Blocked by Gender: Disparities in COVID19 infection detection in Tamil Nadu, India.

Globally, a gender gap in COVID-19 has been noted with men reporting higher share of both morbidity and deaths compared to women. While the gender gap in fatalities has been similar across the globe, there have been interesting disparities in the detection of COVID-19 cases in men and women. While wealthier, more developed nations have generally seen similar case detection in men and women, LMICs especially in Asia have seen far greater proportion of COVID-19 cases among men than women. We utilize age and sex-disaggregated data from the southern Indian state of Tamil Nadu across two waves of the pandemic (May 2020 - Nov 2020, and March 2021, to June 2021) and find that there were only ~70% as many detected COVID-19 cases among women as there were among men. Our initial reading suggested that this might be a protective effect of lower labor force participation rates among women across much of South Asia. However, subsequent sero-prevalence results from Tamil Nadu conducted on October-November 2020, and June-July, 2021 suggest that infection incidence has been similar among men and women; as is the case in countries with better health infrastructure. This empirical puzzle suggests that reduced case detection among women cannot be immediately associated with limited public exposure, but rather evidence of a chronic neglect of women in healthcare access. Overall, we contend that an attention to the gender context holds promise to effective interventions in detection and prevention that goes beyond the traditional epidemiological logic of diseases.

A Statistical Model of COVID-19 Infection Incidence in the Southern Indian State of Tamil Nadu.

In this manuscript, we present an analysis of COVID-19 infection incidence in the Indian state of Tamil Nadu. We used seroprevalence survey data along with COVID-19 fatality reports from a six-month period (1 June 2020 to 30 November 2020) to estimate age- and sex-specific COVID-19 infection fatality rates (IFR) for Tamil Nadu. We used these IFRs to estimate new infections occurring daily using the daily COVID-19 fatality reports published by the Government of Tamil Nadu. We found that these infection incidence estimates for the second COVID wave in Tamil Nadu were broadly consistent with the infection estimates from seroprevalence surveys. Further, we propose a composite statistical model that pairs a k-nearest neighbours model with a power-law characterisation for "out-of-range" extrapolation to estimate the COVID-19 infection incidence based on observed cases and test positivity ratio. We found that this model matched closely with the IFR-based infection incidence estimates for the first two COVID-19 waves for both Tamil Nadu as well as the neighbouring state of Karnataka. Finally, we used this statistical model to estimate the infection incidence during the recent "Omicron wave" in Tamil Nadu and Karnataka.

Describing and mapping scientific articles on alcohol globally for the period 2010-2021: a bibliometric analysis.

OBJECTIVES: To describe and map scientific literature related to alcohol consumption, its determinants, governance, harm and control policies by publication output, author affiliations, funding, countries of study and research themes. DESIGN: Bibliometric analysis using performance analysis and science mapping techniques. DATA SOURCES: Scientific articles. ELIGIBILITY CRITERIA: Indexed scientific articles published between 1 January 2010 and 31 December 2021 with an English abstract focused on alcohol consumption, its determinants, harms, governance and control policies. DATA EXTRACTION AND SYNTHESIS: Searches were run in Web of Science and PubMed. Performance metrics were analysed using descriptive statistics. Keywords were used for science mapping in a deductive approach to cluster articles by five main research themes. The 'policy response' theme was further analysed by six subthemes. RESULTS: 4553 articles were included in the analysis. Three out of four articles (3479/4553, 76.4%) were authored solely by authors affiliated with HIC institutions. One in five articles (906/4553, 19.9%) had at least one author affiliated to an institution from an upper-middle-income, middle-income or low-income country context. Governments, followed by research institutions, were the predominant funding source. Half (53.1%) studied a single country and, of these, 77.0% were high-income countries (HICs). Australia, USA and UK were the most studied countries, together accounting for 44.9% (975/2172) of country-specific articles. Thematically, 'consumption' was most studied, and 'alcohol determinants', least. 'Policy response' articles were predominately conducted in HIC contexts. CONCLUSIONS: Although the attributable harm of alcohol is known to affect more significantly lower-income and middle-income countries, scientific publications primarily report on HIC contexts by authors from HICs. Research themes reflect known cost-effective policy actions, though skewed towards HICs and a focus on consumption. The implementation of context-specific alcohol control policies requires addressing the determinants of the uneven geographical and thematic distribution of research.