scholarly journals Leveraging community mortality indicators to infer COVID-19 mortality and transmission dynamics in Damascus, Syria

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Oliver J. Watson ◽  
◽  
Mervat Alhaffar ◽  
Zaki Mehchy ◽  
Charles Whittaker ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Middle East ◽  
Health System ◽  
Mortality Rates ◽  
Transmission Dynamics ◽  
Mortality Data ◽  
Sensitivity Range ◽  
Hospital Bed ◽  
All Cause Mortality ◽  
Bed Capacity

AbstractThe COVID-19 pandemic has resulted in substantial mortality worldwide. However, to date, countries in the Middle East and Africa have reported considerably lower mortality rates than in Europe and the Americas. Motivated by reports of an overwhelmed health system, we estimate the likely under-ascertainment of COVID-19 mortality in Damascus, Syria. Using all-cause mortality data, we fit a mathematical model of COVID-19 transmission to reported mortality, estimating that 1.25% of COVID-19 deaths (sensitivity range 1.00% – 3.00%) have been reported as of 2 September 2020. By 2 September, we estimate that 4,380 (95% CI: 3,250 – 5,550) COVID-19 deaths in Damascus may have been missed, with 39.0% (95% CI: 32.5% – 45.0%) of the population in Damascus estimated to have been infected. Accounting for under-ascertainment corroborates reports of exceeded hospital bed capacity and is validated by community-uploaded obituary notifications, which confirm extensive unreported mortality in Damascus.

scholarly journals P0818IMPROVING MORTALITY TRENDS FOR PATIENTS WITH CHRONIC KIDNEY DISEASE IN THE IRISH HEALTH SYSTEM: THE IRISH KIDNEY DISEASE SURVEILLANCE SYSTEM (IKDSS)

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Matthew Laird ◽  
Raihan Alheyali ◽  
Leonard Browne ◽  
Liam Plant ◽  
Cathal Walsh ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health System ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Age Distribution ◽  
Mortality Rates ◽  
Mortality Data ◽  
Irish Population ◽  
Disease Surveillance System

Abstract Background and Aims It is unclear whether targeted efforts for the treatment of chronic kidney disease (CKD) has led to a sustained reduction in mortality rates. We examined annual trends in mortality for patients with and without CKD in the Irish health system. Method We utilised data from the Irish Kidney Disease Surveillance System (IKDSS) to explore 1-year mortality rates among patients with and without CKD in the health system. The principal data sources included; regional laboratory information systems; dialysis registers; and mortality data files from the national Central Statistics Office (CSO). We created multi-annual cohorts of patients, age > 18 years with one or more serum creatinine values who received healthcare within the Irish health system from 2008 to 2012. Serum creatinine values (first test in fiscal year) were used to calculate glomerular filtration rate (eGFR) and CKD was defined as GFR < 60ml/min/1.73m. Mortality data were available from the national mortality files with vital status up to December 31st 2013. Age standardised death rates were determined for the Irish population (IRE) and the European Standard Population (ESP) (standardised to the age distribution of a standard European population in 2012. Comparisons were conducted using segmented linear regression. Results We included 351,223 adult individuals between 2008 and 2012. Age standardised mortality rates (EU) were more than 2-fold higher for patients with CKD than without, P<0.001. From 2008-2012, age-standardised mortality rates decreased significantly in patients with CKD from a peak of 47.7 to 31 per 1000 person-years, P for trend=p=0.012, and from a peak of 17.8 to 15.5 per 1000 person-years in patients without CKD, P=0.006. Mortality rates for men were significantly higher than for women in patients with and without CKD, but the pattern of improvement was similar for both sexes. These patterns were replicated when comparisons were made using Irish standard age distribution. Conclusion Mortality rates among CKD patients have declined in the Irish population from 2008 to 2012 in both men and women. The processes and interventions that have led to these reductions need further exploration. Figure 1. (a) Crude and age standardised mortality rates (b-c) of those with and without CKD in the Irish Health System between 2008-2012 .

scholarly journals Education inequalities in adult all-cause mortality: first national data for Australia using linked census and mortality data

2019 ◽  
Vol 49 (2) ◽  
pp. 511-518
Author(s):  
Rosemary J Korda ◽  
Nicholas Biddle ◽  
John Lynch ◽  
James Eynstone-Hinkins ◽  
Kay Soga ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Census Data ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Mortality Data ◽  
Age Group ◽  
National Data ◽  
Registration Data ◽  
All Cause Mortality

Abstract Background National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods We used the Australian Bureau of Statistics Death Registrations to Census file, with data on deaths (2011–2012) linked probabilistically to census data (linkage rate 81%). To assess validity, we compared mortality rates by age group (25–44, 45–64, 65–84 years), sex and area-inequality measures to those based on complete death registration data. We used negative binomial regression to quantify inequalities in all-cause mortality in relation to five levels of education [‘Bachelor degree or higher’ (highest) to ‘no Year 12 and no post-secondary qualification’ (lowest)], separately by sex and age group, adjusting for single year of age and correcting for linkage bias and missing education data. Results Mortality rates and area-based inequality estimates were comparable to published national estimates. Men aged 25–84 years with the lowest education had age-adjusted mortality rates 2.20 [95% confidence interval (CI): 2.08‒2.33] times those of men with the highest education. Among women, the rate ratio was 1.64 (1.55‒1.74). Rate ratios were 3.87 (3.38‒4.44) in men and 2.57 (2.15‒3.07) in women aged 25–44 years, decreasing to 1.68 (1.60‒1.76) in men and 1.44 (1.36‒1.53) in women aged 65–84 years. Absolute education inequalities increased with age. One in three to four deaths (31%) was associated with less than Bachelor level education. Conclusions These linked national data enabled valid estimates of education inequality in mortality suitable for international comparisons. The magnitude of relative inequality is substantial and similar to that reported for other high-income countries.

scholarly journals All-cause mortality supports the COVID-19 mortality in Belgium and comparison with major fatal events of the last century

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Natalia Bustos Sierra ◽  
Nathalie Bossuyt ◽  
Toon Braeye ◽  
Mathias Leroy ◽  
Isabelle Moyersoen ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Nursing Homes ◽  
Excess Mortality ◽  
Influenza Pandemic ◽  
Mortality Rates ◽  
Mortality Data ◽  
Term Care ◽  
All Cause Mortality ◽  
Hospital Deaths ◽  
Mortality Surveillance

Abstract Background The COVID-19 mortality rate in Belgium has been ranked among the highest in the world. To assess the appropriateness of the country’s COVID-19 mortality surveillance, that includes long-term care facilities deaths and deaths in possible cases, the number of COVID-19 deaths was compared with the number of deaths from all-cause mortality. Mortality during the COVID-19 pandemic was also compared with historical mortality rates from the last century including those of the Spanish influenza pandemic. Methods Excess mortality predictions and COVID-19 mortality data were analysed for the period March 10th to June 21st 2020. The number of COVID-19 deaths and the COVID-19 mortality rate per million were calculated for hospitals, nursing homes and other places of death, according to diagnostic status (confirmed/possible infection). To evaluate historical mortality, monthly mortality rates were calculated from January 1900 to June 2020. Results Nine thousand five hundred ninety-one COVID-19 deaths and 39,076 deaths from all-causes were recorded, with a correlation of 94% (Spearman’s rho, p < 0,01). During the period with statistically significant excess mortality (March 20th to April 28th; total excess mortality 64.7%), 7917 excess deaths were observed among the 20,159 deaths from all-causes. In the same period, 7576 COVID-19 deaths were notified, indicating that 96% of the excess mortality were likely attributable to COVID-19. The inclusion of deaths in nursing homes doubled the COVID-19 mortality rate, while adding deaths in possible cases increased it by 27%. Deaths in laboratory-confirmed cases accounted for 69% of total COVID-19-related deaths and 43% of in-hospital deaths. Although the number of deaths was historically high, the monthly mortality rate was lower in April 2020 compared to the major fatal events of the last century. Conclusions Trends in all-cause mortality during the first wave of the epidemic was a key indicator to validate the Belgium’s high COVID-19 mortality figures. A COVID-19 mortality surveillance limited to deaths from hospitalised and selected laboratory-confirmed cases would have underestimated the magnitude of the epidemic. Excess mortality, daily and monthly number of deaths in Belgium were historically high classifying undeniably the first wave of the COVID-19 epidemic as a fatal event.

scholarly journals Integrating Deep Reinforcement Learning Networks with Health System Simulations.

2020 ◽  
Author(s):  
Michael Allen ◽  
Thomas Monks
Keyword(s):  
Reinforcement Learning ◽  
Health System ◽  
Health Systems ◽  
Learning Networks ◽  
Significant Potential ◽  
Hospital Bed Capacity ◽  
Capacity Model ◽  
Hospital Bed ◽  
Bed Capacity

Background and motivation: Combining Deep Reinforcement Learning (Deep RL) and Health Systems Simulations has significant potential, for both research into improving Deep RL performance and safety, and in operational practice. While individual toolkits exist for Deep RL and Health Systems Simulations, no framework to integrate the two has been established. Aim: Provide a framework for integrating Deep RL Networks with Health System Simulations, and to ensure this framework is compatible with Deep RL agents that have been developed and tested using OpenAI Gym. Methods: We developed our framework based on the OpenAI Gym framework, and demonstrate its use on a simple hospital bed capacity model. We built the Deep RL agents using PyTorch, and the Hospital Simulation using SimPy. Results: We demonstrate example models using a Double Deep Q Network or a Duelling Double Deep Q Network as the Deep RL agent. Conclusion: SimPy may be used to create Health System Simulations that are compatible with agents developed and tested on OpenAI Gym environments. GitHub repository of code: https://github.com/MichaelAllen1966/learninghospital

Inequalities and Impact of Socioeconomic-Cultural Factors in Suicide Rates Across Italy

Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Monica Vichi ◽  
Maria Masocco ◽  
Nicola Vanacore ◽  
...  
Keyword(s):  
Suicide Rate ◽  
Age Groups ◽  
Premature Death ◽  
Mortality Rates ◽  
Mortality Data ◽  
Italian Population ◽  
Comprehensive Overview ◽  
Suicide Rates ◽  
Younger Age ◽  
Age And Sex

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.

Novel indicator for the assessment of hospital bed occupancy

2011 ◽  
Vol 152 (20) ◽  
pp. 797-801 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Patient Needs ◽  
Bed Occupancy ◽  
The Past ◽  
Hospital Beds ◽  
Hospital Bed ◽  
Bed Capacity ◽  
Statistical Indicators

In the past decades the bed occupancy of hospitals in Hungary has been calculated from the average of in-patient days and the number of beds during a given period of time. This is the only measure being currently looked at when evaluating the performance of hospitals and changing their bed capacity. The author outlines how limited is the use of this indicator and what other statistical indicators may characterize the occupancy of hospital beds. Since adjustment of capacity to patient needs becomes increasingly important, it is essential to find indicator(s) that can be easily applied in practice and can assist medical personal and funders who do not work with statistics. Author recommends the use of daily bed occupancy as a base for all these statistical indicators. Orv. Hetil., 2011, 152, 797–801.

1603-P: Changes in Age- and Gender-Specific All-Cause Mortality Rates and Ratios in People with T2DM in Hungary between 2001-2016: A Nationwide Cohort Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1603-P
Author(s):  
GYORGY JERMENDY ◽  
ZOLTAN KISS ◽  
GYÖRGY ROKSZIN ◽  
IBOLYA FÁBIÁN ◽  
ISTVAN WITTMANN ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rates ◽  
Age And Gender ◽  
All Cause Mortality ◽  
And Gender ◽  
Gender Specific

scholarly journals Fruit and Vegetable Intake and All-Cause Mortality in a Chinese Population: The China Health and Nutrition Survey

2021 ◽  
Vol 18 (1) ◽  
pp. 342
Author(s):  
Yuxuan Gu ◽  
Yansu He ◽  
Shahmir H. Ali ◽  
Kaitlyn Harper ◽  
Hengjin Dong ◽  
...  
Keyword(s):  
Vegetable Intake ◽  
Total Mortality ◽  
Negative Association ◽  
Mortality Data ◽  
Sample Population ◽  
Fruit And Vegetable ◽  
Nutrition Survey ◽  
Related Factors ◽  
Health And Nutrition ◽  
All Cause Mortality

This study was to investigate the association of long-term fruit and vegetable (FV) intake with all-cause mortality. We utilized data from the China Health and Nutrition Survey (CHNS), a prospective cohort study conducted in China. The sample population included 19,542 adult respondents with complete mortality data up to 31 December 2011. Cumulative FV intake was assessed by 3 day 24 h dietary recalls. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Covariates included sociodemographic characteristics, lifestyle factors, health-related factors, and urban index. A total of 1409 deaths were observed during follow-up (median: 14 years). In the fully adjusted model, vegetable intake of the fourth quintile (327~408 g/day) had the greatest negative association with death compared to the lowest quintile (HR = 0.63, 95% CI: 0.53–0.76). Fruit intake of the fifth quintile (more than 126 g/day) had the highest negative association (HR = 0.24, 95% CI: 0.15–0.40) and increasing general FV intake were also negatively associated with all-cause mortality which demonstrated the greatest negative association in the amount of fourth quintile (HR = 0.59, 95% CI: 0.49–0.70) compared to the lowest quintile. To conclude, greater FV intake is associated with a reduced risk of total mortality for Chinese adults. High intake of fruit has a stronger negative association with mortality than differences in intake of vegetables. Our findings support recommendations to increase the intake of FV to promote overall longevity.

scholarly journals Volterra–Lyapunov Stability Analysis of the Solutions of Babesiosis Disease Model

Symmetry ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1272
Author(s):  
Fengsheng Chien ◽  
Stanford Shateyi
Keyword(s):  
Mathematical Model ◽  
Stability Analysis ◽  
Global Stability ◽  
Numerical Simulations ◽  
Lyapunov Stability ◽  
Disease Model ◽  
Transmission Dynamics ◽  
Global Stability Analysis ◽  
Lyapunov Stability Analysis ◽  
Disease Free

This paper studies the global stability analysis of a mathematical model on Babesiosis transmission dynamics on bovines and ticks populations as proposed by Dang et al. First, the global stability analysis of disease-free equilibrium (DFE) is presented. Furthermore, using the properties of Volterra–Lyapunov matrices, we show that it is possible to prove the global stability of the endemic equilibrium. The property of symmetry in the structure of Volterra–Lyapunov matrices plays an important role in achieving this goal. Furthermore, numerical simulations are used to verify the result presented.

82 The Significant Burden of Burn Injuries in the Middle East: An Epidemiological Study of Nineteen Countries over 27 Years

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Zachary J Collier ◽  
Yasmina Samaha ◽  
Priyanka Naidu ◽  
Katherine J Choi ◽  
Christopher H Pham ◽  
...  
Keyword(s):  
Middle East ◽  
Age Groups ◽  
Mortality Rates ◽  
Burn Injuries ◽  
Burn Care ◽  
Life Years ◽  
Significant Burden ◽  
Mortality Ratio ◽  
Incident Cases ◽  
Age And Sex

Abstract Introduction Despite ongoing improvements in burn care around the world, the burden of burn morbidity and mortality has remined a significant challenge in the Middle East due to ongoing conflicts, economic crises, social disparities, and dangerous living conditions. Here, we examine the epidemiology of burn injuries in the Middle East (ME) relative to socio-demographic index (SDI), age, and sex in order to better define regional hotspots that may benefit most from sustainability and capacity building initiatives. Methods Computational modeling from the 2017 Global Burden of Disease (GBD17) database was used to extrapolate burn data about the nineteen countries that define the ME. Using the GBD17, the yearly incidence, deaths, and Disability-Adjusted Life Years (DALYs) from 1990 to 2017 were defined with respect to age and sex as rates of cases, deaths, and years per 100,000 persons, respectively. Mortality ratio represents the percentage of deaths relative to incident cases. Data from 2017 was spatially mapped using heat-mapping for the region. Results Over 27 years in the ME, an estimated 18,289,496 burns and 308,361 deaths occurred causing 24.5 million DALYs. Burn incidence decreased by 5% globally but only 1% in the ME. Although global incidence continued to decline, most ME countries exhibit steady increases since 2004. Compared to global averages, higher mortality rates (2.8% vs 2.0%) and DALYs (205 vs 152 years) were observed in the Middle East during this time although the respective disparities narrowed by 95% and 42% by 2017. Yemen had the worst death and DALY rates all 27 years with 2 and 2.2 times the ME average, respectively. Sudan had the highest morality ratio (3.7%) for most of the study, twice the ME average (1.8%), followed by Yemen at 3.6%. Sex-specific incidence, deaths, and DALYs in the ME were higher compared to the global cohorts. ME women had the worst rates in all categories. With respect to age, all rates were worse in the ME age groups except in those under 5 years. Conclusions For almost three decades, ME burn incidence, deaths, DALYs, and mortality rates were consistently worse than global average. Despite the already significant differences for burn frequency and severity, especially in women and children, underreporting from countries who lack sufficient registry capabilities likely means that the rates are even worse than predicted.

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