1
|
Raphael NA, Garraud PA, Roelens M, Alfred JP, Richard M, Estill J, Keiser O, Merzouki A. Evaluating tuberculosis treatment outcomes in Haiti from 2018 to 2019: A competing risk analysis. IJID Reg 2024; 11:100350. [PMID: 38577553 PMCID: PMC10993134 DOI: 10.1016/j.ijregi.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/07/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024]
Abstract
Objectives This study assesses tuberculosis (TB) treatment outcomes in Haiti. Methods Data from drug-susceptible patients with TB (2018-2019) were analyzed using the Fine & Gray model with multiple imputation. Results Of the 16,545 patients, 14.7% had concurrent HIV coinfection, with a 66.2% success rate. The median treatment duration was 5 months, with patients averaging 30 years (with an interquartile range of 22-42 years). The estimated hazard of achieving a successful treatment outcome decreased by 2.5% and 8.1% for patients aged 45 and 60 years, respectively, compared with patients aged 30 years. Male patients had a 6.5% lower estimated hazard of success than their female counterparts. In addition, patients coinfected with HIV experienced a 35.3% reduction in the estimated hazard of achieving a successful treatment outcome compared with those with a negative HIV serologic status. Conclusions Integrated health care approaches should be implemented, incorporating innovative solutions, such as machine learning algorithms combined with geographic information systems and non-conventional data sources (including social media), to identify TB hotspots and high-burden households.
Collapse
Affiliation(s)
- Nernst-Atwood Raphael
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Strategic Health Information System, DAI Global LLC, Port-au-Prince, Haiti
| | | | - Maroussia Roelens
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Milo Richard
- National Tuberculosis Program, Ministry of Health, Port-au-Prince, Haiti
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Aziza Merzouki
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
2
|
Wang M, Luo X, Xiao X, Zhang L, Wang Q, Wang S, Wang X, Xue H, Zhang L, Chen Y, Lei J, Štupnik T, Scarci M, Fiorelli A, Laisaar T, Fruscio R, Elkhayat H, Novoa NM, Davoli F, Waseda R, Estill J, Norris SL, Riley DS, Tian J. CARE-radiology statement explanation and elaboration: reporting guideline for radiological case reports. BMJ Evid Based Med 2024:bmjebm-2023-112695. [PMID: 38458654 DOI: 10.1136/bmjebm-2023-112695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
Despite the increasing number of radiological case reports, the majority lack a standardised methodology of writing and reporting. We therefore develop a reporting guideline for radiological case reports based on the CAse REport (CARE) statement. We established a multidisciplinary group of experts, comprising 40 radiologists, methodologists, journal editors and researchers, to develop a reporting guideline for radiological case reports according to the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research network. The Delphi panel was requested to evaluate the significance of a list of elements for potential inclusion in a guideline for reporting mediation analyses. By reviewing the reporting guidelines and through discussion, we initially drafted 46 potential items. Following a Delphi survey and discussion, the final CARE-radiology checklist is comprised of 38 items in 16 domains. CARE-radiology is a comprehensive reporting guideline for radiological case reports developed using a rigorous methodology. We hope that compliance with CARE-radiology will help in the future to improve the completeness and quality of case reports in radiology.
Collapse
Affiliation(s)
- Mengshu Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaojuan Xiao
- Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Shenzhen, China
| | - Linlin Zhang
- Editorial Office of Chinese Journal of Radiology, Beijing, China
| | - Qi Wang
- Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Shiyu Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Huadan Xue
- Department of Radiology, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Longjiang Zhang
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, General Hospital of Eastern Theater Command, Nanjing, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- World Health Organization Collaboration Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Junqiang Lei
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou, China
| | - Tomaž Štupnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Tanel Laisaar
- Department of Thoracic Surgery and Lung Transplantation, Lung Clinic, Tartu University Hospital, Tartu, Estonia
- Lung Clinic, Institute of Clinical Medicine, Medical Faculty, University of Tartu, Tartu, Estonia
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, IRCCS San Gerardo, Monza, Italy
| | - Hussein Elkhayat
- Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nuria M Novoa
- Thoracic Surgery, Puerta de Hierro University Hospital-Majadahonda, Madrid, Spain
- Biomedical Institute of Salamanca, Salamanca, Spain
| | - Fabio Davoli
- General & Thoracic Surgery Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Susan L Norris
- Oregon Health & Science University, Portland, Oregon, USA
| | - David S Riley
- University of New Mexico Medical School, Santa Fe, New Mexico, USA
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| |
Collapse
|
3
|
Tian C, Wei Y, Xu M, Liu J, Tong B, Ning J, Wang Y, Wang Y, Estill J, Ge L. The effects of exercise on insomnia disorders: An umbrella review and network meta-analysis. Sleep Med 2024; 115:66-75. [PMID: 38335829 DOI: 10.1016/j.sleep.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To summarize the evidence of various exercise modalities on population with insomnia disorders. METHOD PubMed, Embase, Cochrane Library, and Web of Science were searched for eligible studies published from inception to October 2022 and updated on September 2023. Systematic reviews with meta-analyses and randomized controlled trials designed to investigate the effect of various exercise modalities on population with insomnia were eligible. RESULTS A total of 4 SRs with (very) low methodological quality and 1034 participants in 10 network meta-analyses explored the association between different types and intensity exercise modalities with insomnia disorders. Various exercise modalities could significantly improve total sleep time and sleep quality and alleviate insomnia severity. Compared to passive control, moderate aerobic exercise, moderate aerobic exercise combined with light intensity strength and mind-body exercise can improve sleep efficiency and reduce wake after sleep onset by objectively measured. Moderate intensity strength, light intensity strength and mind-body exercise can improve sleep efficiency subjectively measured; mind-body exercise can reduce sleep onset latency and wake time after sleep onset, and increase total sleep time; moderate aerobic exercise can reduce sleep onset latency. Moderate intensity strength, light intensity strength, mind body exercise and moderate aerobic exercise combined with light intensity strength can the severity of insomnia and improv sleep quality. CONCLUSION Exercise had a positive effect on relief insomnia and improve sleep quality. Moderate aerobic exercise, mind-body exercise and moderate aerobic exercise combined with light intensity strength play an important role in improving the sleep quality in people with insomnia disorders.
Collapse
Affiliation(s)
- Chen Tian
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yuanyuan Wei
- Nursing School of Lanzhou University, Lanzhou, China; Department of VIP Outpatient/Chronic Disease Management, First Hospital of Lanzhou University, Lanzhou, China
| | - Meng Xu
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Jianing Liu
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Bo Tong
- Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jinling Ning
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yong Wang
- First Clinical School of Medicine, Lanzhou University, Lanzhou, China
| | - Yiyun Wang
- Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Long Ge
- Evidence-Based Social Sciences Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Depertment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
| |
Collapse
|
4
|
Yang N, Liu H, Estill J, Chen Y. Recommendations for Improving the Quality of Chinese Cardiovascular Guidelines and Evidence. JACC Asia 2024; 4:244-247. [PMID: 38463676 PMCID: PMC10920042 DOI: 10.1016/j.jacasi.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Hui Liu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Guidelines and Standards Research Center, Chinese Medical Association Publishing House, Beijing, China
| |
Collapse
|
5
|
Luo X, Estill J, Chen Y. The use of ChatGPT in medical research: do we need a reporting guideline? Int J Surg 2023; 109:3750-3751. [PMID: 37707517 PMCID: PMC10720843 DOI: 10.1097/js9.0000000000000737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Xufei Luo
- Evidence-Based Medicine Center
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017)
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation
- Institute of Health Data Science, Lanzhou University, Lanzhou, People’s Republic of China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneve, Switzerland
| | - Yaolong Chen
- Evidence-Based Medicine Center
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017)
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation
- Institute of Health Data Science, Lanzhou University, Lanzhou, People’s Republic of China
| |
Collapse
|
6
|
Estill J, Ng’ambi W, Rozanova L, Merzouki A, Keiser O. The spatial spread of HIV in Malawi: An individual-based mathematical model. Heliyon 2023; 9:e21948. [PMID: 38034641 PMCID: PMC10684377 DOI: 10.1016/j.heliyon.2023.e21948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/20/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Background The prevalence of HIV varies greatly between and within countries. We aimed to build a comprehensive mathematical modelling tool capable of exploring the reasons of this heterogeneity and test its applicability by simulating the Malawian HIV epidemic. Methods We developed a flexible individual-based mathematical model for HIV transmission that comprises a spatial representation and individual-level determinants. We tested this model by calibrating it to the HIV epidemic in Malawi and exploring whether the heterogeneity in HIV prevalence could be reproduced. We ran the model for 1975-2030 with five alternative realizations of the geographical structure and mobility: (I) no geographical structure; 28 administrative districts including (II) only permanent inter-district relocations, (III) inter-district permanent relocations and casual sexual relationships, or (IV) permanent relocations between districts and to/from abroad and inter-district casual sex; and (V) a grid of 10 × 10km2 cells, with permanent relocations and between-cell casual relationships. We assumed HIV was present in 1975 in the districts with >10 % prevalence in 2010. We calibrated the models to national and district-level prevalence estimates. Results Reaching the national prevalence required all adults to have at least 22 casual sex acts/year until 1990. Models II, III and V reproduced the geographical heterogeneity in prevalence in 2010 to some extent if between-district relationships were excluded (Model II; 4.9 %-21.1 %). Long-distance casual partnership mixing mitigated the differences in prevalence substantially (range across districts 4.1%-18.9 % in 2010 in Model III; 4.0%-17.6 % in Model V); with international migration the differences disappeared (Model IV; range across districts 6.9%-13.3 % in 2010). National prevalence decreased to 5 % by 2030. Conclusion Earlier introduction of HIV into the Southern part of Malawi may cause some level of heterogeneity in HIV prevalence. Other factors such as sociobehavioural characteristics are likely to have a major impact and need investigation.
Collapse
Affiliation(s)
- Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Wingston Ng’ambi
- College of Medicine, Health Economics and Policy Unit, University of Malawi, Lilongwe, Malawi
| | - Liudmila Rozanova
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Aziza Merzouki
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
7
|
Chipanta D, Mitra S, Amo-Agyei S, Velarde MR, Amekudzi K, Osborne C, Estill J, Keiser O. Differences between persons with and without disability in HIV prevalence, testing, treatment, and care cascade in Tanzania: a cross-sectional study using population-based data. BMC Public Health 2023; 23:2096. [PMID: 37880641 PMCID: PMC10601322 DOI: 10.1186/s12889-023-17013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Persons with disability may have a higher HIV prevalence and be less likely than persons without disability to know their HIV-positive status, access antiretroviral therapy (ART), and suppress their HIV viral load (HIV care cascade). However, studies examining differences between persons with and without disability in HIV prevalence and the HIV care cascade are lacking. Using the Tanzania HIV Impact Survey (THIS) data collected between October 2016 and August 2017, we assessed differences in HIV prevalence and progress towards achieving the 2020 HIV care cascade target between persons with and without disability. METHODS Using the Washington Group Short Set (WG-SS) Questions on Disability, we defined disability as having a functional difficulty in any of the six life domains (seeing, hearing, walking/climbing, remembering/ concentrating, self-care, and communicating). We classified respondents as disabled if they responded having either "Some Difficulty", "A lot of difficulties" or "Unable to" in any of the WG-SS Questions. We presented the sample characteristics by disability status and analyzed the achievement of the cascade target by disability status, and sex. We used multivariable logistic regressions, and adjusted for age, sex, rural-urban residence, education, and wealth quintile. RESULTS A total of 31,579 respondents aged 15 years and older had HIV test results. Of these 1,831 tested HIV-positive, corresponding to an estimated HIV prevalence of 4.9% (CI: 4.5 - 5.2%) among the adult population in Tanzania. The median age of respondents who tested HIV-positive was 32 years (with IQR of 21-45 years). HIV prevalence was higher (5.7%, 95% CI: 5.3-7.4%) among persons with disability than persons without disability (4.3%, 95% CI: 4.0 - 4.6%). Before adjustment, compared to women without disability, more women with disability were aware of their HIV-positive status (n = 101, 79.0%, 95% CI: 68.0-87.0% versus n = 703, 63.0%, 95% CI: 59.1-66.7%) and accessed ART more frequently (n = 98, 98.7%, 95% CI: 95.3-99.7% versus n = 661, 94.7%, 95% CI: 92.6-96.3%). After adjusting for socio-demographic characteristics, the odds of having HIV and of accessing ART did not differ between persons with and without disability. However, PLHIV with disability had higher odds of being aware of their HIV-positive status (aOR 1.69, 95% 1.05-2.71) than PLHIV without disability. Men living with HIV and with disability had lower odds (aOR = 0.23, 95% CI: 0.06-0.86) to suppress HIV viral loads than their counterparts without disability. CONCLUSION We found no significant differences in the odds of having HIV and of accessing ART between persons with and without disability in Tanzania. While PLHIV and disability, were often aware of their HIV-positive status than their non-disabled counterparts, men living with HIV and with disability may have been disadvantaged in having suppressed HIV viral loads. These differences are correctable with disability-inclusive HIV programming. HIV surveys around the world should include questions on disability to measure potential differences in HIV prevalence and in attaining the 2025 HIV care cascade target between persons with and without disability.
Collapse
Affiliation(s)
- David Chipanta
- University of Geneva, Geneva, Switzerland.
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.
| | | | | | - Minerva Rivas Velarde
- University of Geneva, Geneva, Switzerland
- Geneva School of Health Science, Geneva, Switzerland
| | - Kofi Amekudzi
- International Labour Organisation, Geneva, Switzerland
| | | | | | | |
Collapse
|
8
|
Sun M, Lai H, Huang J, Liu J, Li Y, Tian J, Zhang C, Estill J, Zhang Z, Ge L. Molnupiravir for the treatment of non-severe COVID-19: a systematic review and meta-analysis of 14 randomized trials with 34 570 patients. J Antimicrob Chemother 2023; 78:2131-2139. [PMID: 37437106 DOI: 10.1093/jac/dkad216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/25/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Molnupiravir has been considered a promising candidate for COVID-19. Its efficacy and safety in non-severe COVID-19 patients and the differences between patients with different risk factors need further evaluation. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials that allocated adult patients with non-severe COVID-19 to molnupiravir or a control. We used random-effects models, and conducted subgroup analyses and meta-regression for COVID-19 patients with high-risk factors. The GRADE approach was used to rate the certainty of evidence. RESULTS Fourteen trials with 34 570 patients were included. Moderate- to low-certainty evidence showed that molnupiravir was associated with a reduction in the risk of hospitalization (relative risk [RR] = 0.63, 95% CI: 0.47-0.85), risk of mechanical ventilation (RR = 0.37, 95% CI: 0.19-0.72) and time to symptom resolution (mean differences [MD] = -2.91 days, 95% CI: -3.66 to -2.16). However, no significant differences were found in adverse events, all-cause mortality, rate of and time to viral clearance, or duration of hospitalization. For the rate of viral clearance, subgroup effects were found between trials with low and high risk of bias (P = 0.001) and between trials with male or female majority (P < 0.001). For admission to hospital, subgroup effects were also found between trials with ≥50% and <50% of the participants being female (P = 0.04). Meta-regression showed a significant association between higher trial mean age and elevated risk of hospitalization (P = 0.011), and female majority and elevated risk of hospitalization (P = 0.011). CONCLUSIONS Molnupiravir was found to be effective in non-severe COVID-19, but the efficacy varied with age and sex.
Collapse
Affiliation(s)
- Mingyao Sun
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jiajie Huang
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Jianing Liu
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Ying Li
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Caiyun Zhang
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Zhigang Zhang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Department of Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
| |
Collapse
|
9
|
Estill J, Venkova-Marchevska P, Günthard HF, Botero-Mesa S, Thiabaud A, Roelens M, Vancauwenberghe L, Damonti L, Heininger U, Iten A, Schreiber PW, Sommerstein R, Tschudin-Sutter S, Troillet N, Vuichard-Gysin D, Widmer A, Hothorn T, Keiser O. Treatment effect of remdesivir on the mortality of hospitalised COVID-19 patients in Switzerland across different patient groups: a tree-based model analysis. Swiss Med Wkly 2023; 153:40095. [PMID: 37769356 DOI: 10.57187/smw.2023.40095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
AIMS OF THE STUDY Remdesivir has shown benefits against COVID-19. However, it remains unclear whether, to what extent, and among whom remdesivir can reduce COVID-19-related mortality. We explored whether the treatment response to remdesivir differed by patient characteristics. METHODS We analysed data collected from a hospital surveillance study conducted in 21 referral hospitals in Switzerland between 2020 and 2022. We applied model-based recursive partitioning to group patients by the association between treatment levels and mortality. We included either treatment (levels: none, remdesivir within 7 days of symptom onset, remdesivir after 7 days, or another treatment), age and sex, or treatment only as regression variables. Candidate partitioning variables included a range of risk factors and comorbidities (and age and sex unless included in regression). We repeated the analyses using local centring to correct the results for the propensity to receive treatment. RESULTS Overall (n = 21,790 patients), remdesivir within 7 days was associated with increased mortality (adjusted hazard ratios 1.28-1.54 versus no treatment). The CURB-65 score caused the most instability in the regression parameters of the model. When adjusted for age and sex, patients receiving remdesivir within 7 days of onset had higher mortality than those not treated in all identified eight patient groups. When age and sex were included as partitioning variables instead, the number of groups increased to 19-20; in five to six of those branches, mortality was lower among patients who received early remdesivir. Factors determining the groups where remdesivir was potentially beneficial included the presence of oncological comorbidities, male sex, and high age. CONCLUSIONS Some subgroups of patients, such as individuals with oncological comorbidities or elderly males, may benefit from remdesivir.
Collapse
Affiliation(s)
- Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | | | - Huldrych F Günthard
- Department of Infectious Diseaes and Hospital Epidemiology, University Hospital Zürich, Zürich, Switzerland
- Institute of Medical Virology, University of Zürich, Switzerland
| | - Sara Botero-Mesa
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Amaury Thiabaud
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Maroussia Roelens
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Lauro Damonti
- Department of Infectious Diseases, Bern University Hospital (Inselspital), Bern, Switzerland
| | - Ulrich Heininger
- Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland
| | - Anne Iten
- Service of Prevention and Infection Control, Directorate of Medicine and Quality, Geneva University Hospitals, Geneva, Switzerland
| | - Peter W Schreiber
- Department of Infectious Diseaes and Hospital Epidemiology, University Hospital Zürich, Zürich, Switzerland
| | - Rami Sommerstein
- Department of Infectious Diseases, Bern University Hospital (Inselspital), Bern, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Nicolas Troillet
- Service of Infectious Diseases, Central Institute, Valais Hospitals, Sion, Switzerland
| | - Danielle Vuichard-Gysin
- Department of Infectious Diseases, Thurgau Hospital Group, Muensterlingen and Frauenfeld, Switzerland
| | - Andreas Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Torsten Hothorn
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
10
|
Esra RT, Carstens J, Estill J, Stoch R, Le Roux S, Mabuto T, Eisenstein M, Keiser O, Maskew M, Fox MP, De Voux L, Sharpey-Schafer K. Historical visit attendance as predictor of treatment interruption in South African HIV patients: Extension of a validated machine learning model. PLOS Glob Public Health 2023; 3:e0002105. [PMID: 37467217 DOI: 10.1371/journal.pgph.0002105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/05/2023] [Indexed: 07/21/2023]
Abstract
Retention of antiretroviral (ART) patients is a priority for achieving HIV epidemic control in South Africa. While machine-learning methods are being increasingly utilised to identify high risk populations for suboptimal HIV service utilisation, they are limited in terms of explaining relationships between predictors. To further understand these relationships, we implemented machine learning methods optimised for predictive power and traditional statistical methods. We used routinely collected electronic medical record (EMR) data to evaluate longitudinal predictors of lost-to-follow up (LTFU) and temporal interruptions in treatment (IIT) in the first two years of treatment for ART patients in the Gauteng and North West provinces of South Africa. Of the 191,162 ART patients and 1,833,248 visits analysed, 49% experienced at least one IIT and 85% of those returned for a subsequent clinical visit. Patients iteratively transition in and out of treatment indicating that ART retention in South Africa is likely underestimated. Historical visit attendance is shown to be predictive of IIT using machine learning, log binomial regression and survival analyses. Using a previously developed categorical boosting (CatBoost) algorithm, we demonstrate that historical visit attendance alone is able to predict almost half of next missed visits. With the addition of baseline demographic and clinical features, this model is able to predict up to 60% of next missed ART visits with a sensitivity of 61.9% (95% CI: 61.5-62.3%), specificity of 66.5% (95% CI: 66.4-66.7%), and positive predictive value of 19.7% (95% CI: 19.5-19.9%). While the full usage of this model is relevant for settings where infrastructure exists to extract EMR data and run computations in real-time, historical visits attendance alone can be used to identify those at risk of disengaging from HIV care in the absence of other behavioural or observable risk factors.
Collapse
Affiliation(s)
- Rachel T Esra
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Imperial College of London, London, United Kingdom
| | | | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Sue Le Roux
- The Aurum Institute, Johannesburg, South Africa
| | | | | | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Mhari Maskew
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Matthew P Fox
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Departments of Epidemiology and Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | | | | |
Collapse
|
11
|
Chipanta D, Kapambwe S, Nyondo-Mipando AL, Pascoe M, Amo-Agyei S, Bohlius J, Estill J, Keiser O. Socioeconomic inequalities in cervical precancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe: analysis of Population-Based HIV Impact Assessment surveys. BMJ Open 2023; 13:e067948. [PMID: 37339830 PMCID: PMC10314495 DOI: 10.1136/bmjopen-2022-067948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 05/30/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVES We examined age, residence, education and wealth inequalities and their combinations on cervical precancer screening probabilities for women. We hypothesised that inequalities in screening favoured women who were older, lived in urban areas, were more educated and wealthier. DESIGN Cross-sectional study using Population-Based HIV Impact Assessment data. SETTING Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe. Differences in screening rates were analysed using multivariable logistic regressions, controlling for age, residence, education and wealth. Inequalities in screening probability were estimated using marginal effects models. PARTICIPANTS Women aged 25-49 years, reporting screening. OUTCOME MEASURES Self-reported screening rates, and their inequalities in percentage points, with differences of 20%+ defined as high inequality, 5%-20% as medium, 0%-5% as low. RESULTS The sample size of participants ranged from 5882 in Ethiopia to 9186 in Tanzania. The screening rates were low in the surveyed countries, ranging from 3.5% (95% CI 3.1% to 4.0%) in Rwanda to 17.1% (95% CI 15.8% to 18.5%) and 17.4% (95% CI 16.1% to 18.8%) in Zambia and Zimbabwe. Inequalities in screening rates were low based on covariates. Combining the inequalities led to significant inequalities in screening probabilities between women living in rural areas aged 25-34 years, with a primary education level, from the lowest wealth quintile, and women living in urban areas aged 35-49 years, with the highest education level, from the highest wealth quintile, ranging from 4.4% in Rwanda to 44.6% in Zimbabwe. CONCLUSIONS Cervical precancer screening rates were inequitable and low. No country surveyed achieved one-third of the WHO's target of screening 70% of eligible women by 2030. Combining inequalities led to high inequalities, preventing women who were younger, lived in rural areas, were uneducated, and from the lowest wealth quintile from screening. Governments should include and monitor equity in their cervical precancer screening programmes.
Collapse
Affiliation(s)
- David Chipanta
- ERA, UNAIDS, Geneve, Switzerland
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
| | | | | | | | - Silas Amo-Agyei
- Department of Economics, University of Lausanne, Lausanne, Switzerland
| | - Julia Bohlius
- Swiss Tropical and Public Health Institute, University of Bern, Basel, Switzerland
| | - Janne Estill
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
| | - Olivia Keiser
- Faculty of Medicine, University of Geneva, Geneve, Switzerland
| |
Collapse
|
12
|
Yang N, Liu H, Zhao W, Pan Y, Lyu X, Hao X, Liu X, Qi W, Chen T, Wang X, Zhang B, Zhang W, Li Q, Xu D, Gao X, Jin Y, Sun F, Meng W, Li G, Wu Q, Chen Z, Wang X, Estill J, Norris SL, Du L, Chen Y, Wei J. Development of the Scientific, Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines. Chin Med J (Engl) 2023; 136:1430-1438. [PMID: 37192012 PMCID: PMC10278700 DOI: 10.1097/cm9.0000000000002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Collapse
Affiliation(s)
- Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
| | - Hui Liu
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
- School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Wei Zhao
- Editor-in-Chief Office, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Yang Pan
- Marketing Department, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiangzheng Lyu
- Editorial Department, National Medical Journal of China, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiuyuan Hao
- Editorial Department, Chinese Medical Journal, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Xiaoqing Liu
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Wen’an Qi
- Editorial office of Digital Medicine and Health, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Tong Chen
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoqin Wang
- Evidence-based Medicine Center, Fudan University, Shanghai 200032, China
| | - Boheng Zhang
- Department of Hepatic Oncology, Xiamen Clinical Research Center for Cancer Therapy, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian 361015, China
| | - Weishe Zhang
- Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Qiu Li
- Department of Nephrology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Dong Xu
- SMU Institute for Global Health (SIGHT), School of Health Management and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, Guangdong 510515, China
| | - Xinghua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Yinghui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Feng Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Wenbo Meng
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Guobao Li
- Department of Lung Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong 518112, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Ze Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xu Wang
- Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Institute of Global Health, University of Geneva, Geneva 1202, Switzerland
| | - Susan L. Norris
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon 97239, USA
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu 730000, China
- Guidelines and Standards Research Center, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Junmin Wei
- Chinese Medical Association Publishing House, Beijing 100052, China
| |
Collapse
|
13
|
Li Q, Zhou Q, Florez ID, Mathew JL, Amer YS, Estill J, Smyth RL, Liu E, Chen Y, Luo Z. Reporting standards for child health research were few and poorly implemented. J Clin Epidemiol 2023; 158:141-148. [PMID: 36965601 DOI: 10.1016/j.jclinepi.2023.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 03/11/2023] [Accepted: 03/21/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVES This study aims to identify existing reporting standards for child health research, assess the robustness of the standards development process, and evaluate the dissemination of these standards. STUDY DESIGN AND SETTING We searched MEDLINE, the EQUATOR Network Library, and Google to identify reporting standards for child health research studies. We assessed the adherence of the Guidance for Developers of Health Research Reporting Guidelines (GDHRG) by the identified reporting standards. We also assessed the use of the identified reporting standards by primary research studies, and the endorsement of the included reporting standards by journals. RESULTS We identified six reporting standards for child health research, including two under development. Among the four available standards their median adherence to the 18 main steps of the GDHRG was 58.35% (range: 27.8%-83.3%). None of these four reporting standards had been endorsed by pediatric journals indexed by the Science Citation Index. Only 26 primary research studies declared that they followed one of the reporting standards. CONCLUSION There is a quantitative and qualitative paucity of well-developed reporting standards for child health research. The available standards are also poorly implemented. This situation demands an urgent need to develop robust standards and ensure their implementation.
Collapse
Affiliation(s)
- Qinyuan Li
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qi Zhou
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ivan D Florez
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, University of Antioquia, Medellin, Antioquia, Colombia; Pediatric Intensive Care Unit, Clinica Las Americas-AUNA, Medellin, Colombia
| | - Joseph L Mathew
- Advanced Pediatrics Centre, PGIMER Chandigarh, Chandigarh, India
| | - Yasser Sami Amer
- Department of Pediatrics, Quality Management, King Saud University Medical City, Riyadh, Saudi Arabia; Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia; Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | | | - Enmei Liu
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yaolong Chen
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Chevidence Lab of Child and Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing 40001, China; Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
| | - Zhengxiu Luo
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
| |
Collapse
|
14
|
Xun Y, Luo X, Lv M, Yang B, Lei R, Liu X, Zhang J, Zhang X, Liu H, Shi Q, Liu K, Yang Y, Chen Y, Chen L, Wang R, Norris SL, Amer YS, Qaseem A, Chen Y, Estill J. Protocols for clinical practice guidelines. J Evid Based Med 2023; 16:3-9. [PMID: 36354129 DOI: 10.1111/jebm.12502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Yangqin Xun
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Meng Lv
- Chevidence Lab of Child & Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Bo Yang
- Shapingba District Center for Disease Control and Prevention of Chongqing, Chongqing, China
| | - Ruobing Lei
- Chevidence Lab of Child & Adolescent Health, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiao Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Jingyi Zhang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Hui Liu
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Kefeng Liu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou, China
| | - Yongjie Yang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Drug Clinical Comprehensive Evaluation Center, Zhengzhou, China
| | - Yuyue Chen
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Lan Chen
- School of Nursing, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Runwu Wang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | | | - Yasser Sami Amer
- Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
- Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia
- Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt
| | - Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania, United States
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
15
|
Wangara F, Estill J, Kipruto H, Wools-Kaloustian K, Chege W, Manguro G, Keiser O. Sub optimal HIV status ascertainment at antenatal clinics and the impact on HIV prevalence estimates: A cross sectional study. PLoS One 2022; 17:e0278450. [PMID: 36454873 PMCID: PMC9714869 DOI: 10.1371/journal.pone.0278450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND While many countries including Kenya transitioned from sentinel surveillance to the use of routine antenatal care (ANC) data to estimate the burden of HIV, countries in Sub Saharan Africa reported several challenges of this transition, including low uptake of HIV testing and sub national / site-level differences in HIV prevalence estimates. In Kenya voluntary HIV testing is offered to all 1st ANC clients. However, some women may decline testing. We aim to predict the HIV positivity (as a proxy of prevalence) at ANC assuming 100% uptake of HIV testing and compare this to the observed positivity. METHODS Using a cross sectional study design, we examine routine data on HIV testing among all women attending ANC in Kwale County, Kenya, for the period January 2015 to December 2019.We used a generalized estimating equation with binomial distribution to model the observed HIV prevalence as explained by HIV status ascertainment. We then used marginal standardization to predict the HIV prevalence at 100% HIV status ascertainment and make recommendations to improve the utility of ANC routine data for HIV surveillance. RESULTS HIV testing at ANC was at 91.3%, slightly above the global target of 90%. If there was 100% HIV status ascertainment at ANC, the HIV prevalence would be 2.7% (95% CI 2.3-3.2). This was 0.3% lower than the observed prevalence. Across the yearly predictions, there was no difference between the observed and predicted values except for 2018 where the HIV prevalence was underestimated with an absolute bias of -0.2 percent. This implies missed opportunities for identifying new HIV infections in the year 2018. CONCLUSIONS Imperfect HIV status ascertainment at ANC overestimates HIV prevalence among women attending ANC in Kwale County. However, the use of ANC routine data may underestimate the true population prevalence. There is need to address both community level and health facility level barriers to the uptake of ANC services.
Collapse
Affiliation(s)
- Fatihiyya Wangara
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Health Services, County Government of Kwale, Kwale, Kenya
- * E-mail:
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Hillary Kipruto
- Health Systems & Services, World Health Organization, Harare, Zimbabwe
| | - Kara Wools-Kaloustian
- Department of Medicine, Indiana University, Indianapolis, Indiana, United States of America
| | - Wendy Chege
- National AIDS Control Council, Ministry of Health, Nairobi, Kenya
| | | | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
16
|
Xun Y, Liu H, Meng M, Wang Z, Zhou Q, Yao Y, Su R, Luo X, Shi Q, Yang N, Li Q, Zhao S, Zhang H, Norris SL, Amer YS, Qaseem A, Liu X, Chen Y, Estill J. Characteristics of guidelines registered on the PREPARE platform. J Evid Based Med 2022; 15:341-346. [PMID: 36352555 DOI: 10.1111/jebm.12501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Yangqin Xun
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Hui Liu
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Min Meng
- Chevidence Lab Child & Adolescent Health Department, Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China
| | - Zijun Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qi Zhou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yuanyuan Yao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Renfeng Su
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Qinyuan Li
- Department of Respiratory, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hairong Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
| | | | - Yasser Sami Amer
- Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
- Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia
- Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University Medical Council, Alexandria University, Alexandria, Egypt
| | - Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania, United States
| | - Xingrong Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
17
|
Chipanta D, Amo-Agyei S, Giovenco D, Estill J, Keiser O. Socioeconomic inequalities in the 90-90-90 target, among people living with HIV in 12 sub-Saharan African countries - Implications for achieving the 95-95-95 target - Analysis of population-based surveys. EClinicalMedicine 2022; 53:101652. [PMID: 36159044 PMCID: PMC9489496 DOI: 10.1016/j.eclinm.2022.101652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Inequalities undermine efforts to end AIDS by 2030. We examined socioeconomic inequalities in the 90-90-90 target among people living with HIV (PLHIV) -men (MLHIV), women (WLHIV) and adolescents (ALHIV). METHODS We analysed the available Population HIV Impact Assessment (PHIA) survey data for each of the 12 sub-Saharan African countries, collected between 2015 and 2018 to estimate the attainment of each step of the 90-90-90 target by wealth quintiles. We constructed concentration curves, computed concentration indices (CIX) -a negative (positive) CIX indicated pro-poor (pro-rich) inequalities- and identified factors associated with, and contributing to inequality. FINDINGS Socioeconomic inequalities in achieving the 90-90-90 target components among PLHIV were noted in 11 of the 12 countries surveyed: not in Rwanda. Awareness of HIV positive status was pro-rich in 5/12 countries (Côte d'Ivoire, Tanzania, Uganda, Malawi, and Zambia) ranging from CIX=0·085 (p< 0·05) in Tanzania for PLHIV, to CIX = 0·378 (p<0·1) in Côte d'Ivoire for ALHIV. It was pro-poor in 5/12 countries (Côte d'Ivoire, Ethiopia, Malawi, Namibia and Eswatini), ranging from CIX = -0·076 (p<0·05) for PLHIV in Eswatini, and CIX = -0·192 (p<0·05) for WLHIV in Ethiopia. Inequalities in accessing ART were pro-rich in 5/12 countries (Cameroun, Tanzania, Uganda, Malawi and Zambia) ranging from CIX=0·101 (p<0·05) among PLHIV in Zambia to CIX=0·774 (p<0·1) among ALHIV in Cameroun and pro-poor in 4/12 countries (Tanzania, Zimbabwe, Lesotho and Eswatini), ranging from CIX = -0·072 (p<0·1) among PLHIV in Zimbabwe to CIX = -0·203 (p<0·05) among WLHIV in Tanzania. Inequalities in HIV viral load suppression were pro-rich in 3/12 countries (Ethiopia, Uganda, and Lesotho), ranging from CIX = 0·089 (p< 0·1) among PLHIV in Uganda to CIX = 0·275 (p<0·01) among WLHIV in Ethiopia. Three countries (Tanzania CIX = 0·069 (p< 0·5), Uganda CIX = 0·077 (p< 0·1), and Zambia CIX = 0·116 (p< 0·1)) reported pro-rich and three countries (Côte d'Ivoire CIX = -0·125 (p< 0·1), Namibia CIX = -0·076 (p< 0·05), and Eswatini CIX = -0·050 (p< 0·05) pro-poor inequalities for the cumulative CIX for HIV viral load suppression. The decomposition analysis showed that age, rural-urban residence, education, and wealth were associated with and contributed the most to inequalities observed in achieving the 90-90-90 target. INTERPRETATION Some PLHIV in 11 of 12 countries were not receiving life-saving HIV testing, treatment, or achieving HIV viral load suppression due to socioeconomic inequalities. Socioeconomic factors were associated with and explained the inequalities observed in the 90-90-90 target among PLHIV. Governments should scale up equitable 95-95-95 target interventions, prioritizing the reduction of age, rural-urban, education and wealth-related inequalities. Research is needed to understand interventions to reduce socioeconomic inequities in achieving the 95-95-95 target. FUNDING This study was supported by the Swiss National Science Foundation (grant 202660).
Collapse
Affiliation(s)
- David Chipanta
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- United nations joint programme on HIV/AIDS (UNAIDS), Equality and Rights for All, Geneva 27, CH1211, Switzerland
- Corresponding author at: Institute of Global Health - University of Geneva, Campus Biotech, Chemin des mines 9, 1202 Genève – CH, Switzerland.
| | - Silas Amo-Agyei
- Department of Economics, University of Lausanne, Lausanne, Switzerland
| | - Danielle Giovenco
- Brown University, School of Public Health, International Health Institute, Providence, RI, USA
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
18
|
Chipanta D, Stöckl H, Toska E, Amo-Agyei S, Chanda P, Mwanza J, Kaila K, Matome C, Tembo G, Thiabaud A, Keiser O, Estill J. Women with disabilities in hearing: the last mile in the elimination of mother-to-child transmission of HIV - a cross-sectional study from Zambia. AIDS Care 2022; 34:1203-1211. [PMID: 34789032 DOI: 10.1080/09540121.2021.1998313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article explored the differences in HIV testing in the elimination of mother-to-child transmission of HIV (EMTCT) between women with and without disabilities aged 16-55 years, reported being pregnant and receiving the social cash transfers (SCT) social safety nets in Luapula province, Zambia. We tested for associations between HIV testing in EMTCT and disability using logistic regression analyses. We calculated a functional score for each woman to determine if they had mild, moderate or severe difficulties and controlled for age, intimate partner sexual violence, and the SCT receipt. Of 1692 women, 29.8% (504) reported a disability, 724 (42.8%) mild, 203 (12.0%) moderate, and 83 (4.9%) severe functional difficulties (adjusted odds ratio [aOR] 1.33; 95% confidence interval [CI] 1.04-1.70). Women with moderate (aOR 2.04; 95% CI 1.44-2.88) or mild difficulties (aOR 1.66; 95% CI 1.32-2.08) or with a disability in cognition (aOR 1.67 95% CI 1.22-2.29) reported testing more for HIV than women without disabilities; Women with a disability in hearing (aOR 0.36 CI 0.16-0.80) reported testing less for HIV. Disability is common among women receiving the SCT in the study area accessing HIV testing in the EMTCT setting. HIV testing in EMTCT is challenging for women with disabilities in hearing.
Collapse
Affiliation(s)
- David Chipanta
- Institute of global Health, University of Geneva, Geneva, Switzerland.,Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - Heidi Stöckl
- Medical Faculty, Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilians University, München, Germany
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Silas Amo-Agyei
- Department of Economics Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Patrick Chanda
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Jason Mwanza
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Kelly Kaila
- Disability Inclusion Project Luapula, Internatgonal Labour Organisation, Lusaka, Zambia
| | | | - Gelson Tembo
- Palm Associates Limited, Lusaka, Zambia.,Economics and Agricultural Sciences, University of Zambia, Lusaka, Zambia
| | - Amaury Thiabaud
- Institute of global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
19
|
Luo X, Lv M, Zhang X, Estill J, Yang B, Lei R, Ren M, Liu Y, Wang L, Liu X, Wang Q, Meng M, Chen Y. Clinical manifestations of COVID-19: An overview of 102 systematic reviews with evidence mapping. J Evid Based Med 2022; 15:201-215. [PMID: 35909298 PMCID: PMC9353366 DOI: 10.1111/jebm.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but there is so far no comprehensive analysis of all known symptoms of the disease. Our study aimed to present a comprehensive picture of the clinical symptoms of COVID-19 using an evidence map. METHODS We systematically searched MEDLINE via PubMed, Web of Science, Embase, and Cochrane library from their inception to March 16, 2021. We included systematic reviews reporting the clinical manifestations of COVID-19 patients. We followed the PRISMA guidelines, and the study selection, data extraction, and quality assessment were done by two individuals independently. We assessed the methodological quality of the studies using AMSTAR. We visually presented the clinical symptoms of COVID-19 and their prevalence. RESULTS A total of 102 systematic reviews were included, of which, 68 studies (66.7%) were of high quality, 19 studies (18.6%) of medium quality, and 15 studies (14.7%) of low quality. We identified a total of 74 symptoms including 17 symptoms of the respiratory system, 21 symptoms of the neurological system, 10 symptoms of the gastrointestinal system, 16 cutaneous symptoms, and 10 ocular symptoms. The most common symptoms were fever (67 studies, ranging 16.3%-91.0%, pooled prevalence: 64.6%, 95%CI, 61.3%-67.9%), cough (68 studies, ranging 30.0%-72.2%, pooled prevalence: 53.6%, 95%CI, 52.1%-55.1%), muscle soreness (56 studies, ranging 3.0%-44.0%, pooled prevalence: 18.7%, 95%CI, 16.3%-21.3%), and fatigue (52 studies, ranging 3.3%-58.5%, pooled prevalence: 29.4%, 95%CI, 27.5%-31.3%). The prevalence estimates for COVID-19 symptoms were generally lower in neonates, children and adolescents, and pregnant women than in the general populations. CONCLUSION At least 74 different clinical manifestations are associated with COVID-19. Fever, cough, muscle soreness, and fatigue are the most common, but attention should also be paid to the rare symptoms that can help in the early diagnosis of the disease.
Collapse
Affiliation(s)
- Xufei Luo
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Meng Lv
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Xianzhuo Zhang
- The First School of Clinical MedicineLanzhou UniversityLanzhouChina
| | - Janne Estill
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Institute of Mathematical Statistics and Actuarial ScienceUniversity of BernBernSwitzerland
| | - Bo Yang
- Department of Immune Programming and ManagementShapingba District Center for Disease Control and Prevention of ChongqingChongqingChina
| | - Ruobing Lei
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
| | - Mengjuan Ren
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Yunlan Liu
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Ling Wang
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Xiao Liu
- School of Public HealthLanzhou UniversityLanzhouChina
| | - Qi Wang
- Faculty of Health SciencesDepartment of Health Research Methods, Evidence and ImpactMcMaster UniversityHamiltonCanada
- McMaster Health ForumMcMaster UniversityHamiltonCanada
| | - Min Meng
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of PediatricsChongqingChina
- Department of PharmacyGansu Provincial HospitalLanzhouChina
| | - Yaolong Chen
- School of Public HealthLanzhou UniversityLanzhouChina
- Chevidence Lab of Child & Adolescent Health, Department of Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
- Research Unit of Evidence‐Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical SciencesLanzhou UniversityLanzhouChina
- Institute of Health Data ScienceLanzhou UniversityLanzhouChina
- Evidence‐Based Medicine Center, School of Basic Medical SciencesLanzhou UniversityLanzhouChina
- WHO Collaborating Centre for Guideline Implementation and Knowledge TranslationLanzhou UniversityLanzhouChina
- Guideline International Network AsiaLanzhouChina
- Key Laboratory of Evidence‐Based Medicine and Knowledge Translation of Gansu ProvinceLanzhou UniversityLanzhouChina
- Lanzhou University GRADE CenterLanzhouChina
- Lanzhou UniversityAffiliate of the Cochrane China NetworkLanzhouChina
| | | |
Collapse
|
20
|
Xun Y, Estill J, Ren M, Wang P, Yang N, Wang Z, Zhu Y, Su R, Chen Y, Akl EA. Developing the RIGHT-COI&F extension for the reporting conflicts of interest and funding in practice guidelines: study protocol. Ann Transl Med 2022; 10:717. [PMID: 35845491 PMCID: PMC9279782 DOI: 10.21037/atm-22-2123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/08/2022] [Indexed: 12/08/2022]
Abstract
Background Conflicts of interest (COI) and funding may influence the development of practice guidelines, but there are no internationally endorsed guidelines specifically focusing on the reporting on issues related to COI and funding in practice guidelines. Our aim is to develop an extension of the essential Reporting Items of Practice Guidelines in Healthcare (RIGHT) for COIs and Funding in practice guidelines (i.e., RIGHT-COI&F). Methods We will follow the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network’s toolkit for developing a reporting guideline in six stages: (I) identifying the need for the extension; (II) registering the project and setting up working groups; (III) collecting the initial items; (IV) reaching consensus on the items to be included; (V) revision and formulation of the final checklist; and (VI) dissemination and implementation. We intend to form a multidisciplinary international team of experts to collect and evaluate the items and plan to complete the full reporting guideline in about 2 years. Discussion The RIGHT-COI&F statement will help guideline developers improve their reporting of issues related to COIs and funding, and subsequently improve the reporting quality of their guidelines. Journals editors, guideline users and evaluators will benefit from a more complete and transparent reporting of COI. Trial Registration We have registered the protocol on the EQUATOR network (https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#RIGHT-COI).
Collapse
Affiliation(s)
- Yangqin Xun
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Mengjuan Ren
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Ping Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Zijun Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ying Zhu
- The Michael G. DeGroote Cochrane Canada Center, McMaster University, Hamilton, Canada.,The MacGRADE Center, McMaster University, Hamilton, Canada.,Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Canada
| | - Renfeng Su
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,Lanzhou University Institute of Health Data Science, Lanzhou, China.,Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.,Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
21
|
Ng'ambi WF, Estill J, Jahn A, Orel E, Chimpandule T, Nyirenda R, Keiser O. Factors associated with HIV viral suppression among children and adults receiving antiretroviral therapy in Malawi in 2021: Evidence from the Laboratory Management Information System. Trop Med Int Health 2022; 27:639-646. [PMID: 35622358 DOI: 10.1111/tmi.13782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the prevalence of HIV viral suppression and assess the factors associated with HIV viral suppression among persons receiving antiretroviral therapy (ART) in Malawi in 2021. METHODS Implementation study using routinely collected patient-level HIV RNA-PCR test result data extracted from the national Laboratory Management Information System (LIMS) database managed by the Department of HIV/AIDS in 2021. We calculated frequencies, proportions and odds ratios (OR) of HIV viral suppression with their associated 95% confidence intervals (95%CIs). We performed a random-effects logistic regression to determine the risk factors associated with HIV viral suppression among ART patients, controlling for the spatial autocorrelation between districts and adjusting for other variables. RESULTS We evaluated 515,797 adults and children receiving ART and having a viral load test in 2021. Of these, 92.8% had HIV viral suppression. ART patients living in urban areas had lower likelihood of HIV viral suppression than those living in rural areas (adjusted OR [aOR] = 0.95, 95%CI: 0.92-0.99, p = 0.01). There was an increasing trend in HIV viral suppression with increasing ART duration. Routine VL monitoring samples were 39% more likely to have suppressed VL values than confirmatory HIV VL monitoring samples (aOR = 1.39; 95%CI: 1.34-1.43, p < 0.001). CONCLUSION This is the first national analysis of Malawi HIV VL data from LIMS. Our findings show the need to particularly consider the urban residents, those below 20 years, males, those on ART for less than a year as well as those on specific ARV regimens in order to persistently suppress HIV VL and consequently achieve the goal of achieving HIV VL suppression by 2030.
Collapse
Affiliation(s)
- Wingston Felix Ng'ambi
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Andreas Jahn
- Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Erol Orel
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Rose Nyirenda
- Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
22
|
Estill J. Knowledge is the key to prevention: Managing the silent epidemic of sleep apnoea. Lancet Reg Health Eur 2022; 16:100377. [PMID: 35492961 PMCID: PMC9046863 DOI: 10.1016/j.lanepe.2022.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
23
|
Zhou Q, Zhao S, Gan L, Wang Z, Peng S, Li Q, Liu H, Liu X, Wang Z, Shi Q, Estill J, Luo Z, Wang X, Liu E, Chen Y. Use of non-steroidal anti-inflammatory drugs and adverse outcomes during the COVID-19 pandemic: A systematic review and meta-analysis. EClinicalMedicine 2022; 46:101373. [PMID: 35434582 PMCID: PMC8989274 DOI: 10.1016/j.eclinm.2022.101373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/15/2022] [Accepted: 03/21/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are concerns that the use of non-steroidal anti-inflammatory drugs (NSAIDs) may increase the risk of adverse outcomes among patients with coronavirus COVID-19. This study aimed to synthesize the evidence on associations between the use of NSAIDs and adverse outcomes. METHODS A systematic search of WHO COVID-19 Database, Medline, the Cochrane Library, Web of Science, Embase, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Database for all articles published from January 1, 2020, to November 7, 2021, as well as a supplementary search of Google Scholar. We included all comparative studies that enrolled patients who took NSAIDs during the COVID-19 pandemic. Data extraction and quality assessment of methodology of included studies were completed by two reviewers independently. We conducted a meta-analysis on the main adverse outcomes, as well as selected subgroup analyses stratified by the type of NSAID and population (both positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or not). FINDINGS Forty comparative studies evaluating 4,867,795 adult cases were identified. Twenty-eight (70%) of the included studies enrolled patients positive to SARS-CoV-2 tests. The use of NSAIDs did not reduce mortality outcomes among people with COVID-19 (number of studies [N] = 29, odds ratio [OR] = 0.93, 95% confidence interval [CI]: 0.75 to 1.14, I2 = 89%). Results suggested that the use of NSAIDs was not significantly associated with higher risk of SARS-CoV-2 infection in patients with or without COVID-19 (N = 10, OR = 0.96, 95% CI: 0.86 to 1.07, I2 = 78%; N = 8, aOR = 1.01, 95% CI: 0.94 to 1.09, I2 = 26%), or an increased probability of intensive care unit (ICU) admission (N = 12, OR = 1.28, 95% CI: 0.94 to 1.75, I2 = 82% ; N = 4, aOR = 0.89, 95% CI: 0.65 to 1.22, I2 = 60%), requiring mechanical ventilation (N = 11, OR = 1.11, 95% CI: 0.79 to 1.54, I2 = 63%; N = 5, aOR = 0.80, 95% CI: 0.52 to 1.24, I2 = 66%), or administration of supplemental oxygen (N = 5, OR = 0.80, 95% CI: 0.52 to 1.24, I2 = 63%; N = 2, aOR = 1.00, 95% CI: 0.89 to 1.12, I2 = 0%). The subgroup analysis revealed that, compared with patients not using any NSAIDs, the use of ibuprofen (N = 5, OR = 1.09, 95% CI: 0.50 to 2.39; N = 4, aOR = 0.95, 95% CI: 0.78 to 1.16) and COX-2 inhibitor (N = 4, OR = 0.62, 95% CI: 0.35 to 1.11; N = 2, aOR = 0.73, 95% CI: 0.45 to 1.18) were not associated with an increased risk of death. INTERPRETATION Data suggests that NSAIDs such as ibuprofen, aspirin and COX-2 inhibitor, can be used safely among patients positive to SARS-CoV-2. However, for some of the analyses the number of studies were limited and the quality of evidence was overall low, therefore more research is needed to corroborate these findings. FUNDING There was no funding source for this study.
Collapse
Affiliation(s)
- Qi Zhou
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Lidan Gan
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhili Wang
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Shuai Peng
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qinyuan Li
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiao Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Zijun Wang
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Zhengxiu Luo
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
- Corresponding authors.
| | - Enmei Liu
- Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
- Corresponding authors.
| | - Yaolong Chen
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Corresponding author at: Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
| |
Collapse
|
24
|
Guo Q, Wang J, Estill J, Lan H, Zhang J, Wu S, Yao J, Yan X, Chen Y. Risk of COVID-19 Transmission Aboard Aircraft: An Epidemiological Analysis Based on the National Health Information Platform. Int J Infect Dis 2022; 118:270-276. [PMID: 35331931 PMCID: PMC8935959 DOI: 10.1016/j.ijid.2022.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/23/2022] [Accepted: 03/15/2022] [Indexed: 12/26/2022] Open
Abstract
Objectives This study aims to investigate the risk of COVID-19 transmission on aircraft. Methods We obtained data on all international flights to Lanzhou, China, from June 1, 2020, to August 1, 2020, through the Gansu Province National Health Information Platform and the official website of the Gansu Provincial Center for Disease Control and Prevention. We then performed the statistical analysis. Results Three international flights arrived in Lanzhou. The flights had a total of 700 passengers, of whom 405 (57.9%) were male, and 80 (11.4%) were children under the age of 14 years. Twenty-seven (3.9%) passengers were confirmed to have COVID-19. Confirmed patients were primarily male (17, 65.4%) with a median age of 27.0 years. Most confirmed cases were seated in the middle rows of economy class or near public facility areas such as restrooms and galleys. The prevalence of COVID-19 did not differ between passengers sitting in the window, aisle, or middle seats. However, compared with passengers sitting in the same row up to 2 rows behind a confirmed case, passengers seated in the 2 rows in front of a confirmed case were at a slightly higher risk of being infected. Conclusions COVID-19 may be transmitted during a passenger flight, although there is still no direct evidence.
Collapse
Affiliation(s)
- Qiangqiang Guo
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Jianjian Wang
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Hui Lan
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Juanjuan Zhang
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Shouyuan Wu
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Jingwen Yao
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Xuanchen Yan
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China.
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
| |
Collapse
|
25
|
Orel E, Esra R, Estill J, Thiabaud A, Marchand-Maillet S, Merzouki A, Keiser O. Prediction of HIV status based on socio-behavioural characteristics in East and Southern Africa. PLoS One 2022; 17:e0264429. [PMID: 35239697 PMCID: PMC8893684 DOI: 10.1371/journal.pone.0264429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction High yield HIV testing strategies are critical to reach epidemic control in high prevalence and low-resource settings such as East and Southern Africa. In this study, we aimed to predict the HIV status of individuals living in Angola, Burundi, Ethiopia, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Zambia and Zimbabwe with the highest precision and sensitivity for different policy targets and constraints based on a minimal set of socio-behavioural characteristics. Methods We analysed the most recent Demographic and Health Survey from these 10 countries to predict individual’s HIV status using four different algorithms (a penalized logistic regression, a generalized additive model, a support vector machine, and a gradient boosting trees). The algorithms were trained and validated on 80% of the data, and tested on the remaining 20%. We compared the predictions based on the F1 score, the harmonic mean of sensitivity and positive predictive value (PPV), and we assessed the generalization of our models by testing them against an independent left-out country. The best performing algorithm was trained on a minimal subset of variables which were identified as the most predictive, and used to 1) identify 95% of people living with HIV (PLHIV) while maximising precision and 2) identify groups of individuals by adjusting the probability threshold of being HIV positive (90% in our scenario) for achieving specific testing strategies. Results Overall 55,151 males and 69,626 females were included in the analysis. The gradient boosting trees algorithm performed best in predicting HIV status with a mean F1 score of 76.8% [95% confidence interval (CI) 76.0%-77.6%] for males (vs [CI 67.8%-70.6%] for SVM) and 78.8% [CI 78.2%-79.4%] for females (vs [CI 73.4%-75.8%] for SVM). Among the ten most predictive variables for each sex, nine were identical: longitude, latitude and, altitude of place of residence, current age, age of most recent partner, total lifetime number of sexual partners, years lived in current place of residence, condom use during last intercourse and, wealth index. Only age at first sex for male (ranked 10th) and Rohrer’s index for female (ranked 6th) were not similar for both sexes. Our large-scale scenario, which consisted in identifying 95% of all PLHIV, would have required testing 49.4% of males and 48.1% of females while achieving a precision of 15.4% for males and 22.7% for females. For the second scenario, only 4.6% of males and 6.0% of females would have had to be tested to find 55.7% of all males and 50.5% of all females living with HIV. Conclusions We trained a gradient boosting trees algorithm to find 95% of PLHIV with a precision twice higher than with general population testing by using only a limited number of socio-behavioural characteristics. We also successfully identified people at high risk of infection who may be offered pre-exposure prophylaxis or voluntary medical male circumcision. These findings can inform the implementation of new high-yield HIV tests and help develop very precise strategies based on low-resource settings constraints.
Collapse
Affiliation(s)
- Erol Orel
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Rachel Esra
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Amaury Thiabaud
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Aziza Merzouki
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
26
|
Chipanta D, Estill J, Stöckl H, Hertzog L, Toska E, Chanda P, Mwanza J, Kaila K, Matome C, Tembo G, Keiser O, Cluver L. Associations of Sustainable Development Goals Accelerators With Adolescents’ Well-Being According to Head-of-Household’s Disability Status–A Cross-Sectional Study From Zambia. Int J Public Health 2022; 67:1604341. [PMID: 35283719 PMCID: PMC8916123 DOI: 10.3389/ijph.2022.1604341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/07/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives: We examined associations between accelerators (interventions impacting ≥2 SDG targets) and SDG-aligned well-being indicators among adolescents 16–24 years old in Zambia. Methods: We surveyed adults from 1,800 randomly sampled households receiving social cash transfers. We examined associations between accelerators (social cash transfers, life-long learning, mobile phone access) and seven well-being indicators among adolescents using multivariate logistic regressions. Results: The sample comprised 1,725 adolescents, 881 (51.1%) girls. Mobile phone access was associated with no poverty (adjusted Odds Ratio [aOR] 2.08, p < 0.001), informal cash transfers (aOR 1.82, p = 0.004), and seeking mental health support (aOR 1.61, p = 0.020). Social cash transfers were associated with no disability-related health restrictions (aOR 2.56, p = 0.004) and lesser odds of seeking mental health support (aOR 0.53, p = 0.029). Life-long learning was associated with informal cash transfers (aOR 3.49, p < 0.001) and lower school enrollment (aOR 0.70, p = 0.004). Adolescents with disabled head-of-household reported worse poverty, good health but less suicidal ideation. Conclusions: Social cash transfers, life-long learning, and mobile phone access were positively associated with well-being indicators. Adolescents living with disabled head-of-household benefited less. Governments should implement policies to correct disability-related inequalities.
Collapse
Affiliation(s)
- David Chipanta
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
- *Correspondence: David Chipanta,
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lucas Hertzog
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Patrick Chanda
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Jason Mwanza
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Kelly Kaila
- Disability Inclusion Project Luapula, International Labour Organisation, Lusaka, Zambia
| | | | - Gelson Tembo
- Palm Associates Limited, Lusaka, Zambia
- Economics and Agricultural Sciences, University of Zambia, Lusaka, Zambia
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Lucie Cluver
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
27
|
Ng'ambi WF, Merzouki FA, Estill J, Orel E, Chimpandule T, Nyirenda R, Keiser O. Factors associated with the risk of HIV infection among HIV-exposed infants in Malawi: 2013-2020. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001275. [PMID: 36053628 PMCID: PMC8756276 DOI: 10.1136/bmjpo-2021-001275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/24/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Despite the availability of individual-level data of infants accessing HIV DNA-PCR testing service, there has been little in-depth analysis of such data. Therefore, we describe trends in risk of HIV infection among Malawi's HIV-exposed infants (HEI) with DNA-PCR HIV test result from 2013 to 2020. METHODS This is an implementation study using routinely collected patient-level HIV DNA-PCR test result data extracted from the national Laboratory Management Information System database managed by the Department of HIV/AIDS between 1 January 2013 and 30 June 2020. We calculated frequencies, proportions and odds ratio (OR) with their associated 95% CI. We performed a random-effects logistic regression to determine the risk factors associated with HIV infection in infants, controlling for the spatial autocorrelation between districts and adjusting for other variables. RESULTS We evaluated 255 229 HEI across 750 facilities in 28 districts. The HIV DNA-PCR test was performed within 2 months in 57% of the children. The overall HIV prevalence among all tested HEI between 2013 and 2020 was 7.2% (95% CI 7.1% to 7.3%). We observed a decreasing trend in the proportion of HEI that tested HIV positive from 7.0% (95% CI 6.6% to 7.4%) in 2013 to 5.7% (95% CI 5.4% to 5.9%) in 2015 followed by an increase to 9.9% (95% CI 9.6% to 10.2%) in 2017 and thereafter a decreasing trend between 2017 (i.e. 9.72% (95%CI: 9.43-10.01)) and 2020 (i.e. 3.86% (95%CI: 3.34-4.37)). The HIV prevalence increased by age of the HEI. There was spatial heterogeneity of HIV prevalence between districts of Malawi. The prevalence of HIV was higher among the HEI from the Northern region of Malawi. CONCLUSION The main findings of the study are that the DNA test is performed within 2 months only in 57% of the children, that the decreasing trend of HIV prevalence among HEI observed up to 2015 was followed by an increase up to 2017 and a decrease afterwards, and that the risk of HIV infection increased with age at HIV testing. We summarised spatial and temporal trends of risk of HIV infection among HEI in Malawi between 2013 and 2020. There is need to ensure that all the HEI are enrolled in HIV care by 8 weeks of age in order to further reduce the risk of HIV in this population.
Collapse
Affiliation(s)
- Wingston Felix Ng'ambi
- GRAPH Network, University of Geneva, Geneva, Switzerland .,Epidemiology and Biostatistics, Kamuzu University of Health Sciences, Lilongwe, Central Region, Malawi.,Global Health, University of Geneva, Geneva, Switzerland
| | - Fatma Aziza Merzouki
- GRAPH Network, University of Geneva, Geneva, Switzerland.,Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- GRAPH Network, University of Geneva, Geneva, Switzerland.,Global Health, University of Geneva, Geneva, Switzerland
| | - Erol Orel
- GRAPH Network, University of Geneva, Geneva, Switzerland.,Global Health, University of Geneva, Geneva, Switzerland
| | | | - Rose Nyirenda
- Department of HIV/AIDS, Ministry of Health, Lilongwe, Malawi
| | - Olivia Keiser
- GRAPH Network, University of Geneva, Geneva, Switzerland.,Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
28
|
Temerev A, Rozanova L, Keiser O, Estill J. Geospatial model of COVID-19 spreading and vaccination with event Gillespie algorithm. Nonlinear Dyn 2022; 109:239-248. [PMID: 35095197 PMCID: PMC8783199 DOI: 10.1007/s11071-021-07186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/08/2021] [Indexed: 05/07/2023]
Abstract
We have developed a mathematical model and stochastic numerical simulation for the transmission of COVID-19 and other similar infectious diseases that accounts for the geographic distribution of population density, detailed down to the level of location of individuals, and age-structured contact rates. Our analytical framework includes a surrogate model optimization process to rapidly fit the parameters of the model to the observed epidemic curves for cases, hospitalizations, and deaths. This toolkit (the model, the simulation code, and the optimizer) is a useful tool for policy makers and epidemic response teams, who can use it to forecast epidemic development scenarios in local settings (at the scale of cities to large countries) and design optimal response strategies. The simulation code also enables spatial visualization, where detailed views of epidemic scenarios are displayed directly on maps of population density. The model and simulation also include the vaccination process, which can be tailored to different levels of efficiency and efficacy of different vaccines. We used the developed framework to generate predictions for the spread of COVID-19 in the canton of Geneva, Switzerland, and validated them by comparing the calculated number of cases and recoveries with data from local seroprevalence studies.
Collapse
Affiliation(s)
- Alexander Temerev
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Liudmila Rozanova
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
29
|
Yang N, Liu H, Zhang K, Chen Y, Estill J. Viewpoints on the PRIOR statement—a reporting guideline for overviews of reviews. Ann Transl Med 2022; 11:230. [PMID: 37007563 PMCID: PMC10061445 DOI: 10.21037/atm-22-5724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Hui Liu
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Kaiping Zhang
- Annals of Translational Medicine, AME Publishing Company, Hangzhou, China
| | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Guidelines and Standards Research Center, Chinese Medical Association Publishing House, Beijing, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
30
|
Liu E, Smyth RL, Li Q, Qaseem A, Florez ID, Mathew JL, Amer YS, Estill J, Lu Q, Fu Z, Lu X, Chan ESY, Schwarze J, Wong GWK, Fukuoka T, Ahn HS, Lee MS, Nurdiati D, Cao B, Tu W, Qian Y, Zhao S, Dong X, Luo X, Chen Z, Li G, Zhang X, Zhao X, Xu H, Xu F, Shi Y, Zhao R, Zhao Y, Lei J, Zheng X, Wang M, Yang S, Feng X, Wu L, He Z, Liu S, Wang Q, Song Y, Luo Z, Zhou Q, Guyatt G, Chen Y, Li Q. Guidelines for the prevention and management of children and adolescents with COVID-19. Eur J Pediatr 2022; 181:4019-4037. [PMID: 36109390 PMCID: PMC9483317 DOI: 10.1007/s00431-022-04615-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/26/2022] [Accepted: 09/04/2022] [Indexed: 12/15/2022]
Abstract
UNLABELLED Children are the future of the world, but their health and future are facing great uncertainty because of the coronavirus disease 2019 (COVID-19) pandemic. In order to improve the management of children with COVID-19, an international, multidisciplinary panel of experts developed a rapid advice guideline at the beginning of the outbreak of COVID-19 in 2020. After publishing the first version of the rapid advice guideline, the panel has updated the guideline by including additional stakeholders in the panel and a comprehensive search of the latest evidence. All recommendations were supported by systematic reviews and graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Expert judgment was used to develop good practice statements supplementary to the graded evidence-based recommendations. The updated guideline comprises nine recommendations and one good practice statement. It focuses on the key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin (IVIG) for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health. CONCLUSION This updated evidence-based guideline intends to provide clinicians, pediatricians, patients and other stakeholders with evidence-based recommendations for the prevention and management of COVID-19 in children and adolescents. Larger studies with longer follow-up to determine the effectiveness and safety of systemic glucocorticoids, IVIG, noninvasive ventilation, and the vaccines for COVID-19 in children and adolescents are encouraged. WHAT IS KNOWN • Several clinical practice guidelines for children with COVID-19 have been developed, but only few of them have been recently updated. • We developed an evidence-based guideline at the beginning of the COVID-19 outbreak and have now updated it based on the results of a comprehensive search of the latest evidence. WHAT IS NEW • The updated guideline provides key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health.
Collapse
Affiliation(s)
- Enmei Liu
- grid.488412.3Department of Respiratory Medicine Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Rosalind Louise Smyth
- grid.83440.3b0000000121901201UCL Great Ormond St Institute of Child Health, London, UK ,grid.420468.cGreat Ormond Street Hospital, London, UK
| | - Qinyuan Li
- grid.488412.3Department of Respiratory Medicine Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Amir Qaseem
- grid.417947.80000 0000 8606 7660Clinical Policy and Center for Evidence Reviews, American College of Physicians, Philadelphia, USA
| | - Ivan D. Florez
- grid.25073.330000 0004 1936 8227School of Rehabilitation Science, McMaster University, Hamilton, ON Canada ,grid.412881.60000 0000 8882 5269Department of Pediatrics, University of Antioquia, Medellin, Antioquia Colombia ,Pediatric Intensive Care Unit, Clinica Las Americas, Medellin, Colombia
| | - Joseph L. Mathew
- grid.415131.30000 0004 1767 2903Advanced Pediatrics Centre, PGIMER Chandigarh, Chandigarh, India
| | - Yasser Sami Amer
- grid.56302.320000 0004 1773 5396Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia ,grid.56302.320000 0004 1773 5396Clinical Practice Guidelines & Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia ,grid.56302.320000 0004 1773 5396Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia ,grid.7155.60000 0001 2260 6941Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt
| | - Janne Estill
- grid.8591.50000 0001 2322 4988Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Quan Lu
- grid.16821.3c0000 0004 0368 8293Shanghai Children’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Zhou Fu
- grid.488412.3Department of Respiratory Medicine Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiaoxia Lu
- grid.33199.310000 0004 0368 7223Department of Respiratory Medicine, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei China
| | - Edwin Shih-Yen Chan
- grid.428397.30000 0004 0385 0924Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-National University of Singapore Medical School, Singapore, Singapore ,grid.452814.e0000 0004 0451 6530Singapore Clinical Research Institute, Singapore, Singapore
| | - Jürgen Schwarze
- grid.4305.20000 0004 1936 7988Children’s Research Network and Department of Child Life and Health, Centre for Inflammation Research, The University of Edinburgh, Edinburgh, UK
| | - Gary Wing-Kin Wong
- grid.10784.3a0000 0004 1937 0482Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Toshio Fukuoka
- grid.415565.60000 0001 0688 6269Emergency and Critical Care Center, the Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan ,Advisory Committee in Cochrane Japan, Tokyo, Japan
| | - Hyeong Sik Ahn
- grid.222754.40000 0001 0840 2678Department of Preventive Medicine, Korea University, Seoul, South Korea ,grid.512461.50000 0004 5935 134XKorea Cochrane Centre, Seoul, South Korea ,grid.222754.40000 0001 0840 2678Institute for Evidence-Based Medicine, Korea University College of Medicine, Seoul, South Korea ,grid.222754.40000 0001 0840 2678Korea University School of Medicine, Seoul, South Korea
| | - Myeong Soo Lee
- grid.418980.c0000 0000 8749 5149Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea ,grid.412786.e0000 0004 1791 8264Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea ,grid.410648.f0000 0001 1816 6218Tianjin University of Traditional Chinese Medicine, Tianjin, China ,grid.32566.340000 0000 8571 0482Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Detty Nurdiati
- grid.8570.a0000 0001 2152 4506Cochrane Indonesia, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bin Cao
- grid.415954.80000 0004 1771 3349Department of Pulmonary and Critical Care Medicine, National Center for Respiratory Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China ,grid.506261.60000 0001 0706 7839Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China ,grid.452723.50000 0004 7887 9190Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Wenwei Tu
- grid.194645.b0000000121742757Department of Pediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Yuan Qian
- grid.418633.b0000 0004 1771 7032Capital Institute of Pediatrics, Beijing, China
| | - Shunying Zhao
- grid.411609.b0000 0004 1758 4735Beijing Children’s Hospital, Beijing, China
| | - Xiaoyan Dong
- grid.16821.3c0000 0004 0368 8293Shanghai Children’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Xiaoping Luo
- grid.412793.a0000 0004 1799 5032Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhimin Chen
- grid.411360.1Department of Pulmonology, Children’s Hospital Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Guobao Li
- National Clinical Research Center for Infectious Disease, Shenzhen, China ,grid.410741.7Shenzhen Third People’s Hospital, Shenzhen, China
| | - Xiaobo Zhang
- grid.411333.70000 0004 0407 2968Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Xiaodong Zhao
- grid.488412.3Department of Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China ,grid.488412.3Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei Xu
- grid.488412.3Department of Infection Diseases Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Feng Xu
- grid.488412.3Department of Critical Care Medicine Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yuan Shi
- grid.488412.3Department of Neonatology Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ruiqiu Zhao
- grid.488412.3Department of Infection Diseases Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yao Zhao
- grid.488412.3National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Junqiang Lei
- grid.412643.60000 0004 1757 2902Department of Radiology, the First Hospital of Lanzhou University, Lanzhou, China
| | - Xianlan Zheng
- grid.488412.3Department of Nursing, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Mengshu Wang
- grid.412643.60000 0004 1757 2902Department of Radiology, the First Hospital of Lanzhou University, Lanzhou, China
| | - Shu Yang
- grid.411304.30000 0001 0376 205XChengdu University of TCM, Chengdu, China
| | - Xixi Feng
- grid.413856.d0000 0004 1799 3643Chengdu Medical College, Chengdu, China
| | - Liqun Wu
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Zhihui He
- Chongqing Ninth People’s Hospital, Chongqing, China
| | - Shihui Liu
- grid.414360.40000 0004 0605 7104Beijing Jishuitan Hospital, Beijing, China
| | - Qi Wang
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227McMaster Health Forum, McMaster University, Hamilton, Canada
| | - Yang Song
- grid.413396.a0000 0004 1768 8905Iberoamerican Cochrane Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Zhengxiu Luo
- grid.488412.3Department of Respiratory Medicine Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qi Zhou
- grid.32566.340000 0000 8571 0482Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Gordon Guyatt
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, Canada
| | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China. .,Institute of Health Data Science, Lanzhou University, Lanzhou, China. .,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China. .,Lanzhou University GRADE Centre, Lanzhou, China.
| | - Qiu Li
- Department of Nephrology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
| |
Collapse
|
31
|
Polonsky JA, Böhning D, Keita M, Ahuka-Mundeke S, Nsio-Mbeta J, Abedi AA, Mossoko M, Estill J, Keiser O, Kaiser L, Yoti Z, Sangnawakij P, Lerdsuwansri R, Vilas VJDR. Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018-2020. Emerg Infect Dis 2021; 27:3063-3072. [PMID: 34808076 PMCID: PMC8632194 DOI: 10.3201/eid2712.204958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. We estimated the sensitivity of contact tracing by applying unilist capture-recapture methods on data from the 2018–2020 outbreak of Ebola virus disease in the Democratic Republic of the Congo. To compute sensitivity, we applied different distributional assumptions to the zero-truncated count data to estimate the number of unobserved case-patients with any contacts and infected contacts. Geometric distributions were the best-fitting models. Our results indicate that contact tracing efforts identified almost all (n = 792, 99%) of case-patients with any contacts but only half (n = 207, 48%) of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. We discuss extensions to our work and potential applications for the ongoing coronavirus pandemic.
Collapse
|
32
|
Sadeghimehr M, Bertisch B, Negro F, Butsashvili M, Shilton S, Tskhomelidze I, Tsereteli M, Keiser O, Estill J. Hepatitis C core antigen test as an alternative for diagnosing HCV infection: mathematical model and cost-effectiveness analysis. PeerJ 2021; 9:e11895. [PMID: 34595063 PMCID: PMC8436958 DOI: 10.7717/peerj.11895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/12/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The cost and complexity of the polymerase chain reaction (PCR) test are barriers to diagnosis and treatment of hepatitis C virus (HCV) infection. We investigated the cost-effectiveness of testing strategies using antigen instead of PCR testing. METHODS We developed a mathematical model for HCV to estimate the number of diagnoses and cases of liver disease. We compared the following testing strategies: antibody test followed by PCR in case of positive antibody (baseline strategy); antibody test followed by HCV-antigen test (antibody-antigen); antigen test alone; PCR test alone. We conducted cost-effectiveness analyses considering either the costs of HCV testing of infected and uninfected individuals alone (A1), HCV testing and liver-related complications (A2), or all costs including HCV treatment (A3). The model was parameterized for the country of Georgia. We conducted several sensitivity analyses. RESULTS The baseline scenario could detect 89% of infected individuals. Antibody-antigen detected 86% and antigen alone 88% of infected individuals. PCR testing alone detected 91% of the infected individuals: the remaining 9% either died or spontaneously recovered before testing. In analysis A1, the baseline strategy was not essentially more expensive than antibody-antigen. In analysis A2, strategies using PCR became cheaper than antigen-based strategies. In analysis A3, antibody-antigen was again the cheapest strategy, followed by the baseline strategy, and PCR testing alone. CONCLUSIONS Antigen testing, either following a positive antibody test or alone, performed almost as well as the current practice of HCV testing. The cost-effectiveness of these strategies depends on the inclusion of treatment costs.
Collapse
Affiliation(s)
| | - Barbara Bertisch
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Checkin Helvetiaplatz, Zürich, Switzerland
| | - Francesco Negro
- Divisions of Gastroenterology and Hepatology and of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Irina Tskhomelidze
- TEPHINET for Georgia Hepatitis C Elimination Program, I. Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Maia Tsereteli
- Department of HIV/AIDS, Hepatitis, STI and TB, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| |
Collapse
|
33
|
Zhou Q, Wang X, Estill J, Yang K, Chen Y. Revisiting the evidence for physical distancing, face masks, and eye protection. Lancet 2021; 398:661. [PMID: 34419201 PMCID: PMC8376236 DOI: 10.1016/s0140-6736(21)01738-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/22/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Qi Zhou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Xiaoqin Wang
- The Michael G DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Lanzhou University Institute of Health Data Science, Lanzhou, China.
| |
Collapse
|
34
|
Zhou Q, Wang Z, Shi Q, Zhao S, Xun Y, Liu H, Zhang H, Liu X, Wang X, Yao L, Wang Q, Li Q, Estill J, Yang K, Chen Y. Clinical Epidemiology in China series. Paper 4: The reporting and methodological quality of Chinese clinical practice guidelines published between 2014 and 2018: A systematic review. J Clin Epidemiol 2021; 140:189-199. [PMID: 34416326 DOI: 10.1016/j.jclinepi.2021.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/01/2021] [Accepted: 08/11/2021] [Indexed: 12/08/2022]
Abstract
OBJECTIVE This study aimed to systematically review the methodological and reporting quality of clinical practice guidelines (CPGs) developed in China and published in medical journals between 2014 and 2018. STUDY DESIGN AND SETTING We conducted a comprehensive search in multiple databases: MEDLINE (via PubMed), Embase, CBM (China Biology Medicine), CNKI (China National Knowledge Infrastructure) and Wanfang Data. We included all clinical practice guidelines developed in China between 2014 and 2018. The AGREE II tool and the RIGHT checklist were used to appraise the methodological quality and reporting quality of the included guidelines, respectively. RESULTS We identified 17,188 records, and included finally 573 CPGs. Most (n=507, 88.5%) were published in Chinese, and 508 (88.7%) were about Western medicine. Only 62 (10.8%) of the guidelines used the GRADE approach. The mean overall score of methodological quality over all guidelines was 19.4%, and the mean scores for the AGREE II domains were 28.6% (Scope and purpose), 17.0% (Stakeholder involvement), 11.7% (Rigor of development), 32.2% (Clarity of presentation), 14.2% (Applicability) and 12.8% (Editorial independence). The mean overall score for reporting quality over all guidelines was 30.2%, with the following mean scores for each RIGHT domain: 55.6% (Basic information), 43.8% (Background), 14.5% (Evidence), 29.2% (Recommendations), 10.7% (Review and quality assurance), 12.6% (Funding and declaration of interest) and 8.4% (Other information). Subgroup analyses found that both the methodological and reporting quality were generally higher among CPGs that used evidence grading systems or reported receiving funding. CONCLUSION Both the methodological quality and the reporting quality of CPGs developed in China have improved over time, but are still below the international average.
Collapse
Affiliation(s)
- Qi Zhou
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Zijun Wang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yangqin Xun
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hairong Zhang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiao Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoqin Wang
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Liang Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada; McMaster Health Forum, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Qinyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Kehu Yang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China; Lanzhou University GRADE Centre, Lanzhou, China.
| | - Yaolong Chen
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Lanzhou University Institute of Health Data Science, Lanzhou, China; Lanzhou University GRADE Centre, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
| |
Collapse
|
35
|
Chipanta D, Stöckl H, Toska E, Chanda P, Mwanza J, Kaila K, Matome C, Tembo G, Estill J, Keiser O. Facing the quality of life: physical illness, anxiety, and depression symptoms among people living with HIV in rural Zambia - a cross-sectional study. AIDS Care 2021; 34:957-965. [PMID: 34383600 DOI: 10.1080/09540121.2021.1966693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Widespread access to ART has not improved the quality of life (QoL) for people living with HIV (PLHIV). We used the United Nations Disability project (UNPRPD) evaluation data to examine how physical illness, anxiety, and depression shape the QoL of PLHIV in households receiving the social cash transfers safety nets in Luapula, Zambia. We explored associations between each outcome - physical illness, anxiety, depression symptoms - and age, gender, poverty, hunger and disability, using univariable and multivariable regressions. We adjusted p-values for multiple hypothesis testing with sharpened Qs. The sample comprised 1925 respondents 16-55 years old, median age 31 (IQR 22-42 years), majority women (n = 1514, 78.6%). Two-thirds (1239, 64.4%) reported having a physical illness, a third (671, 34.9%) anxiety, and nine per cent (366) depression symptoms. More HIV positive people had a disability (34.6%, 53 versus 28.3%, 502; Q = 0.033), were physically ill (72.5%, 111 versus 63.7%, 1128; Q = 0.011), and two-fold (aOR 1.97 95% CI 1.31-2.94) more likely to report depression symptoms than HIV negative peers. Food insecurity and disability among PLHIV may worsen their physical illnesses, anxiety, depression symptoms, and other QoL domains. More research on the quality of life of PLHIV in poverty is required.
Collapse
Affiliation(s)
- David Chipanta
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology Medical Faculty, Ludwig Maximilians University, München, Germany
| | - Elona Toska
- Department of Sociology, University of Cape Town, Rondebosch, South Africa
| | - Patrick Chanda
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Jason Mwanza
- Social Work and Sociology, University of Zambia, Lusaka, Zambia
| | - Kelly Kaila
- Disability Inclusion Project Luapula, International Labour Organisation, Lusaka, Zambia
| | | | - Gelson Tembo
- Palm Associates Limited, Lusaka, Zambia.,Economics and Agricultural Sciences, University of Zambia, Lusaka, Zambia
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
36
|
Zhao S, Lu S, Wu S, Wang Z, Guo Q, Shi Q, Zhang H, Zhang J, Liu H, Liu Y, Zhang X, Wang L, Ren M, Wang P, Lan H, Zhou Q, Sun Y, Cao J, Li Q, Estill J, Mathew JL, Ahn HS, Lee MS, Wang X, Zhou C, Chen Y. Analysis of COVID-19 Guideline Quality and Change of Recommendations: A Systematic Review. Health Data Sci 2021; 2021:9806173. [PMID: 36405357 PMCID: PMC9629660 DOI: 10.34133/2021/9806173] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/04/2021] [Indexed: 04/23/2023]
Abstract
Background Hundreds of coronavirus disease 2019 (COVID-19) clinical practice guidelines (CPGs) and expert consensus statements have been developed and published since the outbreak of the epidemic. However, these CPGs are of widely variable quality. So, this review is aimed at systematically evaluating the methodological and reporting qualities of COVID-19 CPGs, exploring factors that may influence their quality, and analyzing the change of recommendations in CPGs with evidence published. Methods We searched five electronic databases and five websites from 1 January to 31 December 2020 to retrieve all COVID-19 CPGs. The assessment of the methodological and reporting qualities of CPGs was performed using the AGREE II instrument and RIGHT checklist. Recommendations and evidence used to make recommendations in the CPGs regarding some treatments for COVID-19 (remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir) were also systematically assessed. And the statistical inference was performed to identify factors associated with the quality of CPGs. Results We included a total of 92 COVID-19 CPGs developed by 19 countries. Overall, the RIGHT checklist reporting rate of COVID-19 CPGs was 33.0%, and the AGREE II domain score was 30.4%. The overall methodological and reporting qualities of COVID-19 CPGs gradually improved during the year 2020. Factors associated with high methodological and reporting qualities included the evidence-based development process, management of conflicts of interest, and use of established rating systems to assess the quality of evidence and strength of recommendations. The recommendations of only seven (7.6%) CPGs were informed by a systematic review of evidence, and these seven CPGs have relatively high methodological and reporting qualities, in which six of them fully meet the Institute of Medicine (IOM) criteria of guidelines. Besides, a rapid advice CPG developed by the World Health Organization (WHO) of the seven CPGs got the highest overall scores in methodological (72.8%) and reporting qualities (83.8%). Many CPGs covered the same clinical questions (it refers to the clinical questions on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir in COVID-19 patients) and were published by different countries or organizations. Although randomized controlled trials and systematic reviews on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir for patients with COVID-19 have been published, the recommendations on those treatments still varied greatly across COVID-19 CPGs published in different countries or regions, which may suggest that the CPGs do not make sufficient use of the latest evidence. Conclusions Both the methodological and reporting qualities of COVID-19 CPGs increased over time, but there is still room for further improvement. The lack of effective use of available evidence and management of conflicts of interest were the main reasons for the low quality of the CPGs. The use of formal rating systems for the quality of evidence and strength of recommendations may help to improve the quality of CPGs in the context of the COVID-19 pandemic. During the pandemic, we suggest developing a living guideline of which recommendations are supported by a systematic review for it can facilitate the timely translation of the latest research findings to clinical practice. We also suggest that CPG developers should register the guidelines in a registration platform at the beginning for it can reduce duplication development of guidelines on the same clinical question, increase the transparency of the development process, and promote cooperation among guideline developers all over the world. Since the International Practice Guideline Registry Platform has been created, developers could register guidelines prospectively and internationally on this platform.
Collapse
Affiliation(s)
- Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
| | - Shuya Lu
- Department of Pediatric, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Shouyuan Wu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Zijun Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qiangqiang Guo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Hairong Zhang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Juanjuan Zhang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunlan Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Ling Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Mengjuan Ren
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Ping Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Hui Lan
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qi Zhou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Yajia Sun
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Jin Cao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qinyuan Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Joseph L. Mathew
- Advanced Pediatrics Centre, PGIMER Chandigarh, Chandigarh, India
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University, Seoul, Republic of Korea
- Korea Cochrane Centre, SeoulRepublic of Korea
- Evidence Based Medicine, SeoulRepublic of Korea
- Korea University School of Medicine, SeoulRepublic of Korea
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- University of Science and Technology, Daejeon, Republic of Korea
- London Southbank University, London, UK
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Chenyan Zhou
- Department of Pediatric, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Yaolong Chen
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, LanzhouChina
- Guideline International Network AsiaChina
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China
- Lanzhou University GRADE Center, China
| |
Collapse
|
37
|
Wang J, Zhao S, Xu DR, Estill J, Lv M, Zhao S, Zhang M, Cai Y, Liao J, Lu Y, Wang R, Wang X, Chen Y. Developing evidenced-based quality assessment checklist for real practice in primary health care using standardized patients: a systematic review. Ann Palliat Med 2021; 10:8232-8241. [PMID: 34263643 DOI: 10.21037/apm-21-712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this review was to explore the quality assessment checklists development methods in previous researches using standardized patients (SPs), as well as to propose an evidence-based checklist development procedure for quality assessment of common conditions in primary health care (PHC) settings. METHODS We conducted a systematic review of studies that described checklist development method and extracted the methodology in terms of the developer, the basis and processes. Based on that, we formulated the development procedure according to the recommendations of the WHO Handbook for Guideline Development. RESULTS We identified a total of 13 articles, and proposed the following five key steps: (I) forming a multidisciplinary team; (II) selecting and evaluating relevant references; (III) extracting medical information and forming the basic items; (IV) clinical expert consensus on the items; and (V) pre-testing the item pool and determining final items. DISCUSSION SP has been proven to be an effective method to assess performance in practice. There are still some deficiencies in the developing of case-specific checklists using SPs. To ensure the validity and reliability of checklists, the development processes need to be more standardized and procedural.
Collapse
Affiliation(s)
- Jianjian Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Shuaixiang Zhao
- School of Public Health, Lanzhou University, Lanzhou, China; Jiaozuo People's Hospital, Jiaozuo, China
| | - Dong Roman Xu
- ACACIA Labs, Institute for Global Health and Dermatology Hospital, Southern Medical University, Guangzhou, China; Center for WHO Studies and Institute for Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Meng Lv
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Ming Zhang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yiyuan Cai
- Department of Epidemiology and Medical Statistics, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Jing Liao
- Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Global Health Institute (SGHI), Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yun Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Ruixin Wang
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou, China; Lanzhou University, Affiliate of the Cochrane China Network, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China; Guideline International Network Asia, Lanzhou University, Lanzhou, China
| |
Collapse
|
38
|
Roelens M, Battista Migliori G, Rozanova L, Estill J, Campbell JR, Cegielski JP, Tiberi S, Palmero D, Fox GJ, Guglielmetti L, Sotgiu G, Brust JCM, Bang D, Lienhardt C, Lange C, Menzies D, Keiser O, Raviglione M. Evidence-based Definition for Extensively Drug-resistant Tuberculosis. Am J Respir Crit Care Med 2021; 204:713-722. [PMID: 34107231 DOI: 10.1164/rccm.202009-3527oc] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Until 2020, extensively drug-resistant tuberculosis (XDR-TB) was defined as resistance to rifampicin and isoniazid (multidrug-resistant tuberculosis, MDR-TB), any fluoroquinolone (FQ) and any second-line injectable drug (SLID). In 2019 the World Health Organization issued new recommendations for managing patients with drug-resistant tuberculosis, substantially limiting the role of SLID in MDR-TB treatment and thus putting that XDR-TB definition into question. OBJECTIVE To propose an up-to-date definition for XDR-TB. METHODS We used a large dataset to assess treatment outcomes for MDR-TB patients exposed to any type of longer regimen. We included patients with bacteriologically confirmed MDR-TB and known FQ and SLID resistance results. We did logistic regression to estimate adjusted odds ratios (aORs) for unfavourable treatment outcome (failure, relapse, death, loss-to-follow-up) by resistance pattern (FQ, SLID) and Group A drug use (moxifloxacin/levofloxacin, linezolid, bedaquiline). MEASUREMENTS AND MAIN RESULTS We included 11,666 patients with MDR-TB; 4653 (39.9%) had an unfavourable treatment outcome. Resistance to FQs increased the odds of an unfavourable treatment outcome (aOR 1.91; 95% confidence interval [95%CI] 1.63-2.23). Administration of bedaquiline and/or linezolid improved treatment outcomes regardless of resistance to FQ and/or SLID. Among XDR-TB patients, compared to persons receiving no Group A drug, aORs for unfavourable outcome were 0.37 (95%CI 0.20-0.69) with linezolid only, 0.40 (95%CI 0.21-0.77) with bedaquiline only, and 0.21 (95%CI 0.12-0.38) with both. CONCLUSIONS Our study supports a new definition of XDR-TB as MDR plus additional resistance to FQ plus bedaquiline and/or linezolid, and helps assess the adequacy of this definition for surveillance and treatment choice.NOTE: This article has been updated on July 16, 2021. When it was initially posted on June 9, 2021, the name of one of the coauthors, Dr. Christian Lienhardt, was inadvertently omitted. This version includes Dr. Lienhardt's affilations and contributions; the affiliations have therefore been renumbered.
Collapse
Affiliation(s)
- Maroussia Roelens
- University of Geneva Institute of Global Health, 30492, Geneve, Switzerland
| | | | - Liudmila Rozanova
- University of Geneva Institute of Global Health, 30492, Geneve, Switzerland
| | - Janne Estill
- University of Geneva Institute of Global Health, 30492, Geneve, Switzerland.,University of Bern, 27210, Institute of Mathematical Statistics and Actuarial Science, Bern, Switzerland
| | | | - J Peter Cegielski
- Rollins School of Public Health, 25798, Department of Epidemiology, Atlanta, Georgia, United States
| | - Simon Tiberi
- Queen Mary University of London Barts and The London School of Medicine and Dentistry, 4952, Blizard Institute, London, United Kingdom of Great Britain and Northern Ireland.,Barts Health NHS Trust, 9744, Division of Infection, Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Gregory J Fox
- University of Sydney, Sydney, New South Wales, Australia
| | - Lorenzo Guglielmetti
- Sorbonne Universite, 27063, Centre d'Immunologie et des Maladies Infectieuses, Paris, France.,APHP, 26930, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
| | - Giovanni Sotgiu
- University of Sassari, 9312, Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, Sassari, Italy
| | - James C M Brust
- Albert Einstein College of Medicine & Montefiore Medical Center, Bronx, New York, United States
| | - Didi Bang
- Statens Serum Institut, 4326, Kobenhavn, Denmark.,Copenhagen University Hospital, 53146, Department of Clinical Microbiology, Kobenhavn, Denmark
| | - Christian Lienhardt
- Unité Mixte Internationale TransVIHMI , (Université de Montpellier, UMI 233 IRD, U1175 INSERM), Institut de Recherche pour le Développement (IRD), Montpellier, France.,London School of Hygiene and Tropical Medicine, Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London, United Kingdom of Great Britain and Northern Ireland
| | - Christoph Lange
- Research Center Borstel, German Center for Infection Research (DZIF) Clinical Tuberculosis Center, Borstel, Germany.,University of Lübeck, Respiratory Medicine & International Health, Lübeck, Germany.,Baylor College of Medicine, 3989, Global TB Program, Houston, Texas, United States
| | - Dick Menzies
- McGill University, 5620, McGill International TB Centre, Montreal, Quebec, Canada
| | - Olivia Keiser
- University of Geneva Institute of Global Health, 30492, Geneve, Switzerland
| | - Mario Raviglione
- University of Milan, 9304, Centre for Multidisciplinary Research in Health Science, Milano, Italy.,University of Geneva Global Studies Institute, 87659, Geneve, Switzerland;
| |
Collapse
|
39
|
Estill J, Islam T, Houben RMGJ, Rudman J, Ragonnet R, McBryde ES, Trauer JM, Orel E, Nguyen AT, Rahevar K, Morishita F, Oh KH, Raviglione MC, Keiser O. Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020-2030 in four countries. Lancet Reg Health West Pac 2021; 11:100147. [PMID: 34327358 PMCID: PMC8315379 DOI: 10.1016/j.lanwpc.2021.100147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/24/2022]
Abstract
Background We aimed to estimate the disease burden of Tuberculosis (TB) and return on investment of TB care in selected high-burden countries of the Western Pacific Region (WPR) until 2030. Methods We projected the TB epidemic in Viet Nam and Lao People's Democratic Republic (PDR) 2020–2030 using a mathematical model under various scenarios: counterfactual (no TB care); baseline (TB care continues at current levels); and 12 different diagnosis and treatment interventions. We retrieved previous modeling results for China and the Philippines. We pooled the new and existing information on incidence and deaths in the four countries, covering >80% of the TB burden in WPR. We estimated the return on investment of TB care and interventions in Viet Nam and Lao PDR using a Solow model. Findings In the baseline scenario, TB incidence in the four countries decreased from 97•0/100,000/year (2019) to 90•1/100,000/year (2030), and TB deaths from 83,300/year (2019) to 71,100/year (2030). Active case finding (ACF) strategies (screening people not seeking care for respiratory symptoms) were the most effective single interventions. Return on investment (2020–2030) for TB care in Viet Nam and Lao PDR ranged US$4-US$49/dollar spent; additional interventions brought up to US$2•7/dollar spent. Interpretation In the modeled countries, TB incidence will only modestly decrease without additional interventions. Interventions that include ACF can reduce TB burden but achieving the End TB incidence and mortality targets will be difficult without new transformational tools (e.g. vaccine, new diagnostic tools, shorter treatment). However, TB care, even at its current level, can bring a multiple-fold return on investment. Funding World Health Organization Western Pacific Regional Office; Swiss National Science Foundation Grant 163878.
Collapse
Affiliation(s)
- Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Tauhid Islam
- End TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Rein M G J Houben
- TB Modeling Group, Department of Infectious Disease Epidemiology, London School of Hygiene ad Tropical Medicine, London, United Kingdom
| | - Jamie Rudman
- TB Modeling Group, Department of Infectious Disease Epidemiology, London School of Hygiene ad Tropical Medicine, London, United Kingdom
| | - Romain Ragonnet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - James M Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Erol Orel
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Anh Tuan Nguyen
- Department of TB and Lung Diseases, Hanoi Medical University, Hanoi, Viet Nam
| | - Kalpeshsinh Rahevar
- End TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Fukushi Morishita
- End TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Kyung Hyun Oh
- End TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Mario C Raviglione
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
40
|
Yan X, Wang J, Yao J, Estill J, Wu S, Lu J, Liang B, Li H, Tao S, Bai H, Liu H, Chen Y. A cross-sectional study of the epidemic situation on COVID-19 in Gansu Province, China - a big data analysis of the national health information platform. BMC Infect Dis 2021; 21:146. [PMID: 33546618 PMCID: PMC7863032 DOI: 10.1186/s12879-020-05743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 12/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background In December 2019, a pneumonia caused by SARS-CoV-2 emerged in Wuhan, China and has rapidly spread around the world since then. This study is to explore the patient characteristics and transmission chains of COVID-19 in the population of Gansu province, and support decision-making. Methods We collected data from Gansu Province National Health Information Platform. A cross-sectional study was conducted, including patients with COVID-19 confirmed between January 23 and February 6, 2020, and analyzed the gender and age of the patients. We also described the incubation period, consultation time and sources of infection in the cases, and calculated the secondary cases that occurred within Gansu for each imported case. Results We found thirty-six (53.7%) of the patients were women and thirty-one (46.3%) men, and the median ages were 40 (IQR 31–53) years. Twenty-eight (41.8%) of the 67 cases had a history of direct exposure in Wuhan. Twenty-five (52.2%) cases came from ten families, and we found no clear reports of modes of transmission other than family clusters. The largest number of secondary cases linked to a single source was nine. Conclusion More women than men were diagnosed with COVID-19 in Gansu Province. Although the age range of confirmed cases of COVID-19 in Gansu Province covered almost all age groups, most patients with confirmed COVID-19 tend to be middle aged persons. The most common suspected mode of transmission was through family cluster. Gansu and other settings worldwide should continue to strengthen the utilization of big data in epidemic control.
Collapse
Affiliation(s)
- Xuanchen Yan
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Jianjian Wang
- School of Public Health, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China
| | - Jingwen Yao
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China.
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Shouyuan Wu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Jie Lu
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Baoping Liang
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Hongmin Li
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Shengxin Tao
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Huanli Bai
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Hongliang Liu
- Health Statistics Information Center of Health Commission of Gansu Province, Lanzhou, China
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou, China. .,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China. .,Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.
| | | |
Collapse
|
41
|
Merzouki A, Estill J, Orel E, Tal K, Keiser O. Clusters of sub-Saharan African countries based on sociobehavioural characteristics and associated HIV incidence. PeerJ 2021; 9:e10660. [PMID: 33520455 PMCID: PMC7812934 DOI: 10.7717/peerj.10660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 12/07/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction HIV incidence varies widely between sub-Saharan African (SSA) countries. This variation coincides with a substantial sociobehavioural heterogeneity, which complicates the design of effective interventions. In this study, we investigated how sociobehavioural heterogeneity in sub-Saharan Africa could account for the variance of HIV incidence between countries. Methods We analysed aggregated data, at the national-level, from the most recent Demographic and Health Surveys of 29 SSA countries (2010–2017), which included 594,644 persons (183,310 men and 411,334 women). We preselected 48 demographic, socio-economic, behavioural and HIV-related attributes to describe each country. We used Principal Component Analysis to visualize sociobehavioural similarity between countries, and to identify the variables that accounted for most sociobehavioural variance in SSA. We used hierarchical clustering to identify groups of countries with similar sociobehavioural profiles, and we compared the distribution of HIV incidence (estimates from UNAIDS) and sociobehavioural variables within each cluster. Results The most important characteristics, which explained 69% of sociobehavioural variance across SSA among the variables we assessed were: religion; male circumcision; number of sexual partners; literacy; uptake of HIV testing; women’s empowerment; accepting attitude toward people living with HIV/AIDS; rurality; ART coverage; and, knowledge about AIDS. Our model revealed three groups of countries, each with characteristic sociobehavioural profiles. HIV incidence was mostly similar within each cluster and different between clusters (median (IQR); 0.5/1000 (0.6/1000), 1.8/1000 (1.3/1000) and 5.0/1000 (4.2/1000)). Conclusions Our findings suggest that the combination of sociobehavioural factors play a key role in determining the course of the HIV epidemic, and that similar techniques can help to predict the effects of behavioural change on the HIV epidemic and to design targeted interventions to impede HIV transmission in SSA.
Collapse
Affiliation(s)
- Aziza Merzouki
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Erol Orel
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Kali Tal
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| |
Collapse
|
42
|
Wang X, Chen Y, Akl EA, Tokalić R, Marušić A, Qaseem A, Falck-Ytter Y, Lee MS, Siedler M, Barber SL, Zhang M, Chan ESY, Estill J, Kwong JSW, Okumura A, Zhou Q, Yang K, Norris SL. The reporting checklist for public versions of guidelines: RIGHT-PVG. Implement Sci 2021; 16:10. [PMID: 33430911 PMCID: PMC7798200 DOI: 10.1186/s13012-020-01066-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/29/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Public or patient versions of guidelines (PVGs) are derivative documents that "translate" recommendations and their rationale from clinical guidelines for health professionals into a more easily understandable and usable format for patients and the public. PVGs from different groups and organizations vary considerably in terms of quality of their reporting. In order to address this issue, we aimed to develop a reporting checklist for developers of PVGs and other potential users. METHODS First, we collected a list of potential items through reviewing a sample of PVGs, existing guidance for developing and reporting PVGs or other similar evidence-based patient tools, as well as qualitative studies on original studies of patients' needs about the content and/or reporting of information in PVGs or similar evidence-based patient tools. Second, we conducted a two-round Delphi consultation to determine the level of consensus on the items to be included in the final reporting checklist. Third, we invited two external reviewers to provide comments on the checklist. RESULTS We generated the initial list of 45 reporting items based on a review of a sample of 30 PVGs, four PVG guidance documents, and 46 relevant studies. After the two-round Delphi consultation, we formed a checklist of 17 items grouped under 12 topics for reporting PVGs. CONCLUSION The RIGHT-PVG reporting checklist provides an international consensus on the important criteria for reporting PVGs.
Collapse
Affiliation(s)
- Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, L8S 4 K1, Canada
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Ružica Tokalić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Amir Qaseem
- American College of Physicians, Philadelphia, PA, USA
| | - Yngve Falck-Ytter
- Division of Internal Medicine, Louis Stokes Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Madelin Siedler
- Division of Physical Education and Exercise Science, University of South Florida, Tampa, FL, USA
| | - Sarah L Barber
- World Health Organization Centre for Health Development, Kobe, 651-0073, Japan
| | - Mingming Zhang
- Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Edwin S Y Chan
- Cochrane Singapore, Singapore Clinical Research Institute, Consortium for Clinical Research & Innovation Singapore, Singapore, Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Joey S W Kwong
- United Nations Population Fund Asia and the Pacific Regional Office, Bangkok, Thailand
| | - Akiko Okumura
- Medical Information Network Distribution Service (MINDS) Guideline Centre, Tokyo, Japan
| | - Qi Zhou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, 730000, China.
| | | |
Collapse
|
43
|
Zhou Q, Li W, Zhao S, Li Q, Shi Q, Wang Z, Liu H, Liu X, Estill J, Luo Z, Li Q, Yang K, Liu E, Chen Y. Guidelines for the Management of Children and Adolescent with COVID-19: protocol for an update. Transl Pediatr 2021; 10:177-182. [PMID: 33633950 PMCID: PMC7882303 DOI: 10.21037/tp-20-290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has become a constant threat to people's lives, bringing huge challenges to the global public health and medical service system. In order to ensure the timeliness and reliability of the recommendations in guidelines, the working group of the Rapid Advice Guidelines for Management of Children with COVID-19 decided to update the guideline to incorporate the latest evidence to guide the management of COVID-19 in children and adolescent. METHODS We will update the guidelines, originally developed as a rapid advice guideline, into a standard guideline. We will follow the clinical practice guideline (CPG) update manuals of the National Institute for Health and Clinical Excellence (NICE) and the Spanish National Health System (SNHS). The updated guidelines will also follow the RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist and Checklist for the Reporting of Updated Guidelines (CheckUp). DISCUSSION Through systematic search, evaluation and grading of the best available relevant clinical evidence, combined with the experience of frontline clinical experts in the fight against the epidemic and the wishes of patients and their caretakers, we will update our previous rapid advice guidelines into a high-quality, implementable standard guidelines for the management of COVID-19 in children and adolescent. TRIAL REGISTRATION The standard guideline update has been registered at the International Practice Guidelines Registry Platform (http://guidelines-registry.cn/?lang=en, registration No. IPGRP-2020CN101).
Collapse
Affiliation(s)
- Qi Zhou
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.,Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Weiguo Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Siya Zhao
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qinyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Zijun Wang
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Hui Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiao Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qiu Li
- Department of Nephrology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Kehu Yang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.,Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.,GIN Asia, Lanzhou, China.,Chinese GRADE Centre, Lanzhou, China.,Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China.,Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yaolong Chen
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.,GIN Asia, Lanzhou, China.,Chinese GRADE Centre, Lanzhou, China.,Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou, China.,Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
| |
Collapse
|
44
|
Yang S, Feng X, Du P, He D, Estill J, Yang L, Wen C, Luo J, Wang X, Lu L, Li T, Tang X, Li W, Xu H, Liu E, Cao P, Chen Y. Family exposure and the impact of containment measures to children with coronavirus disease 2019 outside Hubei, China: a cross-sectional study. Transl Pediatr 2021; 10:92-102. [PMID: 33633941 PMCID: PMC7882296 DOI: 10.21037/tp-20-214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/13/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In response to the ongoing epidemic of coronavirus disease 2019 (COVID-19), China has carried out restrictive disease containment measures across the country. METHODS In this cross-sectional study, we collected demographic and epidemiological data of 376 laboratory-confirmed cases of COVID-19 among children younger than 18 years of age. Using descriptive statistics and odds ratios, we described the odds of exposure outside the family after the implementation of control measures compared to before. RESULTS Children diagnosed on or after February 4, 2020, had a lower odds of exposure to COVID-19 outside of the family compared to those diagnosed before February 3, 2020 (OR =0.594, 95% CI: 0.391 to 0.904). In the stratified analysis, children aged 0 to 5 years had the lowest odds of exposure outside of the family (OR =0.420, 95% CI: 0.196 to 0.904) compared to the other age groups assessed. CONCLUSIONS Our study on the children infected with COVID-19 as well as their exposure within family provided evidence that the implementation of containment measures was effective in reducing the odds of exposure outside of the family, especially for preschool children. Continuation of these efforts, coupled with tailored prevention and health education messaging for younger aged children, may help to reduce the transmission of COVID-19 among children until other therapeutic interventions or vaccines are available.
Collapse
Affiliation(s)
- Shu Yang
- College of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Digital Institute of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xixi Feng
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Peipei Du
- Digital Institute of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Lin Yang
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Chuanbiao Wen
- College of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Digital Institute of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiawei Luo
- West China Biomedical Big Data Center, West China Clinical Medical College of Sichuan University, Chengdu, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Liqun Lu
- Department of Pediatric, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Tingting Li
- School of Pharmacy, Chengdu Medical College, Chengdu, China
| | - Xiujuan Tang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Weiguo Li
- National Clinical Research Center for Child Health and Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Hongmei Xu
- National Clinical Research Center for Child Health and Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Enmei Liu
- National Clinical Research Center for Child Health and Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Peihua Cao
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
- GIN (Guidelines International Network) Asia, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China
| |
Collapse
|
45
|
Zhang X, Lv M, Luo X, Estill J, Wang L, Ren M, Liu Y, Feng Z, Wang J, Wang X, Chen Y. Egg consumption and health outcomes: a global evidence mapping based on an overview of systematic reviews. Ann Transl Med 2020; 8:1343. [PMID: 33313088 PMCID: PMC7723562 DOI: 10.21037/atm-20-4243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Several systematic reviews and meta-analyses have assessed the association between egg consumption and human health, but the evidence is often conflicting. Methods We conducted a systematic literature search to find all systematic reviews and meta-analyses that assess the association between egg consumption and any type of health outcome. We used AMSTAR to evaluate the methodological quality of the reviews, and GRADE to determine the quality of evidence. We visualized the results using a human anatomy diagram and evidence mapping. Results Our search revealed 29 systematic reviews and meta-analyses. Eight studies were of high methodological quality, 16 studies of medium quality, and five studies of low quality. We identified 34 primary outcomes from the included 29 reviews, which were combined into a total of 22 different health outcomes. Two of the primary outcomes were based on high-quality evidence, 18 on moderate-quality evidence, and 14 on low-quality evidence. Egg consumption was associated with an increased risk of two diseases and decreased risk of six outcomes. For ten outcomes, no significant association was found, and for four outcomes, different reviews came to conflicting conclusions. Conclusions The association between egg consumption and the risk of cancer, diabetes, cardiovascular diseases and other related diseases has been studied in several meta-analyses. The evidence from different studies on the same topic was often conflicting, which can complicate the making of dietary recommendations.
Collapse
Affiliation(s)
- Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Meng Lv
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Ling Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Mengjuan Ren
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunlan Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Ziyun Feng
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Jianjian Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
| |
Collapse
|
46
|
Yu Y, Wang D, Zhou Q, Wang C, Ma X, Gao Y, Song X, Xiao S, Wang Q, Zeng X, Estill J, Qian Z, Chen Y. Recommendations in clinical practice guidelines on gout: systematic review and consistency analysis. Clin Exp Rheumatol 2020; 38:964-972. [PMID: 31969230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To compare and analyse the recommendations from clinical practice guidelines (CPGs) on gout worldwide, examine the consistency across CPGs, and provide suggestions to develop and update gout guidelines. METHODS We conducted systematic searches in MEDLINE, CBM, GIN, NICE, NGC, WHO, SIGN, DynaMed, UpToDate, and Best Practice databases, from their inception to August 2019 to identify and select CPGs related to gout. We used the search terms "gout", "hyperuricaemia" and "guideline". After two rounds of screening, we included the eligible CPGs of gout according to the pre-defined inclusion and exclusion criteria. Methodological quality of included guidelines was assessed with the AGREE-II instrument. The general characteristics of included guidelines and the recommendations were extracted, and the consistency of recommendations across guidelines was compared and analysed. RESULTS A total of 15 gout guidelines including 359 recommendations were retrieved. The main topics covered by the recommendations were diagnosis, pharmacologic treatment of gout flares, pharmacologic urate-lowering therapy (ULT) of chronic gouty arthritis, lifestyle interventions, prophylaxis, and management of asymptomatic hyperuricaemia. The results of AGREE-II appraisal showed that only two guidelines achieved high scores (≥50%) in all six domains. There was substantial discrepancy between the guidelines in recommendations covering the value of computed tomography (CT) and x-rays for diagnosis, the use of corticosteroids as a first-line treatment for flare, the use of colchicine, indications for ULT, the use of febuxostat as first-line ULT, the administration of allopurinol, and the timing of ULT initiation. CONLUSIONS A number of countries are devoting themselves to the development of gout guidelines, but the process of updating guidelines is slower than that suggested by the WHO. Methodological quality is not satisfactory in most guidelines, and recommendations between guidelines are not consistent.
Collapse
Affiliation(s)
- Yang Yu
- Department of Tumour Surgery, Lanzhou University Second Hospital, and The Second Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Dongke Wang
- The First Clinical Medical College of Lanzhou University, China
| | - Qi Zhou
- The First Clinical Medical College of Lanzhou University, China
| | - Chunyu Wang
- Department of Endocrine & Rheumatology, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA, Lanzhou, China
| | - Xiaoting Ma
- School of Public health, Lanzhou University, China
| | - Yuting Gao
- The First Clinical Medical College of Lanzhou University, China
| | - Xiaoyang Song
- The First Clinical Medical College of Lanzhou University, China
| | - Shujun Xiao
- Department of Tumour Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Qi Wang
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, China
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, and Institute of Mathematical Statistics and Actuarial Science, University of Bern, Switzerland
| | - Zhicheng Qian
- Department of Intensive Care Unit, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
| | - Yaolong Chen
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, China.
| |
Collapse
|
47
|
Merzouki A, Styles A, Estill J, Orel E, Baranczuk Z, Petrie K, Keiser O. Identifying groups of people with similar sociobehavioural characteristics in Malawi to inform HIV interventions: a latent class analysis. J Int AIDS Soc 2020; 23:e25615. [PMID: 32985772 PMCID: PMC7521110 DOI: 10.1002/jia2.25615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/19/2020] [Accepted: 08/26/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Within many sub-Saharan African countries including Malawi, HIV prevalence varies widely between regions. This variability may be related to the distribution of population groups with specific sociobehavioural characteristics that influence the transmission of HIV and the uptake of prevention. In this study, we intended to identify groups of people in Malawi with similar risk profiles. METHODS We used data from the Demographic and Health Survey in Malawi (2015 to 2016), and stratified the analysis by sex. We considered demographic, socio-behavioural and HIV-related variables. Using Latent Class Analysis (LCA), we identified groups of people sharing common sociobehavioural characteristics. The optimal number of classes (groups) was selected based on the Bayesian information criterion. We compared the proportions of individuals belonging to the different groups across the three regions and 28 districts of Malawi. RESULTS We found nine groups of women and six groups of men. Most women in the groups with highest risk of being HIV positive were living in female-headed households and were formerly married or in a union. Among men, older men had the highest risk of being HIV positive, followed by young (20 to 25) single men. Generally, low HIV testing uptake correlated with lower risk of having HIV. However, rural adolescent girls had a low probability of being tested (48.7%) despite a relatively high HIV prevalence. Urban districts and the Southern region had a higher percentage of high-prevalence and less tested groups of individuals than other areas. CONCLUSIONS LCA is an efficient method to find groups of people sharing common HIV risk profiles, identify particularly vulnerable sub-populations, and plan targeted interventions focusing on these groups. Tailored support, prevention and HIV testing programmes should focus particularly on female household heads, adolescent girls living in rural areas, older married men and young men who have never been married.
Collapse
Affiliation(s)
- Aziza Merzouki
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
| | | | - Janne Estill
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Institute of Mathematical Statistics and Actuarial ScienceUniversity of BernBernSwitzerland
| | - Erol Orel
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
| | - Zofia Baranczuk
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
- Department of PsychologyUniversity of ZurichZurichSwitzerland
- Institute of MathematicsUniversity of ZurichZurichSwitzerland
| | | | - Olivia Keiser
- Institute of Global HealthUniversity of GenevaGenevaSwitzerland
| |
Collapse
|
48
|
Luo X, Estill J, Wang Q, Lv M, Liu Y, Liu E, Chen Y. The psychological impact of quarantine on coronavirus disease 2019 (COVID-19). Psychiatry Res 2020; 291:113193. [PMID: 32544708 PMCID: PMC7831766 DOI: 10.1016/j.psychres.2020.113193] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Xufei Luo
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Janne Estill
- Institute of Global Health, University of Geneva, 1202 Geneva, Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meng Lv
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunlan Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China; National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yaolong Chen
- School of Public Health, Lanzhou University, Lanzhou, China; Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.
| |
Collapse
|
49
|
Estill J, Venkova-Marchevska P, Roelens M, Orel E, Temerev A, Flahault A, Keiser O. Future scenarios for the SARS-CoV-2 epidemic in Switzerland: an age-structured model. F1000Res 2020; 9:646. [PMID: 34631035 PMCID: PMC8477351 DOI: 10.12688/f1000research.24497.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/20/2022] Open
Abstract
The recent lifting of COVID-19 related restrictions in Switzerland causes uncertainty about the future of the epidemic. We developed a compartmental model for SARS-CoV-2 transmission in Switzerland and projected the course of the epidemic until the end of year 2020 under various scenarios. The model was age-structured with three categories: children (0-17), adults (18-64) and seniors (65- years). Lifting all restrictions according to the plans disclosed by the Swiss federal authorities by mid-May resulted in a rapid rebound in the epidemic, with the peak expected in July. Measures equivalent to at least 76% reduction in all contacts were able to eradicate the epidemic; a 54% reduction in contacts could keep the intensive care unit occupancy under the critical level and delay the next wave until October. In scenarios where strong contact reductions were only applied in selected age groups, the epidemic could not be suppressed, resulting in an increased risk of a rebound in July, and another stronger wave in September. Future interventions need to cover all age groups to keep the SARS-CoV-2 epidemic under control.
Collapse
Affiliation(s)
- Janne Estill
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, BE, 3012, Switzerland
| | | | - Maroussia Roelens
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland
| | - Erol Orel
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland
| | - Alexander Temerev
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland
| | - Antoine Flahault
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, GE, 1202, Switzerland
| |
Collapse
|
50
|
Liu E, Smyth RL, Luo Z, Qaseem A, Mathew JL, Lu Q, Fu Z, Zhao X, Zhao S, Estill J, Chan ESY, Liu L, Qian Y, Xu H, Wang Q, Fukuoka T, Luo X, Wong GWK, Lei J, Nurdiati D, Tu W, Zhang X, Zheng X, Ahn HS, Wang M, Dong X, Wu L, Lee MS, Li G, Yang S, Feng X, Zhao R, Lu X, He Z, Liu S, Li W, Zhou Q, Ren L, Chen Y, Li Q. Erratum to rapid advice guidelines for management of children with COVID-19. Ann Transl Med 2020; 8:807. [PMID: 32647730 PMCID: PMC7333161 DOI: 10.21037/atm-2020-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Enmei Liu
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Rosalind L Smyth
- UCL Great Ormond St Institute of Child Health, London, UK.,Great Ormond Street Hospital, London, UK
| | - Zhengxiu Luo
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Amir Qaseem
- Clinical Policy and Center for Evidence Reviews, American College of Physicians, Philadelphia, PA, USA
| | - Joseph L Mathew
- Advanced Pediatrics Centre, PGIMER Chandigarh, Chandigarh, India
| | - Quan Lu
- Shanghai Children's Hospital affiliated to Shanghai Jiaotong University, Shanghai 200240, China
| | - Zhou Fu
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xiaodong Zhao
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | | | - Janne Estill
- Institute of Global Health, University of Geneva, Geneva, Switzerland.,Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Edwin Shih-Yen Chan
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-National University of Singapore Medical School, Singapore.,Singapore Clinical Research Institute, Singapore
| | - Lei Liu
- National Clinical Research Center for Infectious Disease, Shenzhen 518020, China.,Shenzhen Third People's Hospital, Shenzhen 518112, China
| | - Yuan Qian
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing 100020, China
| | - Hongmei Xu
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qi Wang
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.,McMaster Health Forum, McMaster University, Hamilton, Canada
| | - Toshio Fukuoka
- Emergency and Critical Care Center, the Department of General Medicine, Department of Research and Medical Education, Kurashiki Central Hospital, Okayama, Japan.,Advisory Committee in Cochrane Japan, Tokyo, Japan
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Gary Wing-Kin Wong
- Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Junqiang Lei
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Detty Nurdiati
- Clinical Epidemiology & Biostatistics Unit, Department of Obstetrics & Gynaecology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Wenwei Tu
- Department of Pediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Xiaobo Zhang
- Children's Hospital of Fudan University, Shanghai 201102, China
| | - Xianlan Zheng
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University, Seoul, Korea.,Korea Cochrane Centre, Seoul, Korea.,Evidence Based Medicine, Seoul, Korea.,Korea University School of Medicine, Seoul, Korea
| | - Mengshu Wang
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Xiaoyan Dong
- Shanghai Children's Hospital, Shanghai 200040, China
| | - Liqun Wu
- Shenzhen Health Development Research Center, Shenzhen 518028, China
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea.,University of Science and Technology, Daejeon, Korea.,London Southbank University, London, UK.,Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Guobao Li
- National Clinical Research Center for Infectious Disease, Shenzhen 518020, China.,Shenzhen Third People's Hospital, Shenzhen 518112, China
| | - Shu Yang
- College of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.,Digital Institute of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xixi Feng
- Department of Public Health, Chengdu Medical College, Chengdu 610500, China
| | - Ruiqiu Zhao
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Xiaoxia Lu
- Department of Respiratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430015, China
| | - Zhihui He
- Chongqing Ninth People's Hospital, Chongqing 400700, China
| | - Shihui Liu
- Beijing Jishuitan Hospital, Beijing 100035, China
| | - Weiguo Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Qi Zhou
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Luo Ren
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| | - Yaolong Chen
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China.,GIN Asia, Lanzhou 730000, China.,Chinese GRADE Centre, Lanzhou 730000, China.,Lanzhou University, an Affiliate of the Cochrane China Network, Lanzhou 730000, China.,Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Qiu Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Children's Hospital of Chongqing Medical University, Chongqing 400014, China.,Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
| |
Collapse
|