Effect of altitude on COVID-19 mortality in Ecuador: an ecological study

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.

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Effect of Altitude on Covid-19 Mortality in Ecuador: an Ecological Study

10.21203/rs.3.rs-211225/v1 ◽

2021 ◽

Author(s):

ADRIANA CAMPOS ◽

BRIDGET SCHEVECK ◽

JEEGAN PARIKH ◽

SANTIAGO HERNANDEZ-BOJORGE ◽

ENRIQUE TERAN ◽

...

Keyword(s):

Linear Model ◽

Ecological Study ◽

Case Fatality ◽

Significant Negative Correlation ◽

Mortality Rates ◽

Multivariate Linear Model ◽

Level Data ◽

Correlation Statistics ◽

The Relationship ◽

Province Level

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.

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The Effect of Ad Content and Ad Lengthon Consumer Response towards Online Video Advertisement

The Winners ◽

10.21512/tw.v21i2.6797 ◽

2020 ◽

Vol 21 (2) ◽

Author(s):

Djoko Raditya ◽

Willy Gunadi ◽

Dennis Setiono ◽

Jonathan Rawung

Keyword(s):

Data Analysis ◽

Linear Model ◽

Direct Effect ◽

Experimental Research ◽

Univariate Analysis ◽

Consumer Response ◽

Online Video ◽

Academic Literature ◽

Convenience Sampling ◽

The Relationship

The research aimed to determine the moderating effect of advertisement (ad) length on the relationships between ad content and the intention of skipping, as well as ad irritation. Previous research has discussed the factors that affect customers' intention of skipping and ad irritation, centering around the duration of an ad, and whether the ad is skippable. However, no previous research had focused on the relationship between the intention of skipping and ad irritation that consumers experience. The research attempted to fill in the lacuna in the academic literature on the said issue. In doing so, it examined consumers' responses towards the consumers' intention of ad-skipping and irritation. The experimental research utilized four video ads with varying durations and containing both entertaining and boring content, with long and short ad length. The research sample comprised 120 respondents spend at least more than 1 hour online. The research employed convenience sampling and the method of Univariate Analysis of Variance Linear Model. IBM SPSS Statistics was used for data analysis. The results reveal that the content and length of an online video ad have a direct effect on consumers' ad irritation and intention of skipping. The research concludes that the perceived entertainment of an online video ad significantly affects consumers' intention of skipping and ad irritation. Furthermore, the length of video ads has a major impact on their intention of skipping and ad irritation.

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Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti

10.21203/rs.3.rs-28562/v2 ◽

2020 ◽

Author(s):

Kenny Moise ◽

Aude Mélody Achille ◽

Doudou Batumbo ◽

Bertiny Bourdeau ◽

Stanislas Rebaudet ◽

...

Keyword(s):

Population Density ◽

Poisson Distribution ◽

Generalized Linear Models ◽

Ecological Study ◽

Linear Models ◽

Anthropogenic Factors ◽

Diarrheal Diseases ◽

Patron Saint ◽

Continuous Presence ◽

The Relationship

Abstract Introduction Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. Materials/Methods An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and two weeks later was weighted against patronal festivities and weekly precipitation rates. Results In total, 3 633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR=0.4277 (97.5% CI: 0.2798-0.6193), p=0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% one week following patronal festivities. Conclusion This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti 2017.

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The Relationship Between Demographic, Socioeconomic, and Health-Related Parameters and the Impact of COVID-19 on 24 Regions in India: Exploratory Cross-Sectional Study (Preprint)

10.2196/preprints.23083 ◽

2020 ◽

Author(s):

Ravi Philip Rajkumar

Keyword(s):

Mortality Rate ◽

Sex Ratio ◽

Multivariate Analyses ◽

Case Fatality ◽

Negatively Associated ◽

Crude Mortality Rate ◽

Crude Mortality ◽

Health Related ◽

The Impact ◽

The Relationship

BACKGROUND The impact of the COVID-19 pandemic has varied widely across nations and even in different regions of the same nation. Some of this variability may be due to the interplay of pre-existing demographic, socioeconomic, and health-related factors in a given population. OBJECTIVE The aim of this study was to examine the statistical associations between the statewise prevalence, mortality rate, and case fatality rate of COVID-19 in 24 regions in India (23 states and Delhi), as well as key demographic, socioeconomic, and health-related indices. METHODS Data on disease prevalence, crude mortality, and case fatality were obtained from statistics provided by the Government of India for 24 regions, as of June 30, 2020. The relationship between these parameters and the demographic, socioeconomic, and health-related indices of the regions under study was examined using both bivariate and multivariate analyses. RESULTS COVID-19 prevalence was negatively associated with male-to-female sex ratio (defined as the number of females per 1000 male population) and positively associated with the presence of an international airport in a particular state. The crude mortality rate for COVID-19 was negatively associated with sex ratio and the statewise burden of diarrheal disease, and positively associated with the statewise burden of ischemic heart disease. Multivariate analyses demonstrated that the COVID-19 crude mortality rate was significantly and negatively associated with sex ratio. CONCLUSIONS These results suggest that the transmission and impact of COVID-19 in a given population may be influenced by a number of variables, with demographic factors showing the most consistent association.

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Impact of patron saint festivities on cholera in three communes in Haiti

BMC Public Health ◽

10.1186/s12889-020-09601-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kenny Moise ◽

Aude Mélody Achille ◽

Doudou Batumbo ◽

Bertiny Bourdeau ◽

Stanislas Rebaudet ◽

...

Keyword(s):

Population Density ◽

Poisson Distribution ◽

Generalized Linear Models ◽

Ecological Study ◽

Linear Models ◽

Anthropogenic Factors ◽

Diarrheal Diseases ◽

Patron Saint ◽

Continuous Presence ◽

The Relationship

Abstract Background Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. Methods An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and 2 weeks later was weighted against patronal festivities and weekly precipitation rates. Results In total, 3633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR = 0.4277 (97.5% CI: 0.2798–0.6193), p = 0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% 1 week following patronal festivities. Conclusion This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.

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

BMJ Open ◽

10.1136/bmjopen-2020-047566 ◽

2021 ◽

Vol 11 (12) ◽

pp. e047566

Author(s):

Jahirul Islam ◽

Xiya Guo ◽

Md Ahasan Ali ◽

Md Ashraful Islam ◽

Xin Qi ◽

...

Keyword(s):

High Risk ◽

Linear Model ◽

Ecological Study ◽

Census Data ◽

Demographic Data ◽

Case Fatality ◽

Floating Population ◽

Family Welfare ◽

P Value ◽

Population Rate

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.

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Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti

10.21203/rs.3.rs-28562/v4 ◽

2020 ◽

Author(s):

Kenny Moise ◽

Aude Mélody Achille ◽

Doudou Batumbo ◽

Bertiny Bourdeau ◽

Stanislas Rebaudet ◽

...

Keyword(s):

Population Density ◽

Poisson Distribution ◽

Generalized Linear Models ◽

Ecological Study ◽

Linear Models ◽

Anthropogenic Factors ◽

Diarrheal Diseases ◽

Patron Saint ◽

Continuous Presence ◽

The Relationship

Abstract Introduction: Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017. Materials/Methods: An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and two weeks later was weighted against patronal festivities and weekly precipitation rates. Results: In total, 3 633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR=0.4277 (97.5% CI: 0.2798-0.6193), p=0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% one week following patronal festivities. Conclusion: This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.

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Correlation of Demographics, Healthcare Availability, and COVID-19 Outcome: Indonesian Ecological Study

Frontiers in Public Health ◽

10.3389/fpubh.2021.605290 ◽

2021 ◽

Vol 9 ◽

Author(s):

Gede Benny Setia Wirawan ◽

Pande Putu Januraga

Keyword(s):

Mortality Rate ◽

Population Density ◽

Ecological Study ◽

Age Groups ◽

Case Fatality ◽

Density Correlation ◽

Lower Case ◽

Incidence And Mortality ◽

Hospital Beds ◽

Mortality Case

Objective: To analyze the correlation between demographic and healthcare availability indicators with COVID-19 outcome among Indonesian provinces.Methods: We employed an ecological study design to study the correlation between demographics, healthcare availability, and COVID-19 indicators. Demographic and healthcare indicators were obtained from the Indonesian Health Profile of 2019 by the Ministry of Health while COVID-19 indicators were obtained from the Indonesian COVID-19 website in August 31st 2020. Non-parametric correlation and multivariate regression analyses were conducted with IBM SPSS 23.0.Results: We found the number of confirmed cases and case growth to be significantly correlated with demographic indicators, especially with distribution of age groups. Confirmed cases and case growth was significantly correlated (p < 0.05) with population density (correlation coefficient of 0.461 and 0.491) and proportion of young people (−0.377; −0.394). Incidence and incidence growth were correlated with ratios of GPs (0.426; 0.534), hospitals (0.376; 0.431), primary care clinics (0.423; 0.424), and hospital beds (0.472; 0.599) per capita. For mortality, case fatality rate (CFR) was correlated with population density (0.390) whereas mortality rate was correlated with ratio of hospital beds (0.387). Multivariate analyses found confirmed case independently associated with population density (β of 0.638) and demographic structure (−0.289). Case growth was independently associated with density (0.763). Incidence growth was independently associated with hospital bed ratio (0.486).Conclusion: Pre-existing inequality of healthcare availability correlates with current reported incidence and mortality rate of COVID-19. Lack of healthcare availability in some provinces may have resulted in artificially low numbers of cases being diagnosed, lower demands for COVID-19 tests, and eventually lower case-findings.

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Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti

10.21203/rs.3.rs-28562/v3 ◽

2020 ◽

Author(s):

Kenny Moise ◽

Aude Mélody Achille ◽

Doudou Batumbo ◽

Bertiny Bourdeau ◽

Stanislas Rebaudet ◽

...

Keyword(s):

Population Density ◽

Poisson Distribution ◽

Generalized Linear Models ◽

Ecological Study ◽

Linear Models ◽

Anthropogenic Factors ◽

Diarrheal Diseases ◽

Patron Saint ◽

Continuous Presence ◽

The Relationship

Abstract Background: Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017.Methods: An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and two weeks later was weighted against patronal festivities and weekly precipitation rates.Results: In total, 3 633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR=0.4277 (97.5% CI: 0.2798-0.6193), p=0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% one week following patronal festivities.Conclusion: This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.

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Risk factors affecting COVID-19 case fatality rate: A quantitative analysis of top 50 affected countries

Progress In Microbes & Molecular Biology ◽

10.36877/pmmb.a0000171 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Poh Hui Goh ◽

Wafiah Ilyani Mahari ◽

Norhadyrah Izazie Ahad ◽

Li Ling Chaw ◽

Nurolaini Kifli ◽

...

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Case Fatality Rate ◽

Smoking Prevalence ◽

Linear Regression Analysis ◽

Significant Risk ◽

Case Fatality ◽

Data Availability ◽

Fatality Rate ◽

The Relationship

Background: Latest clinical data on treatment on coronavirus disease 2019 (COVID-19) indicated that older patients and those with underlying history of smoking, hypertension or diabetes mellitus might have poorer prognosis of recovery from COVID-19. We aimed to examine the relationship of various prevailing population-based risk factors in comparison with mortality rate and case fatality rate (CFR) of COVID-19.Methods: Demography and epidemiology data were used, which have been identified as verified or postulated risk factors for mortality of adult inpatients with COVID-19. The number of confirmed cases and the number of deaths until April 16, 2020 for all affected countries were extracted from Johns Hopkins University COVID-19 websites. Datasets for indicators that are prevailing or postulated factors of COVID-19 mortality were extracted from the World Bank database. Out of 185 affected countries, the top 50 countries were selected for analysis in this study. The following seven variables were included in the analysis, based on data availability and completeness: 1) proportion of people aged 65 above, 2) proportion of male in the population, 3) smoking prevalence, and 4) number of hospital beds. Linear regression analysis was carried out to determine the relationship between CFR and the aforementioned risk factors.Results: United States shows approximately 0.20% of confirmed cases and it has about 4.85% of CFR. Luxembourg shows the highest percentage of confirmed cases of 0.55% but a low 2.05% of CFR, showing that a high percentage of confirmed cases does not necessarily lead to high CFR. There is a significant association between CFR, people aged 65 and above (β=4.70; p = 0.035).Conclusion: Countries with high proportion of older people above 65 years old have a significant risk of having high CFR from COVID-19. Nevertheless, gender differences and smoking prevalence failed to prove a significant relationship with COVID-19 mortality rate and CFR.

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