Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study

Abstract Background The extent of SARS-CoV-2 exposure and transmission in Mali and the surrounding region is not well understood. We aimed to estimate the cumulative incidence of SARS-CoV-2 in three communities, and understand factors associated with infection. Methods Between July 2020 and January 2021, we collected blood samples and demographic, social, medical, and self-reported symptoms information from residents aged 6 months and older over two study visits. SARS-CoV-2 antibodies were measured using a highly specific two-antigen ELISA optimized for use in Mali. We calculated cumulative adjusted seroprevalence for each community and evaluated factors associated with serostatus at each visit by univariate and multivariate analysis. Results Overall, 94.8% (2533/2672) of participants completed both study visits. A total of 31.3% (837/2672) were aged <10 years, 27.6% (737/2672) were aged 10-17 years, and 41.1% (1098/2572) were aged ≥18 years. The cumulative SARS-CoV-2 exposure rate was 58.5% (95% CI: 47.5 to 69.4). This varied between sites and was 73.4% in the urban community of Sotuba, 53.2% in the rural town of Bancoumana, and 37.1% in the rural village of Donéguébougou. Study site and increased age were associated with serostatus at both study visits. There was minimal difference in reported symptoms based on serostatus. Conclusion The true extent of SARS-CoV-2 exposure in Mali is greater than previously reported and may now approach hypothetical ‘herd immunity’ in urban areas. The epidemiology of the pandemic in the region may be primarily subclinical and within background illness rates.

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Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study

10.1101/2021.04.26.21256016 ◽

2021 ◽

Author(s):

Issaka Sagara ◽

John Woodford ◽

Mamady Kone ◽

Mahamadoun Hamady Assadou ◽

Abdoulaye Katile ◽

...

Keyword(s):

Urban Areas ◽

Herd Immunity ◽

Mitigation Strategies ◽

Factors Associated ◽

Rural Village ◽

Rural Town ◽

First Case ◽

Antigen Elisa ◽

Minimal Difference ◽

Ongoing Surveillance

ABSTRACTBackgroundThe extent of SARS-CoV-2 exposure and transmission in Mali and the surrounding region is not well understood, although infection has been confirmed in nearly 14,000 symptomatic individuals and their contacts since the first case in March 2020. We aimed to estimate the cumulative incidence of SARS-CoV-2 in three Malian communities, and understand factors associated with infection.MethodsBetween 27 July 2020 and 29 January 2021, we collected blood samples along with demographic, social, medical and self-reported symptoms information from residents aged 6 months and older in three study communities at two study visits. SARS-CoV-2 antibodies were measured using a highly specific two-antigen ELISA optimized for use in Mali. We calculated cumulative adjusted seroprevalence for each site and evaluated factors associated with serostatus at each visit by univariate and multivariate analysis.FindingsOverall, 94.8% (2533/2672) of participants completed both study visits. A total of 50.3% (1343/2672) of participants were male, and 31.3% (837/2672) were aged <10 years, 27.6% (737/2672) were aged 10-17 years, and 41.1% (1098/2572) were aged ≥18 years. The cumulative SARS-CoV-2 exposure rate was 58.5% (95% CI: 47.5 to 69.4). This varied between sites and was 73.4% (95% CI: 59.2 to 87.5) in the urban community of Sotuba, 53.2% (95% CI: 42.8 to 63.6) in the rural town of Bancoumana, and 37.1% (95% CI: 29.6 to 44.5) in the rural village of Donéguébougou. This equates to an infection rate of approximately 1% of the population every three days in the study communities between visits. Increased age and study site were associated with serostatus at both study visits. There was minimal difference in reported symptoms based on serostatus.InterpretationThe true extent of SARS-CoV-2 exposure in Mali is greater than previously reported and now approaches hypothetical herd immunity in urban areas. The epidemiology of the pandemic in the region may be primarily subclinical and within background illness rates. In this setting, ongoing surveillance and augmentation of diagnostics to characterize locally circulating variants will be critical to implement effective mitigation strategies like vaccines.FundingThis project was funded by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institute of Biomedical Imaging and Bioengineering, and National Cancer Institute.

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Multivariate Analysis of the Risk Factors Associated with Complications and Mortality after and Emergency Operation for Obstructive, Perforated Colorectal Cancer

Journal of the Korean Society of Coloproctology ◽

10.3393/jksc.2009.25.3.165 ◽

2009 ◽

Vol 25 (3) ◽

pp. 165 ◽

Cited By ~ 4

Author(s):

Dong Baek Kang ◽

Chang Yeol Shin ◽

Jeong Kyun Lee ◽

Won Cheol Park

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Multivariate Analysis ◽

Emergency Operation ◽

Factors Associated ◽

Perforated Colorectal Cancer ◽

Complications And Mortality

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Prevalence and factors associated with hypertension among school children and adolescents in urban and semi‐urban areas in Cameroon

Journal of Clinical Hypertension ◽

10.1111/jch.14309 ◽

2021 ◽

Author(s):

Chris Nadège Nganou‐Gnindjio ◽

Doris Bibi Essama ◽

Jan René Nkeck ◽

Patrick Yvan Tchebegna ◽

Kiliane Maeva Tchatchouang ◽

...

Keyword(s):

Children And Adolescents ◽

School Children ◽

Urban Areas ◽

Factors Associated

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Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

BMJ Global Health ◽

10.1136/bmjgh-2019-002169 ◽

2020 ◽

Vol 5 (12) ◽

pp. e002169

Author(s):

Ngatho Samuel Mugo ◽

Kyaw Swa Mya ◽

Camille Raynes-Greenow

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Adolescent Mothers ◽

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Multinomial Logistic Regression ◽

Wealth Quintile ◽

Adjusted Risk ◽

Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

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Factors associated with human visceral leishmaniasis cases during urban epidemics in Brazil: a systematic review

Parasitology ◽

10.1017/s0031182021000019 ◽

2021 ◽

pp. 1-9

Author(s):

Cleya da Silva Santana Cruz ◽

David Soeiro Barbosa ◽

Vinícius Cunha Oliveira ◽

Diogo Tavares Cardoso ◽

Nathália Sernizon Guimarães ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Urban Areas ◽

Grey Literature ◽

Cochrane Library ◽

Positive Correlation ◽

Individual Level ◽

Factors Associated ◽

The North ◽

Unified Health System

Abstract Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.

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Healthcare seeking and hospital admissions by people who inject drugs in response to symptoms of injection site infections or injuries in three urban areas of England

Epidemiology and Infection ◽

10.1017/s0950268814000284 ◽

2014 ◽

Vol 143 (1) ◽

pp. 120-131 ◽

Cited By ~ 16

Author(s):

V. D. HOPE ◽

F. NCUBE ◽

J. V. PARRY ◽

M. HICKMAN

Keyword(s):

Hospital Admission ◽

Injection Site ◽

Urban Areas ◽

People Who Inject Drugs ◽

Hospital Admissions ◽

Medical Advice ◽

Respondent Driven Sampling ◽

Open Wound ◽

Factors Associated ◽

Healthcare Burden

SUMMARYPeople who inject drugs (PWID) are vulnerable to infections and injuries at injection sites. The factors associated with reporting symptoms of these, seeking related advice, and hospital admission are examined. PWID were recruited in Birmingham, Bristol and Leeds using respondent-driven sampling (N = 855). During the preceding year, 48% reported having redness, swelling and tenderness (RST), 19% an abscess, and 10% an open wound at an injection site. Overall, 54% reported ⩾1 symptoms, with 45% of these seeking medical advice (main sources emergency departments and General Practitioners). Advice was often sought ⩾5 days after the symptom first appeared (44% of those seeking advice about an abscess, 45% about an open wound, and 35% for RST); the majority received antibiotics. Overall, 9·5% reported hospital admission during the preceding year. Ever being diagnosed with septicaemia and endocarditis were reported by 8·8% and 2·9%, respectively. Interventions are needed to reduce morbidity, healthcare burden and delays in accessing treatment.

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