scholarly journals Child mortality in England during the COVID-19 pandemic

2021 ◽  
pp. archdischild-2020-320899
Author(s):  
David Odd ◽  
Sylvia Stoianova ◽  
Tom Williams ◽  
Vicky Sleap ◽  
Peter Blair ◽  
...  

ObjectivesUsing the National Child Mortality Database (NCMD), this work aims to investigate and quantify the characteristics of children dying of COVID-19, and to identify any changes in rate of childhood mortality during the pandemic.DesignWe compared the characteristics of the children who died in 2020, split by SARS-CoV-2 status. A negative binomial regression model was used to compare mortality rates in lockdown (23 March–28 June), with those children who died in the preceding period (6 January–22 March), as well as a comparable period in 2019.SettingEngland.ParticipantsChildren (0–17 years).Main outcome measuresCharacteristics and number of the children who died in 2020, split by SARS-CoV-2 status.Results1550 deaths of children between 6th of January and 28 June 2020 were notified to the NCMD; 437 of the deaths were linked to SARS-CoV-2 virology records, 25 (5.7%) had a positive PCR result. PCR-positive children were less likely to be white (37.5% vs 69.4%, p=0.003) and were older (12.2 vs 0.7 years, p<0.0006) compared with child deaths without evidence of the virus. All-cause mortality rates were similar during lockdown compared with both the period before lockdown in 2020 (rate ratio (RR) 0.93 (0.84 to 1.02)) and a similar period in 2019 (RR 1.02 (0.92 to 1.13)).ConclusionsThere is little to suggest that there has been excess mortality during the period of lockdown. The apparent higher frequency of SARS-CoV-2-positive tests among children from black, Asian and minority ethnic groups is consistent with findings in adults. Ongoing surveillance is essential as the pandemic continues.

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Fares Qeadan ◽  
Nana Akofua Mensah ◽  
Benjamin Tingey ◽  
Rona Bern ◽  
Tracy Rees ◽  
...  

Abstract Background The spread of the COVID-19 pandemic throughout the world presents an unprecedented challenge to public health inequities. People who use opioids may be a vulnerable group disproportionately impacted by the current pandemic, however, the limited prior research in this area makes it unclear whether COVID-19 and opioid use outcomes may be related, and whether other environmental and socioeconomic factors might play a role in explaining COVID-19 mortality. The objective of this study is to evaluate the association between opioid-related mortality and COVID-19 mortality across U.S. counties. Methods Data from 3142 counties across the U.S. were used to model the cumulative count of deaths due to COVID-19 up to June 2, 2020. A multivariable negative-binomial regression model was employed to evaluate the adjusted COVID-19 mortality rate ratios (aMRR). Results After controlling for covariates, counties with higher rates of opioid-related mortality per 100,000 persons were found to be significantly associated with higher rates of COVID-19 mortality (aMRR: 1.0134; 95% CI [1.0054, 1.0214]; P = 0.001). Counties with higher average daily Particulate Matter (PM2.5) exposure also saw significantly higher rates of COVID-19 mortality. Analyses revealed rural counties, counties with higher percentages of non-Hispanic whites, and counties with increased average maximum temperatures are significantly associated with lower mortality rates from COVID-19. Conclusions This study indicates need for public health efforts in hard hit COVID-19 regions to also focus prevention efforts on overdose risk among people who use opioids. Future studies using individual-level data are needed to allow for detailed inferences.


2021 ◽  
Author(s):  
Endale Alemayehu Ali ◽  
Tsigereda Tilahun

Abstract Introduction: The under-five mortality rate, often known by its acronym U5MR or simply as the child mortality rate, indicates the probability of dying between births exactly five years of age, expressed per 1,000 live births. In comparison, the probability of dying after the first month and before reaching age 1 was 12 per 1,000, the probability of dying after age 1 and before age 5 was 10 per 1,000, and the probability of dying after age 5 and before age 15 was 7 per 1,000. Objectives: The study was aimed to determine the major factors of child mortality in Ethiopia using different counting models. In detail the study has the objective of identifying the risk factors of child mortality in Ethiopia and also to prioritize the best counting models that fit the data well. Methods: The Ethiopian demographic and health survey of 2016 was used for this study. About 10641 women aged between 15-49 were included in the survey. To analyze the data, counting models like the Poisson regression model, negative binomial model, zero-inflated regression models, and zero-inflated negative binomial regression model were applicable. Results: The results of the study indicated that of the total 10641 women respondents, 7576 (71.2%) have not faced the problem of child mortality. Thus, this result has the clue that the count models, especially the models that can handle the dispersion may be applicable. The average rate of child mortality is less than the variance of child mortality and this indicated that there is an over-dispersion of the data. Of all the candidate models, a zero-inflated negative binomial regression model was found to be the best model since it has a minimum AIC(15517). The coefficient table of the best model indicated that of child mortality for the women from rural residence is 1.2532 greater than those from urban with a 95% confidence interval (0.0905, 0.3610). Conclusion: The model comparison technique is indicated that the zero-inflated negative binomial regression models were the best mode that fit the data well. Under this model, the residency of women, birth order, Preceding Birth Interval, Size of a child at birth (smaller than average), and number of household members are significant variables in determining the status of child mortality in Ethiopia


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-Yang Zhang ◽  
An-Ran Zhang ◽  
Qing-Bin Lu ◽  
Xiao-Ai Zhang ◽  
Zhi-Jie Zhang ◽  
...  

Abstract Background COVID-19 has impacted populations around the world, with the fatality rate varying dramatically across countries. Selenium, as one of the important micronutrients implicated in viral infections, was suggested to play roles. Methods An ecological study was performed to assess the association between the COVID-19 related fatality and the selenium content both from crops and topsoil, in China. Results Totally, 14,045 COVID-19 cases were reported from 147 cities during 8 December 2019–13 December 2020 were included. Based on selenium content in crops, the case fatality rates (CFRs) gradually increased from 1.17% in non-selenium-deficient areas, to 1.28% in moderate-selenium-deficient areas, and further to 3.16% in severe-selenium-deficient areas (P = 0.002). Based on selenium content in topsoil, the CFRs gradually increased from 0.76% in non-selenium-deficient areas, to 1.70% in moderate-selenium-deficient areas, and further to 1.85% in severe-selenium-deficient areas (P < 0.001). The zero-inflated negative binomial regression model showed a significantly higher fatality risk in cities with severe-selenium-deficient selenium content in crops than non-selenium-deficient cities, with incidence rate ratio (IRR) of 3.88 (95% CIs: 1.21–12.52), which was further confirmed by regression fitting the association between CFR of COVID-19 and selenium content in topsoil, with the IRR of 2.38 (95% CIs: 1.14–4.98) for moderate-selenium-deficient cities and 3.06 (1.49–6.27) for severe-selenium-deficient cities. Conclusions Regional selenium deficiency might be related to an increased CFR of COVID-19. Future studies are needed to explore the associations between selenium status and disease outcome at individual-level.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Nabil Shaaban ◽  
Bárbara Peleteiro ◽  
Maria Rosario O. Martins

Abstract Background This study offers a comprehensive approach to precisely analyze the complexly distributed length of stay among HIV admissions in Portugal. Objective To provide an illustration of statistical techniques for analysing count data using longitudinal predictors of length of stay among HIV hospitalizations in Portugal. Method Registered discharges in the Portuguese National Health Service (NHS) facilities Between January 2009 and December 2017, a total of 26,505 classified under Major Diagnostic Category (MDC) created for patients with HIV infection, with HIV/AIDS as a main or secondary cause of admission, were used to predict length of stay among HIV hospitalizations in Portugal. Several strategies were applied to select the best count fit model that includes the Poisson regression model, zero-inflated Poisson, the negative binomial regression model, and zero-inflated negative binomial regression model. A random hospital effects term has been incorporated into the negative binomial model to examine the dependence between observations within the same hospital. A multivariable analysis has been performed to assess the effect of covariates on length of stay. Results The median length of stay in our study was 11 days (interquartile range: 6–22). Statistical comparisons among the count models revealed that the random-effects negative binomial models provided the best fit with observed data. Admissions among males or admissions associated with TB infection, pneumocystis, cytomegalovirus, candidiasis, toxoplasmosis, or mycobacterium disease exhibit a highly significant increase in length of stay. Perfect trends were observed in which a higher number of diagnoses or procedures lead to significantly higher length of stay. The random-effects term included in our model and refers to unexplained factors specific to each hospital revealed obvious differences in quality among the hospitals included in our study. Conclusions This study provides a comprehensive approach to address unique problems associated with the prediction of length of stay among HIV patients in Portugal.


Author(s):  
Hitesh Chawla ◽  
Megat-Usamah Megat-Johari ◽  
Peter T. Savolainen ◽  
Christopher M. Day

The objectives of this study were to assess the in-service safety performance of roadside culverts and evaluate the potential impacts of installing various safety treatments to mitigate the severity of culvert-involved crashes. Such crashes were identified using standard fields on police crash report forms, as well as through a review of pertinent keywords from the narrative section of these forms. These crashes were then linked to the nearest cross-drainage culvert, which was associated with the nearest road segment. A negative binomial regression model was then estimated to discern how the risk of culvert-involved crashes varied as a function of annual average daily traffic, speed limit, number of travel lanes, and culvert size and offset. The second stage of the analysis involved the use of the Roadside Safety Analysis Program to estimate the expected crash costs associated with various design contexts. A series of scenarios were evaluated, culminating in guidance as to the most cost-effective treatments for different combinations of roadway geometric and traffic characteristics. The results of this study provide an empirical model that can be used to predict the risk of culvert-involved crashes under various scenarios. The findings also suggest that the installation of safety grates on culvert openings provides a promising alternative for most of the cases where the culvert is located within the clear zone. In general, a guardrail is recommended when adverse conditions are present or when other treatments are not feasible at a specific location.


Author(s):  
Bingqing Liu ◽  
Divya Bade ◽  
Joseph Y. J. Chow

With the rise of cycling as a mode choice for commuting and short-distance delivery, as well as policy objectives encouraging this trend, bike count models are increasingly critical to transportation planning and investment. Studies have found that network connectivity plays a role in such models, but there remains a lack of measure for the connectivity of a link in a multimodal trip context. This study proposes a connectivity measure that captures the importance of a link in connecting the origins of cyclists and nearby subway stations, and incorporates it in a negative binomial regression model to forecast bike counts at links. Representative bike trips are generated with regard to bike-friendliness using the New York City transit trip planner and used to determine the deviation from the shortest path via the designated link. The measure is shown to improve model fitness with a significance level within 10%. Insights are also drawn for income levels, bike lanes, subway station availability, and average commute time of travelers.


2012 ◽  
Vol 36 (2) ◽  
pp. 88-103 ◽  
Author(s):  
Lai-Fa Hung

Rasch used a Poisson model to analyze errors and speed in reading tests. An important property of the Poisson distribution is that the mean and variance are equal. However, in social science research, it is very common for the variance to be greater than the mean (i.e., the data are overdispersed). This study embeds the Rasch model within an overdispersion framework and proposes new estimation methods. The parameters in the proposed model can be estimated using the Markov chain Monte Carlo method implemented in WinBUGS and the marginal maximum likelihood method implemented in SAS. An empirical example based on models generated by the results of empirical data, which are fitted and discussed, is examined.


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