RESUMO
Background: Mobility restrictions prevent the spread of infections to disease-free areas, and early in the coronavirus disease 2019 (COVID-19) pandemic, most countries imposed severe restrictions on mobility as soon as it was clear that containment of local outbreaks was insufficient to control spread. These restrictions have adverse impacts on the economy and other aspects of human health, and it is important to quantify their impact for evaluating their future value. Methods: Here we develop Scotland Coronavirus transmission Model (SCoVMod), a model for COVID-19 in Scotland, which presents unusual challenges because of its diverse geography and population conditions. Our fitted model captures spatio-temporal patterns of mortality in the first phase of the epidemic to a fine geographical scale. Results: We find that lockdown restrictions reduced transmission rates down to an estimated 12\% of its pre-lockdown rate. We show that, while the timing of COVID-19 restrictions influences the role of the transmission rate on the number of COVID-related deaths, early reduction in long distance movements does not. However, poor health associated with deprivation has a considerable association with mortality; the Council Area (CA) with the greatest health-related deprivation was found to have a mortality rate 2.45 times greater than the CA with the lowest health-related deprivation considering all deaths occurring outside of carehomes. Conclusions: We find that in even an early epidemic with poor case ascertainment, a useful spatially explicit model can be fit with meaningful parameters based on the spatio-temporal distribution of death counts. Our simple approach is useful to strategically examine trade-offs between travel related restrictions and physical distancing, and the effect of deprivation-related factors on outcomes.
RESUMO
Mosquito-borne flaviviruses with an enzootic transmission cycle like Japanese encephalitis virus (JEV) and West Nile virus (WNV) are a major public health concern. The circulation of JEV in Southeast Asia is well-documented, and the important role of pigs as amplification hosts for the virus is long known. The influence of other domestic animals especially poultry that lives in high abundance and close proximity to humans is not intensively analyzed. Another understudied field in Asia is the presence of the closely related WNV. Such analyses are difficult to perform due to the intense antigenic cross-reactivity between these viruses and the lack of suitable standardized serological assays. The main objective of this study was to assess the prevalence of JEV and WNV flaviviruses in domestic birds, detailed in chickens and ducks, in three different Cambodian provinces. We determined the flavivirus seroprevalence using an hemagglutination inhibition assay (HIA). Additionally, we investigated in positive samples the presence of JEV and WNV neutralizing antibodies (nAb) using foci reduction neutralization test (FRNT). We found 29% (180/620) of the investigated birds positive for flavivirus antibodies with an age-depended increase of the seroprevalence (OR = 1.04) and a higher prevalence in ducks compared to chicken (OR = 3.01). Within the flavivirus-positive birds, we found 43% (28/65) with nAb against JEV. We also observed the expected cross-reactivity between JEV and WNV, by identifying 18.5% double-positive birds that had higher titers of nAb than single-positive birds. Additionally, seven domestic birds (10.7%) showed only nAb against WNV and no nAb against JEV. Our study provides evidence for an intense JEV circulation in domestic birds in Cambodia, and the first serological evidence for WNV presence in Southeast Asia since decades. These findings mark the need for a re-definition of areas at risk for JEV and WNV transmission, and the need for further and intensified surveillance of mosquito-transmitted diseases in domestic animals.
RESUMO
Peste des petits ruminants virus (PPRV), responsible for peste des petits ruminants (PPR), is widely circulating in Africa and Asia. The disease is a huge burden for the economy and development of the affected countries. In Eastern Africa, the disease is considered endemic. Because of the geographic proximity and existing trade between eastern African countries and the Comoros archipelago, the latter is at risk of introduction and spread, and the first PPR outbreaks occurred in the Union of the Comoros in 2012. The objective of this study was to map the areas suitable for PPR occurrence and spread in the Union of the Comoros and four eastern African countries, namely Ethiopia, Uganda, Kenya, and Tanzania. A Geographic Information System (GIS)-based Multicriteria Evaluation (MCE) was developed. Risk factors for PPR occurrence and spread, and their relative importance, were identified using literature review and expert-based knowledge. Corresponding geographic data were collected, standardized, and combined based on a weighted linear combination to obtain PPR suitability maps. The accuracy of the maps was assessed using outbreak data from the EMPRES database and a ROC curve analysis. Our model showed an excellent ability to distinguish between absence and presence of outbreaks in Eastern Africa (AUC = 0.907; 95% CI [0.820-0.994]), and a very good performance in the Union of the Comoros (AUC = 0.889, 95% CI: [0.694-1]). These results highlight the efficiency of the GIS-MCE method, which can be applied at different geographic scales: continental, national and local. The resulting maps provide decision support tools for implementation of disease surveillance and control measures, thus contributing to the PPR eradication goal of OIE and FAO by 2030.