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5.
Int J Tuberc Lung Dis ; 24(8): 829-837, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32912388

RESUMO

OBJECTIVES: Italy has been badly affected by the COVID-19 pandemic and has one of the highest death tolls. We analyzed the severity of COVID-19 across all 20 Italian regions.METHOD: We manually retrieved the daily cumulative numbers of laboratory-confirmed cases and deaths attributed to COVID-19 in each region, and estimated the crude case fatality ratio and time delay-adjusted case fatality ratio (aCFR). We then assessed the association between aCFR and sociodemographic, health care and transmission factors using multivariate regression analysis.RESULTS: The overall aCFR in Italy was estimated at 17.4%. Lombardia exhibited the highest aCFR (24.7%), followed by Marche (19.3%), Emilia Romagna (17.7%) and Liguria (17.6%). Our aCFR estimate was greater than 10% for 12 regions. Our aCFR estimates were statistically associated with population density and cumulative morbidity rate in a multivariate analysis.CONCLUSION: Our aCFR estimates for Italy as a whole and for seven out of the 20 regions exceeded those reported for the most badly affected region in China. These findings highlight the importance of social distancing to suppress transmission to avoid overwhelming the health care system and reduce the risk of death.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Densidade Demográfica , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Itália/epidemiologia , Mortalidade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Medição de Risco/métodos , Análise Espaço-Temporal
9.
PLoS One ; 15(9): e0239234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931509

RESUMO

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.


Assuntos
Controle de Doenças Transmissíveis/métodos , Higiene das Mãos , Betacoronavirus , Criança , Doenças Transmissíveis/patologia , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Grupos Focais , Humanos , Índia , Entrevistas como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Professores Escolares/psicologia , Serra Leoa , Inquéritos e Questionários , Reino Unido
10.
Health Res Policy Syst ; 18(1): 105, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943078

RESUMO

Mali, like the rest of the world, has seen a rapid spread of COVID-19 since the first report of imported cases. Despite being a low-income country, Mali has leveraged scientific research resources via coordinated approaches to enable public health emergency planning and response to the COVID-19 pandemic. Mali's approach includes the harmonization of research activities; leveraging of research laboratory capacity of the University Clinical Research Center, Mali International Center for Excellence and three other in-country laboratories for community COVID-19 testing; strengthening relationships amongst local and international stakeholders; and collaboration with the Ministry of Health to integrate scientific evidence into public policy and emergency management of COVID-19 through a platform of consultation and open communication. The country has implemented national coordination of its COVID-19 response by establishing a COVID-19 Scientific Advisory Committee and a COVID-19 Technical Coordination Committee, both within the Ministry of Health and working collaboratively with other stakeholders. Members of Mali's COVID-19 Scientific Advisory Committee also serve as leaders of its principal academic and government clinical and public health research entities. This centralised approach has enabled the prioritisation of COVID-19 control activities, informed allocation of resources, evidence-based public health practices and timely decision-making in the pandemic setting. Though challenges remain, lessons learned from Mali's harnessing of clinical research capacity to guide and support its COVID-19 response can be applied to future global health research challenges and illustrate the power of building public health-responsive research capacity in resource-limited settings through international collaboration.


Assuntos
Infecções por Coronavirus , Países em Desenvolvimento , Pandemias , Pneumonia Viral , Saúde Pública , Pesquisa , Betacoronavirus , Controle de Doenças Transmissíveis , Comportamento Cooperativo , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Prática Clínica Baseada em Evidências , Governo , Órgãos Governamentais , Humanos , Laboratórios , Mali/epidemiologia , Organizações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Política Pública , Alocação de Recursos
11.
Epidemiol Infect ; 148: e201, 2020 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-32873358

RESUMO

While most research focuses on the clinical treatment of COVID-19, fewer studies have investigated individuals' responses towards this novel infectious disease. This study aims to report the temporal changes in individuals' psychological wellbeing, perceived discrimination, sociopolitical perceptions and information-seeking behaviours among the general public in Hubei, China. Data were obtained from a two-wave survey of 1902 respondents aged 18-80 in Hubei province during the peak and mitigation stages of the outbreak. The results showed that the prevalence of psychological distress dropped from over 75% to around 15% throughout the study period, but perceived discrimination remained stable. Female, middle-aged, well-educated respondents and those employed in government/public institutions/state-owned enterprises tended to report more distress. While respondents' attention on COVID-19 information kept high and stable, their sources of information diversified across different sociodemographic groups. Over time, people obtained more social support from neighbourhoods than from their friends and relatives or non-government organisations. Over 80% of respondents were satisfied with the performance of the central government, which was notably higher than their ratings on the local government and neighbourhood/village committees. The findings of this research are informative for formulating effective intervention strategies to tackle various psychosocial problems during COVID-19.


Assuntos
Atitude , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Comportamento de Busca de Informação , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/métodos , Coleta de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Apoio Social , Adulto Jovem
13.
PLoS One ; 15(9): e0238559, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886696

RESUMO

The novel coronavirus (SARS-CoV-2), identified in China at the end of December 2019 and causing the disease COVID-19, has meanwhile led to outbreaks all over the globe with about 2.2 million confirmed cases and more than 150,000 deaths as of April 17, 2020. In this work, mathematical models are used to reproduce data of the early evolution of the COVID-19 outbreak in Germany, taking into account the effect of actual and hypothetical non-pharmaceutical interventions. Systems of differential equations of SEIR type are extended to account for undetected infections, stages of infection, and age groups. The models are calibrated on data until April 5. Data from April 6 to 14 are used for model validation. We simulate different possible strategies for the mitigation of the current outbreak, slowing down the spread of the virus and thus reducing the peak in daily diagnosed cases, the demand for hospitalization or intensive care units admissions, and eventually the number of fatalities. Our results suggest that a partial (and gradual) lifting of introduced control measures could soon be possible if accompanied by further increased testing activity, strict isolation of detected cases, and reduced contact to risk groups.


Assuntos
Infecções por Coronavirus/epidemiologia , Modelos Teóricos , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Alemanha/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão
14.
J Korean Med Sci ; 35(35): e321, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32893522

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed significant global public health challenges and created a substantial economic burden. Korea has experienced an extensive outbreak, which was linked to a religion-related super-spreading event. However, the implementation of various non-pharmaceutical interventions (NPIs), including social distancing, spring semester postponing, and extensive testing and contact tracing controlled the epidemic. Herein, we estimated the effectiveness of each NPI using a simulation model. METHODS: A compartment model with a susceptible-exposed-infectious-quarantined-hospitalized structure was employed. Using the Monte-Carlo-Markov-Chain algorithm with Gibbs' sampling method, we estimated the time-varying effective contact rate to calibrate the model with the reported daily new confirmed cases from February 12th to March 31st (7 weeks). Moreover, we conducted scenario analyses by adjusting the parameters to estimate the effectiveness of NPI. RESULTS: Relaxed social distancing among adults would have increased the number of cases 27.4-fold until the end of March. Spring semester non-postponement would have increased the number of cases 1.7-fold among individuals aged 0-19, while lower quarantine and detection rates would have increased the number of cases 1.4-fold. CONCLUSION: Among the three NPI measures, social distancing in adults showed the highest effectiveness. The substantial effect of social distancing should be considered when preparing for the 2nd wave of COVID-19.


Assuntos
Controle de Doenças Transmissíveis/métodos , Busca de Comunicante/métodos , Infecções por Coronavirus/transmissão , Programas de Rastreamento/métodos , Pneumonia Viral/transmissão , Distância Social , Betacoronavirus , Simulação por Computador , Exposição Ambiental/prevenção & controle , Humanos , Cadeias de Markov , Modelos Teóricos , Método de Monte Carlo , Pandemias , Prática de Saúde Pública/legislação & jurisprudência , República da Coreia
15.
Arch Iran Med ; 23(8): 564-567, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894970

RESUMO

The coronavirus infection is an evolving pandemic with high morbidity and mortality, especially in people with comorbidities. The case fatality rate (CFR) is 9.2% in the presence of diabetes, while it is 1.4% in those without any comorbidity. Diabetes is a prevalent disease globally; hence, healthcare professionals are highly concerned about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic progression. Current evidence does not support higher incidence of coronavirus disease 2019 (COVID-19) in people with diabetes (PWD). However, people with diabetes are considered high risk for developing complications. Optimal metabolic control is a challenging concept, especially in the presence of an acute and severe respiratory viral infection. In this consensus, we considered the challenging issues in management of patients with diabetes during the COVID-19 pandemic. The consensus covers various aspects of outpatient as well as inpatient care based on the current evidence.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Diabetes Mellitus/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus/virologia , Humanos , Irã (Geográfico) , Pandemias , Pneumonia Viral/epidemiologia
16.
Arch Iran Med ; 23(8): 578-581, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894975

RESUMO

In the past two centuries, several fatal infectious outbreaks have arisen in Iran. Presented here is a brief historical account of four fatal epidemics including cholera, plague, Spanish influenza of 1918 and smallpox between1796 and 1979. The lessons from these outbreaks could be helpful for better combatting other deadly epidemics including the present-day disastrous COVID-19 pandemic.


Assuntos
Cólera/história , Controle de Doenças Transmissíveis/história , Epidemias/história , Influenza Pandêmica, 1918-1919/história , Peste/história , Varíola/história , Cólera/epidemiologia , Cólera/prevenção & controle , Epidemias/prevenção & controle , História do Século XIX , História do Século XX , Humanos , Irã (Geográfico)/epidemiologia , Peste/epidemiologia , Peste/prevenção & controle , Varíola/epidemiologia , Varíola/prevenção & controle
19.
Clin Imaging ; 67: 219-225, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871426

RESUMO

Since first report of a novel coronavirus in December of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic has crippled healthcare systems around the world. While many initial screening protocols centered around laboratory detection of the virus, early testing assays were thought to be poorly sensitive in comparison to chest computed tomography, especially in asymptomatic disease. Coupled with shortages of reverse transcription polymerase chain reaction (RT-PCR) testing kits in many parts of the world, these regions instead turned to the use of advanced imaging as a first-line screening modality. However, in contrast to previous Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronavirus epidemics, chest X-ray has not demonstrated optimal sensitivity to be of much utility in first-line screening protocols. Though current national and international guidelines recommend for the use of RT-PCR as the primary screening tool for suspected cases of COVID-19, institutional and regional protocols must consider local availability of resources when issuing universal recommendations. Successful containment and social mitigation strategies worldwide have been thus far predicated on unified governmental responses, though the underlying ideologies of these practices may not be widely applicable in many Western nations. As the strain on the radiology workforce continues to mount, early results indicate a promising role for the use of machine-learning algorithms as risk stratification schema in the months to come.


Assuntos
Técnicas de Laboratório Clínico/métodos , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Saúde Global , Programas de Rastreamento/métodos , Pandemias , Pneumonia Viral/diagnóstico , Ásia , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Europa (Continente) , Humanos , América do Norte , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
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