scholarly journals Spatial pattern of COVID-19 in Bangladesh: an ecological study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e047566
Author(s):  
Jahirul Islam ◽  
Xiya Guo ◽  
Md Ahasan Ali ◽  
Md Ashraful Islam ◽  
Xin Qi ◽  
...  

ObjectiveTo analyse the spatial clustering of COVID-19 case fatality risks in the districts of Bangladesh and to explore the association of sociodemographic indicators with these risks.Study designEcological study.Study settingSecondary data were collected for a total of 64 districts of Bangladesh.MethodsThe data for district-wise COVID-19 cases were collected from the Ministry of Health and Family Welfare, Bangladesh from March 2020 to June 2020. Socioeconomic and demographic data were collected from National Census Data, 2011. Retrospective spatial analysis was conducted based on district-wise COVID-19 cases in Bangladesh. Global Moran’s I was adopted to find out the significance of the clusters. Furthermore, generalised linear model was conducted to find out the association of COVID-19 cases with sociodemographic variables.ResultsTotal 87 054 COVID-19 cases were included in this study. The epidemic hotspots were distributed in the 11 most populous cities. The most likely clusters are primarily situated in the central, south-eastern and north-western regions of the country. High-risk clusters were found in Dhaka (Relative Risk (RR): 5.22), Narayanganj (RR: 2.70), Chittagong (RR: 1.69), Munshiganj (RR: 2.31) Cox’s Bazar (RR: 1.63), Faridpur (RR: 1.65), Gazipur (RR: 1.33), Bogra (RR: 1.35), Khulna (RR: 1.22), Barishal (RR: 1.07) and Noakhali (RR: 1.06). Weekly progression of COVID-19 cases showed spatially clustered by Moran’s I statistics (p value ranging from 0.013 to 0.436). After fitting a Poisson linear model, we found a positive association of COVID-19 with floating population rate (RR=1.542, 95% CI 1.520 to 1.564), and urban population rate (RR=1.027, 95% CI 1.026 to 1.028).ConclusionThis study found the high-risk cluster areas in Bangladesh and analysed the basic epidemiological issues; further study is needed to find out the common risk behaviour of the patients and other relative issues that involve the spreading of this infectious disease.

Author(s):  
Pinky Karam ◽  
B. Shanthi ◽  
Kalai Selvi

Background: Metabolic syndrome is a group of metabolic abnormalities in which the chance of developing cardiovascular disease, diabetes mellitus, chronic kidney disease are high. Aim: It aims at studying the lipid abnormalities in metabolic syndrome patients. Methods: Total of 100 metabolic syndrome patients were selected for study over a period of 1year. These patients were selected based on the criteria for metabolic syndrome as established by National Cholesterol Education Program (NCEP) adult Treatment Panel III (ATP III). Demographic data were taken and biochemical parameters were estimated by standard guideline. Results: Total cholesterol is significantly higher in very high risk (272.1 ± 8.591) compared to high risk (241.2 ± 3.901) and moderate risk (231.5 ± 4.498). TGL is significantly higher in very high risk (263.9 ± 13.70) compared to high risk (202.1 ± 6.531) and moderate risk (183.7 ± 7.650). HDL is almost same in very high risk (43.09 ± 1.533), high risk (40.44 ± 0.996) and moderate risk (42.53 ± 1.088). LDL is significantly higher in very high risk (177.9 ± 4.255) and high risk (169.4 ± 3.190) compared to moderate risk (155.7 ± 3.098). VLDL is significantly higher in very high risk (52.78 ± 2.739) compared to high risk (40.43 ± 1.306) and moderate risk (36.73 ± 1.530). CHO: HDL is significantly higher in very high risk (6.648 ± 0.366) compared to moderate risk (5.560 ± 0.207). High risk (6.060 ± 0.156) is not significantly different from very high risk and moderate risk. Thus, TC, TGL, LDL, VLDL, and CHO: HDL is significant as p value < 0.05 while HDL did not have any significance as p value > 0.05. Conclusion: In this study, high prevalence of dyslipidaemia is seen. So, timely diagnosis and treatment will help in detecting dyslipidaemia patients in future.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S376-S377
Author(s):  
Mariam Younas ◽  
Danielle Osterholzer ◽  
Brandon R Flues ◽  
Carlos Rios-Bedoya ◽  
Philip McDonald ◽  
...  

Abstract Background Bamlanivimab (BAM), a neutralizing IgG1 monoclonal antibody (mAb), received emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for treatment of mild to moderate COVID-19 infection in patients 12 years of age and older weighing at least 40 kg at high risk for progressive and severe disease on Nov 10, 2020. The purpose of this study is to describe our experience with this treatment modality. Methods Hurley Medical Center (HMC), is a 443-bed inner city teaching hospital in Flint, MI. HMC administered its first BAM infusion on Nov 19, 2020. Through April 30, 2021, 407 patients with confirmed SARS-CoV-2 infection, received a mAb infusion. 62/407 patients received the combination mAb therapy of BAM + Etesevimab, as the EUA for BAM monotherapy was revoked on 04/16/21. We retrospectively collected basic demographic data and hospitalization to our facility within 14 days of receiving mAb therapy on these patients. Results During the 5.5 month study period, patients receiving mAb therapy at HMC had a mean age of 56 years (yrs) (± standard deviation) (± 15.4) and a mean Body Mass Index (BMI) of 34 kg/m² (± 8.5) (Tables 1,2). African Americans (AA) comprised 48% (194/407) (Table 3) and females comprised 54% (220/407) of the cohort. 6% (25/407) of the patients required hospitalization within 14 days of mAb infusion, had a mean age of 58 yrs (± 17) (p-value 0.62) and a mean BMI of 32 kg/m² (± 9) (p-value 0.33). Females and AA comprised 56% (14/25) and 48% (12/25) of this subgroup respectively (p-value 1.0). No deaths were reported within 30 days of infusion in this cohort. Conclusion Previously published reports cite a hospitalization rate in untreated high-risk COVID-19 infected patients of 9-15%. During the period of study, the county hospitalization rate and county mortality rate for all comers with COVID-19 was 6.6% and 2.7% respectively while our high risk cohort had a hospitalization rate of 6% and with no deaths reported. Our cohort had much lower rates of hospitalization and death than would be expected especially in a group which comprised of 48% AA in an underserved area. mAb therapy seems to have a protective effect with significant reduction in the hospitalization and mortality rate among high-risk patients with COVID-19 infection and should be prioritized for administration. Disclosures All Authors: No reported disclosures


Author(s):  
Prathima Shivaji Rao ◽  
Manikya Manjunath

Introduction: Gastrointestinal Stromal Tumours (GISTs) are the most common mesenchymal tumours of the alimentary canal. Interstitial cells of Cajal are believed to be the cell of origin of GIST which regulates gastrointestinal peristalsis. GISTs encompass a clinicopathologically distinctive, but heterogenous group of neoplasms with reference to their origin, cellular differentiation and prognosis. Aim: The aim of this study was to analyse the histopathological and immunohistochemical characteristics of GIST. Materials and Methods: A hospital-based cross-sectional study of 108 cases of GIST were studied over a period of three years from January, 2017 to December, 2019 in Department of Pathology, Vydehi Institute of Medical Sciences and Research Institute (VIMS&RC), Bangalore. Patient’s demographic data like age and gender were collected. Tumour characteristics like site, size and number of lesions were analysed. Histopathological and immunohistochemistry for Desmin, CD117 and DOG-1 were analysed for significant association with risk groups. Risk stratification according to the Fletcher's risk classification, the cases were divided was divided into very low, low, intermediate and high risk groups. The master chart of collected data was prepared in Excel sheet. Chi-square test with Yates correction was used to calculate p-value to ascertain statistical significance. The master chart of collected data was prepared in Excel sheet. Descriptive statistical analysis was presented in the form of tables, figures and diagrams wherever necessary using Epi info 07 statistical software package. Results: The mean age of the patients was 55.6±14.4 years. Males (55.6%/60 cases) were commonly affected than females (44.4%/48 cases). Small intestine was the commonest location (44.4%/48 cases). Tumour size ranged from 1.5 cm to 25 cm with a mean of 9.1 cm. Microscopic findings revealed that spindle cell type was the most common (86.1%/93 cases). Majority of the cases belonged to high risk category. Multifocality, necrosis, tumour size and >5 mitosis/50 High Power Field (HPF) showed significant association with high risk category tumours (p-value 0.033, 0.016, 0.004 and <0.001, respectively). Immunohistochemical staining showed positivity for CD 117 (83.3%/90 cases), DOG-1 (88.9%/96 cases) and 108 cases/100% negativity for desmin. Conclusion: This study found significant association of high risk groups with tumour size, multifocality, necrosis and mitosis >5/50 HPF. Risk categorisation of GIST remains important. A combination of CD117 and DOG-1 will be more useful in diagnosing GIST rather than using them alone.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adriana Campos ◽  
Bridget Scheveck ◽  
Jeegan Parikh ◽  
Santiago Hernandez-Bojorge ◽  
Enrique Terán ◽  
...  

Abstract Background The SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19. Methods This is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Population statistics attributed to COVID-19 were included in the linear model to control for confounding factors. Results Statistically significant differences were observed in the regions of Amazónica, Sierra, Costa of Ecuador for incidence, mortality, and case fatality rates, suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity (p-value ≤0.05). In univariate analysis, altitude had a negative association to mortality rate with a 1-unit change in altitude resulting in the decrease of 0.006 units in mortality rate (p-value = 0.03). The multiple linear models adjusted for population statistics showed a statistically significant negative association of altitude with mortality rate (p-value = 0.01) with a 1-unit change in altitude resulting in the decrease in mortality rate by 0.015 units. Overall, the model helped in explaining 50% (R2 = 0.4962) of the variance in mortality rate. Conclusion Altitude may have an effect on COVID-19 mortality rates. However, based on our model and R2 value, the relationship between our variables of interest and COVID-19 mortality may be nonlinear. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.


2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Rawahah Husna Ramli ◽  
Artika Hassan ◽  
Jamalludin Abd Rahman ◽  
Razman Mohd Rus ◽  
Hafizah Pasi ◽  
...  

Introduction: Obstructive sleep apnea (OSA) is an insidious sleep breathing disorder, with cardinal manifestations of snoring, witnessed breathing pause during sleep and excessive daytime sleepiness. The aim of the study was to estimate the prevalence of OSA and its associated factors among adult population in Taman Dato’ Rashid Salleh, Kuantan. Materials and  method: A cross-sectional study was carried out among 157 participants who lived in Taman Dato’ Rashid Salleh from May 2018 to June 2018. Obstructive sleep apnea was quantified using the self-administered Malaynvalidated Berlin questionnaire which apart from the demographic data included three categories (10 questions) designed to elicit information regarding snoring (category 1), daytime somnolence (category 2) and the presence of obesity and/or hypertension (category 3). The respondents were considered as high risk of OSA if two or more categories were positive. Weight, height and neck circumference were measured by using Secca© weight scales, Secca© stadiometer and non-elastic plastic tape, respectively. Descriptive statistics was used to measure the prevalence, while chi-square test was used to explore the association of OSA and its background variables. Results: Out of 157 respondents, female and Malay were dominant with the 56.7% and 91.0 %, respectively. The mean age of the respondents was 36.7 (12.2) years old. The prevalence of high risk of OSA in was 18.5%. There was no association between gender, age, race, smoking and neck circumference with risk of OSA while Body Mass Index (BMI) and hypertension were significantly related to an increased risk for developing OSA (p-value < 0.001 and p=0.001, respectively).  Conclusions: Two in every 10 adults in Taman Dato’ Rashid Salleh, Kuantan were at high risk of OSA. It is recommended that appropriate health promotion should be targeted to this community to instill awareness and increase the level of understanding of the public on OSA.


2021 ◽  
Vol 33 (3) ◽  
pp. 186-195
Author(s):  
Maybin Kalubula ◽  
Heqing Shen ◽  
Mpundu Makasa ◽  
Longjian Liu

BackgroundCancer is one of the leading causes of death worldwide. More than two-thirds of deaths due to cancers occur in low- and middle-income countries where Zambia belongs. This study, therefore, sought to assess the epidemiology of various types of cancers in Zambia.MethodsWe conducted a retrospective observational study using the Zambia National Cancer Registry (ZNCR) population based data from 2007 to 2014. Zambia Central Statistics Office (CSO) demographic data were used to determine catchment area denominator used to calculate prevalence and incidence rates of cancers. Age-adjusted rates and case fatality rates were estimated using standard methods. We used a Poisson Approximation for calculating 95% confidence intervals (CI). ResultsThe seven most cancer prevalent districts in Zambia were Luangwa, Kabwe, Lusaka, Monze, Mongu, Katete and Chipata. Cervical cancer, prostate cancer, breast cancer and Kaposi’s sarcoma were the four most prevalent cancers as well as major causes of cancer related deaths in Zambia. Age adjusted rates and 95% CI for these cancers were: cervix uteri (186.3; CI = 181.77 – 190.83), prostate (60.03; CI = 57.03 – 63.03), breast (38.08; CI = 36.0 – 40.16) and Kaposi’s sarcoma (26.18; CI = 25.14 – 27.22). CFR were: Leukaemia (38.1%); pancreatic cancer (36.3%); lung cancer (33.3%); and brain, nervous system (30.2%). The cancer population was associated with HIV with p- value of 0.000 and a Pearson correlation coefficient of 0.818.ConclusionsThe widespread distribution of cancers with high prevalence observed in the southern zone may have been perpetrated by lifestyle and sexual culture (traditional male circumcision known to prevent STIs is practiced in the northern belt) as well as geography. Intensifying cancer screening and early detection countrywide as well as changing the lifestyle and sexual culture would greatly help in the reduction of cancer cases in Zambia.


2021 ◽  
Author(s):  
ADRIANA CAMPOS ◽  
BRIDGET SCHEVECK ◽  
JEEGAN PARIKH ◽  
SANTIAGO HERNANDEZ-BOJORGE ◽  
ENRIQUE TERAN ◽  
...  

Abstract BackgroundThe SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19. MethodsThis is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Populations statistics attributed to COVID-19 were included in the linear model to control for confounding factors. ResultsRegional differences were observed for incidence, mortality, and case fatality rate suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity. In both the correlation analysis and linear model altitude showed a statistically significant negative correlation between altitude and COVID-19 mortality. ConclusionAltitude may have an effect on COVID-19 mortality rates. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.


Author(s):  
Jiao Huang ◽  
Nianhua Xie ◽  
Xuejiao Hu ◽  
Han Yan ◽  
Jie Ding ◽  
...  

Abstract Background We aimed to describe the epidemiological, virological, and serological features of coronavirus disease 2019 (COVID-19) cases in people living with human immunodeficiency virus (HIV; PLWH). Methods This population-based cohort study identified all COVID-19 cases among all PLWH in Wuhan, China, by 16 April 2020. The epidemiological, virological, and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the disease, and SARS-CoV-2–specific immunoglobin (Ig) M and G after recovery. Results From 1 January to 16 April 2020, 35 of 6001 PLWH experienced COVID-19, with a cumulative incidence of COVID-19 of 0.58% (95% confidence interval [CI], .42–.81%). Among the COVID-19 cases, 15 (42.86) had severe illness, with 2 deaths. The incidence, case-severity, and case-fatality rates of COVID-19 in PLWH were comparable to those in the entire population in Wuhan. There were 197 PLWH who had discontinued combination antiretroviral therapy (cART), 4 of whom experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 days (interquartile range, 20–46). Cases with high HIV viral loads (≥20 copies/mL) had lower IgM and IgG levels than those with low HIV viral loads (&lt;20 copies/ml; median signal value divided by the cutoff value [S/CO] for IgM, 0.03 vs 0.11, respectively [P &lt; .001]; median S/CO for IgG, 10.16 vs 17.04, respectively [P = .069]). Conclusions Efforts are needed to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Sangkum ◽  
Chama Wathanavaha ◽  
Visasiri Tantrakul ◽  
Munthana Pothong ◽  
Cherdkiat Karnjanarachata

Abstract Background Undiagnosed obstructive sleep apnea (OSA) is associated with adverse perioperative outcomes. The STOP-Bang questionnaire is a validated screening tool for OSA. However, its precision may vary among different populations. This study determined the association between high-risk OSA based on the modified STOP-Bang questionnaire and perioperative adverse events. Methods This cross-sectional study included patients undergoing elective surgery from December 2018 to February 2019. The modified STOP-Bang questionnaire includes a history of Snoring, daytime Tiredness, Observed apnea, high blood Pressure, Body mass index > 30 kg/m2, Age > 50, Neck circumference > 40 cm, and male Gender. High risk for OSA was considered as a score ≥ 3. Results Overall, 400 patients were included, and 18.3% of patients experienced perioperative adverse events. On the basis of modified STOP-Bang, the incidence of perioperative adverse events was 23.2 and 13.8% in patients with high risk and low risk (P-value 0.016) (Original STOP-Bang: high risk 22.5% vs. low risk 14.7%, P-value 0.043). Neither modified nor original STOP-Bang was associated with perioperative adverse events (adjusted OR 1.91 (95% CI 0.99–3.66), P-value 0.055) vs. 1.69 (95%CI, 0.89–3.21), P-value 0.106). Modified STOP-Bang ≥3 could predict the incidence of difficult ventilation, laryngoscopic view ≥3, need for oxygen therapy during discharge from postanesthetic care unit and ICU admission. Conclusions Neither modified nor original STOP-Bang was significantly associated with perioperative adverse events. However, a modified STOP-Bang ≥3 can help identify patients at risk of difficult airway, need for oxygen therapy, and ICU admission. Trial registrations This study was registered on Thai Clinical Trials Registry, identifier TCTR20181129001, registered 23 November 2018 (Prospectively registered).


Author(s):  
Karen Chapple ◽  
Ate Poorthuis ◽  
Matthew Zook ◽  
Eva Phillips

The new availability of big data sources provides an opportunity to revisit our ability to predict neighborhood change. This article explores how data on urban activity patterns, specifically, geotagged tweets, improve the understanding of one type of neighborhood change—gentrification—by identifying dynamic connections between neighborhoods and across scales. We first develop a typology of neighborhood change and risk of gentrification from 1990 to 2015 for the San Francisco Bay Area based on conventional demographic data from the Census. Then, we use multivariate regression to analyze geotagged tweets from 2012 to 2015, finding that outsiders are significantly more likely to visit neighborhoods currently undergoing gentrification. Using the factors that best predict gentrification, we identify a subset of neighborhoods that Twitter-based activity suggests are at risk for gentrification over the short term—but are not identified by analysis with traditional census data. The findings suggest that combining Census and social media data can provide new insights on gentrification such as augmenting our ability to identify that processes of change are underway. This blended approach, using Census and big data, can help policymakers implement and target policies that preserve housing affordability and protext tenants more effectively.


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