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Xiu F, Flores Anato JL, Cox J, Grace D, Hart TA, Skakoon-Sparling S, Dvorakova M, Knight J, Wang L, Gatalo O, Campbell E, Zhang T, Sbihi H, Irvine MA, Mishra S, Maheu-Giroux M. Characteristics of the Sexual Networks of Men Who Have Sex With Men in Montréal, Toronto, and Vancouver: Insights from Canada's 2022 Mpox Outbreak. J Infect Dis 2024; 229:S293-S304. [PMID: 38323703 DOI: 10.1093/infdis/jiae033] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The 2022-2023 global mpox outbreak disproportionately affected gay, bisexual, and other men who have sex with men (GBM). We investigated differences in GBM's sexual partner distributions across Canada's 3 largest cities and over time, and how they shaped transmission. METHODS The Engage Cohort Study (2017-2023) recruited GBM via respondent-driven sampling in Montréal, Toronto, and Vancouver (n = 2449). We compared reported sexual partner distributions across cities and periods: before COVID-19 (2017-2019), pandemic (2020-2021), and after lifting of restrictions (2021-2023). We used Bayesian regression and poststratification to model partner distributions. We estimated mpox's basic reproduction number (R0) using a risk-stratified compartmental model. RESULTS Pre-COVID-19 pandemic distributions were comparable: fitted average partners (past 6 months) were 10.4 (95% credible interval: 9.4-11.5) in Montréal, 13.1 (11.3-15.1) in Toronto, and 10.7 (9.5-12.1) in Vancouver. Sexual activity decreased during the pandemic and increased after lifting of restrictions, but remained below prepandemic levels. Based on reported cases, we estimated R0 of 2.4 to 2.7 and similar cumulative incidences (0.7%-0.9%) across cities. CONCLUSIONS Similar sexual partner distributions may explain comparable R0 and cumulative incidence across cities. With potential for further recovery in sexual activity, mpox vaccination and surveillance strategies should be maintained.
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Affiliation(s)
- Fanyu Xiu
- Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
| | | | - Joseph Cox
- Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
- Direction régionale de santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Shayna Skakoon-Sparling
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Milada Dvorakova
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - Jesse Knight
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Linwei Wang
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada, Canada
| | - Oliver Gatalo
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada, Canada
| | - Evan Campbell
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Terri Zhang
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Hind Sbihi
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael A Irvine
- Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sharmistha Mishra
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Canada, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada
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Gatalo O, Tseng K, Hamilton A, Lin G, Klein E. Associations between phone mobility data and COVID-19 cases. Lancet Infect Dis 2021; 21:e111. [PMID: 32946835 PMCID: PMC7492011 DOI: 10.1016/s1473-3099(20)30725-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/28/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Oliver Gatalo
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA
| | - Katie Tseng
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA
| | - Alisa Hamilton
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA
| | - Gary Lin
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA,Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Eili Klein
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA,Johns Hopkins School of Medicine, Baltimore, MD, USA
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Frost I, Craig J, Osena G, Hauck S, Kalanxhi E, Schueller E, Gatalo O, Yang Y, Tseng KK, Lin G, Klein E. Modelling COVID-19 transmission in Africa: countrywise projections of total and severe infections under different lockdown scenarios. BMJ Open 2021; 11:e044149. [PMID: 34006031 PMCID: PMC7941678 DOI: 10.1136/bmjopen-2020-044149] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/18/2021] [Accepted: 02/05/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES As of 13 January 2021, there have been 3 113 963 confirmed cases of SARS-CoV-2 and 74 619 deaths across the African continent. Despite relatively lower numbers of cases initially, many African countries are now experiencing an exponential increase in case numbers. Estimates of the progression of disease and potential impact of different interventions are needed to inform policymaking decisions. Herein, we model the possible trajectory of SARS-CoV-2 in 52 African countries under different intervention scenarios. DESIGN We developed a compartmental model of SARS-CoV-2 transmission to estimate the COVID-19 case burden for all African countries while considering four scenarios: no intervention, moderate lockdown, hard lockdown and hard lockdown with continued restrictions once lockdown is lifted. We further analysed the potential impact of COVID-19 on vulnerable populations affected by HIV/AIDS and tuberculosis (TB). RESULTS In the absence of an intervention, the most populous countries had the highest peaks in active projected number of infections with Nigeria having an estimated 645 081 severe infections. The scenario with a hard lockdown and continued post-lockdown interventions to reduce transmission was the most efficacious strategy for delaying the time to the peak and reducing the number of cases. In South Africa, projected peak severe infections increase from 162 977 to 2 03 261, when vulnerable populations with HIV/AIDS and TB are included in the analysis. CONCLUSION The COVID-19 pandemic is rapidly spreading across the African continent. Estimates of the potential impact of interventions and burden of disease are essential for policymakers to make evidence-based decisions on the distribution of limited resources and to balance the economic costs of interventions with the potential for saving lives.
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Affiliation(s)
- Isabel Frost
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
- Imperial College Faculty of Medicine-Hammersmith Campus, London, UK
| | - Jessica Craig
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Gilbert Osena
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Stephanie Hauck
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Erta Kalanxhi
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Emily Schueller
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Oliver Gatalo
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Yupeng Yang
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Katie K Tseng
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
| | - Gary Lin
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
- Department of Emergency Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Eili Klein
- Center for Disease Dynamics Economics and Policy, Washington, District of Columbia, USA
- Johns Hopkins University, Baltimore, Maryland, USA
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Klein EY, Tseng KK, Gatalo O, Cosgrove SE. Reply to Hemmige and David. Clin Infect Dis 2019; 69:2040-2042. [PMID: 31044246 PMCID: PMC6853679 DOI: 10.1093/cid/ciz348] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Eili Y Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Katie K Tseng
- Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Oliver Gatalo
- Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Sara E Cosgrove
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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