder reported adjusted ratio estimates from 0.9 to 4.0; all 95% CIs included the null value; study quality was high in four. No conclusions could be drawn about the association between exposure to maternal influenza and neuropsychiatric outcomes due to the limited quantity and quality of available research. Large observational studies with long-term follow-up are required to investigate these associations.
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Affiliation(s)
- Stephen G Fung
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
| | - Romina Fakhraei
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; The Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, United States; Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | | | - Damien Foo
- Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Mohinder Sarna
- Curtin School of Population Health, Curtin University, Perth, WA, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | | | - Deshayne B Fell
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
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Mishra P, Parveen R, Bajpai R, Agarwal N. Vitamin D Deficiency and Comorbidities as Risk Factors of COVID-19 Infection: A Systematic Review and Meta-analysis. J Prev Med Public Health 2022; 55:321-333. [PMID: 35940187 PMCID: PMC9371781 DOI: 10.3961/jpmph.21.640] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection. METHODS We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. RESULTS Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally non-significant, associations with COVID-19 infection. CONCLUSIONS Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.
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Affiliation(s)
- Pinki Mishra
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
| | - Rizwana Parveen
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire,
UK
| | - Nidhi Agarwal
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
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Tizzoni M, Nsoesie EO, Gauvin L, Karsai M, Perra N, Bansal S. Addressing the socioeconomic divide in computational modeling for infectious diseases. Nat Commun 2022; 13:2897. [PMID: 35610237 PMCID: PMC9130127 DOI: 10.1038/s41467-022-30688-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/13/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has highlighted how structural social inequities fundamentally shape disease dynamics. Here, the authors provide a set of practical and methodological recommendations to address socioeconomic vulnerabilities in epidemic models.
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Affiliation(s)
| | - Elaine O Nsoesie
- Department of Global Health, School of Public Health, Boston University, Boston, MA, USA
- Center for Antiracist Research, Boston University, Boston, MA, USA
| | | | - Márton Karsai
- Department of Network and Data Science, Central European University, 1100, Vienna, Austria
- Alfréd Rényi Institute of Mathematics, 1053, Budapest, Hungary
| | - Nicola Perra
- School of Mathematical Sciences, Queen Mary University of London, London, UK
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
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Pietraszek A, Sobieszczańska M, Makuch S, Dróżdż M, Mazur G, Agrawal S. Identification of Barriers Limiting the Use of Preventive Vaccinations against Influenza among the Elderly Population: A Cross-Sectional Analysis. Vaccines (Basel) 2022; 10:vaccines10050651. [PMID: 35632407 PMCID: PMC9143662 DOI: 10.3390/vaccines10050651] [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: 03/08/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
Older adults are at a high risk of experiencing severe complications of influenza. Receiving a vaccination is a beneficial strategy to prevent the disease and reduce the severity of influenza illnesses. This cross-sectional questionnaire-based study aimed to evaluate the influence of sociodemographic, clinical, and mental parameters as well as other potential risk factors on refusal to vaccinate against influenza among the elderly population in Poland. Furthermore, due to the prevailing COVID-19 pandemic, we put efforts into finding any statistical correlations between the fear of COVID-19 infection in patients and their attitudes toward receiving an influenza vaccination. The study was conducted in November−December 2020 in Poland on a representative nationwide sample of 500 individuals aged > 60. Of the respondents, 62 (12.4%) and 51 (10.2%) underwent influenza vaccination in 2019 and 2020, respectively. Out of ten different factors analyzed in this study, three were significantly associated with attitudes towards influenza vaccination. Participants with net income below the national average of PLN 3000 (OR = 2.37, CI 95% [1.26−4.47]), compared to those earning more than PLN 3000, had significantly higher odds of having a negative attitude towards influenza vaccination. Furthermore, respondents with <174 cm height (OR = 2.56, CI 95% [1.51−4.33]) and those with strong fear of COVID-19 infection (OR = 1.65, CI95% [1.02−2.66]) were also more likely to refrain from influenza vaccination. We believe the identification of factors limiting the willingness to receive influenza vaccination is an effective way to help clinicians focus their efforts on educating the groups of patients with the highest odds of refusing to receive the vaccine. Moreover, it may aid the design and enforcement of national solutions or the implementation of novel legislative measures and preventive programs, increasing public confidence and promoting vaccination, especially among groups at high risk of developing this disease.
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Affiliation(s)
- Alicja Pietraszek
- Clinical Department of Geriatrics, Wroclaw Medical University, Skłodowskiej-Curie Str. 66, 50-369 Wroclaw, Poland;
- Correspondence:
| | - Małgorzata Sobieszczańska
- Clinical Department of Geriatrics, Wroclaw Medical University, Skłodowskiej-Curie Str. 66, 50-369 Wroclaw, Poland;
| | - Sebastian Makuch
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, K. Marcinkowskiego St. 1, 50-368 Wroclaw, Poland;
| | - Mateusz Dróżdż
- Faculty of Medicine, Wroclaw Medical University, Jana Mikulicza-Radeckiego 5, 50-345 Wroclaw, Poland;
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wroclaw, Poland; (G.M.); (S.A.)
| | - Siddarth Agrawal
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska St. 213, 50-556 Wroclaw, Poland; (G.M.); (S.A.)
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Surveillance of COVID-19 outbreaks in prisons in the US South: The role of economic distress in the communities surrounding prison facilities. J Clin Transl Sci 2022; 6:e101. [PMID: 36106130 PMCID: PMC9428667 DOI: 10.1017/cts.2022.432] [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: 03/11/2022] [Revised: 06/12/2022] [Accepted: 07/21/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction: The US South is the epicenter of the epidemic of mass incarceration. Prisons have experienced substantial challenges in preventing COVID-19. Incarcerated individuals and prison staff are at a high risk for infection due to minimal available preventive measures. Prisons are not closed systems and many staff come from communities in close proximity to the facility. Characteristics of the communities immediately surrounding prisons are an overlooked but critical factor to better understand the role prisons play in pandemics. Methods: We used facility-level COVID-19 data from the COVID Prison Project to identify the number of unique outbreaks between May 2019 and May 2020. We used a county-level composite indicator of economic distress (DCI score) to identify the environment surrounding each prison (2015–2019). We modeled the number of outbreaks to DCI scores using negative binomial regression, adjusting for race/ethnicity (African American and Latino/Hispanic), age (65 and older), and rurality level. Results: Our sample included 570 prisons in 368 counties across 13 Southern states. We found that score was positively and significantly associated with prison COVID-19 outbreaks (aRR, 1.012; p < 0.0001), and rurality was potentially a stronger surrogate measure of economic distress (aRR, 1.35; p, 0.02). Economic stability is a key precursor to physical health. Poorer communities have been disproportionately impacted by the pandemic, and we found that prisons located in these communities were more susceptible to recurring outbreaks. Prison-based disease prevention interventions should consider the impact that the outside world has on the health of incarcerated individuals.
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Goffe L, Antonopoulou V, Meyer CJ, Graham F, Tang MY, Lecouturier J, Grimani A, Bambra C, Kelly MP, Sniehotta FF. Factors associated with vaccine intention in adults living in England who either did not want or had not yet decided to be vaccinated against COVID-19. Hum Vaccin Immunother 2021; 17:5242-5254. [PMID: 34919492 PMCID: PMC8903974 DOI: 10.1080/21645515.2021.2002084] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/30/2021] [Indexed: 01/04/2023] Open
Abstract
Early studies showed that 28-36% of UK adults were unsure or unwilling to be vaccinated against COVID-19. We wanted to identify which socio-demographic, socio-economic, personal health and psychological factors were associated with COVID-19 vaccine intentions (CVI) in adults living in England who did not want, yet to consider, or not sure whether to vaccinate. In October/November 2020, prior to vaccine availability, we surveyed adults stratified by gender, region, and deprivation, with additional purposive sampling of those aged 50 and over and those from an ethnic minority. Two hundred and ten did not want; 407 had yet to consider; and 1,043 were not sure whether to be vaccinated. Factors positively associated with CVI were: favorable vaccine views, trust in institutions associated with vaccine approval, vaccine subjective norms, anticipated regret of not having a vaccine, perceived vaccine benefits, perceived safety knowledge sufficiency, and a history of having an influenza vaccine. Factors negatively associated were: anti-lockdown views, and being a health or social care worker. Whilst showing significant relationships with CVI when analyzed in isolation, neighborhood deprivation and ethnicity did show an independent relationship to intention when all study measures were controlled for. Our findings suggest vaccine promotion focusing on the anticipated regret of not having a vaccine, the benefits of a mass COVID-19 immunization program, and the safety of a vaccine whilst ensuring or engendering trust in those bodies that brand a campaign may be most supportive of COVID-19 vaccine uptake.
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Affiliation(s)
- Louis Goffe
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vivi Antonopoulou
- NIHR Policy Research Unit in Behavioural Science – Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, London, UK
| | - Carly J Meyer
- NIHR Policy Research Unit in Behavioural Science – Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, London, UK
| | - Fiona Graham
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mei Yee Tang
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Aikaterini Grimani
- NIHR Policy Research Unit in Behavioural Science – Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, UK
| | - Clare Bambra
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Michael P. Kelly
- NIHR Policy Research Unit in Behavioural Science – Primary Care Unit, East Forvie Building, Cambridge Biomedical Campus, Cambridge, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science – Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Faculty of Behavioural, Management and Social Sciences - University of Twente, Enschede, The Netherlands
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