scholarly journals Modelling testing and response strategies for COVID-19 outbreaks in remote Australian Aboriginal communities

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ben B. Hui ◽  
Damien Brown ◽  
Rebecca H. Chisholm ◽  
Nicholas Geard ◽  
Jodie McVernon ◽  
...  
Keyword(s):  
Initial Response ◽  
Infection Prevalence ◽  
Epidemic Control ◽  
Remote Communities ◽  
Australian Aboriginal ◽  
Response Strategies ◽  
First Case ◽  
Secondary Infections ◽  
Individual Based Simulation ◽  
Close Contacts

Abstract Background Remote Australian Aboriginal and Torres Strait Islander communities have potential to be severely impacted by COVID-19, with multiple factors predisposing to increased transmission and disease severity. Our modelling aims to inform optimal public health responses. Methods An individual-based simulation model represented SARS-CoV2 transmission in communities ranging from 100 to 3500 people, comprised of large, interconnected households. A range of strategies for case finding, quarantining of contacts, testing, and lockdown were examined, following the silent introduction of a case. Results Multiple secondary infections are likely present by the time the first case is identified. Quarantine of close contacts, defined by extended household membership, can reduce peak infection prevalence from 60 to 70% to around 10%, but subsequent waves may occur when community mixing resumes. Exit testing significantly reduces ongoing transmission. Concurrent lockdown of non-quarantined households for 14 days is highly effective for epidemic control and reduces overall testing requirements; peak prevalence of the initial outbreak can be constrained to less than 5%, and the final community attack rate to less than 10% in modelled scenarios. Lockdown also mitigates the effect of a delay in the initial response. Compliance with lockdown must be at least 80–90%, however, or epidemic control will be lost. Conclusions A SARS-CoV-2 outbreak will spread rapidly in remote communities. Prompt case detection with quarantining of extended-household contacts and a 14 day lockdown for all other residents, combined with exit testing for all, is the most effective strategy for rapid containment. Compliance is crucial, underscoring the need for community supported, culturally sensitive responses.

scholarly journals Modelling testing and response strategies for COVID-19 outbreaks in remote Australian Aboriginal communities

2020 ◽  
Author(s):  
Ben B. Hui ◽  
Damien Brown ◽  
Rebecca H. Chisholm ◽  
Nicholas Geard ◽  
Jodie McVernon ◽  
...  
Keyword(s):  
Initial Response ◽  
Infection Prevalence ◽  
Epidemic Control ◽  
Remote Communities ◽  
Australian Aboriginal ◽  
Response Strategies ◽  
First Case ◽  
Secondary Infections ◽  
Individual Based Simulation ◽  
Close Contacts

AbstractBackgroundRemote Australian Aboriginal and Torres Strait Islander communities have potential to be severely impacted by COVID-19, with multiple factors predisposing to increased transmission and disease severity. Our modelling aims to inform optimal public health responses.MethodsAn individual-based simulation model represented communities ranging from 100 to 3,500 people, comprised of large interconnected households. A range of strategies for case finding, quarantining of contacts, testing, and lockdown were examined, following the silent introduction of a case.ResultsMultiple secondary infections are likely present by the time the first case is identified. Quarantine of close contacts, defined by extended household membership, can reduce peak infection prevalence from 60-70% to around 10%, but subsequent waves may occur when community mixing resumes. Exit testing significantly reduces ongoing transmission.Concurrent lockdown of non-quarantined households for 14 days is highly effective for epidemic control and reduces overall testing requirements; peak prevalence of the initial outbreak can be constrained to less than 5%, and the final community attack rate to less than 10% in modelled scenarios. Lockdown also mitigates the effect of a delay in the initial response. Compliance with lockdown must be at least 80-90%, however, or epidemic control will be lost.ConclusionsA SARS-CoV-2 outbreak will spread rapidly in remote communities. Prompt case detection with quarantining of extended-household contacts and a 14-day lockdown for all other residents, combined with exit testing for all, is the most effective strategy for rapid containment. Compliance is crucial, underscoring the need for community supported, culturally sensitive responses.

scholarly journals Modelling testing and response strategies for COVID-19 outbreaks in remote Australian Aboriginal communities

2020 ◽  
Author(s):  
Ben B Hui ◽  
Damien Brown ◽  
Rebecca H Chisholm ◽  
Nicholas Geard ◽  
Jodie McVernon ◽  
...  
Keyword(s):  
Initial Response ◽  
Infection Prevalence ◽  
Epidemic Control ◽  
Remote Communities ◽  
Australian Aboriginal ◽  
Response Strategies ◽  
First Case ◽  
Secondary Infections ◽  
Individual Based Simulation ◽  
Close Contacts

Abstract BackgroundRemote Australian Aboriginal and Torres Strait Islander communities have potential to be severely impacted by COVID-19, with multiple factors predisposing to increased transmission and disease severity. Our modelling aims to inform optimal public health responses. MethodsAn individual-based simulation model represented communities ranging from 100 to 3,500 people, comprised of large interconnected households. A range of strategies for case finding, quarantining of contacts, testing, and lockdown were examined, following the silent introduction of a case.ResultsMultiple secondary infections are likely present by the time the first case is identified. Quarantine of close contacts, defined by extended household membership, can reduce peak infection prevalence from 60-70% to around 10%, but subsequent waves may occur when community mixing resumes. Exit testing significantly reduces ongoing transmission. Concurrent lockdown of non-quarantined households for 14 days is highly effective for epidemic control and reduces overall testing requirements; peak prevalence of the initial outbreak can be constrained to less than 5%, and the final community attack rate to less than 10% in modelled scenarios. Lockdown also mitigates the effect of a delay in the initial response. Compliance with lockdown must be at least 80-90%, however, or epidemic control will be lost.ConclusionsA SARS-CoV-2 outbreak will spread rapidly in remote communities. Prompt case detection with quarantining of extended-household contacts and a 14-day lockdown for all other residents, combined with exit testing for all, is the most effective strategy for rapid containment. Compliance is crucial, underscoring the need for community supported, culturally sensitive responses.

Barriers and facilitators of sexually transmissible infection testing in remote Australian Aboriginal communities: results from the Sexually Transmitted Infections in Remote Communities, Improved and Enhanced Primary Health Care (STRIVE) Study

Sexual Health ◽  
2015 ◽  
Vol 12 (1) ◽  
pp. 4 ◽  
Author(s):  
Belinda Hengel ◽  
Rebecca Guy ◽  
Linda Garton ◽  
James Ward ◽  
Alice Rumbold ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Team Work ◽  
Remote Communities ◽  
Improvement Program ◽  
Aboriginal Communities ◽  
Small Communities ◽  
Australian Aboriginal ◽  
Sti Testing ◽  
Primary Health

Background Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STI). A key strategy to reduce STIs is to increase testing in primary health care centres. The current study aimed to explore barriers to offering and conducting STI testing in this setting. Methods: A qualitative study was undertaken as part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program. We conducted 36 in-depth interviews in 22 participating health centres across four regions in northern and central Australia. Results: Participants identified barriers including Aboriginal cultural norms that require the separation of genders and traditional kinship systems that prevent some staff and patients from interacting, both of which were exacerbated by a lack of male staff. Other common barriers were concerns about client confidentiality (lack of private consulting space and living in small communities), staff capacity to offer testing impacted by the competing demands for staff time, and high staff turnover resulting in poor understanding of clinic systems. Many participants also expressed concerns about managing positive test results. To address some of these barriers, participants revealed informal strategies, such as team work, testing outside the clinic and using adult health checks. Conclusions: Results identify cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems. Many of these barriers can be readily addressed through strengthening existing systems of cultural and clinical orientation and educating staff to view STI in a population health framework. However others, particularly issues in relation to culture, kinship ties and living in small communities, may require testing modalities that do not rely on direct contact with health staff or the clinic environment.

1. Fatal Acute Hepatitis in Infectious Mononucleosis in a Forensic Setting

2005 ◽  
Vol 45 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Anny Sauvageau ◽  
Stéphanie Racette
Keyword(s):  
Acute Hepatitis ◽  
Infectious Mononucleosis ◽  
Splenic Rupture ◽  
Upper Airway ◽  
Neurological Complications ◽  
Bleeding Complications ◽  
Respiratory Obstruction ◽  
First Case ◽  
Secondary Infections ◽  
Forensic Setting

Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.

scholarly journals Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea

2020 ◽  
Vol 42 ◽  
pp. e2020007 ◽  
Author(s):  
Moran Ki
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Additional Data ◽  
Reproduction Number ◽  
First Case ◽  
Novel Coronavirus ◽  
Epidemiologic Characteristics ◽  
Index Cases ◽  
Epidemiological Information ◽  
Close Contacts

In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.

An overview of acute otitis media in Australian Aboriginal children living in remote communities

Vaccine ◽  
2007 ◽  
Vol 25 (13) ◽  
pp. 2389-2393 ◽  
Author(s):  
P.S. Morris ◽  
A.J. Leach ◽  
S. Halpin ◽  
G. Mellon ◽  
G. Gadil ◽  
...  
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Remote Communities ◽  
Australian Aboriginal ◽  
Aboriginal Children

scholarly journals Maitjara Wangkanyi: Insights from an Ethnographic Study of Food Practices of Households in Remote Australian Aboriginal Communities

2020 ◽  
Vol 17 (21) ◽  
pp. 8109
Author(s):  
Suzanne Bryce ◽  
Inawantji Scales ◽  
Lisa-Maree Herron ◽  
Britta Wigginton ◽  
Meron Lewis ◽  
...  
Keyword(s):  
Aboriginal People ◽  
Systemic Reform ◽  
Ethnographic Study ◽  
Food Storage ◽  
Remote Communities ◽  
Family Structures ◽  
Economic Cycles ◽  
Australian Aboriginal ◽  
Food Practices ◽  
Improve Food Security

Many historical, environmental, socioeconomic, political, commercial, and geographic factors underscore the food insecurity and poor diet-related health experienced by Aboriginal people in Australia. Yet, there has been little exploration of Aboriginal food practices or perspectives on food choice recently. This study, with 13 households in remote communities on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, fills this gap using ethnographic and Indigenist methods. Results highlight Anangu resourcefulness, securing food despite poverty and adversity, and provide unique insights into factors influencing the three major types and range of dietary patterns identified. These factors include household economic cycles and budgeting challenges; overcrowding and family structures, mobility and ‘organization’; available food storage, preparation and cooking infrastructure; and familiarity and convenience. Structural and systemic reform, respecting Aboriginal leadership, is required to improve food security.

scholarly journals SARS transmission in Vietnam outside of the health-care setting

2006 ◽  
Vol 135 (3) ◽  
pp. 392-401 ◽  
Author(s):  
P. A. TUAN ◽  
P. HORBY ◽  
P. N. DINH ◽  
L. T. Q. MAI ◽  
M. ZAMBON ◽  
...  
Keyword(s):  
Health Care ◽  
Care Setting ◽  
Health Care Setting ◽  
Sars Coronavirus ◽  
Serological Evidence ◽  
Household Level ◽  
Laboratory Evidence ◽  
Secondary Infections ◽  
Coronavirus Infection ◽  
Close Contacts

To evaluate the risk of transmission of SARS coronavirus outside of the health-care setting, close household and community contacts of laboratory-confirmed SARS cases were identified and followed up for clinical and laboratory evidence of SARS infection. Individual- and household-level risk factors for transmission were investigated. Nine persons with serological evidence of SARS infection were identified amongst 212 close contacts of 45 laboratory- confirmed SARS cases (secondary attack rate 4·2%, 95% CI 1·5–7). In this cohort, the average number of secondary infections caused by a single infectious case was 0·2. Two community contacts with laboratory evidence of SARS coronavirus infection had mild or sub-clinical infection, representing 3% (2/65) of Vietnamese SARS cases. There was no evidence of transmission of infection before symptom onset. Physically caring for a symptomatic laboratory-confirmed SARS case was the only independent risk factor for SARS transmission (OR 5·78, 95% CI 1·23–24·24).

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