scholarly journals Epidemiological Philosophy of Pandemics

2021 ◽  
Author(s):  
Tareef Fadhil Raham
Keyword(s):  
Viral Load ◽  
Fixed Ratio ◽  
Case Fatality ◽  
Positive Influence ◽  
P Value ◽  
Power Model ◽  
Regression Analyses ◽  
Background Theory ◽  
New Evidence ◽  
Testing Coverage

Objectives: Currents estimates of total cases of COVID-19 are largely based on previously determined case fatality rates (CFR)s. The background theory in this study is based on two: There is no evidence that during epidemics CFR is fixed throughout time or place and there is evidence that viral load (dense of infection) leads to more fatalities. Study Design: This study was done to look for any relationship between mortality rate (MR) presented as deaths/ million (M) population with both of the total cases / (M) population (density of infection) and of CFR. We chose 31 countries with testing coverage > 400,0000 tests /M and with> 1 million population. Methods: We used ANOVA regression analyses for testing the associations. Results: CRF is not a fixed ratio as it changed with a change in (MR). The COVID-19 deaths / million data were fit to calculate the total cases through the equation: total deaths /M =0.006593 X (total cases to the power 1.016959) with a too highly significant correlation between total deaths / 1M and total cases (P-value 0.0000). There was a high positive influence of COVID-19 MR on the CFR (P-value = 0.0002) by non-linear regression (power model), through the equation: CFR = (0.093200) X (total deaths/ M.) to the power 0.366580 Conclusions: There is new evidence of using MR for estimation of CFR and total cases through uniform formulas applicable during this pandemic and possibly for every epidemic. This evidence gives us an understandable idea about epidemics' behavior.

scholarly journals Epidemiological philosophy of pandemics

2021 ◽  
Vol 8 (7) ◽  
pp. 3255
Author(s):  
Tareef Fadhil Raham
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Mortality Rates ◽  
Positive Influence ◽  
Fatality Rate ◽  
Regression Analyses ◽  
Background Theory ◽  
Very High ◽  
Testing Coverage

Background: During  the COVID-19 pandemic, clinicians have struggled to understand why case fatality rates vary among countries. The role of clusters of infections in COVID-19 severity is well known before, furthermore the case overload was attributed to increased COVID-19 mortality in certain locations. The background theory in this study was the  already existing evidence that an increased viral load (density of infection) leads to more fatalities. The aim of this study was to find the correlation between high number of cases and high mortality (MR) in different countries and to find the correlation of MR with case fatality rate (CFR).Methods: We chose thirty-one countries with testing coverage levels of >400,0000 tests/M and populations greater than 1 million inhabitants. We used ANOVA regression analyses to test the associations.Results: There was a very highly significant correlation between MR and the total number of cases/million population inhabitants (M) (p=0.0000). The CRF changed with a change in the MR. A very high positive influence of the COVID-19 MR on the CFR (p= 0.0000).Conclusions: Increased number of cases per million inhabitants is associated with increased MR. Increased MR is associated with increased CFR. These findings explain variable mortality rates in relation to CFR and to the number of cases/M. This evidence gives us an idea of the behavior of epidemics in general. This  will help in the development of infection control policies.

scholarly journals Covid-19 High Attack Rate Can Lead to High Case Fatality Rate

2021 ◽  
Author(s):  
Tareef Fadhil Raham
Keyword(s):  
Mortality Rate ◽  
Attack Rate ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Positive Influence ◽  
P Value ◽  
Fatality Rate ◽  
Mean Values ◽  
Paired Samples ◽  
Significant Difference

Background: During the current Covid-19 pandemic case fatality rate (CFR) estimates were subjected to a lot of debates regarding the accuracy of its estimations, predictions, and the reason of across countries variances. In this context, we conduct this study to see the relationship between attack rate (AR) and CFR. The study hypothesis is based on two: 1- evidence suggests that the mortality rate (MR) has a positive influence on case fatality ratio (CFR), 2- and increase number of Covid-19 cases leads to increased mortality rate (MR). Material and methods: Thirty countries and territories were chosen. Inclusion criterion was > 500 Covid-19 reported cases per 10,000 population inhabitants. Data on covid-19 cases and deaths was selected as it was on March 10, 2021. Statistical methods used are descriptive and one-sample Kolmogorov-Smirnov (K-S), the one-way ANOVA, Levene, least significant different (LSD), and matched paired-samples T-tests. Results: ANOVA test showed a significant difference at P<0.01 among all studied groups concerning AR and CFR mean values. Group of countries with MR ≥ 15 death / 104 inhabitants recorded the highest level of crude mean CFR and AR values, and recorded the highest gap with leftover groups, especially with countries reported MR of <10 death/ 104 inhabitants. There were independence 95% confidence intervals of mean CFR and AR values between countries with ≥ 15 death / 104 MR and countries with MR of <10 death /104. There was a significant difference between countries with MR ≥ 15 death / 104 inhabitants and countries with MR of <10 death / 10 4 inhabitants groups through least significant difference (LSD) test for CFR%( 0.042 p-values) and Games Howell (GH) test for AR/104 (p-value 0.000). Conclusions: CFR has a positive significant association with AR.

scholarly journals Factors associated with prognostic or treatment outcomes in HIV/AIDS patients with and without hypertension in Eswatini

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabelo Bonginkosi Dlamini ◽  
Hans-Uwe Dahms ◽  
Ming-Tsang Wu
Keyword(s):  
Viral Load ◽  
P Value ◽  
Aids Patients ◽  
Large Hospital ◽  
Hypertensive Patients ◽  
Factors Associated ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Hiv Aids

AbstractNon-communicable diseases are increasing faster in HIV/AIDS patients than in the general population. We studied the association between hypertension and other possible confounding factors on viral load and CD4-cell counts in hypertensive and non-hypertensive HIV/AIDS patients receiving antiretroviral therapy (ART) at a large hospital in Eswatini over a 4-year period. We performed a retrospective longitudinal review of the medical records of 560 ART patients divided into non-hypertension and hypertension groups (n = 325 and n = 235) from July 27 to September 8, 2018. Generalized Estimated Equation was used to analyze the longitudinal data. Hypertensive patients were more likely to have improved CD4-cell counts than non-hypertensive patients (OR = 1.83, [1.37–2.44]). ART patients with hypertension were more likely to have detectable viral loads, though not significant (OR = 1.37 [0.77–2.43]). In non-hypertensive patients, second line ART was significantly associated with viral load (OR = 8.61 [2.93–25.34]) and adverse side effects (OR = 3.50 [1.06–11.54]), while isoniazid preventive therapy was significantly associated with CD4-cell counts (OR = 1.68 [1.16–2.45]). In hypertensive patients, factors associated with viral load were WHO HIV stage (OR = 2.84 [1.03–7.85]) and adherence (OR = 8.08 [1.33–49.04]). In both groups, CD4-cell counts significantly and steadily increased over time (p-value < 0.001). Results show a significant association between hypertension and CD4 cell counts but not viral load. In ART patients with and without hypertension, the factors associated with prognostic markers were different. More attention may need to be paid to ART patients with well controlled HIV status to monitoring and controlling of hypertension status.

scholarly journals Population-Predicted MHC Class II Epitope Presentation of SARS-CoV-2 Structural Proteins Correlates to the Case Fatality Rates of COVID-19 in Different Countries

2021 ◽  
Vol 22 (5) ◽  
pp. 2630
Author(s):  
Chunguang Liang ◽  
Elena Bencurova ◽  
Eric Psota ◽  
Priya Neurgaonkar ◽  
Martina Prelog ◽  
...  
Keyword(s):  
Mhc Class Ii ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Class Ii ◽  
Viral Envelope ◽  
Structural Proteins ◽  
P Value ◽  
Fatality Rate ◽  
Different Populations ◽  
Infection Spread

We observed substantial differences in predicted Major Histocompatibility Complex II (MHCII) epitope presentation of SARS-CoV-2 proteins for different populations but only minor differences in predicted MHCI epitope presentation. A comparison of this predicted epitope MHC-coverage revealed for the early phase of infection spread (till day 15 after reaching 128 observed infection cases) highly significant negative correlations with the case fatality rate. Specifically, this was observed in different populations for MHC class II presentation of the viral spike protein (p-value: 0.0733 for linear regression), the envelope protein (p-value: 0.023), and the membrane protein (p-value: 0.00053), indicating that the high case fatality rates of COVID-19 observed in some countries seem to be related with poor MHC class II presentation and hence weak adaptive immune response against these viral envelope proteins. Our results highlight the general importance of the SARS-CoV-2 structural proteins in immunological control in early infection spread looking at a global census in various countries and taking case fatality rate into account. Other factors such as health system and control measures become more important after the early spread. Our study should encourage further studies on MHCII alleles as potential risk factors in COVID-19 including assessment of local populations and specific allele distributions.

Abstract WMP88: Shorter Door-to-Needle Times of Intravenous Alteplase Improve “Efficiency” of Care and Moderately Affect “Quality” of Care: Study Based on a Large Comprehensive Stroke Center

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Suja S Rajan ◽  
Jessica N Wise ◽  
Marquita Decker-palmer ◽  
Thanh Dao ◽  
Cynthia Salem ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Clinical Outcomes ◽  
Heart Association ◽  
P Value ◽  
Regression Analyses ◽  
Inpatient Mortality ◽  
Care Outcomes ◽  
Comprehensive Stroke Center ◽  
Stroke Center

Introduction: The American Heart Association (AHA) recently raised the bar on timely treatment of acute ischemic stroke (AIS) with intravenous (IV) alteplase, by recommending door-to-needle times of 30 minutes or less for 50% or more of the AIS patients. Our study looks at the effectiveness of this new standard, by examining the effect of varying door-to-needle times on efficiency and quality of care, and clinical outcomes. Methods: Our study examined 762 AIS patients treated with IV alteplase in a large academic health system from 2015-2018, and compared their outcomes after treatment within 30, 45 and 60 minutes of arrival. The outcomes compared were: 1) Efficiency of care outcome - Length of stay (LOS); 2) Quality of care outcomes - Inpatient mortality and Disability at discharge; 3) Clinical outcomes - Discharge and 90-day modified Rankin Scale (mRS), and Post-alteplase (24 hr) NIH Stroke Scale (NIHSS). Adjusted logistic and linear regression analyses were used, after controlling for baseline patient socio-demographic and clinical characteristics. Results: Based on the adjusted regression analyses (Table 1), being treated within 30 minutes of arrival reduced the average LOS by 1.3 days (p-value: 0.02), but did not affect the quality of care outcomes. Similarly, being treated within 45 minutes of arrival reduced LOS by 0.9 days (p-value: 0.04). Being treated within 60 minutes of arrival did not affect LOS, but reduced the odds of inpatient mortality by 68% (p-value: 0.00), and disability at discharge by 29% (p-value: 0.08). Being treated within 30 minutes of arrival was associated with better mRS and NIHSS scores as compared with being treated within 45 or 60 minutes. Conclusion: Quicker IV alteplase treatment significantly improved efficiency of care and clinical outcomes. Quality of care outcomes did not improve beyond the 60 minute door-to-needle threshold. This study provides evidence supporting AHA’s new recommendation of 30 minutes or less door-to-needle time.

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

scholarly journals THE INFLUENCE OF LIQUIDITY AND PROFITABILITY TOWARD SHARE PRICE: MEDIATED EFFECT OF HEDGING (EVIDENCES FROM SHARES OF LQ-45 LISTED IN INDONESIAN STOCK EXCHANGE FOR PERIOD OF 2011 TO 2015)

2019 ◽  
Vol 7 (5) ◽  
pp. 150-160 ◽  
Author(s):  
Tigor Sitorus ◽  
Ratlan Pardede ◽  
Ardi
Keyword(s):  
Structural Equation Modelling ◽  
Structural Equation ◽  
Stock Exchange ◽  
Negative Influence ◽  
Positive Influence ◽  
Share Price ◽  
Direct Influence ◽  
Equation Modelling ◽  
New Evidence

Purpose: This study aims at investigating and testing the mediated effect of Hedging on the effect of profitability and liquidity toward share price at shares of LQ-45, listed in Indonesian Stock Exchange from2011 to 2015. The current research was conducted because the phenomenon and the fluctuations in price of shares were unavoidable. Methodology: The Structural Equation Modelling (SEM) by Amos was used to analyze the 110 observations of data. Main Findings: The result of analysis shows that; (1) the liquidity gives not significantly negative influence to share price, (2) the liquidity gives  significantly negative influence to hedging, (3) the profitability gives significantly positive influence to share price, (4) the profitability gives significantly negative influence to hedging, (5). Hedging gives significantly positive influence to share price. Implications/Applications: The present study provides new evidence that the mediated effect of Hedging on the influence of liquidity and profitability toward share price has more strength compared to the direct influence of liquidity but not for profitability.

scholarly journals Pemberantasan Sarang Nyamuk 3M Plus terhadap Kejadian Demam Berdarah Dengue di Puskesmas Payung Sekaki Kota Pekanbaru; Studi Kasus Kontrol

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Tyagita Widya Sari ◽  
Retno Putri
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
P Value ◽  
Fatality Rate ◽  
Purposive Sampling

Demam Berdarah Dengue (DBD) adalah penyakit menular yangdisebabkan oleh virus Dengue dan ditularkan melalui gigitan nyamukAedes aegypti. Dinas Kesehatan Provinsi Riau melaporkan jumlah kasusDBD sebanyak 277 dan Case Fatality Rate (CFR) DBD sebesar 1,4% padatahun 2016, di mana kasus terbanyak berasal dari Kota Pekanbaru yaitu58 kasus dengan CFR sebesar 0%. Adapun, CFR DBD di wilayah kerjaPuskesmas Payung Sekaki meningkat dari 0% pada tahun 2015 menjadi0,7% pada tahun 2016. DBD merupakan penyakit berbasis lingkunganyang dapat dicegah dengan melakukan tindakan pengendalian vektor,antara lain dengan pemberantasan sarang nyamuk (PSN) dan tindakanpencegahan lainnya. Akan tetapi, partisipasi aktif masyarakat dalam PSNmasih rendah dan kurang. Tujuan penelitian adalah untuk mengetahuihubungan PSN 3M Plus dengan kejadian DBD di wilayah kerja PuskesmasPayung Sekaki Kota Pekanbaru tahun 2017. Penelitian ini dilakukan padabulan Agustus tahun 2017. Desain studi penelitian ini adalah observasionaldengan pendekatan kasus kontrol. Jumlah sampel kasus dipilih denganteknik total sampling yaitu 40 kasus, sedangkan sampel kontrol dipilihdengan teknik purposive sampling yaitu 80 kontrol. Analisis datamenggunakan uji regresi logistik ganda. Hasil analisis multivariatmenunjukkan bahwa kebiasaan menggunakan obat nyamuk palingdominan menjelaskan perubahan variabel kejadian DBD (p-value = 0,092;OR = 2,76; 95% CI = 0,85-8,87). Variabel praktik M1 (menguras TPA),keberadaan kawat kassa nyamuk dalam ventilasi rumah, kebiasaanmenggantung pakaian, dan kebiasaan menggunakan obat nyamukberhubungan dan merupakan faktor risiko kejadian DBD di wilayah kerjaPuskesmas Payung Sekaki Kota Pekanbaru

scholarly journals Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa Zone, Oromiya, Ethiopia, 2018

2019 ◽  
Author(s):  
Jemal H Ali
Keyword(s):  
Viral Load ◽  
Marital Status ◽  
Associated Factors ◽  
Plasma Viral Load ◽  
Baseline Viral Load ◽  
Rank Test ◽  
P Value ◽  
People Living With Hiv ◽  
Age Group ◽  
Significant Difference

Abstract Background: Human immuno-deficiency virus is a virus that causes Acquired Immuno- Deficiency Syndrome. The key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East shewa zone, Oromiya, Ethiopia. Methods: The study was conducted in East Shewa zone, Oromiya, Ethiopia from August 2017 to January 2018. Patients diagnosed with human immunodeficiency virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Data was collected by using structured questionnaires and interview. A total of ETB 81,120.00 was utilized to carry out the study. Result: plasma viral load was suppressed below detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was log 5.3111 copies/ml. Survival curve difference were observed in category of marital status (p-value 0.023) and baseline CD4 values (p-value 0.023) whereas no significant difference were observed in Educational status (p-value 0.404), MUAC (p- value 0.407) BMI(p-value 0.335) and BTB(p-value 0.257). Estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was age group between 50-59 years. Conclusion: Estimated time to achieve PVL after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4.

scholarly journals Assessment of Effect of Hydropower Plant Projects on Socio-Environmental Sustenance and Development in Rwanda: A Review Done At Rubagabaga Hydropower Ltd.

2022 ◽  
Vol 10 (01) ◽  
pp. 2888-2904
Author(s):  
Dr. MUTESI Jean Claude
Keyword(s):  
Community Structure ◽  
Null Hypothesis ◽  
Quantitative Research ◽  
Target Population ◽  
Positive Influence ◽  
Hydropower Plant ◽  
P Value ◽  
Structure And Dynamics ◽  
Hydropower Plants ◽  
The Impact

The study investigated the socio-economic and environmental impact of hydropower projects in Rwanda with a case study of Rubagabaga hydropower Ltd operating from Nyabihu District. It examines the impact of a socio-economic and environmental hydropower plant in Rwanda, identifies the challenge hydropower plants face in Rwanda, and finally investigates the relationship between hydro powers and their socio-economic impact in Rwanda? In this research, the quantitative research design is based on statistical data of the research that was used with quantitative and qualitative methods. Questionnaires were used to collect data. The target population of this study was made up of 252 participants including 154 respondents all from ten different villages surrounding the Rubagabaga plant in Nyabihu District. Data were analyzed using descriptive and correlation analysis and tables that were interpreted to confirm or deny the relevance of the main and specific objectives. Based on results from table no.16 demonstrates that the beta= 0.397 with the t value of 2.333 and the p-value of 0. 021. Since the p-value is less than 0.05, the researcher rejected the null hypothesis and considered it an alternate. There is a strong positive relationship between environmental assessment of hydropower plant projects and socio-environmental sustenance and development. In a nutshell, the researcher has rejected the null hypothesis and considered its alternate. Community structure and dynamics have a positive influence on socio-environmental sustenance and development. Table no.16 shows that beta= 0.341 with the t value of 2.668 as the p-value was 0.009. Since the p-value is less than 0.05. Therefore, the researcher rejected the null hypothesis and considered it an alternate. According to table no.21, the changes in community structure and dynamics of the hydropower plant project cause the increase of 0.341 (34.1%) of the socio-environment sustenance and development. The ratio of beta modal results for the t value expressed t=2.66 hence the probability value is significant on socio-environment sustenance and development noting that sig. =0.009. Carefully, the researcher has rejected the null hypothesis and considered its alternate. With this in mind, community structure and dynamics has a positive influence on socio-environmental sustenance and development. Table no.16 has shown beta= 0.478 with the t value of 4.543 as the p-value was 0.000 which is less than 0.05. According to the findings, the changes in government policies, stability, and support of hydropower plant project causes the increase of 0.478 (47.80%) of the socio-environment sustenance and development. The ratio of beta modal results for the t value expressed t= 4.54 hence the probability value is significant on socio-environment sustenance and development noting that sig. =0.000.

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