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1.
BMC Infect Dis ; 21(1): 640, 2021 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-34217261

RESUMO

BACKGROUND: The hepatitis C virus (HCV) infection is a candidate disease for micro-elimination. Accurate baseline HCV prevalence estimation is essential to monitor progress to micro-elimination but can be methodologically challenging in low-endemic regions like the Netherlands due to lack of disaggregated data by age or risk-groups on the number of chronic HCV patients (i.e. HCV RNA positive). This study estimates the number of patients that has had a chronic HCV infection (ever-chronic) in the Utrecht region of the Netherlands. METHODS: In the Utrecht province in the Netherlands, positive HCV tests from the period 2001-2015 from one diagnostic center and four hospital laboratories were collected. A two-source capture-recapture method was used to analyze the overlap between the two registries (with 92% HCV RNA and 8% HCV immunoblot confirmed infections) to obtain the number of ever-chronic HCV infections in the Utrecht region. The Utrecht region was defined as an area with a 25 km radius from the Utrecht city center. The current viremic HCV prevalence was calculated by taking into account the proportion of cured and deceased HCV patients from a local HCV retrieval (REACH) project. RESULTS: The estimated number of ever-chronic HCV patients was 1245 (95% CI 1164-1326) and would indicate a prevalence of 0.10 (95% CI 0.09-0.10) in the Utrecht region. This is 30% (95% CI 21-38%) more than the number of known HCV patients in the records. The ever-chronic HCV prevalence was highest in the 1960-1969 age cohort (0.16; 95% CI 0.14-0.18). Since 50% of the HCV patients were cured or deceased in the REACH-project, the number of current viremic HCV patients was estimated at 623 individuals in the Utrecht region (prevalence 0.05%). CONCLUSION: The results of this study suggest a low ever-chronic and current HCV prevalence in the Utrecht area in the Netherlands, but other studies need to confirm this.


Assuntos
Hepatite C Crônica/epidemiologia , Vigilância da População/métodos , Viremia/epidemiologia , Adulto , Fatores Etários , Idoso , Feminino , Hepacivirus/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , RNA Viral , Fatores de Risco
4.
PLoS One ; 16(6): e0253193, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1268213

RESUMO

BACKGROUND: There is a worrying lack of epidemiological data on the sex differential in COVID-19 infection and death rates between the regions of Peru. METHODS: Using cases and death data from the national population-based surveillance system of Peru, we estimated incidence, mortality and fatality, stratified by sex, age and geographic distribution (per 100,000 habitants) from March 16 to November 27, 2020. At the same time, we calculated the risk of COVID-19 death. RESULTS: During the study period, 961894 cases and 35913 deaths were reported in Peru. Men had a twofold higher risk of COVID-19 death within the overall population of Peru (odds ratio (OR), 2.11; confidence interval (CI) 95%; 2.06-2.16; p<0.00001), as well as 20 regions of Peru, compared to women (p<0.05). There were variations in incidence, mortality and fatality rates stratified by sex, age, and region. The incidence rate was higher among men than among women (3079 vs. 2819 per 100,000 habitants, respectively). The mortality rate was two times higher in males than in females (153 vs. 68 per 100,000 habitants, respectively). The mortality rates increased with age, and were high in men 60 years of age or older. The fatality rate was two times higher in men than in women (4.96% vs. 2.41%, respectively), and was high in men 50 years of age or older. CONCLUSIONS: These findings show the higher incidence, mortality and fatality rates among men than among women from Peru. These rates vary widely by region, and men are at greater risk of COVID-19 death. In addition, the mortality and fatality rates increased with age, and were most predominant in men 50 years of age or older.


Assuntos
COVID-19/epidemiologia , COVID-19/mortalidade , Vigilância da População/métodos , SARS-CoV-2 , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/virologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Razão de Chances , Peru/epidemiologia , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
5.
Pan Afr Med J ; 38: 254, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1218865

RESUMO

Since the announcement of the coronavirus disease (COVID-19) pandemic in January 30th 2020, 68 countries reported to the World Health Organization that they were experiencing disruptions in malaria diagnosis and treatment. This situation had the potential to lead to delays in diagnosis and treatment, which could result in an increase in severe cases and deaths. This analysis was based on findings from a field visit, carried out between June 30th and July 1st, 2020, to a warehouse, to two health facilities, and a meeting with a community health worker, and an descriptive epidemiologic data analysis of health information system (HIS) to evaluate trends of the number of people tested for malaria and number of malaria cases reported, by comparing data from 2018, 2019 and 2020 for the period between January and May. The two health facilities and the warehouse had about two months of stock of antimalarial drugs, and patients with malaria symptoms were being tested for malaria at the COVID-19 screening site. The HIS data showed that the number of reported malaria cases decreased by 3.0% (177.646/172.246) in April, and 7.0% (173.188/161.812) in May, when comparing 2019 and 2020 data. People tested for malaria in community increased by 39.0% (190.370/264.730), between 2019 and 2020. The COVID-19 may have had a negative impact on the diagnosis and treatment of malaria in health facility (HF). The decrease in people tested for malaria in the health facilities may have overwhelmed the activities of the community.


Assuntos
COVID-19 , Malária/epidemiologia , Vigilância da População/métodos , Antimaláricos/administração & dosagem , Antimaláricos/provisão & distribuição , Humanos , Malária/diagnóstico , Malária/tratamento farmacológico , Programas de Rastreamento/métodos , Moçambique/epidemiologia
6.
J Clin Neurosci ; 89: 165-170, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119263

RESUMO

Knowledge on high-grade meningiomas in octogenarian and elderly patients is limited. We aimed to analyze the outcomes and identify factors that influence overall survival (OS) in this population, using data from the Surveillance, Epidemiology, and End Results (SEER) database.Patients (≥80 years old) diagnosed with high-grade meningiomas between 1990 and 2016 were retrieved from the SEER database. According to treatments received, patients were classified into three groups: observation, radiation only, and surgery (with or without radiation). A Cox proportional hazards regression model was used for univariate and multivariate analyses. Based on the inclusion criteria, 678 patients with high-grade meningiomas were included.Surgery was the most common treatment modality. The median OS was 32 months for patients who received surgery, compared with 20 months for observation (p = 0.001).The factors significantly associated with OS on multivariate analysis included increasing age (hazard ratio [HR] 1.353, p < 0.001), diagnosis after 2008 (HR 0.693, p = 0.022), and surgical treatment (HR 0.807, p = 0.028). Further analysis revealed increasing age (HR 1.451, p = 0.003), and subtotal resection (HR 1.275, p = 0.043) were significantly associated with worse OS following surgery. This is the largest clinical study of high-grade meningiomas in octogenarian and elderly patients conducted thus far. Age, treatment modality, and year of diagnosis were associated with OS in octogenarian and elderly patients with high-grade meningiomas. Patients who received subtotal resection had a worse prognosis than gross total resection.


Assuntos
Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico , Meningioma/cirurgia , Vigilância da População , Programa de SEER/tendências , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais/tendências , Feminino , Seguimentos , Humanos , Masculino , Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Análise Multivariada , Vigilância da População/métodos , Modelos de Riscos Proporcionais , Estudos Retrospectivos
7.
PLoS One ; 16(6): e0252185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34143776

RESUMO

The world is currently dealing with a devastating pandemic. Although growing COVID-19 case numbers, deaths, and hospitalizations are concerning, this spread is particularly alarming in the United States where polarizing opinions, changing policies, and misinformation abound. In particular, American college campuses have been a venue of rampant transmission, with concerning spillover into surrounding, more vulnerable, communities. We surveyed over 600 college students from across the United States and modeled predictors of compliance with non-pharmaceutical interventions. We identified concern with severity, constitutionalism, news exposure, and religiosity as significant positive correlates with compliance, and general trust in science as a significant negative correlate. To determine how applicable nationwide modeling might be to individual local campuses we also administered this same survey to nearly 600 students at two large universities in Utah County. In this population, concern with severity was the only significant positive correlate with compliance; Additionally, feelings of inconvenience were negatively correlated. The effects of feelings of inconvenience, and news exposure were significantly different between populations. These results suggest that we should focus our efforts on increasing knowledge about the pandemic's effects on our society and informing about constitutionality amongst college students. However, we also show that nationwide surveys and modeling are informative, but if campuses are to efficiently curb the spread of COVID-19 this coming semester, they would be best served to utilize data collected from their student populations as these might significantly differ from general consensus data.


Assuntos
COVID-19/prevenção & controle , SARS-CoV-2/isolamento & purificação , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , COVID-19/epidemiologia , COVID-19/virologia , Feminino , Humanos , Masculino , Modelos Teóricos , Pandemias , Vigilância da População/métodos , SARS-CoV-2/fisiologia , Estados Unidos , Utah , Adulto Jovem
8.
PLoS One ; 16(6): e0253451, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34143839

RESUMO

BACKGROUND: Various public health measures have been implemented globally to counter the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to evaluate respiratory virus surveillance data to determine the effectiveness of such interventions in reducing transmission of seasonal respiratory viruses. METHOD: We retrospectively analysed data from the Respiratory Virus Detection Surveillance System in Canada, before and during the COVID-19 pandemic, by interrupted time series regression. RESULTS: The national level of infection with seasonal respiratory viruses, which generally does not necessitate quarantine or contact screening, was greatly reduced after Canada imposed physical distancing and other quarantine measures. The 2019-2020 influenza season ended earlier than it did in the previous year. The influenza virus was replaced by rhinovirus/enterovirus or parainfluenza virus in the previous year, with the overall test positivity remaining at approximately 35%. However, during the 2019-2020 post-influenza period, the overall test positivity of respiratory viruses during the COVID-19 was still low (7.2%). Moreover, the 2020-2021 influenza season had not occurred by the end of February 2021. CONCLUSION: Respiratory virus surveillance data may provide real-world evidence of the effectiveness of implemented public health interventions during the current and future pandemics.


Assuntos
COVID-19/prevenção & controle , Análise de Séries Temporais Interrompida/métodos , Vigilância da População/métodos , Saúde Pública/métodos , SARS-CoV-2/isolamento & purificação , COVID-19/epidemiologia , COVID-19/virologia , Canadá/epidemiologia , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/virologia , Análise de Séries Temporais Interrompida/estatística & dados numéricos , Modelos Estatísticos , Pandemias , Distanciamento Físico , Saúde Pública/estatística & dados numéricos , Quarentena , Estudos Retrospectivos , SARS-CoV-2/fisiologia , Estações do Ano , Vírus/classificação
9.
Pan Afr Med J ; 38: 254, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104302

RESUMO

Since the announcement of the coronavirus disease (COVID-19) pandemic in January 30th 2020, 68 countries reported to the World Health Organization that they were experiencing disruptions in malaria diagnosis and treatment. This situation had the potential to lead to delays in diagnosis and treatment, which could result in an increase in severe cases and deaths. This analysis was based on findings from a field visit, carried out between June 30th and July 1st, 2020, to a warehouse, to two health facilities, and a meeting with a community health worker, and an descriptive epidemiologic data analysis of health information system (HIS) to evaluate trends of the number of people tested for malaria and number of malaria cases reported, by comparing data from 2018, 2019 and 2020 for the period between January and May. The two health facilities and the warehouse had about two months of stock of antimalarial drugs, and patients with malaria symptoms were being tested for malaria at the COVID-19 screening site. The HIS data showed that the number of reported malaria cases decreased by 3.0% (177.646/172.246) in April, and 7.0% (173.188/161.812) in May, when comparing 2019 and 2020 data. People tested for malaria in community increased by 39.0% (190.370/264.730), between 2019 and 2020. The COVID-19 may have had a negative impact on the diagnosis and treatment of malaria in health facility (HF). The decrease in people tested for malaria in the health facilities may have overwhelmed the activities of the community.


Assuntos
COVID-19 , Malária/epidemiologia , Vigilância da População/métodos , Antimaláricos/administração & dosagem , Antimaláricos/provisão & distribuição , Humanos , Malária/diagnóstico , Malária/tratamento farmacológico , Programas de Rastreamento/métodos , Moçambique/epidemiologia
10.
PLoS One ; 16(6): e0253193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34125851

RESUMO

BACKGROUND: There is a worrying lack of epidemiological data on the sex differential in COVID-19 infection and death rates between the regions of Peru. METHODS: Using cases and death data from the national population-based surveillance system of Peru, we estimated incidence, mortality and fatality, stratified by sex, age and geographic distribution (per 100,000 habitants) from March 16 to November 27, 2020. At the same time, we calculated the risk of COVID-19 death. RESULTS: During the study period, 961894 cases and 35913 deaths were reported in Peru. Men had a twofold higher risk of COVID-19 death within the overall population of Peru (odds ratio (OR), 2.11; confidence interval (CI) 95%; 2.06-2.16; p<0.00001), as well as 20 regions of Peru, compared to women (p<0.05). There were variations in incidence, mortality and fatality rates stratified by sex, age, and region. The incidence rate was higher among men than among women (3079 vs. 2819 per 100,000 habitants, respectively). The mortality rate was two times higher in males than in females (153 vs. 68 per 100,000 habitants, respectively). The mortality rates increased with age, and were high in men 60 years of age or older. The fatality rate was two times higher in men than in women (4.96% vs. 2.41%, respectively), and was high in men 50 years of age or older. CONCLUSIONS: These findings show the higher incidence, mortality and fatality rates among men than among women from Peru. These rates vary widely by region, and men are at greater risk of COVID-19 death. In addition, the mortality and fatality rates increased with age, and were most predominant in men 50 years of age or older.


Assuntos
COVID-19/epidemiologia , COVID-19/mortalidade , Vigilância da População/métodos , SARS-CoV-2 , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/virologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Razão de Chances , Peru/epidemiologia , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
11.
Reprod Health ; 18(Suppl 1): 120, 2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34134720

RESUMO

BACKGROUND: In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission of HIV. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities. METHODS: HIV prevalence data at ages 15-19 years were obtained for 31 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Country medians and average annual rates of changes were used to summarize the trends for two subregions in sub-Saharan Africa, Eastern and Southern Africa and West and Central Africa, which largely correspond with higher and lower HIV prevalence countries. Data on HIV incidence at ages 15-24 and prevalence at 5-9 and 10-14 years were reviewed from 11 recent national surveys. Trends in urban-rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15-24 years, using the same surveys. RESULTS: HIV prevalence among girls 15-19 years declined in eastern and Southern Africa from 5.7 to 2.6% during 2005-2015 (country median), corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1 to 1.2%. Changes were also observed in West and Central Africa where median HIV prevalence among girls decreased from 0.7 to 0.4% (average annual rate of reduction 5.9%), but not for boys (0.3%). Girl-boy differences at 10-14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15-24 had at least 1.5 times higher HIV prevalence than their rural counterparts in both subregions, and since the urban-rural declines were similar, the gaps persisted during 2005-2015. CONCLUSIONS: HIV prevalence among adolescents declined in almost all countries during the last decade, in both urban and rural settings. The urban-rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in Eastern and Southern African countries.


Assuntos
Infecções por HIV/epidemiologia , Características de Residência/estatística & dados numéricos , População Rural , População Urbana , Adolescente , África ao Sul do Saara/epidemiologia , África Austral , Feminino , Humanos , Incidência , Masculino , Vigilância da População/métodos , Prevalência , Distribuição por Sexo , Adulto Jovem
12.
J Mol Diagn ; 23(7): 788-795, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33957320

RESUMO

The clinical performance of saliva compared with nasopharyngeal swabs (NPSs) has shown conflicting results in healthcare and community settings. In the present study, a total of 429 matched NPS and saliva sample pairs, collected in either healthcare or community setting, were evaluated. Phase-1 (protocol U) tested 240 matched NPS and saliva sample pairs; phase 2 (SalivaAll protocol) tested 189 matched NPS and saliva sample pairs, with an additional sample homogenization step before RNA extraction. A total of 85 saliva samples were evaluated with both protocols. In phase-1, 28.3% (68/240) samples tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from saliva, NPS, or both. The detection rate from saliva was lower compared with that from NPS samples (50.0% versus 89.7%). In phase-2, 50.2% (95/189) samples tested positive for SARS-CoV-2 from saliva, NPS, or both. The detection rate from saliva was higher compared with that from NPS samples (97.8% versus 78.9%). Of the 85 saliva samples evaluated with both protocols, the detection rate was 100% for samples tested with SalivaAll, and 36.7% with protocol U. The limit of detection with SalivaAll protocol was 20 to 60 copies/mL. The pooled testing approach demonstrated a 95% positive and 100% negative percentage agreement. This protocol for saliva samples results in higher sensitivity compared with NPS samples and breaks the barrier to using pooled saliva for SARS-CoV-2 testing.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , Atenção à Saúde , Programas de Rastreamento/métodos , Vigilância da População/métodos , Características de Residência , SARS-CoV-2/genética , Saliva/virologia , COVID-19/epidemiologia , COVID-19/virologia , Testes Diagnósticos de Rotina/métodos , Georgia/epidemiologia , Humanos , Limite de Detecção , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade
13.
Radiol Med ; 126(7): 946-955, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33954896

RESUMO

BACKGROUND: Women with aesthetic prostheses must be included in the target population of mammography screening programmes. Breast implants are radiopaque and partially obscure the breast tissue. This can be avoided with the use of the Eklund technique, which causes an increased radiation exposure. In this study, augmented women undergoing a dedicated protocol within a population-based screening programme were compared according to selected indicators with the standard screening population. Essential dosimetric parameters and their time trend were also assessed. MATERIALS AND METHODS: The study was conducted in a screening centre in Milan in the years 2009-2016. The screening protocol for women with breast implants included a double-read mammography with the Eklund views, ultrasound and clinical breast examination. RESULTS: A total of 28,794 women were enrolled, including 588 (2%) women with breast implants and 28,206 (98%) undergoing the standard screening protocol. The invasive assessment rate was 9.0‰ for women with breast implants vs. 15‰ in the standard cohort. The surgical referral rate was 2.2% vs. 0.9%. The detection rate was similar in the two groups (4.0 and 4.5‰, respectively). There were significant differences in the average glandular dose according to the mammography equipment. The use of the Eklund views increased over time. CONCLUSIONS: Screening of augmented women according to a specific protocol in the contexts of population-based programmes is feasible. Observed differences in screening indicators relative to the standard screening population require further research. The increasing use of Eklund views probably results from quality assurance measures associated with screening programmes.


Assuntos
Implantes de Mama , Neoplasias da Mama/cirurgia , Detecção Precoce de Câncer , Programas de Rastreamento/métodos , Vigilância da População/métodos , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Incidência , Itália/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Lancet Digit Health ; 3(6): e383-e396, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1221078

RESUMO

Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public-private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public-private partnerships, and ethically and safely apply artificial intelligence in the National Health Service.


Assuntos
COVID-19 , Sistema de Aprendizagem em Saúde , Informática Médica , Inteligência Artificial/tendências , Busca de Comunicante/métodos , Interoperabilidade da Informação em Saúde , Humanos , Aplicativos Móveis , Vigilância da População/métodos , Parcerias Público-Privadas , Robótica/tendências , Integração de Sistemas , Reino Unido
15.
Lancet Digit Health ; 3(6): e349-e359, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1240695

RESUMO

BACKGROUND: Until broad vaccination coverage is reached and effective therapeutics are available, controlling population mobility (ie, changes in the spatial location of a population that affect the spread and distribution of pathogens) is one of the major interventions used to reduce transmission of SARS-CoV-2. However, population mobility differs across locations, which could reduce the effectiveness of pandemic control measures. Here we assess the extent to which socioeconomic factors are associated with reductions in population mobility during the COVID-19 pandemic, at both the city level in China and at the country level worldwide. METHODS: In this retrospective, observational study, we obtained anonymised daily mobile phone location data for 358 Chinese cities from Baidu, and for 121 countries from Google COVID-19 Community Mobility Reports. We assessed the intra-city movement intensity, inflow intensity, and outflow intensity of each Chinese city between Jan 25 (when the national emergency response was implemented) and Feb 18, 2020 (when population mobility was lowest) and compared these data to the corresponding lunar calendar period from the previous year (Feb 5 to March 1, 2019). Chinese cities were classified into four socioeconomic index (SEI) groups (high SEI, high-middle SEI, middle SEI, and low SEI) and the association between socioeconomic factors and changes in population mobility were assessed using univariate and multivariable linear regression. At the country level, we compared six types of mobility (residential, transit stations, workplaces, retail and recreation, parks, and groceries and pharmacies) 35 days after the implementation of the national emergency response in each country and compared these to data from the same day of the week in the baseline period (Jan 3 to Feb 6, 2020). We assessed associations between changes in the six types of mobility and the country's sociodemographic index using univariate and multivariable linear regression. FINDINGS: The reduction in intra-city movement intensity in China was stronger in cities with a higher SEI than in those with a lower SEI (r=-0·47, p<0·0001). However, reductions in inter-city movement flow (both inflow and outflow intensity) were not associated with SEI and were only associated with government control measures. In the country-level analysis, countries with higher sociodemographic and Universal Health Coverage indexes had greater reductions in population mobility (ie, in transit stations, workplaces, and retail and recreation) following national emergency declarations than those with lower sociodemographic and Universal Health Coverage indexes. A higher sociodemographic index showed a greater reduction in mobility in transit stations (r=-0·27, p=0·0028), workplaces (r=-0·34, p=0·0002), and areas retail and recreation (rxs=-0·30, p=0·0012) than those with a lower sociodemographic index. INTERPRETATION: Although COVID-19 outbreaks are more frequently reported in larger cities, our analysis shows that future policies should prioritise the reduction of risks in areas with a low socioeconomic level-eg, by providing financial assistance and improving public health messaging. However, our study design only allows us to assess associations, and a long-term study is needed to decipher causality. FUNDING: Chinese Ministry of Science and Technology, Research Council of Norway, Beijing Municipal Science & Technology Commission, Beijing Natural Science Foundation, Beijing Advanced Innovation Program for Land Surface Science, National Natural Science Foundation of China, China Association for Science and Technology.


Assuntos
COVID-19 , Dinâmica Populacional , Fatores Socioeconômicos , Viagem , Adulto , Telefone Celular , China , Cidades , Saúde Global , Humanos , Distanciamento Físico , Dinâmica Populacional/tendências , Vigilância da População/métodos , Estudos Retrospectivos , SARS-CoV-2
16.
PLoS One ; 16(5): e0251242, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1236586

RESUMO

The SARS-CoV-2 pandemic led to closure of nearly all K-12 schools in the United States of America in March 2020. Although reopening K-12 schools for in-person schooling is desirable for many reasons, officials understand that risk reduction strategies and detection of cases are imperative in creating a safe return to school. Furthermore, consequences of reclosing recently opened schools are substantial and impact teachers, parents, and ultimately educational experiences in children. To address competing interests in meeting educational needs with public safety, we compare the impact of physical separation through school cohorts on SARS-CoV-2 infections against policies acting at the level of individual contacts within classrooms. Using an age-stratified Susceptible-Exposed-Infected-Removed model, we explore influences of reduced class density, transmission mitigation, and viral detection on cumulative prevalence. We consider several scenarios over a 6-month period including (1) multiple rotating cohorts in which students cycle through in-person instruction on a weekly basis, (2) parallel cohorts with in-person and remote learning tracks, (3) the impact of a hypothetical testing program with ideal and imperfect detection, and (4) varying levels of aggregate transmission reduction. Our mathematical model predicts that reducing the number of contacts through cohorts produces a larger effect than diminishing transmission rates per contact. Specifically, the latter approach requires dramatic reduction in transmission rates in order to achieve a comparable effect in minimizing infections over time. Further, our model indicates that surveillance programs using less sensitive tests may be adequate in monitoring infections within a school community by both keeping infections low and allowing for a longer period of instruction. Lastly, we underscore the importance of factoring infection prevalence in deciding when a local outbreak of infection is serious enough to require reverting to remote learning.


Assuntos
COVID-19/transmissão , Busca de Comunicante/métodos , Pandemias , Vigilância da População/métodos , Instituições Acadêmicas , Adolescente , Criança , Humanos , Modelos Teóricos , Estados Unidos
18.
J Mol Diagn ; 23(7): 788-795, 2021 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1275505

RESUMO

The clinical performance of saliva compared with nasopharyngeal swabs (NPSs) has shown conflicting results in healthcare and community settings. In the present study, a total of 429 matched NPS and saliva sample pairs, collected in either healthcare or community setting, were evaluated. Phase-1 (protocol U) tested 240 matched NPS and saliva sample pairs; phase 2 (SalivaAll protocol) tested 189 matched NPS and saliva sample pairs, with an additional sample homogenization step before RNA extraction. A total of 85 saliva samples were evaluated with both protocols. In phase-1, 28.3% (68/240) samples tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from saliva, NPS, or both. The detection rate from saliva was lower compared with that from NPS samples (50.0% versus 89.7%). In phase-2, 50.2% (95/189) samples tested positive for SARS-CoV-2 from saliva, NPS, or both. The detection rate from saliva was higher compared with that from NPS samples (97.8% versus 78.9%). Of the 85 saliva samples evaluated with both protocols, the detection rate was 100% for samples tested with SalivaAll, and 36.7% with protocol U. The limit of detection with SalivaAll protocol was 20 to 60 copies/mL. The pooled testing approach demonstrated a 95% positive and 100% negative percentage agreement. This protocol for saliva samples results in higher sensitivity compared with NPS samples and breaks the barrier to using pooled saliva for SARS-CoV-2 testing.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , Atenção à Saúde , Programas de Rastreamento/métodos , Vigilância da População/métodos , Características de Residência , SARS-CoV-2/genética , Saliva/virologia , COVID-19/epidemiologia , COVID-19/virologia , Testes Diagnósticos de Rotina/métodos , Georgia/epidemiologia , Humanos , Limite de Detecção , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade
19.
Eur J Epidemiol ; 36(5): 497-506, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34002295

RESUMO

Early-life environmental factors have been suggested in the pathophysiology of dementia. Season of birth has previously been used as a proxy for these external exposures. We investigated the link between season of birth and the risk of dementia and further explored underlying pathways by studying structural brain changes on MRI. From the Dutch, population-based Rotterdam Study, 12,964 participants born between 1887 and 1960 were followed between 1990 and 2018 for dementia. Cox regression was conducted to assess the association between season of birth and dementia. In addition, we distinguished between mild and cold winters. The association of season of birth with structural brain markers on MRI was examined in 5237 participants. The risk of dementia in participants born in winter and fall was higher than of those born in summer (hazard ratio (HR) 1.15 [95% confidence interval (CI) 1.01-1.31] for winter and HR 1.17 [95% CI 1.01-1.33] for fall), especially for Alzheimer's disease (HR 1.23 [1.06-1.43] for winter and HR 1.15 [95% CI 0.99-1.35] for fall). The risk was particularly increased for participants born in a cold winter. Except for slightly lower hippocampus in fall born participants (ß - 0.03; 95% CI - 0.06 to 0.00), we did not find associations with brain imaging markers. In conclusion, winter and fall births were associated with a higher incidence of dementia, especially of AD. We did not find evidence for structural brain changes as an underlying mechanism.


Assuntos
Encéfalo/diagnóstico por imagem , Demência/diagnóstico , Parto , Vigilância da População/métodos , Idoso , Idoso de 80 Anos ou mais , Demência/epidemiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Neuroimagem , Estudos Prospectivos , Estações do Ano
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