Mathematical modelling of COVID-19 transmission dynamics in a partially comorbid community.

A deterministic S,Em,Ec,Im,Ic,H,R epidemic model that describes the spreading of SARS-COV-2 within a community with comorbidities is formulated. Size dependent area is incorporated into the model to quantify the effect of social distancing and the results indicate that the risk of community transmission is optimally minimised when the occupancy area is increased. The reproduction number is shown to have a positive relationship with the infection rate, the proportion of individuals with comorbidities and the proportion of susceptible individuals adhering to standard operating procedures. The model exhibits a unique endemic equilibrium whose stability largely depends on the rate of hospitalisation of individuals with underlying health conditions (ωm) as compared to those without these conditions (ωc), such that stability is guaranteed if ωm<ωc. Furthermore, if individuals with comorbidities effectively report for treatment and hospitalisation at a rate of 0.5 per day, the epidemic curve peaks 3-fold higher among people with comorbidities. The infection peaks are delayed if the area occupied by community is increased. In conclusion, we observed that community infections increase significantly with decreasing detection rates for both individuals with or without comorbidities.

Mathematical model for COVID-19 management in crowded settlements and high-activity areas.

This paper develops and analyses a habitat area size dependent mathematical model to study the transmission dynamics of COVID-19 in crowded settlements such as refugee camps, schools, markets and churches. The model quantifies the potential impact of physical/social distancing and population density on the disease burden. Results reveal that with no fatalities and no infected entrants, the reproduction numbers associated with asymptomatic and symptomatic cases are inversely proportional to; the habitat area size, and the efforts employed in tracing and hospitalising these cases. The critical habitat area below which the disease dies out is directly proportion to the time taken to identify and hospitalise infected individuals. Results also show that disease persistence in the community is guaranteed even with minimal admission of infected individuals. Our results further show that as the level of compliance to standard operating procedures (SOPs) increases, then the disease prevalence peaks are greatly reduced and delayed. Therefore, proper adherence to SOPs such as use of masks, physical distancing measures and effective contact tracing should be highly enforced in crowded settings if COVID-19 is to be mitigated.

The role of couple negotiation in unmet need for contraception and the decision to stop childbearing in Uganda.

This study uses survey and focus-group data from the 1995-96 Negotiating Reproductive Outcomes study in Uganda to describe the nature of the decision to stop childbearing and to question the simplifying assumption of consensus decision-making implicit in much demographic research on unmet need. Negotiation is characterized in four stages, from normative precedent for decision-making to communication, disagreement, and conflict resolution. Indirect forms of communication between partners predominate, contributing to the tendency of both men and women to overestimate each other's demand for additional children. Partner opposition is found to cause a statistically significant increase in unmet need reported by women and a shift in contraceptive mix favoring use of traditional methods over modern methods. For women, partner opposition may account for as much as 20 percent of unmet need in urban areas, 12 percent in rural areas, and 15 percent overall.

The value of children as a major influence on fertility in Uganda: a case study of Ankole.

PIP: In the high fertility area of Bankole, a 1985 study of the value of children to the Banyankole was conducted. Information on marriage patterns, perceptions of the pros and cons of children, and the costs and benefits of extended families was obtained through a random sampling of 900 household and surveys of more than 1000 ever-married man and 1000 ever-married women. A total fertility rate of 8.7 exists for the area, with rate differences observed between socioeconomic groups. Of pastoralists, peasants, and cultivators, the pastoralists reported the lowest fertility rate of 7.1, compared to the highest rate from the cultivators of 10.3. Despite the effect of education, employment, and religion in increasing the age of first marriage from 18 years in 1969 to 21.5 by 1985, cultural practices persist in encouraging high fertility levels. Pastoralist male migration for work during dry season, and the female return to her parents' home following delivery may be 2 practices contributing to a comparative lower fertility rate among this group. Absence of taboos regarding postpartum sexual abstinence among the Banyankole is a determinant of high fertility for the Ankole as a whole. With recorded 4% annual growth in the area, and governmental budgetary constraints to shifting funds into the social service sector, politically, culturally, and socially acceptable population policies are needed to combat pronatalist customs of the Ankole.^ieng