A New Method for Estimating the Incidence of Infectious Diseases

2021 ◽  
Author(s):  
Hamish McManus ◽  
Denton Callander ◽  
Jason Asselin ◽  
James McMahon ◽  
Jennifer F Hoy ◽  
...  
Keyword(s):  
Incidence Rates ◽  
World Health ◽  
Hiv Incidence ◽  
Routine Testing ◽  
Uniform Probability ◽  
Immunodeficiency Virus ◽  
Incidence Estimation ◽  
Baseline Incidence ◽  
Low Incidence ◽  
Health Organization

Abstract Ambitious World Health Organization targets for disease elimination require monitoring of epidemics using routine health data in settings of decreasing and low incidence. We evaluated two methods commonly applied to routine testing results to estimate incidence rates that assume uniform probability of infection between consecutive negative and positive tests based on: 1. the midpoint of this interval; and 2. a randomly selected point on this interval. We compared these with an approximation to the Poisson-binomial distribution which assigns partial incidence to time-periods based on the uniform probability of occurrence in these intervals. We assessed bias, variance and convergence of estimates using simulations of Weibull distributed failure times with systematically varied baseline incidence, and varying trend. We considered results for quarterly, half-yearly and yearly incidence estimation frequencies. We applied methods to assess human immunodeficiency virus (HIV) incidence in HIV-negative patients from the Treatment with Antiretrovirals and their Impact on Positive And Negative men study between 2012 and 2018. The Poisson-binomial method had reduced bias and variance at low levels of incidence and for increased estimation frequency, with increased consistency of estimation. Application of methods to real-world assessment of HIV incidence found decreased variance in Poisson-binomial model estimates, with observed incidence declining to levels where simulation results had indicated bias in midpoint and random-point methods.

scholarly journals Determinants of HIV-1 Late Presentation in Patients Followed in Europe

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 835
Author(s):  
Mafalda N. S. Miranda ◽  
Marta Pingarilho ◽  
Victor Pimentel ◽  
Maria do Rosário O. Martins ◽  
Anne-Mieke Vandamme ◽  
...  
Keyword(s):  
Late Presentation ◽  
World Health ◽  
Prevention Measures ◽  
Demographic Information ◽  
Late Presenters ◽  
Major Threat ◽  
Immunodeficiency Virus ◽  
Mode Of Transmission ◽  
Health Organization ◽  
Hiv 1

To control the Human Immunodeficiency Virus (HIV) pandemic, the World Health Organization (WHO) set the 90-90-90 target to be reached by 2020. One major threat to those goals is late presentation, which is defined as an individual presenting a TCD4+ count lower than 350 cells/mm3 or an AIDS-defining event. The present study aims to identify determinants of late presentation in Europe based on the EuResist database with HIV-1 infected patients followed-up between 1981 and 2019. Our study includes clinical and socio-demographic information from 89851 HIV-1 infected patients. Statistical analysis was performed using RStudio and SPSS and a Bayesian network was constructed with the WEKA software to analyze the association between all variables. Among 89,851 HIV-1 infected patients included in the analysis, the median age was 33 (IQR: 27.0–41.0) years and 74.4% were males. Of those, 28,889 patients (50.4%) were late presenters. Older patients (>56), heterosexuals, patients originated from Africa and patients presenting with log VL >4.1 had a higher probability of being late presenters (p < 0.001). Bayesian networks indicated VL, mode of transmission, age and recentness of infection as variables that were directly associated with LP. This study highlights the major determinants associated with late presentation in Europe. This study helps to direct prevention measures for this population.

scholarly journals Trends in tuberculosis incidence rates in the Region of Sousse (Tunisia) from 1992 to 2016

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Sahli ◽  
M Mellouli ◽  
M Limam ◽  
M El Ghardallou ◽  
A Mtiraoui ◽  
...  
Keyword(s):  
Current Trend ◽  
National Level ◽  
Incidence Rates ◽  
World Health ◽  
Epidemiological Surveillance ◽  
Tuberculosis Control ◽  
Tuberculosis Incidence ◽  
Significant Downward Trend ◽  
Development Goals ◽  
Health Organization

Abstract Introduction In 1993, the World Health Organization declared that tuberculosis is a public health emergency of global concern. All efforts were made in accordance with the Millennium Development Goals (MDGs) to reduce the burden of Tuberculosis. The MDG framework built into national priorities and development strategies has, in fact, strengthened epidemiological surveillance and the use of reliable data to make decisions based on objective data. These data are essential for planning, managing the activities of the National Tuberculosis program, monitoring and ongoing evaluation of its performance. In this context, we conducted this study to trace the trend of Tuberculosis incidence rate recorded in the Sousse Region between 1992 and 2016. Methods This is a longitudinal study of the registered data of tuberculosis cases in Sousse between 1992 and 2016. For the trend analysis the software JOINPOINT version 4.5.0.1 was used. This software offers the closest possible regression model of the different points and gives an annual percentage change (APC) with a 95% confidence interval. Results The highest TB incidence rates was recorded in 1993 (85.66 cases per 100 000 inhabitants). Between 1992 and 1997, there was a significant downward trend of TB incidence (APC = -23.2; 95% CI [-28.8, 1]). Between 1997 and 2004 the trend was stable. Between 2004 and 2016, there was a significant upward trend (APC = 8.3; 95% CI: [4.3, 12.4]). Conclusions At the national level, between 1992 and 2002, tuberculosis experienced a fall in incidence rates, as a result of an improvement in the socio-economic level and the organization of tuberculosis control. Since 2004, the trend has been rising. Increased tuberculosis control is advocated to end tuberculosis by 2030 in line with sustainable development goals. Key messages After a significant decrease, the tuberculosis incidence has increased significantly since 2004. The tuberculosis prevention efforts should be intensified to reverse the current trend.

scholarly journals The global prevalence of latent tuberculosis: a systematic review and meta-analysis

2019 ◽  
Vol 54 (3) ◽  
pp. 1900655 ◽  
Author(s):  
Adam Cohen ◽  
Victor Dahl Mathiasen ◽  
Thomas Schön ◽  
Christian Wejse
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Preventive Therapy ◽  
Incidence Rates ◽  
World Health ◽  
Global Prevalence ◽  
Ltbi Prevalence ◽  
Health Organization

In 1999, the World Health Organization (WHO) estimated that one-third of the world's population had latent tuberculosis infection (LTBI), which was recently updated to one-fourth. However, this is still based on controversial assumptions in combination with tuberculin skin test (TST) surveys. Interferon-γ release assays (IGRAs) with a higher specificity than TST have since been widely implemented, but never used to estimate the global LTBI prevalence.We conducted a systematic review and meta-analysis of LTBI estimates based on both IGRA and TST results published between 2005 and 2018. Regional and global estimates of LTBI prevalence were calculated. Stratification was performed for low, intermediate and high TB incidence countries and a pooled estimate for each area was calculated using a random effects model.Among 3280 studies screened, we included 88 studies from 36 countries with 41 IGRA (n=67 167) and 67 TST estimates (n=284 644). The global prevalence of LTBI was 24.8% (95% CI 19.7–30.0%) and 21.2% (95% CI 17.9–24.4%), based on IGRA and a 10-mm TST cut-off, respectively. The prevalence estimates correlated well to WHO incidence rates (Rs=0.70, p<0.001).In the first study of the global prevalence of LTBI derived from both IGRA and TST surveys, we found that one-fourth of the world's population is infected. This is of relevance, as both tests, although imperfect, are used to identify individuals eligible for preventive therapy. Enhanced efforts are needed targeting the large pool of latently infected individuals, as this constitutes an enormous source of potential active tuberculosis.

scholarly journals Outcomes of Coronavirus Disease 2019 (COVID-19) Related Hospitalization Among People With Human Immunodeficiency Virus (HIV) in the ISARIC World Health Organization (WHO) Clinical Characterization Protocol (UK): A Prospective Observational Study

2020 ◽  
Author(s):  
Anna Maria Geretti ◽  
Alexander J Stockdale ◽  
Sophie H Kelly ◽  
Muge Cevik ◽  
Simon Collins ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
World Health Organization ◽  
Cox Regression ◽  
World Health ◽  
Rank Test ◽  
Hiv Positive ◽  
Protein Levels ◽  
Increased Risk ◽  
Immunodeficiency Virus ◽  
Health Organization

Abstract Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P &lt; .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P &lt; .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged &lt;60 years (aHR 2.87; 95% CI 1.70–4.84; P &lt; .001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.

scholarly journals Two diseases, same person: moving toward a combined HIV and tuberculosis continuum of care

2018 ◽  
Vol 29 (9) ◽  
pp. 873-883 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Treatment Success ◽  
World Health ◽  
People Living With Hiv ◽  
Global Public Health ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Living With Hiv

The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and tuberculosis (TB) global targets have been set; however, success will depend on achieving combined disease control objectives and care continua. The objective of this study was to review available policy, budgets, and data to reconceptualize TB and HIV disease control objectives by combining HIV and TB care continua. For 22 World Health Organization (WHO) TB and TB/HIV priority countries, we used 2015 data from the HIV90–90–90watch website, UNAIDS AIDSinfo, and WHO 2016 and 2017 Global TB Reports. Global resources available in TB and HIV/TB activities for 2003–2017 were collected from publicly available sources. In 22 high-burden countries, people living with HIV on antiretroviral therapy ranged from 9 to 70%; viral suppression was 38–63%. TB treatment success ranged from 71 to 94% with 14 (81% HIV/TB burden) countries above 80% TB treatment success. From 2003 to 2017, reported global international and domestic resources for HIV-associated TB and TB averaged $2.85 billion per year; the total for 2003–2017 was 43 billion dollars. Reviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.

Has survival improved for nasopharyngeal carcinoma in the United States?

2005 ◽  
Vol 132 (2) ◽  
pp. 303-308 ◽  
Author(s):  
Jivianne T. Lee ◽  
Clifford Y. Ko
Keyword(s):  
United States ◽  
Nasopharyngeal Carcinoma ◽  
Survival Rates ◽  
The United States ◽  
Incidence Rates ◽  
World Health ◽  
Type Iii ◽  
Favorable Histology ◽  
Health Organization ◽  
Over Time

OBJECTIVE: To analyze the epidemiologic patterns and survival rates for patients with nasopharyngeal carcinoma over the last three decades. METHODS: The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program tumor registries were used to identify patients with nasopharyngeal carcinoma in the United States from 1973 to 1999. Incidence and survival rates for each decade were then determined according to age, gender, race, histological type, and stage using the SEER statistical program. RESULTS: From 1973 to 1999, 4680 cases of patients with nasopharyngeal carcinoma in the United States were sampled by the NCI/SEER database. Overall incidence rates for each decade essentially remained unchanged over time (0.7/100,000). Asians exhibited the highest incidence rates (3.0–4.2), followed by blacks (0.7–1.1) and then whites (0.4–0.7). In contrast, survival rates have gradually improved over time for all stages and histological types (35.7% 5-year survival in the 1970s vs. 44.1% in the 1980, and 51% in the 1990s). With respect to race, Asians demonstrated the best 5-year survival rate (62.9%) followed by whites (42.6%) and then blacks (36.2%). However, this may be due to histology, because Asians were also found to have a greater proportion of World Health Organization (WHO) type III cases (27.6%) in comparison to the other 2 groups (22.4% for blacks and 15% for whites). CONCLUSIONS: Although the incidence rates of nasopharyngeal carcinoma have remained essentially unchanged in the United States in the last 3 decades, survival rates for each stage and histological subtype have exhibited considerable improvement over time. The higher survival rates in Asians may be partially attributed to the more favorable histology (type III) often seen in this group. EBM rating: B-3.

scholarly journals Hepatitis C Worldwide and in Brazil: Silent Epidemic—Data on Disease including Incidence, Transmission, Prevention, and Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Iara Fabricia Kretzer ◽  
Andrea do Livramento ◽  
Joel da Cunha ◽  
Sabrina Gonçalves ◽  
Iraci Tosin ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Viral Hepatitis ◽  
Universal Access ◽  
Public Health Problem ◽  
Incidence Rates ◽  
World Health ◽  
Current Status ◽  
The World ◽  
Prevention And Treatment ◽  
Health Organization

Hepatitis C virus (HCV) is endemic worldwide and according to the World Health Organization (WHO), there are about 150 million chronic carriers worldwide. The infection is a leading cause of liver diseases like cirrhosis and hepatocellular carcinoma (HCC); thus, HCV infection constitutes a critical public health problem. There are increasing efforts worldwide in order to reduce the global impact of hepatitis C through the implementation of programmatic actions that may increase the awareness of viral hepatitis and also improve surveillance, prevention, and treatment. In Brazil, about 1,5 million people have been chronically infected with HCV. The country has a vast territory with uneven population density, and hepatitis C incidence rates are variable with the majority of cases concentrated in the most populated areas. Currently, the main priorities of Brazilian Ministry of Health's strategies for viral hepatitis management include the prevention and early diagnosis of viral hepatitis infections; strengthening of the healthcare network and lines of treatment for sexually transmitted diseases, viral hepatitis, and AIDS; improvement and development of surveillance, information, and research; and promotion of universal access to medication. This review aims to summarize the available data on hepatitis C epidemiology and current status of efforts in prevention and infection control around the world and in Brazil.

scholarly journals Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination

2000 ◽  
Vol 125 (3) ◽  
pp. 549-554 ◽  
Author(s):  
E. GOMEZ ◽  
M. PEGUERO ◽  
J. SANCHEZ ◽  
P. L. CASTELLANOS ◽  
J. FERIS ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Dominican Republic ◽  
Group B Streptococcus ◽  
Case Series ◽  
Population Based ◽  
Incidence Rates ◽  
World Health ◽  
Laboratory Methods ◽  
Group B ◽  
Health Organization

Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100 000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness.

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