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Aguolu OG, Kiti MC, Nelson K, Liu CY, Sundaram M, Gramacho S, Jenness S, Melegaro A, Sacoor C, Bardaji A, Macicame I, Jose A, Cavele N, Amosse F, Uamba M, Jamisse E, Tchavana C, Briones HGM, Jarquín C, Ajsivinac M, Pischel L, Ahmed N, Mohan VR, Srinivasan R, Samuel P, John G, Ellington K, Joaquim OA, Zelaya A, Kim S, Chen H, Kazi M, Malik F, Yildirim I, Lopman B, Omer SB. Comprehensive profiling of social mixing patterns in resource poor countries: a mixed methods research protocol. medRxiv 2023:2023.12.05.23299472. [PMID: 38105989 PMCID: PMC10723497 DOI: 10.1101/2023.12.05.23299472] [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] [Indexed: 12/19/2023]
Abstract
Background Low-and-middle-income countries (LMICs) bear a disproportionate burden of communicable diseases. Social interaction data inform infectious disease models and disease prevention strategies. The variations in demographics and contact patterns across ages, cultures, and locations significantly impact infectious disease dynamics and pathogen transmission. LMICs lack sufficient social interaction data for infectious disease modeling. Methods To address this gap, we will collect qualitative and quantitative data from eight study sites (encompassing both rural and urban settings) across Guatemala, India, Pakistan, and Mozambique. We will conduct focus group discussions and cognitive interviews to assess the feasibility and acceptability of our data collection tools at each site. Thematic and rapid analyses will help to identify key themes and categories through coding, guiding the design of quantitative data collection tools (enrollment survey, contact diaries, exit survey, and wearable proximity sensors) and the implementation of study procedures.We will create three age-specific contact matrices (physical, nonphysical, and both) at each study site using data from standardized contact diaries to characterize the patterns of social mixing. Regression analysis will be conducted to identify key drivers of contacts. We will comprehensively profile the frequency, duration, and intensity of infants' interactions with household members using high resolution data from the proximity sensors and calculating infants' proximity score (fraction of time spent by each household member in proximity with the infant, over the total infant contact time) for each household member. Discussion Our qualitative data yielded insights into the perceptions and acceptability of contact diaries and wearable proximity sensors for collecting social mixing data in LMICs. The quantitative data will allow a more accurate representation of human interactions that lead to the transmission of pathogens through close contact in LMICs. Our findings will provide more appropriate social mixing data for parameterizing mathematical models of LMIC populations. Our study tools could be adapted for other studies.
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Affiliation(s)
| | | | - Kristin Nelson
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Carol Y. Liu
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Maria Sundaram
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Sergio Gramacho
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Samuel Jenness
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Alessia Melegaro
- DONDENA Centre for Research in Social Dynamics and Public Policy, Bocconi University, Italy
| | | | - Azucena Bardaji
- Manhiça Health Research Centre, Manhica, Mozambique
- ISGlobal, Hospital Clinic – Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ivalda Macicame
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | - Americo Jose
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | - Nilzio Cavele
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | | | - Migdalia Uamba
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | | | | | | | - Claudia Jarquín
- Centro de Estudios en Salud (CES), Universidad del Valle de Guatemala
| | - María Ajsivinac
- Centro de Estudios en Salud (CES), Universidad del Valle de Guatemala
| | - Lauren Pischel
- Yale School of Medicine, Yale University, Connecticut, USA
| | - Noureen Ahmed
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
| | | | | | | | - Gifta John
- Christian Medical College Vellore, India
| | - Kye Ellington
- Rollins School of Public Health, Emory University, Georgia, USA
| | | | - Alana Zelaya
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Sara Kim
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Holin Chen
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Momin Kazi
- The Aga Khan University, Karachi, Pakistán
| | - Fauzia Malik
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
| | - Inci Yildirim
- Yale School of Medicine, Yale University, Connecticut, USA
| | - Benjamin Lopman
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Saad B. Omer
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
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Aguolu OG, Willebrand K, Elharake JA, Qureshi HM, Kiti MC, Liu CY, Restrepo Mesa A, Nelson K, Jenness S, Melegaro A, Ahmed F, Yildirim I, Malik FA, Lopman B, Omer SB. Factors influencing the decision to receive seasonal influenza vaccination among US corporate non-healthcare workers. Hum Vaccin Immunother 2022; 18:2122379. [PMID: 36136345 PMCID: PMC9746537 DOI: 10.1080/21645515.2022.2122379] [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] [Indexed: 12/15/2022] Open
Abstract
Influenza causes significant mortality and morbidity in the United States (US). Employees are exposed to influenza at work and can spread it to others. The influenza vaccine is safe, effective, and prevents severe outcomes; however, coverage among US adults (50.2%) is below Healthy People 2030 target of 70%. These highlights need for more effective vaccination promotion interventions. Understanding predictors of vaccination acceptance could inform vaccine promotion messages, improve coverage, and reduce illness-related work absences. We aimed to identify factors influencing influenza vaccination among US non-healthcare workers. Using mixed-methods approach, we evaluated factors influencing influenza vaccination among employees in three US companies during April-June 2020. Survey questions were adapted from the WHO seasonal influenza survey. Most respondents (n = 454) were women (272, 59.9%), 20-39 years old (n = 250, 55.1%); white (n = 254, 56.0%); had a college degree (n = 431, 95.0%); and reported receiving influenza vaccine in preceding influenza season (n = 297, 65.4%). Logistic regression model was statistically significant, X (16, N = 450) = 31.6, p = .01. Education [(OR) = 0.3, 95%CI = 0.1-0.6)] and race (OR = 0.4, 95%CI = 0.2-0.8) were significant predictors of influenza vaccine acceptance among participants. The majority had favorable attitudes toward influenza vaccination and reported that physician recommendation would influence their vaccination decisions. Seven themes were identified in qualitative analysis: "Protecting others" (109, 24.0%), "Protecting self" (105, 23.1%), "Vaccine accessibility" (94, 20.7%), "Education/messaging" (71, 15.6%), "Policies/requirements" (15, 3.3%), "Reminders" (9, 2.0%), and "Incentives" (3, 0.7%). Our findings could facilitate the development of effective influenza vaccination promotion messages and programs for employers, and workplace vaccination programs for other diseases such as COVID-19, by public health authorities.
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Affiliation(s)
- Obianuju Genevieve Aguolu
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
- CONTACT Obianuju Genevieve Aguolu Yale Institute of Global Health, Yale University, 1 Church Street, Room 345, New Haven, CT06510, USA
| | | | - Jad A. Elharake
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Hanya M. Qureshi
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Moses Chapa Kiti
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Carol Y. Liu
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Kristin Nelson
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samuel Jenness
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Alessia Melegaro
- DONDENA Centre for Research in Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Faruque Ahmed
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, Georgia
| | - Inci Yildirim
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Fauzia A. Malik
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
| | - Benjamin Lopman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Saad B. Omer
- Yale Institute of Global Health, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
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Willebrand K, Pischel L, Malik AA, Jenness S, Omer S. 386. A Systematic Review of COVID-19 Transmission Dynamics and Clinical Response on Cruise Ships Globally Between January and October 2020. Open Forum Infect Dis 2021. [PMCID: PMC8644941 DOI: 10.1093/ofid/ofab466.587] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Cruise ships provide an ideal setting for efficient transmission of SARS-CoV- 2 given a socially dense exposure environment. No systematic review of transmission of COVID-19 on cruise ships to date has been completed. Methods MEDLINE was searched in accordance with PRIMSA guidelines for COVID-19 cases associated with cruise ships. A list of cruise ships with COVID-19 was crossed referenced with the Centers for Disease Controls’ list of cruise ships that had at least one COVID-19 case associated with them within 14 days of disembarkation. News articles were also searched for epidemiologic information. 43 full text articles from MEDLINE and 177 from news sources were included in the final analysis. Narratives of the outbreak in ships with over 100 cases are presented. PRISMA Flow Diagram ![]()
PRISMA Flow diagram of articles screened, reviewed, and analyzed Results A total of 80 ships and 104 unique voyages on cruise ships were identified with at least one COVID-19 case before 30 October 2020. Nineteen ships had more than one voyage with a case of COVID-19. The median number of cases per ship was three (intraquartile range (IQR) 1–17.8), with two notable outliers the Diamond Princess and Ruby Princess which had 712 and 907 cases respectively. The median attack rate for COVID-19 was 0.2% (IQR 0.03% -1.5%), though this distribution was skewed to the right with a mean attack rate of 3.7%. 25.9% of voyages had at least one associated death. Outbreaks involving only crew were later than outbreaks with guests and crew. Cases of COVID-19 on cruise ships in 2020 ![]()
Number of cases of COVID-19 on cruise ships by date COVID-19 outbreak identified and if case was a guest or crew member. Percent of COVID-19 cases that were crew in 2020 ![]()
Percent of COVID-19 cases that were in crew members by date outbreak identified in 2020 Percent of passengers on cruise ships that were crew ![]()
Percentage of passengers on cruise ships that were crew members in 2020 by date outbreak identified Conclusion COVID-19 can spread easily on cruise ships in a susceptible population when there is an absence of mitigation measures due to the confined space and high-density of contact networks. This can not only create super spreader events but also facilitate international spread. Disclosures All Authors: No reported disclosures
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Kiti MC, Aguolu OG, Liu CY, Mesa AR, Regina R, Woody M, Willebrand K, Couzens C, Bartelsmeyer T, Nelson KN, Jenness S, Riley S, Melegaro A, Ahmed F, Malik F, Lopman BA, Omer SB. Social contact patterns among employees in 3 U.S. companies during early phases of the COVID-19 pandemic, April to June 2020. Epidemics 2021; 36:100481. [PMID: 34171510 PMCID: PMC8419109 DOI: 10.1016/j.epidem.2021.100481] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 01/22/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 11/24/2022] Open
Abstract
We measured contact patterns using online diaries for 304 employees of 3 U.S. companies working remotely. The median number of daily contacts was 2 (IQR 1-4); majority were conversation (55 %), occurred at home (64 %) and lasted >4 h (38 %). These data are crucial for modeling outbreak control among the workforces.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Faruque Ahmed
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Wang L, Lander M, McManus M, Butcher K, Colman J, Chadwick H, Jenness S, Letim M, Simmonds B, Hastie C, Farshid A. 759 Use of Activity Trackers to Monitor Activity Patterns in Cardiac Rehabilitation Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gwadz M, Cleland CM, Hagan H, Jenness S, Kutnick A, Leonard NR, Applegate E, Ritchie AS, Banfield A, Belkin M, Cross B, Del Olmo M, Ha K, Martinez BY, McCright-Gill T, Swain QL, Perlman DC, Kurth AE. Strategies to uncover undiagnosed HIV infection among heterosexuals at high risk and link them to HIV care with high retention: a "seek, test, treat, and retain" study. BMC Public Health 2015; 15:481. [PMID: 25958200 PMCID: PMC4434577 DOI: 10.1186/s12889-015-1816-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 04/17/2015] [Accepted: 05/01/2015] [Indexed: 11/10/2022] Open
Abstract
Background Over 50,000 individuals become infected with HIV annually in the U.S., and over a quarter of HIV infected individuals are heterosexuals. Undiagnosed HIV infection, as well as a lack of retention in care among those diagnosed, are both primary factors contributing to ongoing HIV incidence. Further, there are racial/ethnic disparities in undiagnosed HIV and engagement in care, with African Americans/Blacks and Latinos remaining undiagnosed longer and less engaged in care than Whites, signaling the need for culturally targeted intervention approaches to seek and test those with undiagnosed HIV infection, and link them to care with high retention. Methods/Design The study has two components: one to seek out and test heterosexuals at high risk for HIV infection, and another to link those found infected to HIV care with high retention. We will recruit sexually active African American/Black and Latino adults who have opposite sex partners, negative or unknown HIV status, and reside in locations with high poverty and HIV prevalence. The “Seek and Test” component will compare the efficacy and cost effectiveness of two strategies to uncover undiagnosed HIV infection: venue-based sampling and respondent-driven sampling (RDS). Among those recruited by RDS and found to have HIV infection, a “Treat and Retain” component will assess the efficacy of a peer-driven intervention compared to a control arm with respect to time to an HIV care appointment and health indicators using a cluster randomized controlled trial design to minimize contamination. RDS initial seeds will be randomly assigned to the intervention or control arm at a 1:1 ratio and all recruits will be assigned to the same arm as the recruiter. Participants will be followed for 12 months with outcomes assessed using medical records and biomarkers, such as HIV viral load. Discussion Heterosexuals do not test for HIV as frequently as and are diagnosed later than other risk groups. The study has the potential to contribute an efficient, innovative, and sustainable multi-level recruitment approach and intervention to the HIV prevention portfolio. Because the majority of heterosexuals at high risk are African American/Black or Latino, the study has great potential to reduce racial/ethnic disparities in HIV/AIDS. Trial registration ClinicalTrials.gov, NCT01607541, Registered May 23, 2012.
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Affiliation(s)
- Marya Gwadz
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Charles M Cleland
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Holly Hagan
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Samuel Jenness
- Department of Epidemiology, University of Washington, Box 357236, Seattle, WA, 98195, USA.
| | - Alexandra Kutnick
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Noelle R Leonard
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Elizabeth Applegate
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Amanda S Ritchie
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Angela Banfield
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Mindy Belkin
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Bridget Cross
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Montserrat Del Olmo
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Katharine Ha
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Belkis Y Martinez
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Talaya McCright-Gill
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - Quentin L Swain
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
| | - David C Perlman
- Mount Sinai Beth Israel, Baron Edmond de Rothschild Chemical Dependency Institute, 120 Water Street, Floor 24, New York, NY, 10038, USA.
| | - Ann E Kurth
- NYU College of Nursing, Center for Drug Use and HIV Research (CDUHR), 433 First Avenue, 7th Floor, New York, NY, 10010, USA.
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