scholarly journals Area deprivation is inversely associated with measles incidence: A spatiotemporal analysis in Germany

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rohleder ◽  
C Stock ◽  
K Bozorgmehr
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
High Risk ◽  
Disease Incidence ◽  
Socioeconomic Inequalities ◽  
Elevated Risk ◽  
Socioeconomic Deprivation ◽  
Area Deprivation ◽  
Geographical Factors ◽  
Measles Incidence

Abstract Background Although measles is endemic in all WHO European regions, very few studies have directly analysed socioeconomic inequalities in disease incidence of measles. We examined the spatiotemporal association between socioeconomic deprivation and measles incidence considering relevant demographic and geographical factors at district level. Methods We conducted a longitudinal small-area analysis using nationally representative data of 401 districts from 2001 to 2017. We used Bayesian spatiotemporal regression models to assess the potential effects of area deprivation on measles incidence, adjusted for relevant demographic (district population size, sex, age, and proportion of non-nationals) and geographical factors (north-south-west-east effect) as well as spatial and temporal effects. We computed risk ratios (RR) for deprivation quintiles (Q1 - Q5), and district-specific adjusted relative risks (ARR) to assess the area-level risk profile of measles in Germany. Results The risk of measles infection in areas with lowest deprivation quintile (Q1) was 1.58 times higher (95%-credible interval [CrI] 1.32-2.00) than in those with highest deprivation (Q5). Areas with medium-low (Q2), medium (Q3), and medium-high deprivation (Q4) had higher adjusted risks of measles relative to areas with highest deprivation (Q5) (RR: 1.23 (0.99-1.51), 1.05 (0.87-1.26), and 1.23 (1.05-1.43), respectively). We identified 22 areas at high risk and 56 at medium-high risk for measles infections, with highest area-level risks in south-western Germany. Conclusions Socioeconomic deprivation in Germany is inversely associated with measles incidence, with elevated risk for measles infections in areas with higher socioeconomic status. Our findings contribute to current global and national debates on measles elimination strategies, and demonstrate the importance of spatial modelling techniques in identifying socioeconomic inequalities and spatial risk patterns of measles for public health actions. Key messages Socioeconomic deprivation is inversely associated with measles incidence in Germany, with higher risk of infection in areas with highest socioeconomic status. The social, spatial, and temporal patterns of elevated risk of measles infection require targeted public health action and policy to address the complexity underlying measles epidemiology.

scholarly journals Socioeconomic deprivation is inversely associated with measles incidence: a longitudinal small-area analysis, Germany, 2001 to 2017

2021 ◽  
Vol 26 (17) ◽  
Author(s):  
Sven Rohleder ◽  
Christian Stock ◽  
Kayvan Bozorgmehr
Keyword(s):  
High Risk ◽  
Small Area ◽  
Bayesian Regression ◽  
Socioeconomic Deprivation ◽  
World Health ◽  
Area Deprivation ◽  
Spatial And Temporal Patterns ◽  
Public Health Action ◽  
Small Area Analysis ◽  
Measles Incidence

Background Although measles is endemic throughout the World Health Organization European Region, few studies have analysed socioeconomic inequalities and spatiotemporal variations in the disease’s incidence. Aim To study the association between socioeconomic deprivation and measles incidence in Germany, while considering relevant demographic, spatial and temporal factors. Methods We conducted a longitudinal small-area analysis using nationally representative linked data in 401 districts (2001–2017). We used spatiotemporal Bayesian regression models to assess the potential effect of area deprivation on measles incidence, adjusted for demographic and geographical factors, as well as spatial and temporal effects. We estimated risk ratios (RR) for deprivation quintiles (Q1–Q5), and district-specific adjusted relative risks (ARR) to assess the area-level risk profile of measles in Germany. Results The risk of measles incidence in areas with lowest deprivation quintile (Q1) was 1.58 times higher (95% credible interval (CrI): 1.32–2.00) than in those with highest deprivation (Q5). Areas with medium-low (Q2), medium (Q3) and medium-high deprivation (Q4) had higher adjusted risks of measles relative to areas with highest deprivation (Q5) (RR: 1.23, 95%CrI: 0.99–1.51; 1.05, 95%CrI: 0.87–1.26 and 1.23, 95%CrI: 1.05–1.43, respectively). We identified 54 districts at medium-high risk for measles (ARR > 2) in Germany, of which 22 were at high risk (ARR > 3). Conclusion Socioeconomic deprivation in Germany, one of Europe’s most populated countries, is inversely associated with measles incidence. This association persists after demographic and spatiotemporal factors are considered. The social, spatial and temporal patterns of elevated risk require targeted public health action and policy to address the complexity underlying measles epidemiology.

scholarly journals Species abundance and temporal variation of arbovirus vectors in Brownsville, Texas

2017 ◽  
Vol 41 ◽  
pp. 1 ◽  
Author(s):  
Krithika Srinivasan ◽  
Beatriz Tapia ◽  
Arturo Rodriguez ◽  
Robert Wood ◽  
Jennifer J Salinas
Keyword(s):  
Public Health ◽  
High Risk ◽  
Disease Incidence ◽  
South Texas ◽  
Late Winter ◽  
Surveillance Program ◽  
Public Health Department ◽  
Mosquito Vector ◽  
Vector Surveillance ◽  
Public Health Response

The recent outbreaks of the dengue fever and West Nile viruses and the looming threats of the Zika and chikungunya viruses highlight the importance of establishing effective, proactive arboviral surveillance in communities at high risk of transmission, such as those on the Texas–Mexico border. Currently, there are no approved human vaccines available for these mosquito-borne diseases, so entomological control and case management are the only known methods for decreasing disease incidence. The principal vectors, which include Culex quinquefasciatus, Aedes aegypti, and Ae. Albopictus, all have an established presence in South Texas. The public health response to most arbovirus outbreaks in the region has been reactionary rather than proactive. However, after the 2005 dengue outbreak and subsequent fatality, the City of Brownsville Public Health Department began collecting data on mosquito vector abundance and incidence. The objective of this study was to describe the various species of mosquitoes found in vector surveillance in Brownsville, Texas, during 2009–2013; quantify their prevalence; and identify any associations with temporal or weather-related variations. The results confirm a significant mosquito population in Brownsville in late winter months, indicating a high risk of arbovirus transmission in South Texas year-round, and not just until November, previously considered the end date of arbovirus season by state health services. The data from Brownsville’s surveillance program can help characterize local vector ecology and facilitate more proactive mitigation of future arboviral threats in South Texas.

scholarly journals Socioeconomic status determines COVID-19 incidence and related mortality in Santiago, Chile

2021 ◽  
Author(s):  
Gonzalo Mena ◽  
Pamela P. Martinez ◽  
Ayesha S. Mahmud ◽  
Pablo A. Marquet ◽  
Caroline O. Buckee ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Socioeconomic Status ◽  
Human Mobility ◽  
Disease Incidence ◽  
Strong Association ◽  
Age Groups ◽  
Large City ◽  
Urban Centers ◽  
Incidence And Mortality

AbstractThe current coronavirus disease 2019 (COVID-19) pandemic has impacted dense urban populations particularly hard. Here, we provide an in-depth characterization of disease incidence and mortality patterns, and their dependence on demographic and socioeconomic strata in Santiago, a highly segregated city and the capital of Chile. We find that among all age groups, there is a strong association between socioeconomic status and both mortality –measured either by direct COVID-19 attributed deaths or excess deaths– and public health capacity. Specifically, we show that behavioral factors like human mobility, as well as health system factors such as testing volumes, testing delays, and test positivity rates are associated with disease outcomes. These robust patterns suggest multiple possibly interacting pathways that can explain the observed disease burden and mortality differentials: (i) in lower socioeconomic status municipalities, human mobility was not reduced as much as in more affluent municipalities; (ii) testing volumes in these locations were insufficient early in the pandemic and public health interventions were applied too late to be effective; (iii) test positivity and testing delays were much higher in less affluent municipalities, indicating an impaired capacity of the health-care system to contain the spread of the epidemic; and (iv) infection fatality rates appear much higher in the lower end of the socioeconomic spectrum. Together, these findings highlight the exacerbated consequences of health-care inequalities in a large city of the developing world, and provide practical methodological approaches useful for characterizing COVID-19 burden and mortality in other segregated urban centers.

scholarly journals COVID-19 Twitter-based analysis reveals differential concerns across areas with socioeconomic disparities

2020 ◽  
Author(s):  
Yihua Su ◽  
Aarthi Venkat ◽  
Yadush Yadav ◽  
Lisa B. Puglisi ◽  
Samah J. Fodeh
Keyword(s):  
Public Health ◽  
Social Media ◽  
Socioeconomic Status ◽  
Topic Modeling ◽  
National Level ◽  
Crisis Response ◽  
Lifestyle Changes ◽  
Area Deprivation ◽  
Media Platform ◽  
Health Messaging

ABSTRACTObjectiveWe sought to understand how U.S. residents responded to COVID-19 as it emerged, and the extent to which spatial-temporal factors impacted response.Materials and MethodsWe mined and reverse-geocoded 269,556 coronavirus-related social media postings on Twitter from January 23rd to March 25th, 2020. We then ranked tweets based on the socioeconomic status of the county they originated from using the Area Deprivation Index (ADI); that we also used to identify areas with high initial disease counts (“hotspots”). We applied topic modeling on the tweets to identify chief concerns and determine their evolution over time. We also investigated how topic proportions varied based on ADI and between hotspots and non-hotspots.ResultsWe identified 45 topics, which shifted from early-outbreak-related content in January, to the presidential election and governmental response in February, to lifestyle changes in March. Highly resourced areas (low ADI) were concerned with stocks, social distancing, and national-level policies, while high ADI areas shared content with negative expression, prayers, and discussion of the CARES Act economic relief package. Within hotspots, these differences stand, with the addition of increased discussion regarding employment in high ADI versus low ADI hotspots.DiscussionTopic modeling captures the major concerns in COVID-19-related discussion on a social media platform in the early months of the pandemic. Our study extends previous studies that utilized topic modeling on COVID-19 related tweets and linked the identified topics to socioeconomic status using ADI. Comparisons between low and high ADI areas indicate differential Twitter discussions, corresponding to greater concern with economic hardship and impacts of the pandemic in less resourced communities, and less focus on general public health messaging.ConclusionThis work demonstrates a novel framework for assessing differential topics of conversation correlating to income, education, and housing disparities. This, with integration of COVID-19 hotspots, offers improved analysis of crisis response on Twitter. Such insight is critical for informed public health messaging campaigns in future waves of the pandemic, which should focus in part specifically on the interests of those who are most vulnerable in the lowest resourced health settings.

scholarly journals The demographics and geographic distribution of laboratory-confirmed Lyme disease cases in England and Wales (2013–2016): an ecological study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028064 ◽  
Author(s):  
John S P Tulloch ◽  
Amanda E Semper ◽  
Tim J G Brooks ◽  
Katherine Russell ◽  
Kate D Halsby ◽  
...  
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
Lyme Disease ◽  
Geographic Distribution ◽  
Rural Areas ◽  
Ecological Study ◽  
Disease Incidence ◽  
Testing Laboratory ◽  
England And Wales ◽  
Southern England

ObjectiveLyme disease is a tick-borne disease of increasing incidence and public concern across the Northern Hemisphere. However, the socio-demographics and geographic distribution of the population affected in England and Wales are poorly understood. Therefore, the proposed study was designed to describe the demographics and distribution of laboratory-confirmed cases of Lyme disease from a national testing laboratory.DesignAn ecological study of routinely collected laboratory surveillance data.SettingPublic Health England’s national Lyme disease testing laboratory.Participants3986 laboratory-confirmed cases of Lyme disease between 2013 and 2016.ResultsIn England and Wales, the incidence of laboratory-confirmed Lyme disease rose significantly over the study period from 1.62 cases per 100 000 in 2013 to 1.95 cases per 100 000 in 2016. There was a bimodal age distribution (with peaks at 6–10 and 61–65 years age bands) with a predominance of male patients. A significant clustering of areas with high Lyme disease incidence was located in southern England. An association was found between disease incidence and socioeconomic status, based on the patient’s resident postcode, with more cases found in less deprived areas. Cases were disproportionately found in rural areas compared with the national population distribution.ConclusionsThese results suggest that Lyme disease patients originate from areas with higher socioeconomic status and disproportionately in rural areas. Identification of the Lyme disease hotspots in southern England, alongside the socio-demographics described, will enable a targeted approach to public health interventions and messages.

scholarly journals Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications in Australia

2021 ◽  
Author(s):  
Joanne Enticott ◽  
Jaskirath Gill ◽  
Simon Bacon ◽  
Kim Lavoie ◽  
Dan Epstein ◽  
...  
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
High Risk ◽  
Vaccine Uptake ◽  
List Type ◽  
Social Distancing ◽  
Knowing That ◽  
Vaccine Confidence ◽  
To Receive ◽  
Intent To Continue

AbstractObjectiveTo examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults.MethodsNationwide survey in February-March 2021 of adults representative across sex, age and location. Vaccine uptake and a range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were examined using logistic and Bayesian regressions for vaccines generally and for SARS-CoV-2 vaccines.ResultsOverall 1,166 surveys were collected from participants aged 18-90 years (mean 52, SD of 19). Seventy-eight percent reported being likely to receive a vaccine against COVID-19. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 1.04 95%CI [1.03-1.044]), being male (OR: 1.37, 95% CI [1.08 – 1.72]), residing in the least disadvantaged area quintile (OR: 2.27 95%CI [1.53 – 3.37]) and a self-perceived high risk of getting COVID-19 (OR: 1.52 95% CI [1.08 – 2.14]). However, 72% of participants did not believe that they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level, and rurality. Knowing that the vaccine is safe and effective, and that getting vaccinated will protect others, trusting the company that made it and getting vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight percent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing etc.) post-vaccine.ConclusionsSeventy-eight percent of Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified in this study (e.g. knowing that the vaccine is safe and effective, getting a doctor’s recommendation to get vaccinated) can be used to inform public health messaging to enhance vaccination rates.Strengths and limitations of this studyThis research captured a large, representative sample of the adult Australian population across age, sex, location, and socioeconomic status.We have self-reported Australian uptake intentions and attitudes on general vaccines and COVID-19 vaccine, and intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing etc.) post SARS-CoV-2 vaccine.We examine a range of drivers and factors that may influence intent to get the SARS-CoV-2 vaccine uptake, including vaccine confidence, demographics and socioeconomic status.The survey is based on established behavioural theories, and is the Australian arm of the international iCARE survey which to date has collected global comparative information from over 90,000 respondents in 140 countries.Our survey was only available in English, which may have led to an underrepresentation of ethnic groups, and participation was voluntary, so our sample may be prone to selection bias from those with more interest or engagement in COVID-19.

scholarly journals A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments

2019 ◽  
Vol 8 (2) ◽  
pp. 252 ◽  
Author(s):  
Miguel de Araújo Nobre ◽  
Francisco Salvado ◽  
Paulo Nogueira ◽  
Evangelista Rocha ◽  
Peter Ilg ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Disease Incidence ◽  
Risk Groups ◽  
Risk Profile ◽  
Moderate Risk ◽  
C Statistic ◽  
Disease Risk Score ◽  
Very High

Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect/impact of the recall regimen (≤ six months; > six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of < six months or > six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile.

Screening at ports of entry for Ebola Virus Disease in England—a descriptive analysis of screening assessment data, 2014–2015

2020 ◽  
Author(s):  
Nicki L Boddington ◽  
Sophia Steinberger ◽  
Richard G Pebody
Keyword(s):  
Public Health ◽  
High Risk ◽  
Secondary Care ◽  
Ebola Virus ◽  
Virus Disease ◽  
Descriptive Analysis ◽  
Health Assessment ◽  
Ebola Virus Disease ◽  
Screening Assessment

Abstract Background In response to the outbreak of Ebola Virus Disease (EVD) in West Africa in 2014 and evidence of spread to other countries, pre-entry screening was introduced by PHE at five major ports of entry in the England. Methods All passengers that entered the England via the five ports returning from Liberia, Guinea and Sierra Leonne were required to complete a Health Assessment Form and have their temperature taken. The numbers, characteristics and outcomes of these passengers were analysed. Results Between 14 October 2014 and 13 October 2015, a total of 12 648 passengers from affected countries had been screened. The majority of passengers were assessed as having no direct contact with EVD cases or high-risk events (12 069, 95.4%), although 535 (4.2%) passengers were assessed as requiring public health follow-up. In total, 39 passengers were referred directly to secondary care, although none were diagnosed with EVD. One high-risk passenger was later referred to secondary care and diagnosed with EVD. Conclusions Collection of these screening data enabled timely monitoring of the numbers and characteristics of passengers screened for EVD, facilitated resourcing decisions and acted as a mechanism to inform passengers of the necessary public health actions.

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