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Rocha AC, Valente BG, Ramalho DW, Borri JB, de Mattos CA, Bittar CK. Cost and time of hospitalization for elderly people with bone fractures in a reference hospital. EINSTEIN-SAO PAULO 2024; 22:eGS0493. [PMID: 39082508 PMCID: PMC11239199 DOI: 10.31744/einstein_journal/2024gs0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 12/18/2023] [Indexed: 08/03/2024] Open
Abstract
OBJECTIVE To describe and analyze the aspects regarding the cost and length of stay for elderly patients with bone fractures in a tertiary reference hospital. METHODS A cross-sectional retrospective study using data obtained from medical records between January and December 2020. For statistical analysis, exploratory analyses, Shapiro-Wilk test, χ2 test, and Spearman correlation were used. RESULTS During the study period, 156 elderly patients (62.2% women) with bone fractures were treated. The main trauma mechanism was a fall from a standing height (76.9%). The most common type of fracture in this sample was a transtrochanteric fracture of the femur, accounting for 40.4% of cases. The mean length of stay was 5.25 days. The total cost varied between R$2,006.53 and R$106,912.74 (average of R$15,695.76) (updated values). The mean daily cost of hospitalization was R$4,478.64. A positive correlation was found between the length of stay and total cost. No significant difference in cost was observed between the two main types of treated fractures. CONCLUSION Fractures in the elderly are frequent, resulting in significant costs. The longer the hospital stay for treatment, the higher the total cost. No correlation was found between total cost and number of comorbidities, number of medications used, and the comparison between the treatment of transtrochanteric and femoral neck fractures.
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Affiliation(s)
- Aline Cremasco Rocha
- Pontifícia Universidade Católica de CampinasCampinasSPBrazil Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
| | - Bruna Granig Valente
- Pontifícia Universidade Católica de CampinasCampinasSPBrazil Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
| | - Danilo Wingeter Ramalho
- Pontifícia Universidade Católica de CampinasCampinasSPBrazil Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
| | - Juliana Baleki Borri
- Pontifícia Universidade Católica de CampinasCampinasSPBrazil Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
| | - Carlos Augusto de Mattos
- Hospital PUC-Campinas Celso PierroCampinasSPBrazil Hospital PUC-Campinas Celso Pierro, Campinas, SP, Brazil.
| | - Cintia Kelly Bittar
- Pontifícia Universidade Católica de CampinasCampinasSPBrazil Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.
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Mohamed YS, Spaska A, Andrade G, Baraka MA, Ahmad H, Steele S, Abu-rish EY, Nasor EM, Forsat K, Teir HJ, Bani I, Panigrahi D. Hand hygiene knowledge, attitude, and practice before, during and post COVID-19: a cross-sectional study among university students in the United Arab Emirates. Infect Prev Pract 2024; 6:100361. [PMID: 38646024 PMCID: PMC11033129 DOI: 10.1016/j.infpip.2024.100361] [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: 08/27/2023] [Accepted: 03/13/2024] [Indexed: 04/23/2024] Open
Abstract
Aims Hand hygiene (HH) is an essential practice to evade the transmission of germs and minimize community-acquired infections. This study assesses the knowledge, attitude and practice (KAP) of HH and other health and safety measures before, during, and after the COVID-19 pandemic. in university students in the United Arab Emirates (UAE). Methods A cross-sectional questionnaire study was conducted between December 2022 and March 2023, targeting university students from all disciplines and study levels. A 44-item questionnaire was used which included student demographics, knowledge, attitude, and practice of HH, as well as the anticipated risk of COVID-19 morbidity and mortality. Participants consented before commencing the questionnaire, and the collected data were analysed using the student's t-test and ANOVA test, as required. Results A total of 378 responses were received nationwide, with a valid response rate of 98%. The HH knowledge revealed an average score of 62%, which was significantly higher in students with moderate family income. Additionally, the average attitude score was 74.7%, as measured on the Likert scale, and the score lacked any correlation with the other variables. HH practice showed an average score of 86.8%, which was correlated with the students' gender and field of study. Conclusions This study showed a moderate level of knowledge, a good attitude, and good practice around HH and other safety measures among the UAE's university students. Socioeconomic status, gender, and field of study influenced the study outcomes. This study highlights the need for effective awareness campaigns to reinforce students' health and safety, especially for male and non-health science students, in order to protect against communicable diseases.
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Affiliation(s)
- Yehia S. Mohamed
- College of Medicine, Ajman University, Ajman, UAE
- Department of Microbiology and Immunology, Faculty of Pharmacy Pharmacy (boys), Al-Azhar University, Cairo, Egypt
| | | | | | - Mohamed A. Baraka
- Pharmacy Department, Fatima College of Health Sciences, Abu Dhabi, UAE
- Clinical Pharmacy Department, Faculty of Pharmacy Pharmacy (boys), Al-Azhar University, Cairo, Egypt
| | - Hafiz Ahmad
- College of Medical Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
- Molecular Division- NGS and COVID Laboratory, RAK Hospital, Ras Al Khaimah, UAE
| | | | - Eman Y. Abu-rish
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | | | | | - Ibrahim Bani
- College of Medicine, Ajman University, Ajman, UAE
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Park J, Joo H, Kim D, Mase S, Christensen D, Maskery BA. Cost-effectiveness of mask mandates on subways to prevent SARS-CoV-2 transmission in the United States. PLoS One 2024; 19:e0302199. [PMID: 38748706 PMCID: PMC11095714 DOI: 10.1371/journal.pone.0302199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/30/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Community-based mask wearing has been shown to reduce the transmission of SARS-CoV-2. However, few studies have conducted an economic evaluation of mask mandates, specifically in public transportation settings. This study evaluated the cost-effectiveness of implementing mask mandates for subway passengers in the United States by evaluating its potential to reduce COVID-19 transmission during subway travel. MATERIALS AND METHODS We assessed the health impacts and costs of subway mask mandates compared to mask recommendations based on the number of infections that would occur during subway travel in the U.S. Using a combined box and Wells-Riley infection model, we estimated monthly infections, hospitalizations, and deaths averted under a mask mandate scenario as compared to a mask recommendation scenario. The analysis included costs of implementing mask mandates and COVID-19 treatment from a limited societal perspective. The cost-effectiveness (net cost per averted death) of mandates was estimated for three different periods based on dominant SARS-CoV-2 variants: Alpha, Beta, and Gamma (November 2020 to February 2021); Delta (July to October 2021); and early Omicron (January to March 2022). RESULTS Compared with mask recommendations only, mask mandates were cost-effective across all periods, with costs per averted death less than a threshold of $11.4 million (ranging from cost-saving to $3 million per averted death). Additionally, mask mandates were more cost-effective during the early Omicron period than the other two periods and were cost saving in January 2022. Our findings showed that mandates remained cost-effective when accounting for uncertainties in input parameters (e.g., even if mandates only resulted in small increases in mask usage by subway ridership). CONCLUSIONS The findings highlight the economic value of mask mandates on subways, particularly during high virus transmissibility periods, during the COVID-19 pandemic. This study may inform stakeholders on mask mandate decisions during future outbreaks of novel viral respiratory diseases.
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Affiliation(s)
- Joohyun Park
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heesoo Joo
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Daniel Kim
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
- Georgia Institute of Technology, H. Milton Stewart School of Industrial and Systems Engineering, Atlanta, Georgia, United States of America
| | - Sundari Mase
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Deborah Christensen
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brian A. Maskery
- Division of Global Migration Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Joshi K, Scholz S, Maschio M, Kohli M, Lee A, Fust K, Ultsch B, Van de Velde N, Beck E. Clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2023 vaccines in Germany. J Med Econ 2024; 27:39-50. [PMID: 38050685 DOI: 10.1080/13696998.2023.2290388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVES To assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged ≥60 years and high-risk persons aged 30-59 years in Germany over a 1-year analytic time horizon (September 2023-August 2024). METHODS A compartmental Susceptible-Exposed-Infected-Recovered model was updated and adapted to the German market. Numbers of symptomatic infections, a number of COVID-19 related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio of an Autumn 2023 Moderna updated COVID-19 (mRNA-1273.815) vaccine was compared to no additional vaccination. Potential differences between the mRNA-1273.815 and the Autumn Pfizer-BioNTech updated COVID-19 (XBB.1.5 BNT162b2) vaccines, as well as societal return on investment for the mRNA-1273.815 vaccine relative to no vaccination, were also examined. RESULTS Compared to no autumn vaccination, the mRNA-1273.815 campaign is predicted to prevent approximately 1,697,900 symptomatic infections, 85,400 hospitalizations, and 4,100 deaths. Compared to an XBB.1.5 BNT162b2 campaign, the mRNA-1273.815 campaign is also predicted to prevent approximately 90,100 symptomatic infections, 3,500 hospitalizations, and 160 deaths. Across both analyses we found the mRNA-1273.815 campaign to be dominant. CONCLUSIONS The mRNA-1273.815 vaccine can be considered cost-effective relative to the XBB.1.5 BNT162b2 vaccine and highly likely to provide more benefits and save costs compared to no vaccine in Germany, and to offer high societal return on investment.
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Affiliation(s)
| | | | | | - Michele Kohli
- Quadrant Health Economics Inc, Cambridge, ON, Canada
| | - Amy Lee
- Quadrant Health Economics Inc, Cambridge, ON, Canada
| | - Kelly Fust
- Quadrant Health Economics Inc, Cambridge, ON, Canada
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Poudel N, Ngorsuraches S. A Preference-Based Value Assessment of the Fear of COVID-19 Contagion. Patient Prefer Adherence 2023; 17:3435-3448. [PMID: 38143944 PMCID: PMC10746924 DOI: 10.2147/ppa.s431148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose To assess the preference-based value of the fear of COVID-19 contagion. Patients and Methods We conducted a web-based, cross-sectional discrete choice experiment among 544 US adults. We used a Bayesian efficient design to generate choice sets. Each choice set comprised two hypothetical COVID-19 vaccine options characterized by seven attributes: chance of COVID-19 infection, chance of having severe symptoms from COVID-19 infection, vaccine protection duration, chance of mild to moderate adverse events from vaccination, chance of serious adverse events from vaccination, chance of future exposure to COVID-19 after vaccination, and out-of-pocket cost. We used mixed logit (ML) and latent class (LC) models to analyze data. Furthermore, we calculated the willingness-to-pay for eliminating the chance of future exposure to COVID-19, shedding light on the value attributed to the fear of contagion. Results The ML model demonstrated all attributes, including the chance of future exposure to COVID-19, were statistically significant. The participants were willing to pay approximately $13,046 to eliminate the chance of future exposure to COVID-19 or their fear of contagion when COVID-19 was still pandemic. The LC model unveiled two participant classes with distinct preference weights for the chance of future exposure to COVID-19 and out-of-pocket cost attributes. Nevertheless, the chance of future exposure to COVID-19 exposure held a significant degree of importance in both classes. Conclusion The chance of future exposure to COVID-19 exposure or fear of contagion was a significant element in the value assessment of COVID-19 vaccines. Further studies should be conducted to verify the value of fear of contagion and include it in the value assessment of healthcare technologies for infectious diseases.
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Affiliation(s)
- Nabin Poudel
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Surachat Ngorsuraches
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
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Yang L, Hu M, Zeng H, Liang W, Zhu J. The impact of multiple non-pharmaceutical interventions for China-bound travel on domestic COVID-19 outbreaks. Front Public Health 2023; 11:1202996. [PMID: 37521963 PMCID: PMC10373927 DOI: 10.3389/fpubh.2023.1202996] [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: 04/10/2023] [Accepted: 06/01/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives Non-pharmaceutical interventions (NPIs) implemented on China-bound travel have successfully mitigated cross-regional transmission of COVID-19 but made the country face ripple effects. Thus, adjusting these interventions to reduce interruptions to individuals' daily life while minimizing transmission risk was urgent. Methods An improved Susceptible-Infected-Recovered (SIR) model was built to evaluate the Delta variant's epidemiological characteristics and the impact of NPIs. To explore the risk associated with inbound travelers and the occurrence of domestic traceable outbreaks, we developed an association parameter that combined inbound traveler counts with a time-varying initial value. In addition, multiple time-varying functions were used to model changes in the implementation of NPIs. Related parameters of functions were run by the MCSS method with 1,000 iterations to derive the probability distribution. Initial values, estimated parameters, and corresponding 95% CI were obtained. Reported existing symptomatic, suspected, and asymptomatic case counts were used as the training datasets. Reported cumulative recovered individual data were used to verify the reliability of relevant parameters. Lastly, we used the value of the ratio (Bias2/Variance) to verify the stability of the mathematical model, and the effects of the NPIs on the infected cases to analyze the sensitivity of input parameters. Results The quantitative findings indicated that this improved model was highly compatible with publicly reported data collected from July 21 to August 30, 2021. The number of inbound travelers was associated with the occurrence of domestic outbreaks. A proportional relationship between the Delta variant incubation period and PCR test validity period was found. The model also predicted that restoration of pre-pandemic travel schedules while adhering to NPIs requirements would cause shortages in health resources. The maximum demand for hospital beds would reach 25,000/day, the volume of PCR tests would be 8,000/day, and the number of isolation rooms would reach 800,000/day within 30 days. Conclusion With the pandemic approaching the end, reexamining it carefully helps better address future outbreaks. This predictive model has provided scientific evidence for NPIs' effectiveness and quantifiable evidence of health resource allocation. It could guide the design of future epidemic prevention and control policies, and provide strategic recommendations on scarce health resource allocation.
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Affiliation(s)
- Lichao Yang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Mengzhi Hu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Huatang Zeng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Kabir KA. Impact of human cooperation on vaccination behaviors. Heliyon 2023; 9:e16748. [PMID: 37292270 PMCID: PMC10245234 DOI: 10.1016/j.heliyon.2023.e16748] [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: 03/24/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
This paper studies a dynamic vaccination game model embedded with vaccine cost-effectiveness and dyadic game during an epidemic, assuming the appearance of cooperation among individuals from an evolutionary perspective. The infection dynamics of the individuals' states follow a modified S/VIS (susceptible/vaccinated-infected-susceptible) dynamics. Initially, we assume that the individuals are unsure about their infection status. Thus, they make decisions regarding their options based on their neighbors' perceptions, the prevalence of the disease, and the characteristics of the available vaccines. We then consider the strategy updating process IBRA (individuals-based risk assessment) concerning an individual's committing vaccination based on a neighbor's decision. In the perspective of social dilemma, it presents the idea of social efficiency deficit to find the gap between social optimum and Nash equilibrium point based on dilemma strength by considering vaccine decision. The cost and cooperative behavior depend on disease severity, neighbor's attitude, and vaccine properties to obtain a reduced-order optimal solution to control infectious diseases. Vaccine factors (efficiency, cost, and benefit) are crucial in changing human vaccine decisions and cooperative behavior. It turns out that, even in the prisoner's dilemma case, where all defection attitude occurs, vaccine uptake (cooperation) increases. Finally, extensive numerical studies were presented that illustrate interesting phenomena and investigate the ultimate extent of the epidemic, vaccination coverage, average social benefits, and the social efficiency deficit concerning optimal strategies and the dynamic vaccine attitudes of individuals. PACS numbers. Theory and modeling; computer simulation, 87.15. Aa; Dynamics of evolution, 87.23. Kg.
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Lee Y, Park K, Shin J, Oh J, Jang Y, You M. Factors Affecting the Public Intention to Repeat the COVID-19 Vaccination: Implications for Vaccine Communication. Healthcare (Basel) 2023; 11:healthcare11091235. [PMID: 37174775 PMCID: PMC10178399 DOI: 10.3390/healthcare11091235] [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: 03/21/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Although most of the pandemic-related mandatory restrictions have been lifted or eased, vaccination is still recommended as an effective measure to minimize the damage from COVID-19 infection. Since COVID-19 eradication is unlikely, it is necessary to understand the factors affecting the public's vaccination intention when COVID-19 vaccination is continuously recommended. This study aims to explore the factors that affect the intention to repeat the COVID-19 vaccination in South Korea. An online survey was conducted in January 2022 with adults living in Gyeonggi-do, South Korea. In a hierarchical logistic regression analysis, sociodemographic factors, COVID-19 infection-related factors, COVID-19 vaccination-related factors, sociocultural factors, and communication factors were taken into account. In this study, more than three-quarters (78.1%) of Koreans were willing to repeat the COVID-19 vaccination. People who had high-risk perceptions, had been vaccinated against COVID-19 at least once, had more authoritarian attitudes, regarded the vaccination as a social responsibility, and had positive attitudes toward health authorities' regular briefings were more likely to repeat the vaccination. In contrast, those who directly or indirectly experienced COVID-19 vaccine side effects and who showed psychological reactance against the government's vaccination recommendation were less likely to repeat the vaccination. Our research indicates that empathetic communication, promotion of the prosocial aspect of vaccination, and regular and transparent provision of vaccine information are essential for promoting the intention to repeat the COVID-19 vaccination.
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Affiliation(s)
- Yubin Lee
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Kunhee Park
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Jeonghoon Shin
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Jeonghyeon Oh
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Yeongeun Jang
- Gyeonggi Infectious Disease Control Center, Suwon 16508, Republic of Korea
| | - Myoungsoon You
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
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Fu Y, Zhao J, Han P, Zhang J, Wang Q, Wang Q, Wei X, Yang L, Ren T, Zhan S, Li L. Cost-effectiveness of COVID-19 vaccination: A systematic review. J Evid Based Med 2023. [PMID: 37186130 DOI: 10.1111/jebm.12525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/17/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The COVID-19 vaccination strategy has been widely used to protect population health worldwide. This study aims to summarize the cost-effectiveness evidence of economic evaluation of COVID-19 vaccination strategies to provide evidence supporting the usage of COVID-19 vaccination, especially where the supply of COVID-19 vaccine is limited. METHODS A systematic literature review was performed by searching both English and Chinese databases, including PubMed, Embase, Science Direct, Web of Science, Medline, Scopus, and CNKI. Articles published from January 1, 2020 to August 1, 2022 (PROSPERO registration number: CRD42022355442). RESULTS Of the 1035 papers identified, a total of 28 English studies that met the preset criteria were included. COVID-19 vaccination and booster vaccination were cost-effective or cost-saving regardless of the vaccine type; vaccine efficacy, vaccine price, vaccine supply or prioritization, and vaccination pace were the influential factors of cost-effectiveness among different population groups. When supply is adequate, mass vaccination should be encouraged, while when supply is inadequate, prioritizing the high risk and the elderly is more cost-effective. CONCLUSIONS COVID-19 vaccination strategies are economically favorable in a wide range of countries and population groups, and further research on suitable strategies for booster COVID-19 vaccination is needed.
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Affiliation(s)
- Yaqun Fu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jingyu Zhao
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Peien Han
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Jiawei Zhang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Quan Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- Brown School, Washington University in St. Louis, St. Louis MO, U.S., St. Louis, United States
| | - Qingbo Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Xia Wei
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Li Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Tao Ren
- School of Public Health, Peking University, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, China
| | - Liming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
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Chen W, Liu L, Zhang N, Hang J, Li Y. Conversational head movement decreases close-contact exposure to expired respiratory droplets. JOURNAL OF HAZARDOUS MATERIALS 2023; 444:130406. [PMID: 36417778 DOI: 10.1016/j.jhazmat.2022.130406] [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: 09/09/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
People constantly move their heads during conversation, as such movement is an important non-verbal mode of communication. Head movement alters the direction of people's expired air flow, therefore affecting their conversational partners' level of exposure. Nevertheless, there is a lack of understanding of the mechanism whereby head movement affects people's exposure. In this study, a dynamic meshing method in computational fluid dynamics was used to simulate the head movement of a human-shaped thermal manikin. Droplets were released during the oral expiration periods of the source manikin, during which it was either motionless, was shaking its head or was nodding its head, while the head of a face-to-face target manikin remained motionless. The results indicate that the target manikin had a high level of exposure to respiratory droplets when the source manikin was motionless, whereas the target manikin's level of exposure was significantly reduced when the source manikin was shaking or nodding its head. The source manikin had the highest level of self-exposure when it was nodding its head and the lowest level of self-exposure when its head was motionless. People's level of exposure during close contact is highly variable, highlighting the need for further investigations in more realistic conversational scenarios.
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Affiliation(s)
- Wenzhao Chen
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Li Liu
- Department of Building Science, Tsinghua University, Beijing 100084, China
| | - Nan Zhang
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
| | - Jian Hang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai 519082, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China; Faculty of Architecture, The University of Hong Kong, Pokfulam Road, Hong Kong, China.
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Barriers to conducting independent quantitative research in low-income countries: A cross-sectional study of public health graduate students in Liberia. PLoS One 2023; 18:e0280917. [PMID: 36730248 PMCID: PMC9894428 DOI: 10.1371/journal.pone.0280917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION During recent disease outbreaks, quantitative research has been used to investigate intervention scenarios while accounting for local epidemiological, social, and clinical context. Despite the value of such work, few documented research efforts have been observed to originate from low-income countries. This study aimed to assess barriers that may be limiting the awareness and conduct of quantitative research among Liberian public health graduate students. METHODS A semi-structured questionnaire was administered September-November 2021 to Master's in Public Health (MPH) students in Liberia. Potential barriers around technology access, understanding of quantitative science, and availability of mentorship were interrogated. Associations between barriers and self-reported likelihood of conducting quantitative research within six months of the investigation period were evaluated using ordinal logistic regression. RESULTS Among 120 participating MPH students, 86% reported owning a personal computer, but 18.4% and 39.4% had machines with malfunctioning hardware and/or with battery power lasting ≤2 hours, respectively. On average, students reported having poor internet network 3.4 days weekly. 47% reported never using any computer software for analysis, and 46% reported no specific knowledge on statistical analysis. Students indicated spending a median 30 minutes per week reading scientific articles. Moreover, 50% had no access to quantitative research mentors. Despite barriers, 59% indicated they were very likely to undertake quantitative research in the next 6 months; only 7% indicated they were not at all likely. Computer ownership was found to be statistically significantly associated with higher likelihood of conducting quantitative research in the multivariable analysis (aOR: 4.90,95% CI: 1.54-16.3). CONCLUSION The high likelihood of conducting quantitative research among MPH students contrasts with limitations around computing capacity, awareness of research tools/methods, and access to mentorship. To promote rigorous analytical research in Liberia, there is a need for systematic measures to enhance capacity for diverse quantitative methods through efforts sensitive to the local research environment.
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Utami AM, Rendrayani F, Khoiry QA, Noviyanti D, Suwantika AA, Postma MJ, Zakiyah N. Economic evaluation of COVID-19 vaccination: A systematic review. J Glob Health 2023; 13:06001. [PMID: 36637810 PMCID: PMC9838689 DOI: 10.7189/jogh.13.06001] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Safe and effective vaccination is considered to be the most critical strategy to fight coronavirus disease 2019 (COVID-19), leading to individual and herd immunity protection. We aimed to systematically review the economic evaluation of COVID-19 vaccination globally. Methods We performed a systematic search to identify relevant studies in two major databases (MEDLINE/PubMed and EBSCO) published until September 8, 2022. After deduplication, two researchers independently screened the study titles and abstracts according to pre-determined inclusion and exclusion criteria. The remaining full-text studies were assessed for eligibility. We assessed their quality of reporting using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist and summarized and narratively presented the results. Results We identified 25 studies that assessed the economic evaluation of COVID-19 vaccination worldwide by considering several input parameters, including vaccine cost, vaccine efficacy, utility value, and the size of the targeted population. All studies suggested that COVID-19 vaccination was a cost-effective or cost-saving intervention for mitigating coronavirus transmission and its effect in many countries within certain conditions. Most studies reported vaccine efficacy values ranging from 65% to 75%. Conclusions Given the favorable cost-effectiveness profile of COVID-19 vaccines and disparities in affordability across countries, considering prioritization has become paramount. This review provides comprehensive insights into the economic evaluation of COVID-19 vaccination that will be useful to policymakers, particularly in highlighting preventive measures and preparedness plans for the next possible pandemic.
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Affiliation(s)
- Auliasari Meita Utami
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Qisty Aulia Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Dita Noviyanti
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Auliya A Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Maarten J Postma
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands
| | - Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
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Grune J, Savelsberg D, Kobus M, Lindner AK, Herrmann WJ, Schuster A. Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study. Front Public Health 2023; 11:1148029. [PMID: 37033048 PMCID: PMC10081579 DOI: 10.3389/fpubh.2023.1148029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction People experiencing homelessness face lower life expectancy, higher prevalence of somatic and mental diseases and a more difficult access to healthcare compared to people in secure living. During the COVID-19 pandemic transmission rates were higher among people experiencing homelessness and preventive public health measures were not properly adapted to the specific needs of people experiencing homelessness. Thus, goal of our study was understanding the determinants of acceptability and access of the COVID-19 vaccine. Materials and methods We conducted a qualitative interview study with twenty guideline interviews with adult people currently experiencing homelessness in Berlin, Germany (August 2021 - April 2022). Participants were approached in a purposive sampling strategy. The interviews were analyzed with qualitative content analysis according to Mayring. Results Acceptance and attitude toward the COVID-19 vaccine is influenced by confidence in the vaccine as well as in the political and healthcare system, the individual COVID-19 risk perception and sense of collective responsibility. Overall, the acceptance of the vaccine was high among our participants. Facilities offering low threshold COVID-19 vaccines for people experiencing homelessness were perceived as helpful. Language barriers and the need for identity documents were major barriers to access the COVID 19 vaccine. Discussion People experiencing homelessness are a marginalized and vulnerable group often underrepresented in the public and scientific discourse. During the COVID-19 pandemic, preventive public health measures, including the COVID-19 vaccine, failed to consider specific needs of people experiencing homelessness. Multidimensional strategy to enhance inclusive healthcare are needed to improve access and to reduce discrimination and stigmatization.
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Affiliation(s)
- Julianna Grune
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- *Correspondence: Julianna Grune,
| | - Darius Savelsberg
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Marta Kobus
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andreas K. Lindner
- Institute of International Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Wolfram J. Herrmann
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Angela Schuster
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Higher COVID-19 Vaccination Rates Are Associated with Lower COVID-19 Mortality: A Global Analysis. Vaccines (Basel) 2022; 11:vaccines11010074. [PMID: 36679919 PMCID: PMC9862920 DOI: 10.3390/vaccines11010074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Mass vaccination initiatives are underway worldwide, and a considerable percentage of the world's population is now vaccinated. This study examined the association of COVID-19 deaths per 1000 cases with a fully vaccinated population. The global median deaths per 1000 cases were 15.68 (IQR 9.84, 25.87) after 6 months of vaccinations and 11.96 (IQR 6.08, 20.63) after 12 months. Across 164 countries, we found significant variations in vaccination levels of populations, booster doses, and mortality, with higher vaccine coverage and lower mortality in high-income countries. Several regression models were performed to test the association between vaccination and COVID-19 mortality. Control variables were used to account for confounding variables. A 10-percentage-point increase in vaccination was associated with an 18.1% decrease in mortality after 6 months (95%CI, 7.4-28.8%) and a 16.8% decrease after 12 months (95%CI, 6.9-26.7%). A 10-percentage-point increase in booster vaccination rates was associated with a 33.1% decrease in COVID-19 mortality (95%CI, 16.0-50.2%). This relationship is present in most analyses by country income groups with variations in the effect size. Efforts are needed to reduce vaccine hesitancy while ensuring suitable infrastructure and supply to enable all countries to increase their vaccination rates.
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COVID-19-Related Burnout and Intention of Fully Vaccinated Individuals to Get a Booster Dose: The Mediating Role of Resilience. Vaccines (Basel) 2022; 11:vaccines11010062. [PMID: 36679907 PMCID: PMC9860670 DOI: 10.3390/vaccines11010062] [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: 11/23/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Because an annual COVID-19 booster vaccine appears to be required to control the pandemic, identifying the factors that influence individuals' decision to receive a booster dose is critical. Thus, our goal was to quantify the influence of COVID-19-related burnout on vaccination intention and to investigate the role of resilience in mediating the link between burnout and intention. We conducted a cross-sectional study with a convenience sample during October 2022. We used the COVID-19 burnout scale and the Brief Resilience Scale. The study sample included 1256 people who had received their primary COVID-19 vaccination. Among the participants, 34.1% reported being very likely to be vaccinated with a booster dose. COVID-19-related burnout was found to be inversely connected with vaccination intention. Moreover, our results suggested that resilience not only had a positive direct effect on vaccination intention but also mediated the relationship between burnout and vaccination intention. Although our study had limitations, such as a convenience sample and information bias, we demonstrate the critical role of resilience in reducing the impact of COVID-19-related burnout on the vaccination intention. Policymakers should develop and implement initiatives to address the issues of COVID-19-related burnout and enhance booster adoption by strengthening psychosocial resources such as resilience.
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