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1.
Emerg Microbes Infect ; 9(1): 988-990, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32321369

RESUMEN

Since Dec 2019, China has experienced an outbreak caused by a novel coronavirus, 2019-nCoV. A travel ban was implemented for Wuhan, Hubei on Jan 23 to slow down the outbreak. We found a significant positive correlation between population influx from Wuhan and confirmed cases in other cities across China (R2 = 0.85, P < 0.001), especially cities in Hubei (R2 = 0.88, P < 0.001). Removing the travel restriction would have increased 118% (91%-172%) of the overall cases for the coming week, and a travel ban taken three days or a week earlier would have reduced 47% (26%-58%) and 83% (78%-89%) of the early cases. We would expect a 61% (48%-92%) increase of overall cumulative cases without any restrictions on returning residents, and 11% (8%-16%) increase if the travel ban stays in place for Hubei. Cities from Yangtze River Delta, Pearl River Delta, and Capital Economic Circle regions are at higher risk.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Viaje/estadística & datos numéricos , Betacoronavirus/aislamiento & purificación , China/epidemiología , Infecciones por Coronavirus/transmisión , Humanos , Pandemias , Neumonía Viral/transmisión , Viaje/legislación & jurisprudencia
2.
Science ; 368(6490): 493-497, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-32213647

RESUMEN

The ongoing coronavirus disease 2019 (COVID-19) outbreak expanded rapidly throughout China. Major behavioral, clinical, and state interventions were undertaken to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, affected COVID-19 spread in China. We used real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation in transmission in cities across China and to ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was explained well by human mobility data. After the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases were still indicative of local chains of transmission outside of Wuhan. This study shows that the drastic control measures implemented in China substantially mitigated the spread of COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Viaje/estadística & datos numéricos , Distribución por Edad , Betacoronavirus , China , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Monitoreo Epidemiológico , Humanos , Modelos Lineales , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Distribución por Sexo , Análisis Espacial
4.
BMC Health Serv Res ; 20(1): 93, 2020 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-32028951

RESUMEN

BACKGROUND: The Human Immunodeficiency Virus (HIV) with which over 37 million peoples are living is the leading cause of morbidity and mortality worldwide. The rapid expansion of antiretroviral treatment has dramatically reduced HIV related deaths and transmissions. Patient satisfaction could be an indispensable parameter used to measure patients' desired fulfillment by the services. Hence, this study aimed to determine the level of patient satisfaction with antiretroviral therapy services and determinants at Gondar town health centers. METHODS: An institution-based cross-sectional study was conducted from November 1 to 30, 2018. The systematic random sampling technique was used to select 663 HIV/AIDS patients on antiretroviral therapy follow-ups. Data were collected using a pretested interviewer-administered questionnaire and patient medical document reviews. Summary statistics such as means, medians and proportions were calculated and presented in the form of tables, graphs, and texts. Bivariate and multivariable logistic regression analysis was fitted and adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to assess the strength of association. Variables with p-value 0.05 at multivariable logistic regression considered significant determinants of patient satisfaction. RESULTS: The overall patient satisfaction with antiretroviral therapy services was 75.4% (95%CI, 71.9 to 79%). Patients' age 38-47 years (AOR = 5.90, 95%CI: 3.38,10.31) and ≥ 48 years (AOR = 2.66, 95%CI:1.38,5.12), absence of signs and directions to ART clinic (AOR = 0.53,95%CI:0.35,0.82), Azezo health center (AOR = 2.68,95%CI:1.47,4.66) and Teda health center (AOR = 4.44,95%CI:1.73,11.30), and travel that took more than 1 h (AOR = 0.56;95% CI:0.32,0.97) were determinants of patient satisfaction with the services. CONCLUSION: The overall patient satisfaction with antiretroviral therapy service was lower than the national target of 85% with the marked difference among health centers. Older age, absence of signs and directions to ART clinics, and longer travel from home to health centers were factors influencing patient satisfaction with antiretroviral treatments. This suggests that further improvement of accessibility is likely needed to increase patient satisfaction.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Centros Comunitarios de Salud/estadística & datos numéricos , Estudios Transversales , Etiopía , Femenino , Investigación sobre Servicios de Salud , Humanos , Directorios de Señalización y Ubicación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Viaje/estadística & datos numéricos
5.
PLoS One ; 15(2): e0229458, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092120

RESUMEN

Sharing the use of a bicycle in China has changed people's daily travel modes. Existing studies mainly explored the factors affecting individuals' initial intentions to start using a shared bicycle, but few looked at the likelihood that a user would continue using one. Based on a post-acceptance model of information system (IS) continuance, this investigation proposed a research model to investigate factors influencing riders' intentions to continued usage of shared bikes. Analysis involved structural equation modeling (SEM) and fuzzy-set qualitative comparative analysis (fsQCA) on data from 376 shared bicycle riders. The results from SEM showed that perceived usefulness, service quality, riders' habits, overall satisfaction and the nature of the weather were the most important factors positively influencing users' intentions to continue bike sharing. The results from fsQCA showed that six combinations of these variables were sufficient to explain continued usage. The conclusions of this study can be useful for operators to improve shared bicycle services.


Asunto(s)
Ciclismo , Conducta Cooperativa , Intención , Viaje , Adulto , Conducta , Ciclismo/psicología , Ciclismo/estadística & datos numéricos , China/epidemiología , Conducta de Elección/fisiología , Comportamiento del Consumidor/estadística & datos numéricos , Femenino , Humanos , Masculino , Probabilidad , Asunción de Riesgos , Factores Socioeconómicos , Viaje/psicología , Viaje/estadística & datos numéricos
6.
PLoS Negl Trop Dis ; 14(2): e0007858, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32084134

RESUMEN

We review epidemiological and clinical data on human myiasis from Ecuador, based on data from the Ministry of Public Health (MPH) and a review of the available literature for clinical cases. The larvae of four flies, Dermatobia hominis, Cochliomyia hominivorax, Sarcophaga haemorrhoidalis, and Lucilia eximia, were identified as the causative agents in 39 reported clinical cases. The obligate D. hominis, causing furuncular lesions, caused 17 (43.5%) cases distributed along the tropical Pacific coast and the Amazon regions. The facultative C. hominivorax was identified in 15 (38%) clinical cases, infesting wound and cavitary lesions including orbital, nasal, aural and vaginal, and occurred in both subtropical and Andean regions. C. hominivorax was also identified in a nosocomial hospital-acquired wound. Single infestations were reported for S. haemorrhoidalis and L. eximia. Of the 39 clinical cases, 8 (21%) occurred in tourists. Ivermectin, when it became available, was used to treat furuncular, wound, and cavitary lesions successfully. MPH data for 2013-2015 registered 2,187 cases of which 54% were reported in men; 46% occurred in the tropical Pacific coast, 30% in the temperate Andes, 24% in the tropical Amazon, and 0.2% in the Galapagos Islands. The highest annual incidence was reported in the Amazon (23 cases/100,000 population), followed by Coast (5.1/100,000) and Andes (4.7/100,000). Human myiasis is a neglected and understudied ectoparasitic infestation, being endemic in both temperate and tropical regions of Ecuador. Improved education and awareness among populations living in, visitors to, and health personnel working in high-risk regions, is required for improved epidemiological surveillance, prevention, and correct diagnosis and treatment.


Asunto(s)
Miasis/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Niño , Preescolar , Dípteros/clasificación , Dípteros/genética , Dípteros/fisiología , Ecuador/epidemiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Miasis/diagnóstico , Miasis/parasitología , Viaje/estadística & datos numéricos , Adulto Joven
7.
Plast Reconstr Surg ; 145(2): 471-481, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31985644

RESUMEN

BACKGROUND: Hand surgeons can alleviate the burden associated with various congenital anomalies, burn sequelae, and trauma that debilitate individuals in low- and middle-income countries. Because few surgeons in these areas have the necessary resources to perform complex hand surgery, surgical trips provide essential surgical care. The authors aimed to determine the economic benefit of hand surgical trips to low- and middle-income countries to comprehensively determine the economic implications of hand surgery trips in low-resource settings. METHODS: The authors collected data from two major global hand surgery organizations to analyze the economic benefit of hand surgery trips in low- and middle-income countries. The authors used both the human capital approach and the value of a statistical life-year approach to conduct this cost-benefit analysis. To demonstrate the economic gain, the authors subtracted the budgeted cost of each trip from the economic benefit. RESULTS: The authors analyzed a total of 15 trips to low- and middle-income countries. The costs of the trips ranged from $3453 to $87,434 (average, $24,869). The total cost for all the surgical trips was $373,040. The authors calculated a net economic benefit of $3,576,845 using the human capital approach and $8,650,745 using the value of a statistical life-year approach. CONCLUSIONS: The authors found a substantial return on investment using both the human capital approach and the value of a statistical life-year approach. In addition, the authors found that trips emphasizing education had a net economic benefit. Cost-benefit analyses have substantial financial implications and will aid policy makers in developing cost-reduction strategies to promote surgery in low- and middle-income countries.


Asunto(s)
Países en Desarrollo/economía , Deformidades Congénitas de la Mano/economía , Traumatismos de la Mano/economía , Mano/cirugía , Adolescente , Adulto , Anciano , Niño , Preescolar , Análisis Costo-Beneficio , Prestación de Atención de Salud/economía , Femenino , Deformidades Congénitas de la Mano/cirugía , Traumatismos de la Mano/cirugía , Humanos , Masculino , Turismo Médico/economía , Área sin Atención Médica , Persona de Mediana Edad , Embarazo , Años de Vida Ajustados por Calidad de Vida , Estudios Retrospectivos , Viaje/economía , Viaje/estadística & datos numéricos , Adulto Joven
8.
Epidemiol Psychiatr Sci ; 29: e92, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31928567

RESUMEN

AIMS: Research from high-income countries has implicated travel distance to mental health services as an important factor influencing treatment-seeking for mental disorders. This study aimed to test the extent to which travel distance to the nearest depression treatment provider is associated with treatment-seeking for depression in rural India. METHODS: We used data from a population-based survey of adults with probable depression (n = 568), and calculated travel distance from households to the nearest public depression treatment provider with network analysis using Geographic Information Systems (GIS). We tested the association between travel distance to the nearest public depression treatment provider and 12 month self-reported use of services for depression. RESULTS: We found no association between travel distance and the probability of seeking treatment for depression (OR 1.00, 95% CI 0.98-1.02, p = 0.78). Those living in the immediate vicinity of public depression treatment providers were just as unlikely to seek treatment as those living 20 km or more away by road. There was evidence of interaction effects by caste, employment status and perceived need for health care, but these effect sizes were generally small. CONCLUSIONS: Geographic accessibility - as measured by travel distance - is not the primary barrier to seeking treatment for depression in rural India. Reducing travel distance to public mental health services will not of itself reduce the depression treatment gap for depression, at least in this setting, and decisions about the best platform to deliver mental health services should not be made on this basis.


Asunto(s)
Depresión/terapia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Conducta de Búsqueda de Ayuda , Servicios de Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud , Población Rural/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Estudios Transversales , Depresión/diagnóstico , Depresión/psicología , Femenino , Sistemas de Información Geográfica , Encuestas de Atención de la Salud , Investigación sobre Servicios de Salud , Humanos , India , Masculino , Vigilancia de la Población , Factores de Tiempo
9.
Int J Equity Health ; 19(1): 15, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992319

RESUMEN

BACKGROUND: In sub-Saharan Africa, women are most likely to receive skilled and adequate childbirth care in hospital settings, yet the use of hospital for childbirth is low and inequitable. The poorest and those living furthest away from a hospital are most affected. But the relative contribution of poverty and travel time is convoluted, since hospitals are often located in wealthier urban places and are scarcer in poorer remote area. This study aims to partition the variability in hospital-based childbirth by poverty and travel time in four sub-Saharan African countries. METHODS: We used data from the most recent Demographic and Health Survey in Kenya, Malawi, Nigeria and Tanzania. For each country, geographic coordinates of survey clusters, the master list of hospital locations and a high-resolution map of land surface friction were used to estimate travel time from each DHS cluster to the nearest hospital with a shortest-path algorithm. We quantified and compared the predicted probabilities of hospital-based childbirth resulting from one standard deviation (SD) change around the mean for different model predictors. RESULTS: The mean travel time to the nearest hospital, in minutes, was 27 (Kenya), 31 (Malawi), 25 (Nigeria) and 62 (Tanzania). In Kenya, a change of 1SD in wealth led to a 33.2 percentage points change in the probability of hospital birth, whereas a 1SD change in travel time led to a change of 16.6 percentage points. The marginal effect of 1SD change in wealth was weaker than that of travel time in Malawi (13.1 vs. 34.0 percentage points) and Tanzania (20.4 vs. 33.7 percentage points). In Nigeria, the two were similar (22.3 vs. 24.8 percentage points) but their additive effect was twice stronger (44.6 percentage points) than the separate effects. Random effects from survey clusters also explained substantial variability in hospital-based childbirth in all countries, indicating other unobserved local factors at play. CONCLUSIONS: Both poverty and long travel time are important determinants of hospital birth, although they vary in the extent to which they influence whether women give birth in a hospital within and across countries. This suggests that different strategies are needed to effectively enable poor women and women living in remote areas to gain access to skilled and adequate care for childbirth.


Asunto(s)
Parto Obstétrico/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Viaje/estadística & datos numéricos , Demografía , Femenino , Humanos , Kenia , Malaui , Nigeria , Embarazo , Tanzanía , Factores de Tiempo
10.
Int J Behav Nutr Phys Act ; 16(1): 135, 2019 12 21.
Artículo en Inglés | MEDLINE | ID: mdl-31864372

RESUMEN

BACKGROUND: Innovative approaches are required to move beyond individual approaches to behaviour change and develop more appropriate insights for the complex challenge of increasing population levels of activity. Recent research has drawn on social practice theory to describe the recursive and relational character of active living but to date most evidence is limited to small-scale qualitative research studies. To 'upscale' insights from individual contexts, we pooled data from five qualitative studies and used machine learning software to explore gendered patterns in the context of active travel. METHODS: We drew on 280 transcripts from five research projects conducted in the UK, including studies of a range of populations, travel modes and settings, to conduct unsupervised 'topic modelling analysis'. Text analytics software, Leximancer, was used in the first phase of the analysis to produce inter-topic distance maps to illustrate inter-related 'concepts'. The outputs from this first phase guided a second researcher-led interpretive analysis of text excerpts to infer meaning from the computer-generated outputs. RESULTS: Guided by social practice theory, we identified 'interrelated' and 'relating' practices across the pooled datasets. For this study we particularly focused on respondents' commutes, travelling to and from work, and on differentiated experiences by gender. Women largely described their commute as multifunctional journeys that included the school run or shopping, whereas men described relatively linear journeys from A to B but highlighted 'relating' practices resulting from or due to their choice of commute mode or journey such as showering or relaxing. Secondly, we identify a difference in discourses about practices across the included datasets. Women spoke more about 'subjective', internal feelings of safety ('I feel unsafe'), whereas men spoke more about external conditions ('it is a dangerous road'). CONCLUSION: This rare application of machine learning to qualitative social science research has helped to identify potentially important differences in co-occurrence of practices and discourses about practice between men's and women's accounts of travel across diverse contexts. These findings can inform future research and policy decisions for promoting travel-related social practices associated with increased physical activity that are appropriate across genders.


Asunto(s)
Aprendizaje Automático , Viaje/estadística & datos numéricos , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Distribución por Sexo , Reino Unido , Adulto Joven
11.
Malar J ; 18(1): 440, 2019 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-31870353

RESUMEN

Malaria connectivity describes the flow of parasites among transmission sources and sinks within a given landscape. Because of the spatial and temporal scales at which parasites are transported by their hosts, malaria sub-populations are largely defined by mosquito movement and malaria connectivity among them is largely driven by human movement. Characterising malaria connectivity thus requires characterising human travel between areas with differing levels of exposure to malaria. Whilst understanding malaria connectivity is fundamental for optimising interventions, particularly in areas seeking or sustaining elimination, there is a dearth of human movement data required to achieve this goal. Malaria indicator surveys (MIS) are a generally under utilised but potentially rich source of travel data that provide a unique opportunity to study simple associations between malaria infection and human travel in large population samples. This paper shares the experience working with MIS data from Bioko Island that revealed programmatically useful information regarding malaria importation through human travel. Simple additions to MIS questionnaires greatly augmented the level of detail of the travel data, which can be used to characterise human travel patterns and malaria connectivity to assist targeting interventions. It is argued that MIS potentially represent very important and timely sources of travel data that need to be further exploited.


Asunto(s)
Malaria/epidemiología , Viaje/estadística & datos numéricos , Guinea Ecuatorial/epidemiología , Humanos , Incidencia , Islas , Prevalencia , Riesgo
12.
Artículo en Inglés | MEDLINE | ID: mdl-31597376

RESUMEN

In the global economy, tourism is one of the most noticeable and growing sectors. Thissector plays an important role in boosting a nation's economy. An increase in tourism flow canbring positive economic outcomes to the nations, especially in gross domestic product (GDP) andemployment opportunities. In South Asian countries, the tourism industry is an engine ofeconomic development and GDP growth. This study investigates the impact of tourism onPakistan's economic growth and employment. The period under study was from 1990 to 2015. Tocheck whether the variables under study were stationary, augmented Dickey-Fuller andPhillips-Perron unit root tests were applied. A regression technique and Johansen cointegrationapproach were employed for the analysis of data. The key finding of this study shows that there isa positive and significant impact of tourism on Pakistan's economic growth as well as employmentsector and there is also a long-run relationship among the variables under study. This studysuggests that legislators should focus on the policies with special emphasis on the promotion oftourism due to its great potential throughout the country. Policy implications of this recent studyand future research suggestions are also mentioned.


Asunto(s)
Desarrollo Económico/estadística & datos numéricos , Empleo/estadística & datos numéricos , Producto Interno Bruto/estadística & datos numéricos , Viaje/economía , Viaje/estadística & datos numéricos , Humanos , India , Pakistán
13.
Medicine (Baltimore) ; 98(39): e17330, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31574869

RESUMEN

The aim of this study was to investigate the experiences of medical transportation of Korean travelers who suffered accidents abroad and then transferred home by our aeromedical team.We collected demographic and clinical data on patients injured while traveling abroad from January 2013 to July 2017. Descriptive analyses based on 4 different transportation methods and transport time since hospitalization were performed.A total of 33 patients were repatriated during the study period. Of these, 28 (84.8%) were trauma cases with pedestrian injuries being the most common (11 cases; 39.3%). Twenty patients were repatriated by flight-stretchers, 6 by flight-prestige, 2 by ship, and 5 by air ambulance. The air ambulance was the most expensive (average 61,124 US Dollars) mode of transportation (P = .001) and the ship took the longest time (14 hours) to transport patients back to Korea from regions with similar distance (P = .0023).We experienced medical repatriation of 33 seriously injured Korean travelers back to South Korea. Transfer time should be an important considering factor and directly contacting and communicating with the specialized staff of foreign hospitals could also be very important to reduce unnecessary overseas hospital stay and cost incidence.


Asunto(s)
Transporte de Pacientes , Viaje/estadística & datos numéricos , Heridas y Traumatismos , Accidentes/economía , Accidentes/estadística & datos numéricos , Adulto , Ambulancias Aéreas , Femenino , Humanos , Incidencia , Seguro de Salud , Internacionalidad , Masculino , República de Corea , Camillas , Transporte de Pacientes/economía , Transporte de Pacientes/métodos , Transporte de Pacientes/estadística & datos numéricos , Heridas y Traumatismos/economía , Heridas y Traumatismos/epidemiología
14.
BMC Public Health ; 19(1): 1397, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660916

RESUMEN

BACKGROUND: Travellers visiting friends and relatives (VFR) define a specific population of travellers exposed to higher risks for health and safety than tourists. The aim of this study was to assess differentials in pre-travel health care in VFR travellers compared to other travellers. METHODS: A retrospective cohort study was performed including attendees of the Travel Medicine Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, between January 2007 and December 2017. RESULTS: Over the 10-year period, 47,022 subjects presented to the travel clinic for pre-travel health care, 13.7% of whom were VFR travellers. These showed higher rates of vaccination against yellow fever and meningococcus, but lower rates for hepatitis A, hepatitis B, influenza, rabies, cholera, polio, typhoid IM vaccine and tetanus vaccine boosters. Regarding malaria prevention measures, results highlighted that VFR travellers, when compared with tourists, were more likely to be prescribed with chemoprophylaxis, particularly with mefloquine, than with atovaquone/proguanil. CONCLUSIONS: Findings from this large-scale study indicated differences in vaccination rates and completion, as well as in chemoprophylaxis for malaria, between VFR and non-VFR travellers, fostering specific interventions for promoting adherence to pre-travel health advice among migrant travellers.


Asunto(s)
Migrantes/psicología , Medicina del Viajero/estadística & datos numéricos , Viaje/estadística & datos numéricos , Adulto , Familia , Femenino , Amigos , Hospitales Universitarios , Humanos , Malaria/prevención & control , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , España , Migrantes/estadística & datos numéricos , Vacunación/estadística & datos numéricos
15.
Ann Agric Environ Med ; 26(3): 385-391, 2019 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-31559790

RESUMEN

INTRODUCTION: Arthropod-borne viruses are important causes of human morbidity worldwide. However, the available literatur and the epidemiological data concerning the importation to Poland of globally emerging arboviral infections, such as DENV, CHIKV, WNV, or ZIKV, are scarce. Only few seroepidemiologic studies concerning WNV in animals or humans in Poland have been published. OBJECTIVE: The aim of this review paper is to summarize and present the current state of knowledge and the perspectives for research concerning the importation and the risk posed by the introduction to Poland of the four above-mentioned arboviral diseases. CURRENT STATE OF KNOWLEDGE: Climate change may facilitate the northward expansion of both the vectors for diseases previously unseen in Europe, as well as of the viruses themselves, resulting in autochthonous cases of diseases previously exclusively imported. Little is known about the importation of arboviral diseases to Poland because of the frequently asymptomatic or self-limiting course of the disease, lack of epidemiologic studies or effective disease reporting, as well as inadequate access to diagnostic methods. CONCLUSIONS: Further epidemiologic studies in Polish travellers are necessary in order to prevent importation or introduction of the above-mentioned viruses, and to act against potential problems related to blood transfusion or organ transplantation from infected donors.


Asunto(s)
Infecciones por Arbovirus/epidemiología , Arbovirus/fisiología , Viaje/estadística & datos numéricos , Animales , Infecciones por Arbovirus/sangre , Infecciones por Arbovirus/transmisión , Infecciones por Arbovirus/virología , Arbovirus/genética , Arbovirus/inmunología , Arbovirus/aislamiento & purificación , Investigación Biomédica/tendencias , Humanos , Conocimiento , Polonia/epidemiología
16.
PLoS Comput Biol ; 15(9): e1007111, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31525184

RESUMEN

Prophylactic interventions such as vaccine allocation are some of the most effective public health policy planning tools. The supply of vaccines, however, is limited and an important challenge is to optimally allocate the vaccines to minimize epidemic impact. This resource allocation question (which we refer to as VaccIntDesign) has multiple dimensions: when, where, to whom, etc. Most of the existing literature in this topic deals with the latter (to whom), proposing policies that prioritize individuals by age and disease risk. However, since seasonal influenza spread has a typical spatial trend, and due to the temporal constraints enforced by the availability schedule, the when and where problems become equally, if not more, relevant. In this paper, we study the VaccIntDesign problem in the context of seasonal influenza spread in the United States. We develop a national scale metapopulation model for influenza that integrates both short and long distance human mobility, along with realistic data on vaccine uptake. We also design GreedyAlloc, a greedy algorithm for allocating the vaccine supply at the state level under temporal constraints and show that such a strategy improves over the current baseline of pro-rata allocation, and the improvement is more pronounced for higher vaccine efficacy and moderate flu season intensity. Further, the resulting strategy resembles a ring vaccination applied spatiallyacross the US.


Asunto(s)
Biología Computacional/métodos , Vacunas contra la Influenza/administración & dosificación , Gripe Humana , Asignación de Recursos/métodos , Análisis Espacio-Temporal , Algoritmos , Bases de Datos Factuales , Humanos , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Gripe Humana/transmisión , Estaciones del Año , Factores de Tiempo , Viaje/estadística & datos numéricos , Estados Unidos
17.
Artículo en Inglés | MEDLINE | ID: mdl-31416153

RESUMEN

Despite worldwide efforts, maternal and child mortality remains a major health problem in many developing countries. Cambodia's maternal mortality rate has decreased over recent years through government efforts and support from various international development cooperation agencies. The purpose of this study was to investigate the factors that affected the accessibility of Cambodia's maternal healthcare services. Data from maternal health service surveys conducted in Battambang, Cambodia in 2012 and 2015 were compared and analyzed. Multiple regression analysis was conducted to identify factors related to the accessibility of integrated maternal healthcare service. The travel time to health centers was found to be related to distance from the health center (ß = 0.031, p < 0.001), travel time during the rainy season (ß = 0.166, p < 0.001), and travel cost (ß = 0.001, p < 0.001), with an explanatory power of 27% (R2 = 0.274). Based on these findings, future research and policy should focus on improving accessibility to effective maternal and child healthcare services, to reduce maternal and child mortality. This study is intended to contribute to developing a multi-directional and integrated strategy for access to maternal health services in developing countries.


Asunto(s)
Mortalidad del Niño , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud Materna/organización & administración , Servicios de Salud Materna/estadística & datos numéricos , Mortalidad Materna , Viaje/estadística & datos numéricos , Adulto , Cambodia , Preescolar , Países en Desarrollo , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Encuestas y Cuestionarios
18.
Int J Behav Nutr Phys Act ; 16(1): 72, 2019 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-31438985

RESUMEN

BACKGROUND: Physical activity is associated with improved physical and mental health among children, but many children do not meet the recommended hour per day of moderate-to-vigorous-intensity physical activity (MVPA). The aim of this paper is to investigate participation in active after-school clubs and active travel to and from school at age 11 and estimate the average daily minutes of MVPA associated with active club attendance and active travel. METHODS: Accelerometer data were collected on three weekdays for 1296 11-year-old children in a cross-sectional study. Children reported attendance at active after-school clubs and how they travelled to and from school for each day of the week. To account for repeat days within child and clustering within schools we used multilevel models with random effects at the school and child level, and fixed effects for all covariates. We calculated odds ratios for participation in active after-school clubs and active travel for gender, measures of socio-economic position and BMI category. We also explored the association between active club attendance, active travel and daily average MVPA. RESULTS: Boys and girls were equally likely to attend active after-school clubs. Boys were more likely to travel to school using active modes. Attendance at active after-school clubs and active travel home were not associated with each other. Attending an active after-school club was associated with an additional 7.6 min (95% CI: 5.0 to 10.3) average MVPA on that day among both boys and girls. Active travel was associated with an additional 4.7 min (95% CI: 2.9 to 6.5) average MVPA per journey for boys and 2.4 min (95% CI: 1.0 to 3.7) for girls. CONCLUSIONS: Both active after-school clubs and active travel are associated with greater physical activity on the day that children participate in these, and we saw no evidence that those attending active clubs do so at the expense of active travel home afterwards. While the increased daily MVPA is small to moderate, active after-school clubs and active travel on multiple days of the week could make important contributions as part of complex interventions aimed at increasing population levels of physical activity in children.


Asunto(s)
Ejercicio Físico/fisiología , Instituciones Académicas/organización & administración , Viaje/estadística & datos numéricos , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Reino Unido/epidemiología
19.
Am J Public Health ; 109(9): 1216-1223, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31318587

RESUMEN

Objectives. To explore US geographic areas with limited access to HIV preexposure prophylaxis (PrEP) providers, PrEP deserts.Methods. We sourced publicly listed PrEP providers from a national database of PrEP providers from 2017 and obtained county-level urbanicity classification and population estimates of men who have sex with men (MSM) from public data. We calculated travel time from census tract to the nearest provider. We classified a census tract as a PrEP desert if 1-way driving time was greater than 30 or 60 minutes.Results. One in 8 PrEP-eligible MSM (108 758/844 574; 13%) lived in 30-minute-drive deserts, and a sizable minority lived in 60-minute-drive deserts (38 804/844 574; 5%). Location in the South and lower urbanicity were strongly associated with increased odds of PrEP desert status.Conclusions. A substantial number of persons at high risk for HIV transmission live in locations with no nearby PrEP provider. Rural and Southern areas are disproportionately affected.Public Health Implications. For maximum implementation effectiveness of PrEP, geography should not determine access. Programs to train clinicians, expand venues for PrEP care, and provide telemedicine services are needed.


Asunto(s)
Infecciones por VIH , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Profilaxis Pre-Exposición/estadística & datos numéricos , Adulto , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Masculino , Viaje/estadística & datos numéricos , Estados Unidos/epidemiología
20.
Travel Med Infect Dis ; 30: 73-107, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31279917

RESUMEN

BACKGROUND: Malaria prevention in travellers can be complex and requires consideration of a number of factors. UK healthcare professionals providing pre-travel malaria advice can access specialist support from the National Travel Health Network and Centre (NaTHNaC) telephone advice line. The aim of this study is to characterise queries to the NaTHNaC telephone advice line regarding pre-travel malaria advice. METHOD: Telephone calls received to NaTHNaC's advice line are recorded using an online data capture form. All calls relating to malaria advice during 2016 were selected and data extracted. Analysis was undertaken using Microsoft Excel and STATA. RESULTS: During 2016, 1803 malaria-related calls were received; the majority from general practice and calls were from across the UK. The most common type of pre-travel malaria query was country-specific followed by travellers with special health needs. Many queries related to pregnant and breastfeeding travellers, children under 5 years and travellers over 60 years. CONCLUSIONS: This review presents a large and exceptional dataset and reflects the ambiguity amongst some healthcare professionals regarding malaria advice. We have identified potential knowledge gaps, and as a result will strengthen future guidance, enhance existing malaria maps, and inform the development of future clinical educational activity.


Asunto(s)
Malaria/prevención & control , Consulta Remota/estadística & datos numéricos , Teléfono , Viaje/estadística & datos numéricos , Humanos , Factores de Riesgo , Reino Unido , Vacunación/estadística & datos numéricos
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