scholarly journals New methodologies for the estimation of population vulnerability to diseases: a case study of Lassa fever and Ebola in Nigeria and Sierra Leone

2019 ◽  
Vol 374 (1776) ◽  
pp. 20180265 ◽  
Author(s):  
Olumayowa Kajero ◽  
Victor Del Rio Vilas ◽  
James L. N. Wood ◽  
Giovanni Lo Iacono
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Sierra Leone ◽  
Disease Outbreaks ◽  
Lassa Fever ◽  
High Morbidity ◽  
Theme Issue ◽  
Infectious Disease Outbreaks ◽  
New Methodologies ◽  
The Impact

Public health practitioners require measures to evaluate how vulnerable populations are to diseases, especially for zoonoses (i.e. diseases transmitted from animals to humans) given their pandemic potential. These measures would be valuable to support strategic and operational decision making and allocation of resources. Although vulnerability is well defined for natural hazards, for public health threats the concept remains undetermined. Here, we develop new methodologies to: (i) quantify the impact of zoonotic diseases and the capacity of countries to cope with these diseases, and (ii) combine these two measures (impact and capacity) into one overall vulnerability indicator. The adaptive capacity is calculated from estimations of disease mortality, although the method can be adapted for diseases with no or low mortality but high morbidity. As an example, we focused on the vulnerability of Nigeria and Sierra Leone to Lassa Fever and Ebola. We develop a simple analytical form that can be used to estimate vulnerability scores for different spatial units of interest, e.g. countries or regions. We show how some populations can be highly vulnerable despite low impact threats. We finally outline future research to more comprehensively inform vulnerability with the incorporation of relevant factors depicting local heterogeneities (e.g. bio-physical and socio-economic factors). This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This theme issue is linked with the earlier issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.

scholarly journals The impact of unplanned school closure on children’s social contact: Rapid evidence review

2020 ◽  
Author(s):  
Samantha Brooks ◽  
Louise Smith ◽  
Rebecca Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Relevant Literature ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Spread Of Infection ◽  
The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective. ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted. Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact. ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals The impact of unplanned school closure on children’s social contact: Rapid evidence review

2020 ◽  
Author(s):  
Samantha K. Brooks ◽  
Louise E. Smith ◽  
Rebecca K. Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Relevant Literature ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Spread Of Infection ◽  
The Impact

AbstractBackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective.ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted.Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact.ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals Quantifying the seasonal drivers of transmission for Lassa fever in Nigeria

2019 ◽  
Vol 374 (1775) ◽  
pp. 20180268 ◽  
Author(s):  
Andrei R. Akhmetzhanov ◽  
Yusuke Asai ◽  
Hiroshi Nishiura
Keyword(s):  
Infectious Disease ◽  
Mathematical Model ◽  
Population Dynamics ◽  
Disease Outbreaks ◽  
Case Fatality ◽  
Lassa Fever ◽  
Transmission Dynamics ◽  
Theme Issue ◽  
High Exposure ◽  
Infectious Disease Outbreaks

Lassa fever (LF) is a zoonotic disease that is widespread in West Africa and involves animal-to-human and human-to-human transmission. Animal-to-human transmission occurs upon exposure to rodent excreta and secretions, i.e. urine and saliva, and human-to-human transmission occurs via the bodily fluids of an infected person. To elucidate the seasonal drivers of LF epidemics, we employed a mathematical model to analyse the datasets of human infection, rodent population dynamics and climatological variations and capture the underlying transmission dynamics. The surveillance-based incidence data of human cases in Nigeria were explored, and moreover, a mathematical model was used for describing the transmission dynamics of LF in rodent populations. While quantifying the case fatality risk and the rate of exposure of humans to animals, we explicitly estimated the corresponding contact rate of humans with infected rodents, accounting for the seasonal population dynamics of rodents. Our findings reveal that seasonal migratory dynamics of rodents play a key role in regulating the cyclical pattern of LF epidemics. The estimated timing of high exposure of humans to animals coincides with the time shortly after the start of the dry season and can be associated with the breeding season of rodents in Nigeria. This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’. This issue is linked with the subsequent theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’.

scholarly journals The impact of unplanned school closure on children’s social contact: rapid evidence review

2020 ◽  
Vol 25 (13) ◽  
Author(s):  
Samantha K Brooks ◽  
Louise E Smith ◽  
Rebecca K Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Disease Outbreaks ◽  
Social Contact ◽  
School Closure ◽  
School Closures ◽  
Infectious Disease Outbreaks ◽  
Evidence Review ◽  
Spread Of Infection ◽  
The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

scholarly journals The Impact of Organisational Characteristics of Staff and Facility on Infectious Disease Outbreaks in Care Homes: a Systematic Review

2021 ◽  
Author(s):  
Ann Liljas ◽  
Lenke Morath ◽  
Bo Burström ◽  
Pär Schön ◽  
Janne Agerholm
Keyword(s):  
Infectious Disease ◽  
Systematic Review ◽  
Older People ◽  
Disease Outbreaks ◽  
Care Homes ◽  
Facility Design ◽  
Infectious Disease Outbreaks ◽  
Facility Size ◽  
The Impact ◽  
Nurse Aides

Abstract Background: Infectious disease outbreaks are common in care homes, often with substantial impact on the rates of infection and mortality of the residents, who primarily are older people vulnerable to infections. There is growing evidence that organisational characteristics of staff and facility might play a role in infection outbreaks however such evidence have not previously been systematically reviewed. Therefore, this systematic review aims to examine the impact of facility and staff characteristics on the risk of infectious disease outbreaks in care homes.Methods: Five databases were searched. Studies considered for inclusion were of any design reporting on an outbreak of any infectious disease in one or more care homes providing care for primarily older people with original data on: facility size, facility location (urban/rural), facility design, use of temporary hired staff, staff compartmentalizing, residence of staff, and/or nursing aides hours per resident. Retrieved studies were screened, assessed for quality, and analysed employing a narrative synthesis.Results: Sixteen studies (8 cohort studies, 6 cross-sectional studies, 2 case-control) were included from the search which generated 10,424 unique records. COVID-19 was the most commonly reported cause of outbreak (n=11). The other studies focused on influenza, respiratory and gastrointestinal outbreaks. Most studies reported on the impact of facility size (n=11) followed by facility design (n=4), use of temporary hired staff (n=3), facility location (n=2), staff compartmentalizing (n=2), nurse aides hours (n=2) and residence of staff (n=1). Findings suggest that urban location and larger facility size may be associated with greater risks of an infectious outbreak. Additionally, the risk of a larger outbreak seems lower in larger facilities. Whilst staff compartmentalizing may be associated with lower risk of an outbreak, staff residing in highly infected areas may be associated with greater risk of outbreak. The influence of facility design, use of temporary staff, and nurse aides hours remains unclear.Conclusions: This systematic review suggests that larger facilities have greater risks of infectious outbreaks, yet the risk of a larger outbreak seems lower in larger facilities. Due to lack of robust findings the impact of facility and staff characteristics on infectious outbreaks remain largely unknown.PROSPERO: CRD42020213585

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Mental health services for infectious disease outbreaks including COVID-19: a rapid systematic review

2020 ◽  
Vol 50 (15) ◽  
pp. 2498-2513
Author(s):  
Jing-Li Yue ◽  
Wei Yan ◽  
Yan-Kun Sun ◽  
Kai Yuan ◽  
Si-Zhen Su ◽  
...  
Keyword(s):  
Mental Health ◽  
Infectious Disease ◽  
Disease Outbreaks ◽  
Mental Illnesses ◽  
Stepped Care ◽  
Research Database ◽  
The Public ◽  
Infectious Disease Outbreaks ◽  
Culturally Adapted ◽  
The Impact

AbstractThe upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.

scholarly journals Ethics of instantaneous contact tracing using mobile phone apps in the control of the COVID-19 pandemic

2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Mobile Phone ◽  
Public Health Practice ◽  
Disease Outbreaks ◽  
Contact Tracing ◽  
Mobile Phone Data ◽  
Public Health Response ◽  
Infectious Disease Outbreaks ◽  
Ethical Implications

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.

scholarly journals Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

2019 ◽  
Vol 374 (1776) ◽  
pp. 20180431 ◽  
Author(s):  
Robin N. Thompson ◽  
Oliver W. Morgan ◽  
Katri Jalava
Keyword(s):  
Infectious Disease ◽  
Disease Outbreaks ◽  
Decision Makers ◽  
World Health ◽  
Theme Issue ◽  
Public Health Decision ◽  
Infectious Disease Outbreaks ◽  
Travel Restrictions ◽  
Health Decision ◽  
Health Organization

The World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterizing an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognized transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This issue is linked with the earlier theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.

scholarly journals Translating surveillance data into incidence estimates

2019 ◽  
Vol 374 (1776) ◽  
pp. 20180262 ◽  
Author(s):  
Y. Bourhis ◽  
T. Gottwald ◽  
F. van den Bosch
Keyword(s):  
Infectious Disease ◽  
Disease Incidence ◽  
Disease Outbreaks ◽  
Estimation Methods ◽  
Estimation Model ◽  
Theme Issue ◽  
Online Application ◽  
Infectious Disease Outbreaks ◽  
Sampling Series ◽  
Wide Range

Monitoring a population for a disease requires the hosts to be sampled and tested for the pathogen. This results in sampling series from which we may estimate the disease incidence, i.e. the proportion of hosts infected. Existing estimation methods assume that disease incidence does not change between monitoring rounds, resulting in an underestimation of the disease incidence. In this paper, we develop an incidence estimation model accounting for epidemic growth with monitoring rounds that sample varying incidence. We also show how to accommodate the asymptomatic period that is the characteristic of most diseases. For practical use, we produce an approximation of the model, which is subsequently shown to be accurate for relevant epidemic and sampling parameters. Both the approximation and the full model are applied to stochastic spatial simulations of epidemics. The results prove their consistency for a very wide range of situations. The estimation model is made available as an online application. This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This theme issue is linked with the earlier issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.

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