scholarly journals A novel comprehensive metric to assess COVID-19 testing outcomes: Effects of geography, government, and policy response

2020 ◽  
Author(s):  
Anthony C. Kuster ◽  
Hans J. Overgaard
Keyword(s):  
Detection Rate ◽  
Case Fatality ◽  
Multiple Linear Regression Model ◽  
System Capacity ◽  
Contact Tracing ◽  
Extrinsic Factors ◽  
Detection Rates ◽  
Case Identification ◽  
Rate Test ◽  
Reported Data

AbstractTesting and case identification are key strategies in controlling the COVID-19 pandemic. Contact tracing and isolation are only possible if cases have been identified. The effectiveness of testing must be tracked, but a single comprehensive metric is not available to assess testing effectiveness, and no timely estimates of case detection rate are available globally, making inter-country comparisons difficult. The purpose of this paper was to propose a single, comprehensive metric, called the COVID-19 Testing Index (CovTI) scaled from 0 to 100, that incorporated several testing metrics. The index was based on case-fatality rate, test positivity rate, active cases, and an estimate of the detection rate. It used parsimonious modeling to estimate the true total number of COVID-19 cases based on deaths, testing, health system capacity, and government transparency. Publicly reported data from 188 countries and territories were included in the index. Estimates of detection rates aligned with previous estimates in literature (R2=0.97). As of June 3, 2020, the states with the highest CovTI included Iceland, Australia, New Zealand, Hong Kong, and Thailand, and some island nations. Globally, CovTI increased from April 20 to June 3 but declined in ca. 10% of countries. Bivariate analyses showed the average in countries with open public testing policies (59.7, 95% CI 55.6-63.8) were significantly higher than countries with no testing policy (30.2, 95% CI 18.1-42.3) (p<0.0001). A multiple linear regression model assessed the association of independent grouping variables with CovTI. Open public testing and extensive contact tracing were shown to significantly increase CovTI, after adjusting for extrinsic factors, including geographic isolation and centralized forms of government. This tool may be useful for policymakers to assess testing effectiveness, inform decisions, and identify model countries. It may also serve as a tool for researchers in analyses by combining it with other databases.

scholarly journals A novel comprehensive metric to assess effectiveness of COVID-19 testing: Inter-country comparison and association with geography, government, and policy response

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248176
Author(s):  
Anthony C. Kuster ◽  
Hans J. Overgaard
Keyword(s):  
Detection Rate ◽  
Case Fatality ◽  
Multiple Linear Regression Model ◽  
System Capacity ◽  
Contact Tracing ◽  
Extrinsic Factors ◽  
Detection Rates ◽  
Case Identification ◽  
Rate Test ◽  
Reported Data

Testing and case identification are key strategies in controlling the COVID-19 pandemic. Contact tracing and isolation are only possible if cases have been identified. The effectiveness of testing should be assessed, but a single comprehensive metric is not available to assess testing effectiveness, and no timely estimates of case detection rate are available globally, making inter-country comparisons difficult. The purpose of this paper was to propose a single, comprehensive metric, called the COVID-19 Testing Index (CovTI) scaled from 0 to 100, derived from epidemiological indicators of testing, and to identify factors associated with this outcome. The index was based on case-fatality rate, test positivity rate, active cases, and an estimate of the detection rate. It used parsimonious modeling to estimate the true total number of COVID-19 cases based on deaths, testing, health system capacity, and government transparency. Publicly reported data from 165 countries and territories that had reported at least 100 confirmed cases by June 3, 2020 were included in the index. Estimates of detection rates aligned satisfactorily with previous estimates in literature (R2 = 0.44). As of June 3, 2020, the states with the highest CovTI included Hong Kong (93.7), Australia (93.5), Iceland (91.8), Cambodia (91.3), New Zealand (90.6), Vietnam (90.2), and Taiwan (89.9). Bivariate analyses showed the mean CovTI in countries with open public testing policies (66.9, 95% CI 61.0–72.8) was significantly higher than in countries with no testing policy (29.7, 95% CI 17.6–41.9) (p<0.0001). A multiple linear regression model assessed the association of independent grouping variables with CovTI. Open public testing and extensive contact tracing were shown to significantly increase CovTI, after adjusting for extrinsic factors, including geographic isolation and centralized forms of government. The correlation of testing and contact tracing policies with improved outcomes demonstrates the validity of this model to assess testing effectiveness and also suggests these policies were effective at improving health outcomes. This tool can be combined with other databases to identify other factors or may be useful as a standalone tool to help inform policymakers.

scholarly journals Epidemiological aspects of HIV infection and AIDS among indigenous populations

2019 ◽  
Vol 53 ◽  
pp. 71
Author(s):  
Samara Vilas-Bôas Graeff ◽  
Renata Palópoli Pícolli ◽  
Rui Arantes ◽  
Vivianne De Oliveira Landgraf de Castro ◽  
Rivaldo Venâncio da Cunha
Keyword(s):  
Hiv Infection ◽  
Indigenous Peoples ◽  
Detection Rate ◽  
Case Fatality ◽  
The State ◽  
Hiv And Aids ◽  
Indigenous Populations ◽  
Detection Rates ◽  
Mato Grosso ◽  
Mato Grosso Do Sul

OBJECTIVE: To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS: This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS: The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS: HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

scholarly journals Application Of Statistical Modeling To Interpret A Health System Crisis In Sri Lanka Due To COVID- 19

2021 ◽  
Author(s):  
Indika Karunathilake ◽  
Mayuri Amarasiri ◽  
Anver Hamdani
Keyword(s):  
Sri Lanka ◽  
Regression Model ◽  
Health System ◽  
Positive Relationship ◽  
Correlation Coefficients ◽  
Multiple Linear Regression Model ◽  
System Capacity ◽  
Contact Tracing ◽  
Statistic Modeling ◽  
Strong Positive Relationship

This paper will discuss the application of statistic modeling to interpret a health system crisis in Sri Lanka due to COVID- 19.A strong focus on the preventive approach and the contact tracing with the utilization of available resources in a rational manner describes Sri Lanka&rsquo;s response towards COVID- 19 prevention and mitigation. The early contact tracing, preemptive quarantining, isolation, and treatment were implemented as a concerted effort. This approach, proven efficient during the early phase of the pandemic, was sustainable when there was a rapid increase in the COVID- 19 patients since July 2021, exceeding the health system capacity.The country&rsquo;s COVID- 19 situation during the period from 01st of August 2021 to 31st of October 2021 was taken into consideration. Variables used for analysis were; total number of cases, recovered cases, comorbid and O2 dependent patients, ICU patients, and deaths. The regression model was applied to analyze the data by using the EViews 12 (x64) software application.The correlation coefficients of all the independent variables under consideration implies that they have a strong positive relationship with the number of deaths occurred during the said period. According to the computed multiple linear regression model, the number of positive cases and O2 dependents have a positive relationship with the dependent variable. Further, the Durbin- Watson stat value of the model and multicollinearity test reflect that it is free from serial correlation thereby the model is fit. From the perspective of epidemiological control, these findings highlight the importance of keeping the number of cases within the limits of health system capacity.

scholarly journals Three decades History of Tuberculosis Control in Kerbala/Iraq

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ali Al Mousawi
Keyword(s):  
Treatment Failure ◽  
Detection Rate ◽  
Treatment Success ◽  
Contact Tracing ◽  
Case Detection ◽  
Failure Rates ◽  
Tuberculosis Control ◽  
Detection Rates ◽  
Case Detection Rate ◽  
Tuberculosis Patients

Objective: To assess tuberculosis control between 1988 and 2017 and evaluate the outcomes of treatment among the October patients put on DOTS in Karbala governorate since the initiation of DOTS strategy in 2000. Material and methods: Data on tuberculosis incidence between 1988 and 2017 were assessed. In addition, all quarterly reports were collected in addition to the annual reports to estimate the outcome indices of DOTS in the governorate. Evaluation indices included the incidence and death rates; case detection rate for smear positive and total tuberculosis patients; cure rate; treatment success rate; default rates; treatment failure rates; drug resistance rates; contact tracing during the study period between 2005 and 2014. These indices were compared to the available national indices in the whole country. The indices of treatment success and failure rates were compared to the available previous reported rates in the governorate and in Iraq. Analysis used SPSS-20 and Excel data sheet. Discussion with experts working for decades in TB control programs revealed some defect in determining these indices. Results: Between 1988 and 2017 there was a total of 8665 TB patients, while between 2005 and 2017 the total was 4055: 2592 pulmonary TB patients (62%) and 1541 extra-pulmonary tuberculosis patients (38%). Gender distribution showed male predilection (60.3%) and a mean age of patients was 41.88±19.74 year and one half of the patients were above 44 year of age, but the most frequent age group was 25-34 year. Positive smear Case Detection rates were below the WHO planned goals ranging from 11.5% and 29.1%. The total reported deaths during the study period were 78 deaths. Defaulters were 97 patients at a rate of 2.39, while treatment failure cases amounted to 33 patients (a rate of 0.81%). Drug sensitivity test was introduced to country in 2010 and was done only in Baghdad till the introduction of Genexpert MTB/RIF test in January 2014 and a total of 72 patients were MDR cases. Case detection rate among contacts was 0.31%. Conclusions: The success in DOTS in Karbala is similar to the results in the whole country and in most developing countries and approaching the WHO set goals, while the case detection rates were behind. However, some defect areas need further support to prevent failure and aid continuous tuberculosis control and stop TB.

scholarly journals The New York Islands AVM Study: Detection rates for brain AVM and incident AVM hemorrhage

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 368-368
Author(s):  
C Stapf ◽  
H Mast ◽  
R R Sciacca ◽  
J Pile-Spellman ◽  
J P Mohr
Keyword(s):  
New York ◽  
Detection Rate ◽  
Population Based ◽  
Staten Island ◽  
Detection Rates ◽  
Number Of Patients ◽  
Brain Avm ◽  
Reported Data ◽  
Brain Avms ◽  
Zip Code

P159 Background: Population-based data on the incidence of brain AVM hemorrhage is scarce. We studied detection rates of brain AVM and AVM hemorrhage in a defined population. Methods: The New York islands (Manhattan, Staten Island, and Long Island) are a ZIP-code defined area comprising a 8,898,000 population. In a retrospective investigation, major NY islands hospital centers retrieved the number of patients who lived in the study area and were discharged with a diagnosis of brain AVM between 1996 and 1999. Starting March 15, 2000, all major NY islands hospitals prospectively reported data on consecutive NY islands patients with a diagnosis of brain AVM and whether or not the patient had suffered AVM hemorrhage. Referral patients living outside the study area were excluded from the sample. Results: The retrospective detection rate of brain AVMs in patients living in the study area (Table 1) was estimated to be 1.2/100,000 person-years (95% CI:1.1–1.4). As of July 14, 2000, 37 prospective AVM patients were encountered leading to a calculated AVM detection rate of 1.25/100,000 pers-yrs (95% CI: 0.9–1.7) with an estimated incidence for first-ever AVM hemorrhage (n=6) of 0.2/100,000 pers-yrs (95% CI:0.1 to 0.5). The prevalence of AVM hemorrhage (n=14) was 0.5/100,000 pers-yrs (95% CI:0.3 to 0.8). Conclusions: Our preliminary data suggest similar prospective and retrospective AVM detection rates. More than one third of AVM patients may suffer intracranial hemorrhage.

scholarly journals Training: improving antenatal detection and outcomes of congenital heart disease

2018 ◽  
Vol 7 (4) ◽  
pp. e000276 ◽  
Author(s):  
Orhan Uzun ◽  
Julia Kennedy ◽  
Colin Davies ◽  
Anthony Goodwin ◽  
Nerys Thomas ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Detection Rate ◽  
Congenital Heart ◽  
Training Programme ◽  
Referral Rate ◽  
Cardiac Anomaly ◽  
Cardiac Ultrasound ◽  
Detection Rates ◽  
Antenatal Detection ◽  
The Uk

ObjectivesThis study describes the design, delivery and efficacy of a regional fetal cardiac ultrasound training programme. This programme aimed to improve the antenatal detection of congenital heart disease (CHD) and its effect on fetal and postnatal outcomes.Design setting and participantsThis was a prospective study that compared antenatal CHD detection rates by professionals from 13 hospitals in Wales before and after engaging in our ‘skills development programme’. Existing fetal cardiac practice and perinatal outcomes were continuously audited and progressive targets were set. The work was undertaken by the Welsh Fetal Cardiovascular Network, Antenatal Screening Wales (ASW), a superintendent sonographer and a fetal cardiologist.InterventionsA core professional network was established, engaging all stakeholders (including patients, health boards, specialist commissioners, ASW, ultrasonographers, radiologists, obstetricians, midwives and paediatricians). A cardiac educational lead (midwife, superintendent sonographer, radiologist, obstetrician, or a fetal medicine specialist) was established in each hospital. A new cardiac anomaly screening protocol (‘outflow tract view’) was created and training on the new protocol was systematically delivered at each centre. Data were prospectively collected and outcomes were continuously audited: locally by the lead fetal cardiologist; regionally by the Congenital Anomaly Register and Information Service in Wales; and nationally by the National Institute for Cardiac Outcomes and Research (NICOR) in the UK.Main outcome measuresPatient satisfaction; improvements in individual sonographer skills, confidence and competency; true positive referral rate; local hospital detection rate; national detection rate of CHD; clinical outcomes of selected cardiac abnormalities; reduction of geographical health inequality; cost efficacy.ResultsHigh levels of patient satisfaction were demonstrated and the professional skill mix in each centre was improved. The confidence and competency of sonographers was enhanced. Each centre demonstrated a reduction in the false-positive referral rate and a significant increase in cardiac anomaly detection rate. According to the latest NICOR data, since implementing the new training programme Wales has sustained its status as UK lead for CHD detection. Health outcomes of children with CHD have improved, especially in cases of transposition of the great arteries (for which no perinatal mortality has been reported since 2008). Standardised care led to reduction of geographical health inequalities with substantial cost saving to the National Health Service due to reduced false-positive referral rates. Our successful model has been adopted by other fetal anomaly screening programmes in the UK.ConclusionsAntenatal cardiac ultrasound mass training programmes can be delivered effectively with minimal impact on finite healthcare resources. Sustainably high CHD detection rates can only be achieved by empowering the regional screening workforce through continuous investment in lifelong learning activities. These should be underpinned by high quality service standards, effective care pathways, and robust clinical governance and audit practices.

scholarly journals Mortality due to primary brain tumours in China and detection rate in people with suspected symptoms: a nationally representative cross-sectional survey

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Detection Rate ◽  
Epidemiological Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Detection Rates ◽  
Primary Brain Tumours ◽  
Symptom Screening ◽  
Nationally Representative

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.

scholarly journals Role of efficient testing and contact tracing in mitigating the COVID-19 pandemic: a network modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045886
Author(s):  
Yiying Hu ◽  
Jianying Guo ◽  
Guanqiao Li ◽  
Xi Lu ◽  
Xiang Li ◽  
...  
Keyword(s):  
Real World ◽  
Case Fatality ◽  
Contact Tracing ◽  
Secondary Outcome ◽  
Time Interval ◽  
Fatality Rate ◽  
Real World Data ◽  
Network Modelling ◽  
World Data ◽  
Quantitative Evidence

ObjectivesThis study quantified how the efficiency of testing and contact tracing impacts the spread of COVID-19. The average time interval between infection and quarantine, whether asymptomatic cases are tested or not, and initial delays to beginning a testing and tracing programme were investigated.SettingWe developed a novel individual-level network model, called CoTECT (Testing Efficiency and Contact Tracing model for COVID-19), using key parameters from recent studies to quantify the impacts of testing and tracing efficiency. The model distinguishes infection from confirmation by integrating a ‘T’ compartment, which represents infections confirmed by testing and quarantine. The compartments of presymptomatic (E), asymptomatic (I), symptomatic (Is), and death with (F) or without (f) test confirmation were also included in the model. Three scenarios were evaluated in a closed population of 3000 individuals to mimic community-level dynamics. Real-world data from four Nordic countries were also analysed.Primary and secondary outcome measuresSimulation result: total/peak daily infections and confirmed cases, total deaths (confirmed/unconfirmed by testing), fatalities and the case fatality rate. Real-world analysis: confirmed cases and deaths per million people.Results(1) Shortening the duration between Is and T from 12 to 4 days reduces infections by 85.2% and deaths by 88.8%. (2) Testing and tracing regardless of symptoms reduce infections by 35.7% and deaths by 46.2% compared with testing only symptomatic cases. (3) Reducing the delay to implementing a testing and tracing programme from 50 to 10 days reduces infections by 35.2% and deaths by 44.6%. These results were robust to sensitivity analysis. An analysis of real-world data showed that tests per case early in the pandemic are critical for reducing confirmed cases and the fatality rate.ConclusionsReducing testing delays will help to contain outbreaks. These results provide policymakers with quantitative evidence of efficiency as a critical value in developing testing and contact tracing strategies.

scholarly journals The Effects of Social Distancing Policies on non-SARS-CoV-2 Respiratory Pathogens

2021 ◽  
Author(s):  
Jeff Nawrocki ◽  
Katherine Olin ◽  
Martin C Holdrege ◽  
Joel Hartsell ◽  
Lindsay Meyers ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Detection Rate ◽  
Respiratory Illness ◽  
Respiratory Pathogens ◽  
Public Health Response ◽  
Mixed Effect ◽  
Detection Rates ◽  
Social Distancing ◽  
The Impact

Abstract Background The initial focus of the US public health response to COVID-19 was the implementation of numerous social distancing policies. While COVID-19 was the impetus for imposing these policies, it is not the only respiratory disease affected by their implementation. This study aimed to assess the impact of social distancing policies on non-SARS-CoV-2 respiratory pathogens typically circulating across multiple US states. Methods Linear mixed-effect models were implemented to explore the effects of five social distancing policies on non-SARS-CoV-2 respiratory pathogens across nine states from January 1 through May 1, 2020. The observed 2020 pathogen detection rates were compared week-by-week to historical rates to determine when the detection rates were different. Results Model results indicate that several social distancing policies were associated with a reduction in total detection rate, by nearly 15%. Policies were associated with decreases in pathogen circulation of human rhinovirus/enterovirus and human metapneumovirus, as well as influenza A, which typically decrease after winter. Parainfluenza viruses failed to circulate at historical levels during the spring. Total detection rate in April 2020 was 35% less than historical average. Many of the pathogens driving this difference fell below historical detection rate ranges within two weeks of initial policy implementation. Conclusion This analysis investigated the effect of multiple social distancing policies implemented to reduce transmission of SARS-CoV-2 on non-SARS-CoV-2 respiratory pathogens. These findings suggest that social distancing policies may be used as an impactful public health tool to reduce communicable respiratory illness.

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