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Ofori SK, Schwind JS, Sullivan KL, Chowell G, Cowling BJ, Fung ICH. Modeling the health impact of increasing vaccine coverage and nonpharmaceutical interventions against coronavirus disease 2019 in Ghana. Pathog Glob Health 2024:1-15. [PMID: 38318877 DOI: 10.1080/20477724.2024.2313787] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Seroprevalence studies assessing community exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ghana concluded that population-level immunity remained low as of February 2021. Thus, it is important to demonstrate how increasing vaccine coverage reduces the economic and public health impacts associated with SARS-CoV-2 transmission. To that end, this study used a Susceptible-Exposed-Presymptomatic-Symptomatic-Asymptomatic-Recovered-Dead-Vaccinated compartmental model to simulate coronavirus disease 2019 (COVID-19) transmission and the role of public health interventions in Ghana. The impact of increasing vaccination rates and decline in transmission rates due to nonpharmaceutical interventions (NPIs) on cumulative infections and deaths averted was explored under different scenarios. Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC) was used to investigate the uncertainty and sensitivity of the outcomes to the parameters. Simulation results suggest that increasing the vaccination rate to achieve 50% coverage was associated with almost 60,000 deaths and 25 million infections averted. In comparison, a 50% decrease in the transmission coefficient was associated with the prevention of about 150,000 deaths and 50 million infections. The LHS-PRCC results indicated that in the context of vaccination rate, cumulative infections and deaths averted were most sensitive to vaccination rate, waning immunity rates from vaccination, and waning immunity from natural infection. This study's findings illustrate the impact of increasing vaccination coverage and/or reducing the transmission rate by NPI adherence in the prevention of COVID-19 infections and deaths in Ghana.
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Affiliation(s)
- Sylvia K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Jessica S Schwind
- Institute for Health Logistics & Analytics, Georgia Southern University, Statesboro, Georgia
| | - Kelly L Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
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2
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Muniz-Rodriguez K, Schwind JS, Yin J, Liang H, Chowell G, Fung ICH. Exploring Social Media Network Connections to Assist During Public Health Emergency Response: A Retrospective Case-Study of Hurricane Matthew and Twitter Users in Georgia, USA. Disaster Med Public Health Prep 2023; 17:e315. [PMID: 36799713 DOI: 10.1017/dmp.2022.285] [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] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To assist communities who suffered from hurricane-inflicted damages, emergency responders may monitor social media messages. We present a case-study using the event of Hurricane Matthew to analyze the results of an imputation method for the location of Twitter users who follow school and school districts in Georgia, USA. METHODS Tweets related to Hurricane Matthew were analyzed by content analysis with latent Dirichlet allocation models and sentiment analysis to identify needs and sentiment changes over time. A hurdle regression model was applied to study the association between retweet frequency and content analysis topics. RESULTS Users residing in counties affected by Hurricane Matthew posted tweets related to preparedness (n = 171; 16%), awareness (n = 407; 38%), call-for-action or help (n = 206; 19%), and evacuations (n = 93; 9%), with mostly a negative sentiment during the preparedness and response phase. Tweets posted in the hurricane path during the preparedness and response phase were less likely to be retweeted than those outside the path (adjusted odds ratio: 0.95; 95% confidence interval: 0.75, 1.19). CONCLUSIONS Social media data can be used to detect and evaluate damages of communities affected by natural disasters and identify users' needs in at-risk areas before the event takes place to aid during the preparedness phases.
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Affiliation(s)
- Kamalich Muniz-Rodriguez
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
- Ponce Research Institute, Ponce Medical School Foundation, Ponce, Puerto Rico
| | - Jessica S Schwind
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jingjing Yin
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Hai Liang
- School of Journalism and Communication, The Chinese University of Hong Kong, Hong Kong
| | - Gerardo Chowell
- Department of Population Health Sciences, Georgia State University, Atlanta, GA, USA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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3
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Ofori SK, Schwind JS, Sullivan KL, Chowell G, Cowling BJ, Fung ICH. Age-Stratified Model to Assess Health Outcomes of COVID-19 Vaccination Strategies, Ghana. Emerg Infect Dis 2023; 29:360-370. [PMID: 36626878 PMCID: PMC9881782 DOI: 10.3201/eid2902.221098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We assessed the effect of various COVID-19 vaccination strategies on health outcomes in Ghana by using an age-stratified compartmental model. We stratified the population into 3 age groups: <25 years, 25-64 years, and ≥65 years. We explored 5 vaccination optimization scenarios using 2 contact matrices, assuming that 1 million persons could be vaccinated in either 3 or 6 months. We assessed these vaccine optimization strategies for the initial strain, followed by a sensitivity analysis for the Delta variant. We found that vaccinating persons <25 years of age was associated with the lowest cumulative infections for the main matrix, for both the initial strain and the Delta variant. Prioritizing the elderly (≥65 years of age) was associated with the lowest cumulative deaths for both strains in all scenarios. The consensus between the findings of both contact matrices depended on the vaccine rollout period and the objective of the vaccination program.
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Napit R, Manandhar P, Chaudhary A, Shrestha B, Poudel A, Raut R, Pradhan S, Raut S, Rajbhandari PG, Gurung A, Rajbhandari RM, Dixit SM, Schwind JS, Johnson CK, Mazet JK, Karmacharya DB. Rapid genomic surveillance of SARS-CoV-2 in a dense urban community of Kathmandu Valley using sewage samples. PLoS One 2023; 18:e0283664. [PMID: 36996055 PMCID: PMC10062583 DOI: 10.1371/journal.pone.0283664] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Understanding disease burden and transmission dynamics in resource-limited, low-income countries like Nepal are often challenging due to inadequate surveillance systems. These issues are exacerbated by limited access to diagnostic and research facilities throughout the country. Nepal has one of the highest COVID-19 case rates (915 cases per 100,000 people) in South Asia, with densely-populated Kathmandu experiencing the highest number of cases. Swiftly identifying case clusters (hotspots) and introducing effective intervention programs is crucial to mounting an effective containment strategy. The rapid identification of circulating SARS-CoV-2 variants can also provide important information on viral evolution and epidemiology. Genomic-based environmental surveillance can help in the early detection of outbreaks before clinical cases are recognized and identify viral micro-diversity that can be used for designing real-time risk-based interventions. This research aimed to develop a genomic-based environmental surveillance system by detecting and characterizing SARS-CoV-2 in sewage samples of Kathmandu using portable next-generation DNA sequencing devices. Out of 22 sites in the Kathmandu Valley from June to August 2020, sewage samples from 16 (80%) sites had detectable SARS-CoV-2. A heatmap was created to visualize the presence of SARS-CoV-2 infection in the community based on viral load intensity and corresponding geospatial data. Further, 47 mutations were observed in the SARS-CoV-2 genome. Some detected mutations (n = 9, 22%) were novel at the time of data analysis and yet to be reported in the global database, with one indicating a frameshift deletion in the spike gene. SNP analysis revealed possibility of assessing circulating major/minor variant diversity on environmental samples based on key mutations. Our study demonstrated the feasibility of rapidly obtaining vital information on community transmission and disease dynamics of SARS-CoV-2 using genomic-based environmental surveillance.
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Affiliation(s)
- Rajindra Napit
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Prajwol Manandhar
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Ashok Chaudhary
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Bishwo Shrestha
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Ajit Poudel
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Roji Raut
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Saman Pradhan
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Samita Raut
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Pragun G Rajbhandari
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Anupama Gurung
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Rajesh M Rajbhandari
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
| | - Sameer M Dixit
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
| | - Jessica S Schwind
- Institute for Health Logistics & Analytics, Georgia Southern University, Statesboro, GA, United States of America
| | - Christine K Johnson
- One Health Institute, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States of America
| | - Jonna K Mazet
- One Health Institute, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States of America
| | - Dibesh B Karmacharya
- One Health Research Division, Center for Molecular Dynamics Nepal, Thapathali-11, Kathmandu, Nepal
- Virology Division, BIOVAC Nepal Pvt. Ltd., Nala, Banepa, Nepal
- The School of Biological Sciences, University of Queensland, Brisbane, Australia
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Ofori SK, Schwind JS, Sullivan KL, Cowling BJ, Chowell G, Fung ICH. Transmission Dynamics of COVID-19 in Ghana and the Impact of Public Health Interventions. Am J Trop Med Hyg 2022; 107:tpmd210718. [PMID: 35605636 PMCID: PMC9294683 DOI: 10.4269/ajtmh.21-0718] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
This study characterized COVID-19 transmission in Ghana in 2020 and 2021 by estimating the time-varying reproduction number (Rt) and exploring its association with various public health interventions at the national and regional levels. Ghana experienced four pandemic waves, with epidemic peaks in July 2020 and January, August, and December 2021. The epidemic peak was the highest nationwide in December 2021 with Rt ≥ 2. Throughout 2020 and 2021, per-capita cumulative case count by region increased with population size. Mobility data suggested a negative correlation between Rt and staying home during the first 90 days of the pandemic. The relaxation of movement restrictions and religious gatherings was not associated with increased Rt in the regions with fewer case burdens. Rt decreased from > 1 when schools reopened in January 2021 to < 1 after vaccination rollout in March 2021. Findings indicated most public health interventions were associated with Rt reduction at the national and regional levels.
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Affiliation(s)
- Sylvia K. Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Jessica S. Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Kelly L. Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Benjamin J. Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
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Evans HI, Handberry MT, Muniz-Rodriguez K, Schwind JS, Liang H, Adhikari BB, Meltzer MI, Fung ICH. Winter Storms and Unplanned School Closure Announcements on Twitter: Comparison Between the States of Massachusetts and Georgia, 2017-2018. Disaster Med Public Health Prep 2022; 17:e132. [PMID: 35400357 PMCID: PMC10875728 DOI: 10.1017/dmp.2022.41] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This project aimed to quantify and compare Massachusetts and Georgia public school districts' 2017-2018 winter-storm-related Twitter unplanned school closure announcements (USCA). METHODS Public school district Twitter handles and National Center for Education Statistics data were obtained for Georgia and Massachusetts. Tweets were retrieved using Twitter application programming interface. Descriptive statistics and regression analyses were conducted to compare the rates of winter-storm-related USCA. RESULTS Massachusetts had more winter storms than Georgia during the 2017-2018 winter season, but Massachusetts school districts posted winter-storm-related USCA at a 60% lower rate per affected day (adjusted rate ratio, aRR = 0.40, 95% confidence intervals, CI: 0.30, 0.52) than Georgia school districts after controlling for the student enrollments and Twitter followers count per Twitter account. A 10-fold increase in followers count was correlated with a 118% increase in USCA rate per affected day (aRR = 2.18; 95% CI: 1.74, 2.75). Georgia school districts had a higher average USCA tweet rate per winter-storm-affected day than Massachusetts school districts. A higher number of Twitter followers was associated with a higher number of USCA tweets per winter-storm-affected day. CONCLUSION Twitter accounts of school districts in Massachusetts had a lower tweet rate for USCA per winter-storm-affected days than those in Georgia.
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Affiliation(s)
- Haley I. Evans
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Maya T. Handberry
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kamalich Muniz-Rodriguez
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jessica S. Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Hai Liang
- School of Journalism and Communication, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Bishwa B. Adhikari
- Health Economics and Modeling Unit, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martin I. Meltzer
- Health Economics and Modeling Unit, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
- Health Economics and Modeling Unit, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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7
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Ofori SK, Hung YW, Schwind JS, Muniz-Rodriguez K, Kakou RJ, Alade SE, Diallo K, Sullivan KL, Cowling BJ, Fung ICH. The use of digital technology to improve and monitor handwashing among children 12 years or younger in educational settings: a scoping review. Int J Environ Health Res 2022; 32:547-564. [PMID: 32579032 DOI: 10.1080/09603123.2020.1784398] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Our scoping review aimed to identify and describe the application of digital technology in hand hygiene research among children in educational settings. We searched for articles in PubMed, IEEE Xplore, and Web of Science. Original hand hygiene research with a form of digital technology used among children ≤12 years in educational settings was eligible for inclusion. Twelve studies met the eligibility criteria and the data were extracted by two teams of independent co-authors for narrative synthesis. Ten studies used digital technology as an intervention tool and two for monitoring purposes. Three main digital technologies were identified including computer games (n = 2), videos (n = 8), and video cameras (n = 2). Digital technologies found in our scoping review were reported to be effective in hand hygiene studies over short temporal periods especially when used in combination with other measures. Future research may demonstrate the effectiveness of digital technology in helping children develop sustainable handwashing behaviors.
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Affiliation(s)
- Sylvia K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Yuen Wai Hung
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jessica S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kamalich Muniz-Rodriguez
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Reece J Kakou
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Sunmisola E Alade
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kadiatou Diallo
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kelly L Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region
| | - I C H Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Ofori SK, Hung YW, Schwind JS, Diallo K, Babatunde D, Nwaobi SO, Hua X, Sullivan KL, Cowling BJ, Chowell G, Fung ICH. Economic evaluations of interventions against influenza at workplaces: systematic review. Occup Med (Lond) 2021; 72:70-80. [PMID: 34931675 DOI: 10.1093/occmed/kqab163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/13/2022] Open
Abstract
BACKGROUND The burden of influenza is mostly felt by employees and employers because of increased absenteeism rates, loss of productivity and associated direct costs. Even though interventions against influenza among working adults are effective, patronage and compliance to these measures especially vaccination are low compared to other risk groups. AIMS This study was aimed to assess evidence of economic evaluations of interventions against influenza virus infection among workers or in the workplace setting. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline for systematic reviews was followed. Three databases, PubMed, Web of Science and EconLit, were searched using keywords to identify relevant articles from inception till 25 October 2020. Original peer-reviewed papers that conducted economic evaluations of influenza interventions using cost-benefit, cost-effectiveness or cost-utility analysis methods focused on working-age adults or work settings were eligible for inclusion. Two independent teams of co-authors extracted and synthesized data from identified studies. RESULTS Twenty-four articles were included: 21 were cost-benefit analyses and 3 examined cost-effectiveness analyses. Two papers also presented additional cost-utility analysis. Most of the studies were pharmaceutical interventions (n = 23) primarily focused on vaccination programs while one study was a non-pharmaceutical intervention examining the benefit of paid sick leave. All but two studies reported that interventions against influenza virus infection at the workplace were cost-saving and cost-effective regardless of the analytic approach. CONCLUSIONS Further cost-effectiveness research in non-pharmaceutical interventions against influenza in workplace settings is warranted. There is a need to develop standardized methods for reporting economic evaluation methods to ensure comparability and applicability of future research findings.
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Affiliation(s)
- S K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Y W Hung
- Salient Advisory, Toronto, Ontario, Canada
| | - J S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - K Diallo
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - D Babatunde
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - S O Nwaobi
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - X Hua
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - K L Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - B J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - G Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - I C H Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Tome J, Richmond HL, Rahman M, Karmacharya D, Schwind JS. Climate change and health vulnerability in Nepal: A systematic review of the literature since 2010. Glob Public Health 2021; 17:1406-1419. [PMID: 34061709 DOI: 10.1080/17441692.2021.1924824] [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: 10/21/2022]
Abstract
The Nepali population is among those most vulnerable to the health impacts of climate change. We conducted a systematic literature review to document the health effects of climate change in Nepal and identify knowledge gaps by examining vulnerability categories related to health. Three databases were searched for journal articles that addressed health and vulnerability related to climate change in Nepal from 2010 onwards. Of the 1063 articles identified, 37 were eligible for inclusion. The findings suggested the health of the population was affected mostly by food insecurity, floods, droughts, and reduced water levels. Studies revealed both morbidity and mortality increased due to climate change, with the most impacted populations being women, children, and the elderly. At greatest risk for impacts from climate change were those from poor and marginal populations, especially impoverished women. The public health sector, healthcare, and potable water sources were some of the least mentioned vulnerability subcategories, indicating more research is needed to better understand their adaptation capacities. We propose that identifying vulnerabilities and areas of limited research are critical steps in the prioritization of health policy and interventions for the most vulnerable populations in Nepal.
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Affiliation(s)
- Joana Tome
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Georgia Southern University, Statesboro, Georgia, USA
| | - Holly L Richmond
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Georgia Southern University, Statesboro, Georgia, USA
| | - Munshi Rahman
- Department of Geology and Geography, Georgia Southern University, Statesboro, Georgia, USA
| | | | - Jessica S Schwind
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Georgia Southern University, Statesboro, Georgia, USA
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10
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Muniz-Rodriguez K, Chowell G, Schwind JS, Ford R, Ofori SK, Ogwara CA, Davies MR, Jacobs T, Cheung CH, Cowan LT, Hansen AR, Chun-Hai Fung I. Time-varying Reproduction Numbers of COVID-19 in Georgia, USA, March 2, 2020 to November 20, 2020. Perm J 2021; 25:20.232. [PMID: 33970085 PMCID: PMC8784042 DOI: 10.7812/tpp/20.232] [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: 08/22/2020] [Revised: 12/16/2020] [Accepted: 12/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2020, Severe Acute Respiratory Syndrome Coronavirus 2 impacted Georgia, USA. Georgia announced a state-wide shelter-in-place on April 2 and partially lifted restrictions on April 27. We estimated the time-varying reproduction numbers (Rt) of COVID-19 in Georgia, Metro Atlanta, and Dougherty County and environs from March 2, 2020, to November 20, 2020. METHODS We analyzed the daily incidence of confirmed COVID-19 cases in Georgia, Metro Atlanta, and Dougherty County and its surrounding counties, and estimated Rt using the R package EpiEstim. We used a 9-day correction for the date of report to analyze the data by assumed date of infection. RESULTS The median Rt estimate in Georgia dropped from between 2 and 4 in mid-March to < 2 in late March to around 1 from mid-April to November. Regarding Metro Atlanta, Rt fluctuated above 1.5 in March and around 1 since April. In Dougherty County, the median Rt declined from around 2 in late March to 0.32 on April 26. Then, Rt fluctuated around 1 in May through November. Counties surrounding Dougherty County registered an increase in Rt estimates days after a superspreading event occurred in the area. CONCLUSIONS In Spring 2020, Severe Acute Respiratory Syndrome Coronavirus 2 transmission in Georgia declined likely because of social distancing measures. However, because restrictions were relaxed in late April and elections were conducted in November, community transmission continued, with Rt fluctuating around 1 across Georgia, Metro Atlanta, and Dougherty County as of November 2020. The superspreading event in Dougherty County affected surrounding areas, indicating the possibility of local transmission in neighboring counties.
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Affiliation(s)
- Kamalich Muniz-Rodriguez
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Gerardo Chowell
- Department of Population Health Sciences,
School of Public Health,
Georgia State University,
Atlanta,
GA
| | - Jessica S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Randall Ford
- Department of Community Health and Health Policy,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Sylvia K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Chigozie A Ogwara
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Margaret R Davies
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Terrence Jacobs
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Chi-Hin Cheung
- Independent researcher,
Hong Kong Special Administrative Region
| | - Logan T Cowan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Andrew R Hansen
- Department of Community Health and Health Policy,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences,
Jiann-Ping Hsu College of Public Health,
Georgia Southern University,
Statesboro,
GA
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11
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Nguyen TH, Shah GH, Schwind JS, Richmond HL. Community Characteristics and COVID-19 Outcomes: A Study of 159 Counties in Georgia, United States. J Public Health Manag Pract 2021; 27:251-257. [PMID: 33762540 DOI: 10.1097/phh.0000000000001330] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic affects population groups differently, worsening existing social, economic, and health inequities. PURPOSE This study examined 159 counties within Georgia to identify community characteristics associated with county-level COVID-19 case, hospitalization, and death rates. METHODS Data from the 2020 County Health Rankings, the 2010 US Census, and the Georgia Department of Public Health COVID-19 Daily Status Report were linked using county Federal Information Processing Standard codes and evaluated through multivariable linear regression models. RESULTS The percentages of children in poverty, severe housing problems, and people not proficient in the English language were significant predictors associated with increases in case, hospitalization, and death rates. Diabetic prevalence was significantly associated with increases in the hospitalization and death rates; in contrast, the percentages of people with excessive drinking and female were inversely associated with hospitalization and death rates. Other independent variables showing an association with death rate included the percentages of people reporting fair or poor health and American Indian/Alaska Native. IMPLICATION Local authorities' proper allocation of resources and plans to address community social determinants of health are essential to mitigate disease transmission and reduce hospitalizations and deaths associated with COVID-19, especially among vulnerable groups.
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Affiliation(s)
- Tran Ha Nguyen
- Interdisciplinary Health Sciences Department, College of Allied Health Sciences, Augusta University, Augusta, Georgia (Dr Nguyen); and Department of Biostatistics, Epidemiology, and Environmental Health Sciences (Drs Schwind and Richmond), Health Policy & Community Health Department, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia (Dr Shah)
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12
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Schwind JS, Norman SA, Rahman MK, Richmond HL, Dixit SM, Rajbhandari RM, Wagner SK, Karmacharya D. Health Reporting Characteristics among Journalists in Nepal Utilizing a One Health Framework. Int J Environ Res Public Health 2021; 18:ijerph18052784. [PMID: 33803397 PMCID: PMC7967283 DOI: 10.3390/ijerph18052784] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022]
Abstract
Journalists play a crucial role in the dissemination of health-related information. In developing countries, such as Nepal, the media are integral in shaping the national agenda and informing the public of important health issues. With an increasing need for a collaborative effort to attain optimal health for people, animals, and the environment, the One Health approach was used to characterize health reporting in Nepal. A comprehensive survey was administered to health journalists regarding their public, animal, and environmental health reporting habits. Seventy-one journalists completed the survey across three study sites. Many journalists indicated a history of reporting across all three sectors but did not routinely focus on health reporting in general. The majority of journalists perceived the quality and overall coverage of health-related topics increased over the last five years. However, few journalists reported receiving specialized training in any health sector. Although the overall quality of health reporting in the Nepali media showed improvements, many journalists acknowledged a lack of understanding of common health topics and a desire to learn more skills related to accurate health reporting. One Health provides a conceptual framework for understanding and promoting health communication through mass media to benefit humans, animals, and ecosystems.
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Affiliation(s)
- Jessica S. Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Correspondence:
| | - Stephanie A. Norman
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Marine-Med, Bothell, WA 98021, USA
| | - Munshi Khaledur Rahman
- Department of Geology and Geography, College of Science and Mathematics, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Holly L. Richmond
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
| | - Sameer M. Dixit
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
| | - Rajesh M. Rajbhandari
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
| | - Sarah K. Wagner
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (S.K.W.)
| | - Dibesh Karmacharya
- Center for Molecular Dynamics-Nepal, Kathmandu 44600, Nepal; (S.M.D.); (R.M.R.); (D.K.)
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13
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Cowan LT, Buck B, Schwind JS, Lutsey PL, Pankow JS, Matsushita K, Ishigami J, Lakshminarayan K. Triggering of cardiovascular disease by infection type: The Atherosclerosis Risk in Communities study (ARIC). Int J Cardiol 2021; 325:155-160. [PMID: 33031889 PMCID: PMC10031808 DOI: 10.1016/j.ijcard.2020.09.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/04/2020] [Revised: 09/18/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Acute infections are known triggers of cardiovascular disease (CVD) but how this association varies across infection types is unknown. We hypothesized while acute infections increase CVD risk, the strength of this association varies across infection types. METHOD Acute coronary heart disease (CHD) and ischemic stroke cases were identified in the Atherosclerosis Risk in Communities Study (ARIC). ICD-9 codes from Medicare claims were used to identify cellulitis, pneumonia, urinary tract infections (UTI), and bloodstream infections. A case-crossover design and conditional logistic regression were used to compare infection types among acute CHD and stroke cases 14, 30, 42, and 90 days before the event with two corresponding control periods (1 and 2 years prior). RESULTS Of the 1312 acute CHD cases, 116 had a UTI, 102 had pneumonia, 43 had cellulitis, and 28 had a bloodstream infection 90 days before the CHD event. Pneumonia (OR = 25.53 (9.21,70.78)), UTI (OR = 3.32 (1.93, 5.71)), bloodstream infections (OR = 5.93 (2.07, 17.00)), and cellulitis (OR = 2.58 (1.09, 6.13)) were associated with higher acute CHD risk within 14 days of infection. Of the 727 ischemic stroke cases, 12 had cellulitis, 27 had pneumonia, 56 had a UTI, and 5 had a bloodstream infection within 90 days of the stroke. Pneumonia (OR = 5.59 (1.77, 17.67)) and UTI (OR = 3.16 (1.68, 5.94)) were associated with higher stroke risk within 14 days of infection. CONCLUSIONS Patients with pneumonia, UTI, or bloodstream infection appear to be at a 2.5 to 25.5 fold elevated CVD risk following infection. Preventive therapies during this high-risk period should be considered.
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Affiliation(s)
- Logan T Cowan
- Department of Biostatistics, Epidemiology, & Environmental Health Sciences, Georgia Southern University, PO Box 7989, Statesboro, GA 30460, United States of America.
| | - Brian Buck
- Department of Biostatistics, Epidemiology, & Environmental Health Sciences, Georgia Southern University, PO Box 7989, Statesboro, GA 30460, United States of America
| | - Jessica S Schwind
- Department of Biostatistics, Epidemiology, & Environmental Health Sciences, Georgia Southern University, PO Box 7989, Statesboro, GA 30460, United States of America
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building 1300 S. 2nd St, Minneapolis, MN 55454, United States of America
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building 1300 S. 2nd St, Minneapolis, MN 55454, United States of America
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21287, United States of America
| | - Junichi Ishigami
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21287, United States of America
| | - Kamakshi Lakshminarayan
- Division of Epidemiology and Community Health, University of Minnesota, 300 West Bank Office Building 1300 S. 2nd St, Minneapolis, MN 55454, United States of America
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14
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Richmond HL, Tome J, Rochani H, Fung ICH, Shah GH, Schwind JS. The Use of Penalized Regression Analysis to Identify County-Level Demographic and Socioeconomic Variables Predictive of Increased COVID-19 Cumulative Case Rates in the State of Georgia. Int J Environ Res Public Health 2020; 17:E8036. [PMID: 33142755 PMCID: PMC7663274 DOI: 10.3390/ijerph17218036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 02/07/2023]
Abstract
Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of health that are the main drivers of health inequities. To identify the degree to which social determinants of health predict COVID-19 cumulative case rates at the county-level in Georgia, we performed a sequential, cross-sectional ecologic analysis using a diverse set of socioeconomic and demographic variables. Lasso regression was used to identify variables from collinear groups. Twelve variables correlated to cumulative case rates (for cases reported by 1 August 2020) with an adjusted r squared of 0.4525. As time progressed in the pandemic, correlation of demographic and socioeconomic factors to cumulative case rates increased, as did number of variables selected. Findings indicate the social determinants of health and demographic factors continue to predict case rates of COVID-19 at the county-level as the pandemic evolves. This research contributes to the growing body of evidence that health disparities continue to widen, disproportionality affecting vulnerable populations.
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Affiliation(s)
- Holly L. Richmond
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Joana Tome
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Haresh Rochani
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Isaac Chun-Hai Fung
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Gulzar H. Shah
- Jiann-Ping Hsu College of Public Health, Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Jessica S. Schwind
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
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15
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Schwind JS, Norman SA, Brown R, Frances RH, Koss E, Karmacharya D, Santangelo SL. Association Between Earthquake Exposures and Mental Health Outcomes in Phulpingdanda Village After the 2015 Nepal Earthquakes. Community Ment Health J 2019; 55:1103-1113. [PMID: 31102165 DOI: 10.1007/s10597-019-00404-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Received: 02/09/2018] [Accepted: 05/06/2019] [Indexed: 12/24/2022]
Abstract
In 2015, two strong earthquakes, as well as continuous, high magnitude aftershocks, struck Nepal. Phulpingdanda village was greatly impacted due to its lack of infrastructure and environmental remoteness. Adults from sampled households were surveyed 1-year later to examine the association between earthquake exposures and indicators of depression, post-traumatic stress disorder (PTSD), and resilience. Results showed 33% of surveyed residents screened positive for depression, 9% screened positive for severe PTSD, and 46% displayed moderate to high resilience. Additionally, participants experienced resource loss (100%), damaged home and goods (99%), and exposure to the grotesque (82%). Traumatic earthquake experiences related to personal harm were associated with symptoms of depression and PTSD and resource loss was associated with depressive symptoms. Earthquake experiences associated with less damage to home and goods, but greater exposure to the grotesque were associated with increased resilience. This research adds to our knowledge of the relationship between traumatic exposures and indicators of psychological distress and resilience following a disaster.
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Affiliation(s)
- Jessica S Schwind
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA. .,Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Stephanie A Norman
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Rebecca Hoffmann Frances
- Maine Behavioral Healthcare, Portland, ME, USA.,Tufts University School of Medicine, Department of Psychiatry, Boston, MA, USA
| | | | | | - Susan L Santangelo
- Tufts University School of Medicine, Department of Psychiatry, Boston, MA, USA.,Maine Medical Center Research Institute, Center for Psychiatric Research, Portland, ME, USA
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16
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Schwind JS, Formby CB, Santangelo SL, Norman SA, Brown R, Hoffman Frances R, Koss E, Karmacharya D. Earthquake exposures and mental health outcomes in children and adolescents from Phulpingdanda village, Nepal: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2018; 12:54. [PMID: 30598695 PMCID: PMC6300918 DOI: 10.1186/s13034-018-0257-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Received: 06/25/2018] [Accepted: 12/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health issues can reach epidemic proportions in developed countries after natural disasters, but research is needed to better understand the impact on children and adolescents in developing nations. METHODS A cross-sectional study was performed to examine the relationship between earthquake exposures and depression, PTSD, and resilience among children and adolescents in Phulpingdanda village in Nepal, 1 year after the 2015 earthquakes, using the Depression Self-Rating Scale for Children, Child PTSD Symptom Scale, and the Child and Youth Resilience Measure, respectively. To quantify exposure, a basic demographic and household questionnaire, including an earthquake exposure assessment tool for children and adolescents, was created. RESULTS Of the 62 respondents interviewed, 3.23% and 4.84% displayed symptomatology of depression and PTSD. A large number of respondents interviewed scored high for resiliency (80.65%). All 62 respondents were displaced from their household and witnessed severe damage of both their homes and village. The number of earthquake exposures had a strong, positive correlation with PTSD symptomatology. CONCLUSIONS Although the number of respondents who showed signs of depression and PTSD symptomatology was lower than anticipated, resilience scores were considerably higher. Future research should explore which protective factors may contribute to high resiliency in Nepali children and adolescents.
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Affiliation(s)
- Jessica S. Schwind
- 0000 0001 0657 525Xgrid.256302.0Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, Georgia 30460 USA ,0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Clara B. Formby
- 0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Susan L. Santangelo
- 0000 0004 0433 3945grid.416311.0Maine Medical Research Institute, 509 Forest Ave, Suite 200B, Portland, ME 04101 USA ,0000 0000 8934 4045grid.67033.31Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA
| | - Stephanie A. Norman
- 0000 0001 2284 9329grid.410427.4Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
| | - Rebecca Brown
- St. Joseph’s College of Maine, 278 Whites Bridge Road, Standish, ME 04084 USA
| | - Rebecca Hoffman Frances
- 0000 0000 8934 4045grid.67033.31Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111 USA ,Maine Behavioral Healthcare, 165 Lancaster Street, Portland, ME 04101 USA
| | | | - Dibesh Karmacharya
- grid.428196.0Center for Molecular Dynamics Nepal, GPO Box 21049, Kathmandu, Nepal
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17
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Schwind JS, Norman SA, Karmacharya D, Wolking DJ, Dixit SM, Rajbhandari RM, Mekaru SR, Brownstein JS. Online surveillance of media health event reporting in Nepal: digital disease detection from a One Health perspective. BMC Int Health Hum Rights 2017; 17:26. [PMID: 28934949 PMCID: PMC5609031 DOI: 10.1186/s12914-017-0134-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/03/2016] [Accepted: 09/17/2017] [Indexed: 11/18/2022]
Abstract
Background Traditional media and the internet are crucial sources of health information. Media can significantly shape public opinion, knowledge and understanding of emerging and endemic health threats. As digital communication rapidly progresses, local access and dissemination of health information contribute significantly to global disease detection and reporting. Methods Health event reports in Nepal (October 2013–December 2014) were used to characterize Nepal’s media environment from a One Health perspective using HealthMap - a global online disease surveillance and mapping tool. Event variables (location, media source type, disease or risk factor of interest, and affected species) were extracted from HealthMap. Results A total of 179 health reports were captured from various sources including newspapers, inter-government agency bulletins, individual reports, and trade websites, yielding 108 (60%) unique articles. Human health events were reported most often (n = 85; 79%), followed by animal health events (n = 23; 21%), with no reports focused solely on environmental health. Conclusions By expanding event coverage across all of the health sectors, media in developing countries could play a crucial role in national risk communication efforts and could enhance early warning systems for disasters and disease outbreaks.
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Affiliation(s)
- Jessica S Schwind
- Augusta University, Augusta, GA, USA. .,Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, 30460, Statesboro, GA, USA.
| | - Stephanie A Norman
- Augusta University, Augusta, GA, USA.,Marine-Med, Bothell, Washington, USA
| | | | - David J Wolking
- One Health Institute, University of California, Davis, California, USA
| | | | | | - Sumiko R Mekaru
- HealthMap, Boston Children's Hospital, Boston, MA, USA.,Epidemico, Inc., Boston, MA, USA
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18
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Sullivan S, Aalborg A, Basagoitia A, Cortes J, Lanza O, Schwind JS. Exploring perceptions and experiences of Bolivian health researchers with research ethics. J Empir Res Hum Res Ethics 2015; 10:185-95. [PMID: 25784714 DOI: 10.1177/1556264615576903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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]
Abstract
In Bolivia, there is increasing interest in incorporating research ethics into study procedures, but there have been inconsistent application of research ethics practices. Minimal data exist regarding the experiences of researchers concerning the ethical conduct of research. A cross-sectional study was administered to Bolivian health leaders with research experience (n = 82) to document their knowledge, perceptions, and experiences of research ethics committees and infrastructure support for research ethics. Results showed that 16% of respondents reported not using ethical guidelines to conduct their research and 66% indicated their institutions did not consistently require ethics approval for research. Barriers and facilitators to incorporate research ethics into practice were outlined. These findings will help inform a comprehensive rights-based research ethics education program in Bolivia.
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Affiliation(s)
| | | | - Armando Basagoitia
- Universidad Mayor, Real y Pontificia de San Francisco Xavier in Chuquisaca, Bolivia
| | | | - Oscar Lanza
- Universidad Mayor de San Andrés, La Paz, Bolivia
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19
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Severinsen KD, Tufton A, Hannan E, Schwind JS, Schmucker D, Cutler A. Evaluating Outcomes from an Integrated Health Service for Older Patients. Ochsner J 2015; 15:423-428. [PMID: 26730227 PMCID: PMC4679304] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Hospital-associated disability is the loss of the ability to complete one activity of daily living (ADL), with this decline occurring between the onset of acute illness and discharge from the hospital. Approximately 30% of patients who are >70 years old and admitted to hospitals are discharged with an ADL disability. Comprehensive geriatric assessment (CGA) models use a multidimensional, interdisciplinary process of diagnosis and treatment with the goal of improving outcomes and decreasing lengths of stay. METHODS A retrospective clinical audit of Ipswich Hospital's medical records included patients for random selection who were >75 years of age and had an acute admission to the Older Person Evaluation Review and Assessment (OPERA) or general medicine (GM) service from July 2012 to December 2012. Data were collected for the entire admission period on length of stay, comorbidities, allied health visits, functional ability, and delirium and dementia at admission. RESULTS Of the 267 patients evaluated, 133 were admitted to the OPERA service, and 134 were admitted to the GM service. Patients admitted to the OPERA service were significantly more ill than patients admitted to the GM service as measured by the Charlson Comorbidity Index scores (6.53 ± 1.83 vs 6.02 ± 1.96, respectively, P=0.02), Katz Index of Independence in ADL scores (3.77 ± 2.22 vs 4.72 ± 2.00, respectively, P<0.001), presence of delirium at admission (28% vs 15%, respectively, P=0.02), and presence of dementia at admission (42% vs 21%, respectively, P=0.002). However, patients in both groups had a mean acute length of stay of 4 days (P=0.33), the readmission rate was <20% for both groups (P=0.33), and the mortality rate for each group was similar (3%). CONCLUSION By showing that patients admitted to the OPERA service were more ill than patients admitted to the GM service but health outcomes were maintained, researchers hope to justify the need for such CGA models. Additional goals include garnering support for the maintenance and growth of CGA models; decreasing mortality, cost, and readmission rates; and improving the quality of life for older patients.
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Affiliation(s)
- Kyle D. Severinsen
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
| | - Anne Tufton
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
| | - Emma Hannan
- The University of Queensland School of Medicine, Brisbane, Queensland, Australia
| | - Jessica S. Schwind
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Georgia Regents University, Augusta, GA
| | - Dana Schmucker
- Department of Infection Prevention and Control, Ochsner Clinic Foundation, New Orleans, LA
| | - Allison Cutler
- Department of Geriatrics, Ipswich Hospital, Ipswich, Queensland, Australia
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20
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Schwind JS, Wolking DJ, Brownstein JS, Mazet JAK, Smith WA. Evaluation of local media surveillance for improved disease recognition and monitoring in global hotspot regions. PLoS One 2014; 9:e110236. [PMID: 25333618 PMCID: PMC4198292 DOI: 10.1371/journal.pone.0110236] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/14/2014] [Indexed: 12/22/2022] Open
Abstract
Digital disease detection tools are technologically sophisticated, but dependent on digital information, which for many areas suffering from high disease burdens is simply not an option. In areas where news is often reported in local media with no digital counterpart, integration of local news information with digital surveillance systems, such as HealthMap (Boston Children’s Hospital), is critical. Little research has been published in regards to the specific contribution of local health-related articles to digital surveillance systems. In response, the USAID PREDICT project implemented a local media surveillance (LMS) pilot study in partner countries to monitor disease events reported in print media. This research assessed the potential of LMS to enhance digital surveillance reach in five low- and middle-income countries. Over 16 weeks, select surveillance system attributes of LMS, such as simplicity, flexibility, acceptability, timeliness, and stability were evaluated to identify strengths and weaknesses in the surveillance method. Findings revealed that LMS filled gaps in digital surveillance network coverage by contributing valuable localized information on disease events to the global HealthMap database. A total of 87 health events were reported through the LMS pilot in the 16-week monitoring period, including 71 unique reports not found by the HealthMap digital detection tool. Furthermore, HealthMap identified an additional 236 health events outside of LMS. It was also observed that belief in the importance of the project and proper source selection from the participants was crucial to the success of this method. The timely identification of disease outbreaks near points of emergence and the recognition of risk factors associated with disease occurrence continue to be important components of any comprehensive surveillance system for monitoring disease activity across populations. The LMS method, with its minimal resource commitment, could be one tool used to address the information gaps seen in global ‘hot spot’ regions.
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Affiliation(s)
- Jessica S. Schwind
- One Health Institute, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- * E-mail:
| | - David J. Wolking
- One Health Institute, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
| | - John S. Brownstein
- Children's Hospital Informatics Program, Boston Children's Hospital, Boston, Massachusetts, United States of America
- Department of Pediatrics, Harvard Medical School, Children's Hospital Boston, Boston, Massachusetts, United States of America
| | | | - Jonna A. K. Mazet
- One Health Institute, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
| | - Woutrina A. Smith
- One Health Institute, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
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Schwind JS, Goldstein T, Thomas K, Mazet JAK, Smith WA. Capacity building efforts and perceptions for wildlife surveillance to detect zoonotic pathogens: comparing stakeholder perspectives. BMC Public Health 2014; 14:684. [PMID: 24996851 PMCID: PMC4096412 DOI: 10.1186/1471-2458-14-684] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 06/09/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The capacity to conduct zoonotic pathogen surveillance in wildlife is critical for the recognition and identification of emerging health threats. The PREDICT project, a component of United States Agency for International Development's Emerging Pandemic Threats program, has introduced capacity building efforts to increase zoonotic pathogen surveillance in wildlife in global 'hot spot' regions where zoonotic disease emergence is likely to occur. Understanding priorities, challenges, and opportunities from the perspectives of the stakeholders is a key component of any successful capacity building program. METHODS A survey was administered to wildlife officials and to PREDICT-implementing in-country project scientists in 16 participating countries in order to identify similarities and differences in perspectives between the groups regarding capacity needs for zoonotic pathogen surveillance in wildlife. RESULTS Both stakeholder groups identified some human-animal interfaces (i.e. areas of high contact between wildlife and humans with the potential risk for disease transmission), such as hunting and markets, as important for ongoing targeting of wildlife surveillance. Similarly, findings regarding challenges across stakeholder groups showed some agreement in that a lack of sustainable funding across regions was the greatest challenge for conducting wildlife surveillance for zoonotic pathogens (wildlife officials: 96% and project scientists: 81%). However, the opportunity for improving zoonotic pathogen surveillance capacity identified most frequently by wildlife officials as important was increasing communication or coordination among agencies, sectors, or regions (100% of wildlife officials), whereas the most frequent opportunities identified as important by project scientists were increasing human capacity, increasing laboratory capacity, and the growing interest or awareness regarding wildlife disease or surveillance programs (all identified by 69% of project scientists). CONCLUSIONS A One Health approach to capacity building applied at local and global scales will have the greatest impact on improving zoonotic pathogen surveillance in wildlife. This approach will involve increasing communication and cooperation across ministries and sectors so that experts and stakeholders work together to identify and mitigate surveillance gaps. Over time, this transdisciplinary approach to capacity building will help overcome existing challenges and promote efficient targeting of high risk interfaces for zoonotic pathogen transmission.
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Affiliation(s)
- Jessica S Schwind
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Tracey Goldstein
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Kate Thomas
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Jonna AK Mazet
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Woutrina A Smith
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
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