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1.
PLoS One ; 16(3): e0247794, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33647044

RESUMEN

BACKGROUND: Identified in December 2019 in the city of Wuhan, China, the outbreak of COVID-19 spread throughout the world and its impacts affect different populations differently, where countries with high levels of social and economic inequality such as Brazil gain prominence, for understanding of the vulnerability factors associated with the disease. Given this scenario, in the absence of a vaccine or safe and effective antiviral treatment for COVID-19, nonpharmacological measures are essential for prevention and control of the disease. However, many of these measures are not feasible for millions of individuals who live in territories with increased social vulnerability. The study aims to analyze the spatial distribution of COVID-19 incidence in Brazil's municipalities (counties) and investigate its association with sociodemographic determinants to better understand the social context and the epidemic's spread in the country. METHODS: This is an analytical ecological study using data from various sources. The study period was February 25 to September 26, 2020. Data analysis used global regression models: ordinary least squares (OLS), spatial autoregressive model (SAR), and conditional autoregressive model (CAR) and the local regression model called multiscale geographically weighted regression (MGWR). FINDINGS: The higher the GINI index, the higher the incidence of the disease at the municipal level. Likewise, the higher the nurse ratio per 1,000 inhabitants in the municipalities, the higher the COVID-19 incidence. Meanwhile, the proportional mortality ratio was inversely associated with incidence of the disease. DISCUSSION: Social inequality increased the risk of COVID-19 in the municipalities. Better social development of the municipalities was associated with lower risk of the disease. Greater access to health services improved the diagnosis and notification of the disease and was associated with more cases in the municipalities. Despite universal susceptibility to COVID-19, populations with increased social vulnerability were more exposed to risk of the illness.


Asunto(s)
/epidemiología , Enfermeras y Enfermeros/estadística & datos numéricos , Brasil/epidemiología , /mortalidad , Ciudades/epidemiología , Demografía , Femenino , Humanos , Incidencia , Masculino , Factores de Riesgo , Factores Socioeconómicos , Análisis Espacial , Regresión Espacial
2.
Cien Saude Colet ; 26(3): 1023-1033, 2021 Mar.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33729356

RESUMEN

Vulnerability is a crucial factor in addressing COVID-19 as it can aggravate the disease. Thus, it should be considered in COVID-19 control and health prevention and promotion. This ecological study aimed to analyze the spatial distribution of the incidence of COVID-19 cases in a Brazilian metropolis and its association with social vulnerability indicators. Spatial scan analysis was used to identify COVID-19 clusters. The variables for identifying the vulnerability were inserted in a Geographically Weighted Regression (GWR) model to identify their spatial relationship with COVID-19 cases. The incidence of COVID-19 in Fortaleza was 74.52/10,000 inhabitants, with 3,554 reported cases and at least one case registered in each neighborhood. The spatial GWR showed a negative relationship between the incidence of COVID-19 and demographic density (ß=-0,0002) and a positive relationship between the incidence of COVID-19 and the percentage of self-employed >18 years (ß=1.40), and maximum per capita household income of the poorest fifth (ß=0.04). The influence of vulnerability indicators on incidence showed areas that can be the target of public policies to impact the incidence of COVID-19.


Asunto(s)
/epidemiología , Análisis Espacio-Temporal , Poblaciones Vulnerables , Adulto , Factores de Edad , Teorema de Bayes , Brasil/epidemiología , Ciudades/epidemiología , Comorbilidad , Escolaridad , Empleo/estadística & datos numéricos , Femenino , Vivienda/normas , Humanos , Incidencia , Renta , Masculino , Persona de Mediana Edad , Densidad de Población , Áreas de Pobreza , Factores Socioeconómicos , Salud Suburbana/estadística & datos numéricos
3.
Arq Neuropsiquiatr ; 79(2): 122-126, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33759978

RESUMEN

BACKGROUND: The Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) has launched an initiative to determine the prevalence of multiple sclerosis (MS) in Brazil, based on key cities deemed representative of their regions in terms of demographic and environmental features. OBJECTIVE: To investigate the prevalence rate of MS in Joinville. METHODS: We reviewed the medical records of all patients who lived in Joinville and met the 2010 McDonald's diagnostic criteria revised for MS on the prevalence day (March 11, 2016). Potential MS patients included individuals treated by all practicing neurologists in the city and the ones found in patients' association and the database of the Municipal Department of Health. Advertisements about the survey were also broadcast on radio and television. Patients who were not living in Joinville on the prevalence day were excluded. All potential MS patients were invited to an in-person diagnostic review, carried out by a panel of experienced neurologists with special expertise in MS on March 11, 2016. RESULTS: The MS prevalence rate was 13.5 per 100,000 inhabitants (95% confidence interval [95%CI] 12.9-14.0/100,000). A total of 51 (66.2%) participants were females, and 26 (33.7%) were males (female to male ratio=1.9:1). Out of the 77 patients, 73 (94.8%) were Caucasians, and four (5.1%) were mixed-race. CONCLUSIONS: Despite its latitude location and European colonization, the prevalence rate was below expectation. The intense internal migration from regions with lower MS prevalence rates to Joinville may have played a role in attenuating the increased risk of MS associated with latitude gradient and European ancestry. Prevalence studies in other cities from Southern Brazil with no significant internal migration and taking part in this broad project may clarify this issue.


Asunto(s)
Esclerosis Múltiple , Brasil/epidemiología , Ciudades/epidemiología , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Masculino , Esclerosis Múltiple/epidemiología , Prevalencia
4.
Sci Rep ; 11(1): 4402, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33623105

RESUMEN

COVID-19 is spreading rapidly in Brazil, a country of continental dimensions, but the incidence of the disease is showing to be very heterogeneous, affecting cities and regions differently. Thus, there is a gap regarding what factors would contribute to accentuate the differences in the incidence of COVID-19 among Brazilian cities. This work aimed to evaluate the effect of altitude on the incidence of COVID-19 in Brazilian cities. We analyzed the relative incidence (RI), the relative death rate (RDR) of COVID-19, and air relative humidity (RH) in all 154 cities in Brazil with a population above 200 thousand inhabitants, located between 5 and 1135 m in altitude. Pearson's correlation analysis was performed to compare a relationship between altitude with RI and RDR, and between RH with RI and RDR. Altitudes were classified into three classes [low (altitude ≤ 97 m a. s. l), middle (97 < altitude ≤ 795 m a. s. l), high (795 < altitude ≤ 1135 m a. s. l)] for the RI, RDR, and RH variables. To compare the three classes of altitude, analysis of variance (ANOVA) and Tukey test were used to compare averages (p < 0.05). Our epidemiological analysis found that the RI, RDR, and RH were lower in cities located in high altitudes (795 < altitude ≤ 1135 m a. s. l) when compared to the middle (97 < altitude ≤ 795 m a. s. l) and low (altitude ≤ 97 m a. s. l) cities altitudes. Furthermore, our study shows that there is a negative correlation between the incidence of COVID-19 with altitude and a positive correlation with RH in the cities analyzed. Brazilian cities with high altitude and low RH have lower RI and RDR from COVID-19. Thus, high altitude cities may be favorable to shelter people at risk. This study may be useful for understanding the behavior of SARS-CoV2, and start point for future studies to establish causality of environmental conditions with SARS-CoV2 contributing to the implementation of measures to prevent and control the spread of COVID-19.


Asunto(s)
Altitud , /epidemiología , Brasil/epidemiología , Ciudades/epidemiología , Evolución Molecular , Geografía , Humanos , Incidencia , ARN Viral/genética , /patogenicidad
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(2): 316-320, 2021 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-33626622

RESUMEN

Objective: To study the prevalence and correlates of plasma cytomegalovirus (CMV) viremia among newly reported antiretroviral therapy (ART)-naive HIV/AIDS patients in Taizhou during 2017-2018. Methods: CMV DNA was measured in plasma specimens of newly reported ART-naive HIV/AIDS patients by quantitative PCR. Both univariable and multivariable logistic regression analyses were carried out to evaluate CMV viremia correlations among the individuals. Results: Of 612 HIV/AIDS patients, 480 (78.4%) were male, 125 (20.4%) were over 60 years old, 177 (28.9%) were infected via homosexual transmission, and 430 (70.3%) via heterosexual transmission. The prevalence of CMV viremia among HIV/AIDS patients was 13.4% (82/612). Multivariable logistic regression analysis showed that the risk of CMV viremia in CD4+ lymphocyte cells counts (CD4+) ≤200 cells/µl group was higher than CD4 counts >500 cells/µl (OR=5.10, 95%CI:1.74-14.96, P=0.003); The median CMV DNA level (log10) of 82 viremic patients was 1.57 (P25,P75:1.04,2.13); Viremic patients with CD4 counts ≤200 cells/µl had the highest CMV viral load (P<0.01). Conclusions: Among ART-naive HIV/AIDS patients, the prevalence of CMV viremia was significantly associated with immunodeficiency status. Further research is needed to evaluate the association between CMV viremia and the course of HIV infection.


Asunto(s)
Infecciones por Citomegalovirus , Citomegalovirus , Infecciones por VIH , Viremia , China/epidemiología , Ciudades/epidemiología , Citomegalovirus/aislamiento & purificación , Infecciones por Citomegalovirus/epidemiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/terapia , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Viremia/epidemiología
6.
PLoS One ; 16(2): e0245011, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33596219

RESUMEN

We analyze the trade-offs between health and the economy during the period of social distancing in São Paulo, the state hardest hit by the COVID-19 pandemic in Brazil. We use longitudinal data with municipal-level information and check the robustness of our estimates to several sources of bias, including spatial dependence, reverse causality, and time-variant omitted variables. We use exogenous climate shocks as instruments for social distancing since people are more likely to stay home in wetter and colder periods. Our findings suggest that the health benefits of social distancing differ by levels of municipal development and may have vanished if the COVID-19 spread was not controlled in neighboring municipalities. In turn, we did not find evidence that municipalities with tougher social distancing performed worse economically. Our results also highlight that estimates that do not account for endogeneity may largely underestimate the benefits of social distancing on reducing the spread of COVID-19.


Asunto(s)
/economía , Cuarentena/economía , Brasil/epidemiología , /prevención & control , Ciudades/economía , Ciudades/epidemiología , Humanos , Pandemias/economía , Pandemias/prevención & control , Cuarentena/psicología , /aislamiento & purificación
7.
PLoS One ; 16(2): e0246520, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33596229

RESUMEN

The coronavirus disease that emerged in 2019 (COVID-19) is highly contagious and has given way to a global pandemic. A present COVID-19 has high transmission rates worldwide, including in small Brazilian cities such as Ijuí. Located in the northwest part of the state of Rio Grande do Sul (RS) and with a population of 83,475, Ijuí was selected as the site of a population-based survey involving 2,222 subjects, from April to June 2020. Subjects were tested for the presence of antibodies against coronavirus (SARS-CoV-2) and answered questions regarding social distance adherence (SDA), daily preventive routines (DPR), comorbidities, and sociodemographic characteristics. In parallel, the local government registered the official COVID-19 cases in Ijuí, as well as the mobile social distancing index (MSDI). In this study, we demonstrate that there was a decrease in the levels of SDA, DPR and MSDI before the beginning of COVID-19 community transmission in Ijuí. Furthermore, we provide predictions for the number of COVID-19 cases, hospitalizations, and deaths in the city. We conclude that insufficient social distancing, as evidenced by different methods, may be related to the rapid increase of COVID-19 cases in Ijuí. Our study predicts an approaching outbreak of COVID-19 in Ijuí through community spread, which could be avoided or attenuated with increased levels of social distancing among the population.


Asunto(s)
/transmisión , Pandemias/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Actitud , Actitud Frente a la Salud , Brasil/epidemiología , /virología , Ciudades/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuarentena/psicología , Encuestas y Cuestionarios , Adulto Joven
8.
Isr J Health Policy Res ; 10(1): 17, 2021 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-33637126

RESUMEN

BACKGROUND: Excess all-cause mortality has been used in many countries as an estimate of mortality effects from COVID-19. What was the excess mortality in Israel in 2020 and when, where and for whom was this excess? METHODS: Mortality rates between March to November 2020 for various demographic groups, cities, month and week were compared with the average rate during 2017-2019 for the same groups or periods. RESULTS: Total mortality rates for March-November were significantly higher by 6% in 2020, than the average of 2017-2019, 14% higher among the Arab population and 5% among Jews and Others. Significantly higher monthly mortality rates were found in August, September and October by 11%, 13% and 19%, respectively, among Jews and Others, and by 19%, 64% and 40% in the Arab population. Excess mortality was significant only at older ages, 7% higher rates at ages 65-74 and 75-84 and 8% at ages 85 and above, and greater for males than females in all ages and population groups. Interestingly, mortality rates decreased significantly among the younger population aged under 25. The cities with most significant excess mortality were Ramla (25% higher), Bene Beraq (24%), Bat Yam (15%) and Jerusalem (8%). CONCLUSION: Israel has seen significant excess mortality in August-October 2020, particularly in the Arab sector. The excess mortality in March-November was statistically significant only at older ages, over 65. It is very important to protect this susceptible population from exposure and prioritize them for inoculations. Lockdowns were successful in lowering the excess mortality. The excess mortality is similar to official data on COVID-19 deaths.


Asunto(s)
/mortalidad , Mortalidad/tendencias , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Árabes/estadística & datos numéricos , Niño , Preescolar , Ciudades/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Israel/epidemiología , Judíos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Mortalidad/etnología , Características de la Residencia/estadística & datos numéricos , Distribución por Sexo , Factores de Tiempo , Adulto Joven
9.
MMWR Morb Mortal Wkly Rep ; 70(6): 197-201, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33571179

RESUMEN

An estimated 1.4 million adults in the United States live with congenital heart defects (CHDs), yet their health outcomes are not well understood (1). Using self-reported, cross-sectional data from 1,482 respondents in the 2016-2019 Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) (2), CDC and academic partners estimated the prevalence of comorbidities among adults with CHDs aged 20-38 years born in Arizona (AZ), Arkansas (AR), and metropolitan Atlanta, Georgia (GA) compared with the general population (aged 20-38 years) from the National Health and Nutrition Examination Survey (NHANES) during 2015-2018 (3) and the AZ, AR, and GA Behavioral Risk Factor Surveillance Systems (BRFSS) during 2016-2018 (4). Adults with CHDs were more likely than those in the general population to report cardiovascular comorbidities, such as a history of congestive heart failure (4.3% versus 0.2%) and stroke (1.4% versus 0.3%), particularly those with severe CHDs (2). Adults with CHDs were more likely to report current depressive symptoms (15.1% versus 8.5%), but less likely to report previous diagnoses of depression (14.2% versus 22.6%), asthma (12.7% versus 16.9%), or rheumatologic disease (3.2% versus 8.0%). Prevalence of noncardiovascular comorbidities was similar between adults whose CHD was considered severe and those with nonsevere CHDs. Public health practitioners and clinicians can encourage young adults with CHDs to seek appropriate medical care to help them live as healthy a life as possible.


Asunto(s)
Cardiopatías Congénitas/epidemiología , Adulto , Arizona/epidemiología , Arkansas/epidemiología , Ciudades/epidemiología , Comorbilidad , Femenino , Georgia/epidemiología , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Encuestas y Cuestionarios , Adulto Joven
10.
Rev Bras Parasitol Vet ; 30(1): e018620, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33533796

RESUMEN

Visceral leishmaniasis is a widely distributed zoonosis and canine infection is an important indicator of risk for the occurrence of the disease in humans. The goal of this analysis was to study the spatial clustering of canine leishmaniasis (CL) in the municipality of Santa Luzia, state of Paraíba. For this, 749 samples of canine plasma were tested using three serological tests. The dog was considered positive if it reacted in two serological tests. The location of the residences was performed with a Global Positioning System receiver (GPS Garmin® eTrex 30), and used to perform georeferencing and spatial analysis. The prevalence of CL was 15.49% and it was observed that most cases of the urban area were concentrated in the Frei Damião neighborhood, on the outskirts of the city, where a high-risk cluster for the occurrence of the disease was formed (p = 0.02; RR = 2.48). No statistically significant cluster was observed in rural areas. CL is widely distributed in the municipality of Santa Luzia in a heterogeneous manner and with a tendency to urbanization. The areas identified with high prevalence and highest risk should be prioritized to maximize the efficiency of the Visceral Leishmaniasis Surveillance and Control Program and minimize the chance of new canine and human cases.


Asunto(s)
Enfermedades de los Perros , Leishmaniasis Visceral , Análisis Espacial , Animales , Anticuerpos Antiprotozoarios/sangre , Brasil/epidemiología , Ciudades/epidemiología , Clima Desértico , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/epidemiología , Perros , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/veterinaria
11.
Epidemiol Infect ; 149: e60, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33629938

RESUMEN

The objective of this study was to analyse the dynamics of spatial dispersion of the coronavirus disease 2019 (COVID-19) in Brazil by correlating them to socioeconomic indicators. This is an ecological study of COVID-19 cases and deaths between 26 February and 31 July 2020. All Brazilian counties were used as units of analysis. The incidence, mortality, Bayesian incidence and mortality rates, global and local Moran indices were calculated. A geographic weighted regression analysis was conducted to assess the relationship between incidence and mortality due to COVID-19 and socioeconomic indicators (independent variables). There were confirmed 2 662 485 cases of COVID-19 reported in Brazil from February to July 2020 with higher rates of incidence in the north and northeast. The Moran global index of incidence rate (0.50, P = 0.01) and mortality (0.45 with P = 0.01) indicate a positive spatial autocorrelation with high standards in the north, northeast and in the largest urban centres between cities in the southeast region. In the same period, there were 92 475 deaths from COVID-19, with higher mortality rates in the northern states of Brazil, mainly Amazonas, Pará and Amapá. The results show that there is a geospatial correlation of COVID-19 in large urban centres and regions with the lowest human development index in the country. In the geographic weighted regression, it was possible to identify that the percentage of people living in residences with density higher than 2 per dormitory, the municipality human development index (MHDI) and the social vulnerability index were the indicators that most contributed to explaining incidence, social development index and the municipality human development index contributed the most to the mortality model. We hope that the findings will contribute to reorienting public health responses to combat COVID-19 in Brazil, the new epicentre of the disease in South America, as well as in other countries that have similar epidemiological and health characteristics to those in Brazil.


Asunto(s)
/diagnóstico , Pandemias/estadística & datos numéricos , Teorema de Bayes , Brasil/epidemiología , Ciudades/epidemiología , Humanos , Incidencia , Modelos Lineales , Pandemias/prevención & control , Factores de Riesgo , Factores Socioeconómicos , Análisis Espacial
12.
Antimicrob Resist Infect Control ; 10(1): 42, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33632318

RESUMEN

BACKGROUND: Novel coronavirus pneumonia has been the most serious worldwide public health emergency since being identified in December 2019. The rapid spread of the pandemic and the strong human to human infection rate of COVID-19 poses a great prevention challenge. There has been an explosion in the number of confirmed cases in several cities near Wuhan, including the highest in Honghu, Jinzhou. Owing to the limited admission capacity and medical resources, increasing numbers of suspected cases of COVID-19 infection were difficult to confirm or treat. CASE PRESENTATION: Following the arrival of the Guangdong medical aid team on 11 February, 2020, COVID-19 care in Honghu saw changes after a series of solutions were implemented based on the 'Four-Early' and 'Four-centralization' management measures. The 'Four-Early' measures are: early detection, early reporting, early quarantine, and early treatment for meeting an urgent need like the COVID-19 pandemic. 'Four-centralization' refers to the way in which recruited medical teams can make full use of medical resources to give patients the best treatment. These solutions successfully increased the recovery rate and reduced mortality among patients with COVID-19 in Honghu. CONCLUSIONS: This management strategy is called the 'Honghu Model' which can be generalized to enable the prevention and management of COVID-19 worldwide.


Asunto(s)
/prevención & control , /epidemiología , China/epidemiología , Ciudades/epidemiología , Hospitalización , Humanos , Pandemias/prevención & control , Manejo de Atención al Paciente , Salud Pública , Cuarentena , /aislamiento & purificación
13.
Int J Hyg Environ Health ; 233: 113692, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33592569

RESUMEN

The aim of the present study was to develop a simple, sensitive, and specific approach to quantifying the SARS-CoV-2 genome in wastewater and to evaluate this approach as a means of epidemiological surveillance. Twelve wastewater samples were collected from a metropolitan area in north-eastern France during April and May 2020. In addition to the quantification of the SARS-CoV-2 genome, F-specific RNA phages of genogroup II (FRNAPH GGII), naturally present in wastewater, were used as an internal process control for the viral concentration and processing of RT-PCR inhibitors. A concentration method was required to allow the quantification of the SARS-CoV-2 genome over the longest possible period. A procedure combining ultrafiltration, phenol-chloroform-isoamyl alcohol purification, and the additional purification of the RNA extracts was chosen for the quantification of the SARS-CoV-2 genome in 100-mL wastewater samples. At the same time, the COVID-19 outbreak was evaluated through patients from the neighbouring University Hospital of Nancy, France. A regular decrease in the concentration of the SARS-CoV-2 genome from ~104 gc/L to ~102 gc/L of wastewater was observed over the eight weeks of the study, during which the population was placed under lockdown. The SARS-CoV-2 genome was even undetectable during one week in the second half of May and present but non-quantifiable in the last sample (28 May). A concordant circulation in the human community was highlighted by virological diagnosis using respiratory samples, which showed a decrease in the number of COVID-19 cases from 677 to 52 per week over the same period. The environmental surveillance of COVID-19 using a reliable viral quantification procedure to test wastewater is a key approach. The real-time detection of viral genomes can allow us to predict and monitor the circulation of SARS-CoV-2 in clinical settings and survey the entire urban human population.


Asunto(s)
/epidemiología , Brotes de Enfermedades , Monitoreo del Ambiente/métodos , Genoma Viral , Aguas Residuales/microbiología , /diagnóstico , Precipitación Química , Ciudades/epidemiología , Francia/epidemiología , Hospitales Universitarios , Humanos , Ultrafiltración , Proteínas Virales/química , Proteínas Virales/aislamiento & purificación , Microbiología del Agua
14.
Environ Pollut ; 276: 116682, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33631687

RESUMEN

People with chronic obstructive pulmonary disease, cardiovascular disease, or hypertension have a high risk of developing severe coronavirus disease 2019 (COVID-19) and of COVID-19 mortality. However, the association between long-term exposure to air pollutants, which increases cardiopulmonary damage, and vulnerability to COVID-19 has not yet been fully established. We collected data of confirmed COVID-19 cases during the first wave of the epidemic in mainland China. We fitted a generalized linear model using city-level COVID-19 cases and severe cases as the outcome, and long-term average air pollutant levels as the exposure. Our analysis was adjusted using several variables, including a mobile phone dataset, covering human movement from Wuhan before the travel ban and movements within each city during the period of the emergency response. Other variables included smoking prevalence, climate data, socioeconomic data, education level, and number of hospital beds for 324 cities in China. After adjusting for human mobility and socioeconomic factors, we found an increase of 37.8% (95% confidence interval [CI]: 23.8%-52.0%), 32.3% (95% CI: 22.5%-42.4%), and 14.2% (7.9%-20.5%) in the number of COVID-19 cases for every 10-µg/m3 increase in long-term exposure to NO2, PM2.5, and PM10, respectively. However, when stratifying the data according to population size, the association became non-significant. The present results are derived from a large, newly compiled and geocoded repository of population and epidemiological data relevant to COVID-19. The findings suggested that air pollution may be related to population vulnerability to COVID-19 infection, although the extent to which this relationship is confounded by city population density needs further exploration.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Epidemias , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , China/epidemiología , Ciudades/epidemiología , Exposición a Riesgos Ambientales/análisis , Humanos , Material Particulado/análisis
15.
Ecotoxicol Environ Saf ; 210: 111884, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33421716

RESUMEN

Ambient carbon monoxide (CO) has been linked with mortality and morbidity. Little evidence is available regarding the relation between CO and years of life lost (YLL). Using data from 48 major cities in China from 2013 to 2017, we applied generalized additive models and random effects meta-analyses to explore the effects of CO on YLL from various diseases. Stratified analyses and meta-regression were performed to estimate potential effect modifications of demographic factors, regions, meteorological factors, co-pollutants, urbanization rate, economic level and health service level. Additional life gains due to avoidable YLL under certain scenario were also evaluated. Results indicated that a 1-mg/m³ increase of CO concentrations (lagged over 0-3 d), was associated with 2.08% (95% confidence interval [CI], 1.35%, 2.80%), 2.35% (95% CI: 1.39%, 3.30%), 1.47% (95% CI: -0.01%, 2.93%), 2.28% (95% CI: 1.09%, 3.47%), 2.42% (95% CI: 1.31%, 3.54%), 2.09% (95% CI: 0.47%, 3.72%) increments in daily YLL from non-accidental causes, cardiovascular diseases, respiratory diseases, coronary heart disease, stroke and chronic obstructive pulmonary disease, respectively. These associations were robust to the adjustment of co-pollutants and varied substantially by geography and demographic characteristics. Associations were stronger in the elder people (≥65 years), females, population with low education attainment, and lived in south region, than younger people, males, high educated populations and those lived in north region. Moreover, the harmful impact of increasing CO concentration could be attenuated by city-level characteristics, including the growth of urbanization rate, gross domestic product (GDP), GDP per capita, number of hospital beds, doctors and hospitals. Finally, an estimated life of 0.081 (95% CI: -0.027, 0.190) years would be gained per deceased people if CO concentration could fall to 1 mg/m3. In conclusions, this nationwide analysis showed significant associations between short-term CO exposure and cause-specific YLL. The heterogeneity of both individual- and city-level characteristics should be considered for relevant intervention. These findings may have significant public health implications for the reduction of CO-attributed disease burden in China.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Monóxido de Carbono/efectos adversos , Enfermedades Cardiovasculares/epidemiología , Exposición a Riesgos Ambientales/efectos adversos , Enfermedades Respiratorias/epidemiología , Anciano , Contaminantes Atmosféricos/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Monóxido de Carbono/análisis , China/epidemiología , Ciudades/epidemiología , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Masculino
16.
PLoS One ; 16(1): e0245669, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33481925

RESUMEN

We present a forecasting model aim to predict hospital occupancy in metropolitan areas during the current COVID-19 pandemic. Our SEIRD type model features asymptomatic and symptomatic infections with detailed hospital dynamics. We model explicitly branching probabilities and non-exponential residence times in each latent and infected compartments. Using both hospital admittance confirmed cases and deaths, we infer the contact rate and the initial conditions of the dynamical system, considering breakpoints to model lockdown interventions and the increase in effective population size due to lockdown relaxation. The latter features let us model lockdown-induced 2nd waves. Our Bayesian approach allows us to produce timely probabilistic forecasts of hospital demand. We have applied the model to analyze more than 70 metropolitan areas and 32 states in Mexico.


Asunto(s)
/epidemiología , Teorema de Bayes , Ciudades/epidemiología , Control de Enfermedades Transmisibles , Predicción , Hospitalización , Hospitales , Humanos , México/epidemiología , Densidad de Población , /aislamiento & purificación
17.
Artículo en Inglés | MEDLINE | ID: mdl-33503150

RESUMEN

American Tegumentary Leishmaniasis (ATL) is endemic in the municipality of Montes Claros, Minas Gerais State. The use of geotechnology such as spatial statistics and remote sensing has contributed to a better understanding of the eco-epidemiology of diseases, and consequently a better definition of control strategies. This study aimed to analyze the spatial distribution of probable sites of cases of ATL infection (2007-2011) in the municipality of Montes Claros and to identify related socio-environmental factors. Data on ATL cases notification were obtained from the Municipal Health Department of Montes Claros. The annual incidence of ATL in the municipality was calculated and the probable sites of infection were georeferenced. Crude Rate and the Local Empirical Bayesian Rate were calculated with census sectors considered as the unit of analysis. The Normalized Difference Vegetation Index (NDVI) was calculated from LANDSAT 5 TM images. The spatial association between the crude rate of ATL and the NDVI of the census tracts was evaluated using the Local Bivariate of Moran I. The socio-environmental aspects of household structures were assessed based on a structured questionnaire. The incidence of ATL in the evaluated period ranged from 6.2 to 16.6 cases/100,000 inhabitants. The highest rates of ATL occurrence were found in the census sectors located in the rural area and in the peripheral census sectors in the city. Through the Empirical Bayes Smoothed Rate map, it was found that in the peripheral areas of the city, the rates of ATL occurrence were lower than in the rural area and their values decreased as they approach the city center. Local Bivariate of Moran I showed a positive correlation between NDVI and crude ATL rates, with significant high-high clusters observed in the rural area and in the census sectors in the Western peripheral area of the city that have experienced an urban expansion concomitant to the period investigated. In most homes of people affected by the disease, there were domestic animals and organic matter in the peridomicile. In addition, a high percentage of individuals affected by ATL reported the presence of rodents circulating near their homes. In conclusion, it is possible that the disorderly expansion process in the city of Montes Claros favored the establishment of the ATL periurban and urban transmission cycle. These regions deserve special attention from health surveillance to combat this zoonosis.


Asunto(s)
Leishmania/aislamiento & purificación , Leishmaniasis Cutánea/epidemiología , Animales , Teorema de Bayes , Brasil/epidemiología , Ciudades/epidemiología , Salud Ambiental , Incidencia , Leishmania/genética , Factores Socioeconómicos , Análisis Espacial
18.
Environ Health Prev Med ; 26(1): 7, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33435864

RESUMEN

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has become a severe global burden in terms of both health and the economy. Few studies, however, have thoroughly assessed the influence of air pollution on COPD-related mortality among elderly people in developing areas in the hinterland of southwestern China. This study is the first to examine the association between short-term exposure to ambient airborne pollutants and COPD-related mortality among elderly people in the central Sichuan Basin of southwestern China. METHODS: Data on COPD-related mortality among elderly people aged 60 and older were obtained from the Population Death Information Registration and Management System (PDIRMS). Data on airborne pollutants comprised of particulate matter < 2.5 µm in aerodynamic diameter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were derived from 23 municipal environmental monitoring sites. Data on weather conditions, including daily mean temperature and relative humidity, were obtained from the Chengdu Meteorological Bureau. All data were collected from January 1, 2015, to December 31, 2018. A quasi-Poisson general additive model (GAM) was utilized to assess the effects of short-term exposure to airborne pollutants on COPD-related mortality among elderly people. RESULTS: A total of 61,058 COPD-related deaths of people aged 60 and older were obtained. Controlling the influences of daily temperature and relative humidity, interquartile range (IQR) concentration increases of PM2.5 (43 µg/m3), SO2 (8 µg/m3), NO2 (18 µg/m3), CO (0.4 mg/m3), and O3 (78 µg/m3) were associated with 2.7% (95% CI 1.0-4.4%), 4.3% (95% CI 2.1-6.4%), 3.6% (95% CI 1.7-5.6%), 2.7% (95% CI 0.6-4.8%), and 7.4% (95% CI 3.6-11.3%) increases in COPD-related mortality in people aged 60 and older, respectively. The exposure-response curves between each pollutant and the log-relative risk of COPD-related mortality exhibited linear relationships. Statistically significant differences in the associations between pollutants and COPD-related mortality were not observed among sociodemographic factors including age, gender, and marital status. The effects of O3 remained steady after adjusting for PM2.5, SO2, NO2, and CO each time in the two-pollutant models. CONCLUSIONS: Increased concentrations of ambient airborne pollutants composed of PM2.5, SO2, NO2, O3, and CO were significantly and positively associated with COPD-related mortality in the central Sichuan Basin, which is located in the hinterland of southwestern China. The adverse effects of O3 were stable, a finding that should receive more attention.


Asunto(s)
Contaminantes Atmosféricos/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Anciano , Anciano de 80 o más Años , China/epidemiología , Ciudades/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/inducido químicamente , Factores de Tiempo
20.
J R Soc Interface ; 18(174): 20200599, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33468021

RESUMEN

We study the spread of COVID-19 across neighbourhoods of cities in the developing world and find that small numbers of neighbourhoods account for a majority of cases (k-index approx. 0.7). We also find that the countrywide distribution of cases across states/provinces in these nations also displays similar inequality, indicating self-similarity across scales. Neighbourhoods with slums are found to contain the highest density of cases across all cities under consideration, revealing that slums constitute the most at-risk urban locations in this epidemic. We present a stochastic network model to study the spread of a respiratory epidemic through physically proximate and accidental daily human contacts in a city, and simulate outcomes for a city with two kinds of neighbourhoods-slum and non-slum. The model reproduces observed empirical outcomes for a broad set of parameter values-reflecting the potential validity of these findings for epidemic spread in general, especially across cities of the developing world. We also find that distribution of cases becomes less unequal as the epidemic runs its course, and that both peak and cumulative caseloads are worse for slum neighbourhoods than non-slums at the end of an epidemic. Large slums in the developing world, therefore, contain the most vulnerable populations in an outbreak, and the continuing growth of metropolises in Asia and Africa presents significant challenges for future respiratory outbreaks from perspectives of public health and socioeconomic equity.


Asunto(s)
/epidemiología , Países en Desarrollo , Áreas de Pobreza , Población Urbana , /economía , Ciudades/epidemiología , Humanos
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