Estimating Force of Infection from Serologic Surveys with Imperfect Tests

The force of infection, or the rate at which susceptible individuals become infected, is an important public health measure for assessing the extent of outbreaks and the impact of control programs. Here we present methods for estimating force of infection from serological surveys of infections which produce lasting immunity, taking into account imperfections in the test used, and uncertainty in such imperfections. The methods cover both single serological surveys, in which age is a proxy for time at risk, and repeat surveys in the same people, in which the force of infection is estimated more directly. Fixed values can be used for the sensitivity and specificity of the tests, or existing methods for belief elicitation can be used to include uncertainty in these values. The latter may be applicable, for example, when the specificity of a test depends on co-circulating pathogens, which may not have been well characterized in the setting of interest. We illustrate the methods using data from two published serological studies of dengue.

Download Full-text

Water fluoridation: current challenges

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-318545 ◽

2020 ◽

pp. archdischild-2019-318545

Author(s):

John Furness ◽

Sam J Oddie ◽

Simon Hearnshaw

Keyword(s):

Public Health ◽

Dental Caries ◽

Water Fluoridation ◽

Public Health Measure ◽

Important Public Health ◽

Community Water ◽

Health Measure ◽

Community Water Fluoridation ◽

And Child Health ◽

Do So

Dental extraction for caries is the most common reason for children aged 6–10 years to be admitted to hospital. Community Water Fluoridation (CWF) is safe and effective at reducing dental caries. It is most effective where there is more deprivation. However, many deprived areas do not have CWF despite Public Health England recommending it. Those who lobby against fluoridation do so using emotionally charged language and misinformation. We discuss the benefits of fluoridation and the specious arguments used against this important public health measure. The National CWF Network is led by dentists and promotes CWF. COVID-19 has led to the suspension of routine dentistry, renewing the urgency of implementation of CWF. Professional bodies such as the Royal College of Paediatrics and Child Health are urged to give their support.

Download Full-text

Estimating force of infection from serologic surveys with imperfect tests

PLoS ONE ◽

10.1371/journal.pone.0247255 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247255

Author(s):

Neal Alexander ◽

Mabel Carabali ◽

Jacqueline K. Lim

Keyword(s):

Sensitivity And Specificity ◽

Credible Interval ◽

Serological Tests ◽

Control Programs ◽

Force Of Infection ◽

Binomial Regression ◽

Serological Studies ◽

Analyse Data ◽

The One ◽

The Impact

Background The force of infection, or the rate at which susceptible individuals become infected, is an important public health measure for assessing the extent of outbreaks and the impact of control programs. Methods and findings We present Bayesian methods for estimating force of infection using serological surveys of infections which produce a lasting immune response, accounting for imperfections of the test, and uncertainty in such imperfections. In this estimation, the sensitivity and specificity can either be fixed, or belief distributions of their values can be elicited to allow for uncertainty. We analyse data from two published serological studies of dengue, one in Colombo, Sri Lanka, with a single survey and one in Medellin, Colombia, with repeated surveys in the same individuals. For the Colombo study, we illustrate how the inferred force of infection increases as the sensitivity decreases, and the reverse for specificity. When 100% sensitivity and specificity are assumed, the results are very similar to those from a standard analysis with binomial regression. For the Medellin study, the elicited distribution for sensitivity had a lower mean and higher variance than the one for specificity. Consequently, taking uncertainty in sensitivity into account resulted in a wide credible interval for the force of infection. Conclusions These methods can make more realistic estimates of force of infection, and help inform the choice of serological tests for future serosurveys.

Download Full-text

Workplace bullying in Australia: Recruiting ethical leaders is an important public health measure

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867416660201 ◽

2016 ◽

Vol 50 (11) ◽

pp. 1104-1105 ◽

Cited By ~ 2

Author(s):

Stephen Allison ◽

Tarun Bastiampillai

Keyword(s):

Public Health ◽

Workplace Bullying ◽

Public Health Measure ◽

Important Public Health ◽

Health Measure ◽

Ethical Leaders

Download Full-text

Is Second dose of vaccination useful in previously SARS-CoV-2 infected Health Care Workers?

10.1101/2021.06.22.21257103 ◽

2021 ◽

Author(s):

Gauthier Pean de Ponfilly ◽

Benoit Pilmis ◽

Iheb El Kaibi ◽

Nathalie Castreau ◽

Sophie Laplanche ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Workers ◽

Healthcare Workers ◽

Healthcare Systems ◽

Public Health Measure ◽

Important Public Health ◽

Infected People ◽

Health Measure ◽

Care Workers

Vaccines are the most important public health measure to protect people from COVID‐19 worldwide. In addition, healthcare workers account for a large number of infected people. Then, protecting this population from COVID-19 seems crucial in the preservation of healthcare systems. In a context of few doses available, serological assays could be useful to decide whether one or two doses are needed. Our results show that a first dose of BNT162b2 mRNA vaccine seems to act as a boost after SARS-CoV-2 infection in healthcare workers with a previous SARS-CoV-2 infection and a second dose might not be required.

Download Full-text

Managing essential healthcare services during the first nationwide lockdown: experiences from a Regional Referral Hospital in Bhutan

Bhutan Health Journal ◽

10.47811/bhj.128 ◽

2021 ◽

Vol 7 (2) ◽

pp. 32-35

Author(s):

Purushotam Bhandari ◽

Neelima Chhetri ◽

Dinesh Pradhan

Keyword(s):

Public Health ◽

Healthcare Services ◽

Mobile Clinic ◽

Public Health Measure ◽

Regional Referral Hospital ◽

Important Public Health ◽

Good Communication ◽

Health Measure ◽

Essential Services ◽

The World

The current COVID -19 pandemic has brought unprecedented burden on healthcare system throughout the world. While the pandemic has hijacked all attention and priorities, there is a significant concern that non-COVID essential healthcare services may be negleccted. Lockdowns have become an important public health measure to contain local outbreaks. We describe our experiences in ensuring the provision of essential healthcare services during the first nationwide lockdown. Adequate preparations with a well-thought of contingency plan , identification of roles, good communication system, 24 -hour hotline and a mobile clinic with the most essential services, form important components of essential healthcare services.

Download Full-text

Modelling the impact of travel restrictions on COVID-19 cases in Hong Kong in early 2020

BMC Public Health ◽

10.1186/s12889-021-11889-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wang-Chun Kwok ◽

Ka-Chun Wong ◽

Ting-Fung Ma ◽

Ka-Wai Ho ◽

Louis Wai-Tong Fan ◽

...

Keyword(s):

Public Health ◽

Hong Kong ◽

Scientific Data ◽

Public Health Measure ◽

Seir Model ◽

Health Measure ◽

Travel Restrictions ◽

Almost All ◽

Isolation Facilities ◽

The Impact

Abstract Background Coronavirus Disease 2019 (COVID-19) led to pandemic that affected almost all countries in the world. Many countries have implemented border restriction as a public health measure to limit local outbreak. However, there is inadequate scientific data to support such a practice, especially in the presence of an established local transmission of the disease. Objective To apply a metapopulation Susceptible-Exposed-Infectious-Recovered (SEIR) model with inspected migration to investigate the effect of border restriction as a public health measure to limit outbreak of coronavirus disease 2019. Methods We apply a modified metapopulation SEIR model with inspected migration with simulating population migration, and incorporating parameters such as efficiency of custom inspection in blocking infected travelers in the model. The population sizes were retrieved from government reports, while the number of COVID-19 patients were retrieved from Hong Kong Department of Health and China Centre for Disease Control (CDC) data. The R0 was obtained from previous clinical studies. Results Complete border closure can help to reduce the cumulative COVID-19 case number and mortality in Hong Kong by 13.99% and 13.98% respectively. To prevent full occupancy of isolation facilities in Hong Kong; effective public health measures to reduce local R0 to below 1.6 was necessary, apart from having complete border closure. Conclusions Early complete travel restriction is effective in reducing cumulative cases and mortality. However, additional anti-COVID-19 measures to reduce local R0 to below 1.6 are necessary to prevent COVID-19 cases from overwhelming hospital isolation facilities.

Download Full-text

Impact of school closures and re-openings on COVID-19 transmission

Canada Communicable Disease Report ◽

10.14745/ccdr.v47i12a02 ◽

2021 ◽

Vol 47 (12) ◽

pp. 515-523

Author(s):

Maryem El Jaouhari ◽

Rojiemiahd Edjoc ◽

Lisa Waddell ◽

Patricia Houston ◽

Nicole Atchessi ◽

...

Keyword(s):

Public Health ◽

Empirical Studies ◽

Rapid Review ◽

Public Health Measure ◽

School Closures ◽

Health Measures ◽

Health Measure ◽

Education Of Students ◽

Research Criteria ◽

The Impact

Background: Globally, the education of students at primary and secondary schools has been severely disrupted by the implementation of school closures to reduce the spread of coronavirus disease 2019 (COVID-19). The effectiveness of school closures in reducing transmission of COVID-19 and the impact of re-opening schools are unclear. Methods: Research criteria for this rapid review included empirical studies, published or pre-published worldwide before January 25, 2021, that assessed the effectiveness of school closures in reducing the spread of COVID-19 and the impact of school re-openings on COVID-19 transmission. Results: Twenty-four studies on the impact of school closures and re-openings on COVID-19 transmission were identified through the seven databases that were searched. Overall the evidence from these studies was mixed and varied due to several factors such as the time of implementation of public health measures, research design of included studies and variability among the levels of schooling examined. Conclusion: Preliminary findings suggest that school closures have limited impact on reducing COVID-19 transmission, with other non-pharmaceutical interventions considered much more effective. However, due to the limitations of the studies, further research is needed to support the use of this public health measure in response to the COVID-19 pandemic.

Download Full-text

Running with Face Masks or Respirators Can Be Detrimental to the Respiratory and Cardiovascular Systems

Cardiovascular Innovations and Applications ◽

10.15212/cvia.2021.0010 ◽

2021 ◽

Author(s):

Guoliang Li

Keyword(s):

Public Health ◽

Side Effects ◽

Cardiac Arrhythmias ◽

Spontaneous Pneumothorax ◽

Oxygen Deficiency ◽

Rare Event ◽

Face Mask ◽

Public Health Measure ◽

Important Public Health ◽

Health Measure

Since the first cases of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) were reported at the end of 2019, this infection has spread around the globe, becoming a pandemic. The use of face masks and respirators is an important public health measure to reduce or prevent transmission of SARS-CoV-2. Here we discuss the hypothetical mechanisms by which exercise with face masks orrespirators can induce detrimental effects on the cardiovascular system, potentially explaining adverse events suchas cardiac arrhythmias and spontaneous pneumothorax. Although sudden death associated with the wearing of a face mask during running is a rare event, the risk is higher especially in those with existing cardiac comorbidities.In such cases, a mask designed specifically for runners with no or few side effects of oxygen deficiency should be considered instead.

Download Full-text