scholarly journals Modelling the impact of COVID-19-related programme interruptions on visceral leishmaniasis in India

Author(s):  
Epke A Le Rutte ◽  
Luc E Coffeng ◽  
Johanna Muñoz ◽  
Sake J de Vlas

AbstractBackgroundIn March 2020, India declared a nationwide lockdown to control the spread of COVID-19. As a result, control efforts against visceral leishmaniasis (VL) were interrupted.MethodsUsing an established age-structured deterministic VL transmission model, we predicted the impact of a 6 to 24-month programme interruption on the timeline towards achieving the VL elimination target, as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption.ResultsDelays towards the elimination target are estimated to range between 0 to 9 years. Highly endemic settings where control efforts have been ongoing for 5-8 years are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target.ConclusionBesides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible, to prevent new individuals from becoming infected with VL, and continue the efforts towards VL elimination as a public health problem in India.

Author(s):  
Epke A Le Rutte ◽  
Luc E Coffeng ◽  
Johanna Muñoz ◽  
Sake J de Vlas

Abstract Background In March 2020, India declared a nationwide lockdown to control the spread of coronavirus disease 2019. As a result, control efforts against visceral leishmaniasis (VL) were interrupted. Methods Using an established age-structured deterministic VL transmission model, we predicted the impact of a 6- to 24-month programme interruption on the timeline towards achieving the VL elimination target as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption. Results Delays towards the elimination target are estimated to range between 0 and 9 y. Highly endemic settings where control efforts have been ongoing for 5–8 y are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target. Conclusions Besides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible to prevent new individuals from becoming infected with VL and continue the efforts towards VL elimination as a public health problem in India.


2020 ◽  
Author(s):  
Klodeta Kura ◽  
Diepreye Ayabina ◽  
Jaspreet Toor ◽  
T. Deirdre Hollingsworth ◽  
Roy M. Anderson

AbstractBackgroundThe 2030 goal for schistosomiasis is elimination as a public health problem (EPHP), with mass drug administration (MDA) of praziquantel to school-aged children (SAC) a central pillar of the strategy. However, due to COVID-19, many mass treatment campaigns for schistosomiasis have been halted with uncertain implications for the programmes.MethodWe use mathematical modelling to explore how postponement of MDA and various mitigation strategies affect achievement of the EPHP goal for Schistosoma mansoni and S. haematobium.ResultsIn moderate and some high prevalence settings, the disruption may delay the goal by up to two years. In some high prevalence settings EPHP is not achievable with current strategies, and so the disruption will not impact this. Here, increasing SAC coverage and treating adults can achieve the goal.The impact of MDA disruption and the appropriate mitigation strategy varies according to the baseline prevalence prior to treatment, the burden of infection in adults and stage of the programme.ConclusionsSchistosomiasis MDA programmes in medium and high prevalence areas should restart as soon as is feasible, and mitigation strategies may be required in some settings.


2019 ◽  
Vol 3 ◽  
pp. 1651
Author(s):  

Visceral leishmaniasis (VL) is a neglected tropical disease (NTD) caused by Leishmania protozoa that are transmitted by female sand flies. On the Indian subcontinent (ISC), VL is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020, which is defined as <1 VL case (new and relapse) per 10,000 population at district level in Nepal and sub-district level in Bangladesh and India. WHO is currently in the process of formulating 2030 targets, asking whether to maintain the 2020 target or to modify it, while adding a target of zero mortality among detected cases. The NTD Modelling Consortium has developed various mathematical VL transmission models to gain insight into the transmission dynamics of VL, identify the main knowledge gaps, and predict the feasibility of achieving and sustaining the targets by simulating the impact of varying intervention strategies. According to the models, the current target is feasible at the appropriate district/sub-district level in settings with medium VL endemicities (up to 5 reported VL cases per 10,000 population per year) prior to the start of the interventions. However, in settings with higher pre-control endemicities, additional efforts may be required. We also highlight the risk that those with post-kala-azar dermal leishmaniasis (PKDL) may pose to reaching and sustaining the VL targets, and therefore advocate adding control of PKDL cases to the new 2030 targets. Spatial analyses revealed that local hotspots with high VL incidence remain. We warn that the current target provides a perverse incentive to not detect/report cases as the target is approached, posing a risk for truly achieving elimination as a public health problem although this is taken into consideration by the WHO procedures for validation. Ongoing modelling work focuses on the risk of recrudescence when interventions are relaxed after the elimination target has been achieved.


2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 653-654
Author(s):  
SAMUEL L. KATZ

The passage of 20 years since the first International Conference on Measles Immunization in November 1961 has been accompanied by very significant advances in our understanding of the impact of measles among different groups, in the development and the utilization of measles vaccines, and in the control of the disease. Throughout all these considerations, there remains great variability. This is manifest in the surveillance data on morbidity and mortality, the extent of vaccine utilization, and the attitudes about measles as a serious public health problem. Because of these variations it is obvious that any recommendations must be evaluated carefully and adapted appropriately to meet the needs of a given nation, a population group, a geographic locale, or an environmental setting.


Author(s):  
A. BURGESS Deseri ◽  
Lisa Weed Phifer

Domestic violence is a growing public health problem that affects children nationwide. In fact, research estimates that anywhere between three and 17.8 million children witness domestic abuse each year5. Therefore, it is likely that teachers will regularly encounter students in their classroom who have been exposed to domestic violence. The impact of domestic violence is widespread, affecting academic performance, behavior, and social development. Teachers can make a positive impact by learning how best to identify and support these students. The following chapter will provide an overview of domestic violence, developmental considerations, and strategies for helping children who have been affected by it.


2020 ◽  
Vol 14 (12) ◽  
pp. e0008943
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K. Zayzay ◽  
Karsor K. Kollie ◽  
Eglantine Lebas ◽  
...  

Scabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking. We conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate versions of the dermatology life quality index (DLQI). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression. 1,318 participants from 477 households were surveyed. The prevalence of scabies was 9.3% (95% CI: 6.5–13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4–1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies. Our study indicates a substantial burden of scabies in this peri-urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.


Author(s):  
George A Gellert ◽  

To evaluate the impact of an on demand, digital mobile application deployed via smartphone on the sleep hygiene and nightly duration of employee program participants within a large multinational banking enterprise.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 444-444
Author(s):  
Susanne Iwarsson ◽  
Steven Schmidt ◽  
Björn Slaug

Abstract Falls are a major public health problem among older people. Even if the outcome of a fall is not fatal, it may be a traumatic experience with both physical and psychological consequences. However, there is a lack of studies examining how falls in the home may impact the perception of the home. To compare perceptions of the home between those who had fallen and those who had not, we utilized data from the Swedish SNAC-GÅS study (N=371; mean age=68; 43% men). Perceptions of control and meaning of the home were captured by established psychological instruments. Excluding falls in other environments than the home (n=99), those who fell in the home the previous year (n=34) scored notably higher on housing control by “powerful others” (p=0.053) and notably lower on perceived “behavioral home bonding” (p=0.056) compared to non-fallers (n=238). These results warrant further research into the impact of falls on perceived housing.


2020 ◽  
Vol 14 (06.1) ◽  
pp. 66S-71S
Author(s):  
Daniel Dana ◽  
Johnny Vlaminck ◽  
Zeleke Mekonnen ◽  
Mio Ayana ◽  
Florian Vogt ◽  
...  

Introduction: Soil-transmitted helminthiasis (STH) remains a major public health problem in school children in Ethiopia. Although direct wet mount microscopy (DWMM) is the means to diagnose parasitic diseases in health care facilities in Ethiopia, it remains unclear what its diagnostic performance is for STH. Methodology: A cross-sectional study was performed in Jimma Town (Ethiopia) and included 600 children from 10 primary schools. The diagnostic sensitivity of DWMM was compared to a composite reference standard (CRS) consisting of Kato-Katz, McMaster and Mini-FLOTAC. We also explored the impact of intensity of infection (the highest faecal egg counts (FECs; expressed as eggs per gram of stool (EPG)) across the CRS) on the diagnostic sensitivity of DWMM. Results: Based on the CRS, there were 210 Ascaris (35.0%), 312 Trichuris (52.0%) and 102 hookworm cases (17.0%). The median intensity of infections equalled 2,057 EPG for Ascaris, 200 EPG for Trichuris and 110 EPG for hookworms. The sensitivity of DWMM was 73.8% for Ascaris, but was around 17% for both Trichuris and hookworms. The sensitivity significantly increased with intensity of STH. For Ascaris, the odds for detecting an infection intensity of 1,000 EPG was 6.2 times higher than detecting an infection of 100 EPG. For Trichuris and hookworms, these odds ratios were 7.1 and 14. Conclusions: The diagnostic sensitivity of DWMM is low for STH, but it is able to detect those subjects that are in the highest need of treatment, and hence contributes to the global goal to eliminate STH as a public health problem.


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