Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact

Abstract Background Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed. Methods A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Linguère, and Ranérou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence ≥ 15 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA. Results During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0–10.8 by village), of whom 82% were < 20 years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio = 0.62, 95% CI 0.45–0.84, p = 0.002). The cost of the MTAT was $14.3 per person. Conclusions It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies.

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Does Car-Sharing Reduce Car-Use? An Impact Evaluation of Car-Sharing in Flanders, Belgium

Sustainability ◽

10.3390/su12198155 ◽

2020 ◽

Vol 12 (19) ◽

pp. 8155

Author(s):

Donald A. Chapman ◽

Johan Eyckmans ◽

Karel Van Acker

Keyword(s):

Negative Binomial ◽

Negative Binomial Regression ◽

Experimental Methods ◽

Car Ownership ◽

Car Sharing ◽

Car Use ◽

Binomial Regression ◽

Quasi Experimental ◽

Private Car ◽

The Impact

Private car-use is a major contributor of greenhouse gases. Car-sharing is often hypothesised as a potential solution to reduce car-ownership, which can lead to car-sharing users reducing their car-use. However, there is a risk that car-sharing may also increase car-use amongst some users. Existing studies on the impacts of car-sharing on car-use are often based on estimates of the users’ own judgement of the effects; few studies make use of quasi-experimental methods. In this paper, the impact of car-sharing on car-ownership and car-use in Flanders, Belgium is estimated using survey data from both sharers and non-sharers. The impact on car-use is estimated using zero-inflated negative binomial regression, applied to matched samples of car-sharing users and non-users. The results show that the car-sharing may reduce car-use, but only if a significant number of users reduce their car-ownership. Policy intervention may therefore be required to ensure car-sharing leads to a reduction in car-use by, for example, discouraging car-ownership. Further research using quasi-experimental methods is required to illuminate whether the promise of car-sharing is reflected in reality.

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Association Between Federal Value-Based Incentive Program Implementation and Hospital-Onset C. difficile Infection Rates

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.645 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s133-s133

Author(s):

Mohammad Alrawashdeh ◽

Chanu Rhee ◽

Heather Hsu ◽

Grace Lee

Keyword(s):

Program Implementation ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Neutralization Assay ◽

Nucleic Acid Amplification ◽

Teaching Hospitals ◽

Future Research ◽

Testing Methods ◽

Toxigenic Culture ◽

The Impact

Background: The Hospital-Acquired Conditions Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) are federal value-based incentive programs that financially reward or penalize hospitals based on quality metrics. Hospital-onset C. difficile infection (HO-CDI) rates reported to the CDC NHSN became a target quality metric for both HACRP and HVBP in October 2016, but the impact of these programs on HO-CDI rates is unknown. Methods: We used an interrupted time-series design to examine the association between HACRP/HVBP implementation in October 2016 and quarterly rates of HO-CDI per 10,000 patient days among incentive-eligible acute-care hospitals conducting facility-wide HO-CDI NHSN surveillance between January 2013 and March 2019. Generalized estimating equations were used to fit negative binomial regression models to assess for immediate program impact (ie, level change) and changes in the slope of HO-CDI rates, controlling for each hospital’s predominant method for CDI testing (nucleic acid amplification including PCR (NAAT), enzyme immunoassay for toxin (EIA), or other testing method including cell cytotoxicity neutralization assay and toxigenic culture). Results: Of the 265 study hospitals studied, most were medium-sized (100–399 beds, 55%), not-for-profit (77%), teaching hospitals (70%), and were located in a metropolitan area (87%). Compared to EIA, rates of HO-CDI were higher when detected by NAAT (incidence rate ratio [IRR], 1.55; 95% CI, 1.41–1.70) or other testing methods (IRR, 1.47; 95% CI, 1.26–1.71). Controlling for CDI testing methods, HACRP/HVBP implementation was associated with an immediate 6% decline in HO-CDI rates (IRR, 0.94; 95% CI, 0.89–0.99) and a 4% decline in slope per year-quarter thereafter (IRR, 0.96; 95% CI, 0.95–0.97) (Fig. 1). Conclusions: HACRP/HVBP implementation was associated with both immediate and gradual improvements in HO-CDI rates, independent of CDI testing methods of differing sensitivity. Future research may evaluate the precise mechanisms underlying this improvement and if this impact is sustained in the long term.Funding: NoneDisclosures: None

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The association between a conditional cash transfer programme and malaria incidence: a longitudinal ecological study in the Brazilian Amazon between 2004 and 2015

BMC Public Health ◽

10.1186/s12889-021-11255-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Layana Costa Alves ◽

Mauro Niskier Sanchez ◽

Thomas Hone ◽

Luiz Felipe Pinto ◽

Joilda Silva Nery ◽

...

Keyword(s):

Fixed Effects ◽

Negative Binomial ◽

Malaria Incidence ◽

Panel Study ◽

Negative Binomial Regression ◽

Brazilian Amazon ◽

Conditional Cash Transfer ◽

Cash Transfer ◽

Percentage Point Increase ◽

The Impact

Abstract Background Malaria causes 400 thousand deaths worldwide annually. In 2018, 25% (187,693) of the total malaria cases in the Americas were in Brazil, with nearly all (99%) Brazilian cases in the Amazon region. The Bolsa Família Programme (BFP) is a conditional cash transfer (CCT) programme launched in 2003 to reduce poverty and has led to improvements in health outcomes. CCT programmes may reduce the burden of malaria by alleviating poverty and by promoting access to healthcare, however this relationship is underexplored. This study investigated the association between BFP coverage and malaria incidence in Brazil. Methods A longitudinal panel study was conducted of 807 municipalities in the Brazilian Amazon between 2004 and 2015. Negative binomial regression models adjusted for demographic and socioeconomic covariates and time trends were employed with fixed effects specifications. Results A one percentage point increase in municipal BFP coverage was associated with a 0.3% decrease in the incidence of malaria (RR = 0.997; 95% CI = 0.994–0.998). The average municipal BFP coverage increased 24 percentage points over the period 2004–2015 corresponding to be a reduction of 7.2% in the malaria incidence. Conclusions Higher coverage of the BFP was associated with a reduction in the incidence of malaria. CCT programmes should be encouraged in endemic regions for malaria in order to mitigate the impact of disease and poverty itself in these settings.

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The impact of teaching on the duration of common urological operations

Canadian Urological Association Journal ◽

10.5489/cuaj.3737 ◽

2016 ◽

Vol 10 (5-6) ◽

pp. 172 ◽

Cited By ~ 3

Author(s):

Blayne Welk ◽

Jennifer Winick-Ng ◽

Andrew McClure ◽

Chris Vinden ◽

Sumit Dave ◽

...

Keyword(s):

Radical Prostatectomy ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Potential Effect ◽

Sensitivity Analyses ◽

Teaching Hospitals ◽

Operative Duration ◽

Open Radical Prostatectomy ◽

Academic Hospitals ◽

The Impact

Introduction: The ability of academic (teaching) hospitals to offer the same level of efficiency as non-teaching hospitals in a publicly funded healthcare system is unknown. Our objective was to compare the operative duration of general urology procedures between teaching and non-teaching hospitals. Methods: We used administrative data from the province of Ontario to conduct a retrospective cohort study of all adults who underwent a specified elective urology procedure (2002–2013). Primary outcome was duration of surgical procedure. Primary exposure was hospital type (academic or non-teaching). Negative binomial regression was used to adjust relative time estimates for age, comorbidity, obesity, anesthetic, and surgeon and hospital case volume.Results: 114 225 procedures were included (circumcision n=12 280; hydrocelectomy n=7221; open radical prostatectomy n=22 951; transurethral prostatectomy n=56 066; or mid-urethral sling n=15 707). These procedures were performed in an academic hospital in 14.8%, 13.3%, 28.6%, 17.1%, and 21.3% of cases, respectively. The mean operative duration across all procedures was higher in academic centres; the additional operative time ranged from 8.3 minutes (circumcision) to 29.2 minutes (radical prostatectomy). In adjusted analysis, patients treated in academic hospitals were still found to have procedures that were significantly longer (by 10‒21%). These results were similar in sensitivity analyses that accounted for the potential effect of more complex patients being referred to tertiary academic centres.Conclusions: Five common general urology operations take significantly longer to perform in academic hospitals. The reason for this may be due to the combined effect of teaching students and residents or due to inherent systematic inefficiencies within large academic hospitals.

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Effect of a Fall Prevention Program on Balance Maintenance Using a Quasi-experimental Design in Real-World Settings

Journal of Aging and Health ◽

10.1177/0898264312436713 ◽

2012 ◽

Vol 24 (5) ◽

pp. 827-845 ◽

Cited By ~ 5

Author(s):

Yvonne Robitaille ◽

Michel Fournier ◽

Sophie Laforest ◽

Lise Gauvin ◽

Johanne Filiatrault ◽

...

Keyword(s):

Real World ◽

Fall Prevention ◽

Prevention Program ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Community Dwelling ◽

Balance Performance ◽

Community Based ◽

Fall Prevention Program ◽

Quasi Experimental

Objectives: To examine the effect of a fall prevention program offered under real-world conditions on balance maintenance several months after the program. To explore the program’s impact on falls. Method: A quasi-experimental study was conducted among community-dwelling seniors, with pre- and postintervention measures of balance performance and self-reported falls. Ten community-based organizations offered the intervention (98 participants) and 7 recruited participants to the study’s control arm (102 participants). An earlier study examined balance immediately after the 12-week program. The present study focuses on the 12-month effect. Linear regression (balance) and negative binomial regression (falls) procedures were performed.falls. Results: During the 12-month study period, experimental participants improved and maintained their balance as reflected by their scores on three performance tests. There was no evidence of an effect on falls.falls. Discussion: Structured group exercise programs offered in community-based settings can maintain selected components of balance for several months after the program’s end.

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Trends of limb amputation considering type, level, sex and age in Saskatchewan, Canada 2006–2019: an in-depth assessment

Archives of Public Health ◽

10.1186/s13690-021-00759-1 ◽

2022 ◽

Vol 80 (1) ◽

Author(s):

Samuel Kwaku Essien ◽

David Kopriva ◽

A. Gary Linassi ◽

Audrey Zucker-Levin

Keyword(s):

Negative Binomial ◽

Negative Binomial Regression ◽

Limb Amputation ◽

Annual Percent Change ◽

Discharge Data ◽

Resident Population ◽

True Incidence ◽

Depth Analysis ◽

The Impact ◽

Extremity Amputation

Abstract Background Most epidemiologic reports focus on lower extremity amputation (LEA) caused specifically by diabetes mellitus. However, narrowing scope disregards the impact of other causes and types of limb amputation (LA) diminishing the true incidence and societal burden. We explored the rates of LEA and upper extremity amputation (UEA) by level of amputation, sex and age over 14 years in Saskatchewan, Canada. Methods We calculated the differential impact of amputation type (LEA or UEA) and level (major or minor) of LA using retrospective linked hospital discharge data and demographic characteristics of all LA performed in Saskatchewan and resident population between 2006 and 2019. Rates were calculated from total yearly cases per yearly Saskatchewan resident population. Joinpoint regression was employed to quantify annual percentage change (APC) and average annual percent change (AAPC). Negative binomial regression was performed to determine if LA rates differed over time based on sex and age. Results Incidence of LEA (31.86 ± 2.85 per 100,000) predominated over UEA (5.84 ± 0.49 per 100,000) over the 14-year study period. The overall LEA rate did not change over the study period (AAPC -0.5 [95% CI − 3.8 to 3.0]) but fluctuations were identified. From 2008 to 2017 LEA rates increased (APC 3.15 [95% CI 1.1 to 5.2]) countered by two statistically insignificant periods of decline (2006–2008 and 2017–2019). From 2006 to 2019 the rate of minor LEA steadily increased (AAPC 3.9 [95% CI 2.4 to 5.4]) while major LEA decreased (AAPC -0.6 [95% CI − 2.1 to 5.4]). Fluctuations in the overall LEA rate nearly corresponded with fluctuations in major LEA with one period of rising rates from 2010 to 2017 (APC 4.2 [95% CI 0.9 to 7.6]) countered by two periods of decline 2006–2010 (APC -11.14 [95% CI − 16.4 to − 5.6]) and 2017–2019 (APC -19.49 [95% CI − 33.5 to − 2.5]). Overall UEA and minor UEA rates remained stable from 2006 to 2019 with too few major UEA performed for in-depth analysis. Males were twice as likely to undergo LA than females (RR = 2.2 [95% CI 1.99–2.51]) with no change in rate over the study period. Persons aged 50–74 years and 75+ years were respectively 5.9 (RR = 5.92 [95% Cl 5.39–6.51]) and 10.6 (RR = 10.58 [95% Cl 9.26–12.08]) times more likely to undergo LA than those aged 0–49 years. LA rate increased with increasing age over the study period. Conclusion The rise in the rate of minor LEA with simultaneous decline in the rate of major LEA concomitant with the rise in age of patients experiencing LA may reflect a paradigm shift in the management of diseases that lead to LEA. Further, this shift may alter demand for orthotic versus prosthetic intervention. A more granular look into the data is warranted to determine if performing minor LA diminishes the need for major LA.

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Geographical factors in access: investigating the impact of distance on the use of primary care extended hours, an administrative data study.

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1245 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Jen Murphy ◽

William Whittaker ◽

Mark Elliot ◽

Rathi Ravindrarajah

Keyword(s):

Primary Care ◽

Negative Binomial ◽

Unmet Need ◽

Negative Binomial Regression ◽

City Region ◽

Hub Location ◽

Barriers To Access ◽

Access To Primary Care ◽

The Right ◽

The Impact

IntroductionNHS national targets mandate extended opening hours of doctors’ surgeries as a mechanism for increasing access to primary care, based on the assumption that unmet need is caused by a lack of appointments at the right time. Research has shown that other factors impact access and it may not simply be availability that limits an individual’s ability to access healthcare. Aims and Objectives To determine whether distance, familiarity and deprivation impact on the uptake of extended hours GP services that use a hub practice model. MethodsWe linked an appointments dataset to publicly available population datasets. With that linked dataset, we used negative binomial regression to model count data relating to uses of the extended hours service in one care commissioning group in the Greater Manchester city region. The dataset included 32,693 appointments across 4 hubs serving 37 practices. ResultsFamiliarity and distance are important in predicting the number of uses of the extended hours service at a GP practice level. For a theoretical pair of practices collocated at the hub location, the model predicts a use rate of 101.2 for the non hub compared with 283.7 for the hub, a 180% uplift. For a pair of non-hub practices, one located the mean distance from the hub, the other located one mile further away, the model predicts 64.8 uses for the nearer practice, and 46.5 uses for the far practice, a 28% penalty. ConclusionThe results indicate geographical inequity in the extended hours service. There may be many patients with unmet need for whom the extension of hours via a hub model does not address barriers to access. Providers should consider whether or not this type of model actually works to facilitate access. This is particularly of importance in the context of closing health inequality gaps.

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Assessing the Impact of Nightlight Gradients on Street Robbery and Burglary in Cincinnati of Ohio State, USA

Remote Sensing ◽

10.3390/rs11171958 ◽

2019 ◽

Vol 11 (17) ◽

pp. 1958 ◽

Cited By ~ 8

Author(s):

Hanlin Zhou ◽

Lin Liu ◽

Minxuan Lan ◽

Bo Yang ◽

Zengli Wang

Keyword(s):

Negative Binomial ◽

Infrared Imaging ◽

Negative Impact ◽

Positive Impact ◽

Negative Binomial Regression ◽

Information Criterion ◽

Binomial Regression ◽

Street Robbery ◽

The Impact

Previous research has recognized the importance of edges to crime. Various scholars have explored how one specific type of edges such as physical edges or social edges affect crime, but rarely investigated the importance of the composite edge effect. To address this gap, this study introduces nightlight data from the Visible Infrared Imaging Radiometer Suite sensor on the Suomi National Polar-orbiting Partnership Satellite (NPP-VIIRS) to measure composite edges. This study defines edges as nightlight gradients—the maximum change of nightlight from a pixel to its neighbors. Using nightlight gradients and other control variables at the tract level, this study applies negative binomial regression models to investigate the effects of edges on the street robbery rate and the burglary rate in Cincinnati. The Akaike Information Criterion (AIC) of models show that nightlight gradients improve the fitness of models of street robbery and burglary. Also, nightlight gradients make a positive impact on the street robbery rate whilst a negative impact on the burglary rate, both of which are statistically significant under the alpha level of 0.05. The different impacts on these two types of crimes may be explained by the nature of crimes and the in-situ characteristics, including nightlight.

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Innovation-Supporting Effect of Government Versus Private Venture Capital: Evidence from Chinese Listed Companies

African and Asian Studies ◽

10.1163/15692108-12341459 ◽

2020 ◽

Vol 19 (3) ◽

pp. 245-281

Author(s):

Xiaohui Tao ◽

Yang Li

Keyword(s):

Venture Capital ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Threshold Effect ◽

Listed Companies ◽

Threshold Test ◽

Chinese Listed Companies ◽

Enterprise Innovation ◽

Private Venture ◽

The Impact

Abstract Venture capital (VC) can promote the innovation of invested enterprises through financial support, social networking, and intellectual capital. Based on data of Chinese listed companies from 2003 to 2016, this study, firstly, compares the impact of government and private VC on enterprise innovation using Possion regression, and applies the ITCV method and Negative Binomial Regression for Robustness Examination, then, explores the relationship between their shareholding percentage and enterprise innovation with threshold test. The results show that: the performance of private VC is significantly positive and in line. With the increasing shareholding percentage of private VC, the innovation of invested enterprises increases. The overall performance of government VC, however, is not significant, and the shareholding percentage of government VC also has no significant impact on the innovation of invested companies. Additional testing revealed that a “threshold effect” however exists in the impact of the shareholding percentage of government VC on innovation: within a certain range, the higher the shareholding percentage, the more significant the impact on innovations becomes, but beyond that range, the percentage is inversely related to innovation.

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Drug overdose deaths at work, 2011–2016

Injury Prevention ◽

10.1136/injuryprev-2018-043104 ◽

2019 ◽

Vol 25 (6) ◽

pp. 577-580 ◽

Cited By ~ 2

Author(s):

Hope M Tiesman ◽

Srinivas Konda ◽

Lauren Cimineri ◽

Dawn N Castillo

Keyword(s):

Drug Overdose ◽

Negative Binomial ◽

Occupational Injuries ◽

Negative Binomial Regression ◽

Opioid Overdose ◽

Full Time ◽

Demographic Groups ◽

Drug Overdoses ◽

The Impact ◽

Overdose Deaths

Drug overdose fatalities have risen sharply and the impact on US workplaces has not been described. This paper describes US workplace overdose deaths between 2011 and 2016. Drug overdose deaths were identified from the Census of Fatal Occupational Injuries and fatality rates calculated using denominators from the Current Population Survey. Fatality rates were compared among demographic groups and industries. Negative binomial regression was used to analyse trends. Between 2011 and 2016, 760 workplace drug overdoses occurred for a fatality rate of 0.9 per 1 000 000 full-time equivalents (FTEs). Workplace overdose fatality rates significantly increased 24% annually. Workplace overdose fatality rates were highest in transportation and mining industries (3.0 and 2.6 per 1 000 000 FTEs, respectively). One-third of workplace overdose fatalities occurred in workplaces with fewer than 10 employees. Heroin was the single most frequent drug documented in workplace overdose deaths (17%). Workplace overdose deaths were low, but increased considerably over the six-year period. Workplaces are impacted by the national opioid overdose epidemic.

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