scholarly journals Use of routine death and illness surveillance data to provide insight for UK pandemic planning: lessons from COVID-19

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044707
Author(s):  
Helen E Clough ◽  
K Marie McIntyre ◽  
Grace E Patterson ◽  
John P Harris ◽  
Jonathan Rushton

ObjectivesReporting of COVID-19 cases, deaths and testing has often lacked context for appropriate assessment of disease burden within risk groups. The research considers how routine surveillance data might provide initial insights and identify risk factors, setting COVID-19 deaths early in the pandemic into context. This will facilitate the understanding of wider consequences of a pandemic from the earliest stage, reducing fear, aiding in accurately assessing disease burden and ensuring appropriate disease mitigation.SettingUK, 2020.ParticipantsThe study is a secondary analysis of routine, public domain, surveillance data and information from Office for National Statistics (ONS), National Health Service (NHS) 111 and Public Health England (PHE) on deaths and disease.Primary and secondary outcome measuresOur principal focus is ONS data on deaths mentioning COVID-19 on the death certificate. We also consider information provided in NHS 111 and PHE data summaries.ResultsDeaths with COVID-19 significantly contributed to, yet do not entirely explain, abnormally elevated all-cause mortality in the UK from weeks 12–18 of 2020. Early in the UK epidemic, COVID-19 was the greatest threat to those with underlying illness, rarely endangering people aged under 40 years. COVID-19-related death rates differed by region, possibly reflecting underlying population structure. Risk of COVID-19-related death was greater for healthcare and social care staff and black, Asian and minority ethnic individuals, having allowed for documented risk factors.ConclusionEarly contextualisation of public health data is critical to recognising who gets sick, when and why. Understanding at-risk groups facilitates a targeted response considering indirect consequences of society’s reaction to a pandemic alongside disease-related impacts. COVID-19-related deaths mainly mirror historical patterns, and excess non-COVID-19-related deaths partly reflect reduced access to and uptake of healthcare during lockdown. Future outbreak response will improve through better understanding of connectivity between disease monitoring systems to aid interpretation of disease risk patterns, facilitating nuanced mitigation measures.

2020 ◽  
Vol 15 (17) ◽  
pp. 1679-1688
Author(s):  
James Clark-Wright ◽  
Pollyanna Hudson ◽  
Conor McCloskey ◽  
Stuart Carroll

Aim: An overview of recent epidemiology and disease burden, independent of patient age, of diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis and Hemophilus influenzae invasive disease in the UK. Materials & methods: A systematic review was undertaken. Outcomes included incidence, prevalence, risk factors and cost burden. Results: 39 publications were included. Hepatitis B prevalence is high among certain risk groups. A small pertussis risk remains in pregnancy and for infants, which led to the introduction of maternal vaccination. H. influenzae invasive disease cases are limited to rare serotypes. Polio, tetanus and diphtheria are well controlled. Conclusion: The evaluated diseases are currently well controlled, thanks to a comprehensive vaccination program, with a generally low clinical and cost burden.


2017 ◽  
Vol 18 (6) ◽  
pp. 296-300 ◽  
Author(s):  
Lasantha Ratnayake ◽  
Amy Harris ◽  
Doreen Ko ◽  
Linda Hawtin

Background: Incidence of carbapenemase-producing enterobacteriaceae (CPE) in the UK is increasing. In 2013, Public Health England (PHE) published a toolkit to control spread of CPE within healthcare settings. Aim: To assess compliance to hospital CPE policy (adapted from PHE) in the identification, isolation and screening of suspected CPE patients. Methods: Admission booklets of 150 patients were evaluated to see whether the relevant section had been completed to identify high-risk CPE patients. Where necessary, patients were interviewed or their GPs were contacted to assess their CPE risk. Additionally, 28 patients screened for CPE were audited to assess compliance to screening and isolation. Findings: Only 23 patients out of 147 (15.6%) were risk assessed on admission. Risk status of 27 (18.4%) patients could not be assessed due to lack of data. Fifteen patients out of 28 (54%) screened for CPE were identified and isolated on admission. Ten out of 19 patients (53%) had three screens 48 h apart. Discussion: This audit highlights difficulties in screening based on individual risk factors as the majority of patients were not screened on admission and documentation on isolation and screening was poor. More needs to be done to raise awareness of the requirements for routine assessment, isolation and screening.


2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Jeremiah N. Ngugi ◽  
Eric M. Fèvre ◽  
Georgies F. Mgode ◽  
Mark Obonyo ◽  
Ginethon G. Mhamphi ◽  
...  

Abstract Background Leptospirosis is a neglected zoonosis of public health importance transmitted through contact with contaminated soil, water or urine of infected animals. In pigs the disease is characterized by abortion, still births and weak piglets. A cross-sectional study was conducted in May to July 2018 to estimate the sero-prevalence of leptospirosis and factors associated with seropositivity in slaughter pigs. A questionnaire was used to collect information on animal demographics. Serum was tested for anti-leptospiral antibodies using microscopic agglutination test (MAT) with a panel of 8 serovars. Sera were considered positive for sero-reactivity at a MAT titre ≥1:40 against at least one serovar. Chi-square tests were used to measure the strength of association between the MAT test result and exploratory variables. Results A total of 252 pig serum samples from seven slaughterhouses were tested for Leptospira antibodies by MAT. Of the 252 pigs sampled, 88.8% (244/252) were indigenous breeds; 55.6% (140/252) were female and 88.7% (220/252) were reared in extensive production systems. Eighty-three (32.9%; 83/252) sera samples tested positive on MAT against at least one serovar. Of the 8 serovars, the highest prevalence was recorded for serovar Lora 21.4% followed by Kenya 5.2%, Sokoine 3.6% and Grippotyphosa at 3.2%. Risk factors for leptospirosis seropositivity in pigs were: originating from farms with other types of livestock (OR 2.3; 95% CI 1.0–4.5) and mature pigs (OR 1.9; 95% CI 1.1–3.3). Conclusion This study demonstrates that there is a high prevalence of leptospirosis positive pigs at slaughter in a small-holder livestock keeping region of the Lake Victoria basin. The potential for cross species transmission of pathogenic serovars is highlighted as well as the potential for occupational exposure to slaughterhouse personnel. Improvements in husbandry practices (confinement and rodent control) and public health education among slaughterhouse workers and other high-risk groups is recommended.


Author(s):  
Vita Dikariyanto ◽  
Sarah E. Berry ◽  
Lucy Francis ◽  
Leanne Smith ◽  
Wendy L. Hall

Abstract Purpose  This work aimed to estimate whole almond consumption in a nationally representative UK survey population and examine associations with diet quality and cardiovascular disease (CVD) risk. Methods  Four-day food record data from the National Diet and Nutrition Survey (NDNS) 2008–2017 (n = 6802, age ≥ 19 year) were analyzed to investigate associations between whole almond consumption and diet quality, measured by the modified Mediterranean Diet Score (MDS) and modified Healthy Diet Score (HDS), and CVD risk markers, using survey-adjusted multivariable linear regression. Results  Whole almond consumption was reported in 7.6% of the population. Median intake in whole almond consumers was 5.0 g/day (IQR 9.3). Consumers had higher diet quality scores relative to non-consumers; higher intakes of protein, total fat, monounsaturated, n-3 and n-6 polyunsaturated fats, fiber, folate, vitamin C, vitamin E, potassium, magnesium, phosphorus, and iron; and lower intakes of trans-fatty acids, total carbohydrate, sugar, and sodium. BMI and WC were lower in whole almond consumers compared to non-consumers: 25.5 kg/m2 (95% CI 24.9, 26.2) vs 26.3 kg/m2 (25.9, 26.7), and 88.0 cm (86.2, 89.8) vs 90.1 cm (89.1, 91.2), respectively. However, there were no dose-related fully adjusted significant associations between increasing almond intake (g per 1000 kcal energy intake) and lower CVD risk markers. Conclusions  Almond intake is low in the UK population, but consumption was associated with better dietary quality and lower CVD risk factors. Habitual consumption of whole almonds should be encouraged as part of a healthy diet.


2019 ◽  
Vol 70 (11) ◽  
pp. 2428-2431
Author(s):  
Laura A Cooley ◽  
Tracy Pondo ◽  
Louise K Francois Watkins ◽  
Priti Shah ◽  
Stephanie Schrag ◽  
...  

Abstract We used US population-based surveillance data to characterize clinical risk factors for Legionnaires’ disease (LD). The LD incidence increased by age and the risk was elevated for 12 clinical conditions, when compared to healthy adults. This information can be used to guide testing, treatment, and public health prevention efforts.


2012 ◽  
Vol 141 (1) ◽  
pp. 45-53 ◽  
Author(s):  
K. A. HAVAS ◽  
M. RAMISHVILI ◽  
A. NAVDARASHVILI ◽  
A. E. HILL ◽  
S. TSANAVA ◽  
...  

SUMMARYHuman brucellosis occurs when humans ingest or contact Brucella spp. from shedding animals or contaminated environments and food. In Georgia animal and human brucellosis is endemic, but the epidemiology has not been fully characterized. A case-control study was conducted in 2010 to identify risk factors for human brucellosis. Using multivariable logistic regression, the following risk factors were identified: animal-related work [odds ratio (OR) 77·8, 90% confidence interval (CI) 4·7–1278], non-animal-related work (OR 12·7, 90% CI 1·1–149), being unemployed or a pensioner (OR 13·1, 90% CI 1·7, 101), sheep ownership (OR 19·3, 90% CI 5·1–72·6), making dairy products (OR 12·4, 90% CI 1·4–113), living in eastern Georgia (Kakheti) (OR 278·1, 90% CI 9·5–8100), and being aged >44 years (OR 9·3, 90% CI 1·02–84·4). Education of at-risk groups about risk factors and control of disease in sheep may reduce the human disease risk. This is the first study of its kind in Georgia since the collapse of the Soviet Union.


2020 ◽  
Vol 20 (2) ◽  
pp. 860-870
Author(s):  
Monica Ewomazino Akokuwebe ◽  
Clifford Odimegwu ◽  
Femi Omololu

Background: Kidney disease (KD) is increasingly recognized as a major public health problem worldwide with rising inci- dence and prevalence. Early identification of KD risk factors will slow down progression to kidney failure and death. Objective: To determine the prevalence, risk-inducing lifestyle and perceived susceptibility among Nigerians in South-west- ern Nigeria. Methods: A pretested structured questionnaire was employed to draw information on socio-demographic, knowledge, risk-inducing lifestyle and perceived susceptibility to conventional risk factors of KD from 1757 residents aged ≥15 years. Results: The mean age of the respondents was 47.61±13.0 years with a male-female ratio of 1.13:1. Knowledge of KD was low (mean score 2.29; 95% CI: 2.18, 2.32). The prevalence of some established KD risk factors was regular use of herbal medications, 26.8% and physical inactivity, 70.0%. Females with factors such as use of herbal drink [RRR: 1.56; CI=1.06- 2.30; p=0.02] and smoking [RRR: 2.72; CI=1.37-5.37; p=0.00] predicted increased odds of perceived susceptibility to KD than their male counterparts. Conclusion: The prevalence of KD risk-inducing lifestyles was high. More emphasis should be placed on effective public health programmes towards behavioural change in order to adopt lifestyle modification as well as to reduce the tendency to develop KD. Keywords: Kidney disease; risk-inducing lifestyles; perceived susceptibility.


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