A ten-year review of neonatal tetanus cases managed at a tertiary health facility in a resource poor setting: The trend, management challenges and outcome

Background Neonatal Tetanus (NNT) is a vaccine preventable disease of public health importance. It is still being encountered in clinical practice largely in developing countries including Nigeria. NNT results from unhygienic delivery practices and some harmful traditional cord care practices. The easiest, quickest and most cost-effective preventive measure against NNT is vaccination of the pregnant women with the tetanus toxoid (TT) vaccine. The case-fatality rate from tetanus in resource-constrained settings can be close to 100% but can be reduced to 50% if access to basic medical care with adequate number of experienced staff is available. Materials and methods This retrospective study reviewed the admissions into the Special Care Baby Unit (SCBU) of the Ekiti State University Teaching Hospital, Ado-Ekiti from January 2011 to December 2020. The folders were retrieved from the records department of the hospital; Information obtained from folders were entered into a designed proforma for the study. Results During the study period, NNT constituted 0.34% of all neonatal admissions with case fatality rate of 52.6%. Seven [36.8%] of the babies were delivered at Mission home/Traditional Birth Attendant’s place while 5 [26.3%] were delivered in private hospitals. Cord care was with hot water compress in most of these babies16 [48.5%] while only 9% of the mothers cleaned the cord with methylated spirit. Age at presentation of less than one week was significantly associated with mortality, same with presence of autonomic dysfunction. Low family socio-economic class 5 was significantly associated with poor outcome, so also maternal age above 24 years. Conclusion This study revealed that neonatal tetanus is still being seen in our clinical practice with poor outcome and the risk factors are the same as of old. Increased public health campaign, promotion of clean deliveries, safe cord care practices, affordable and accessible health care provision are recommended to combat NNT scourge.

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Covid-19 Fatality Rate in Third World Countries: A Review of Environmental Challenges and Impacts on Public Health and Human Security

Journal of Intellectual Disability - Diagnosis and Treatment ◽

10.6000/2292-2598.2021.09.01.5 ◽

2021 ◽

Vol 9 (1) ◽

pp. 39-44

Author(s):

Chukwuemeka E. Etodike ◽

◽

Elsie C. Ekeghalu ◽

Kelechi Johnmary Ani ◽

Emmanuel Mutambara

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Third World ◽

Case Fatality ◽

Personal Hygiene ◽

Fatality Rate ◽

Environmental Challenges ◽

The Third ◽

The Third World ◽

Sanitary Conditions

The novel coronavirus is far from being over; with the case-fatality rate (CFR) hitting more than 16,500 globally as of July, there is a worry that despite the fact that the global CFR curve is showing signs of flattening, the environmental peculiarities of the third world countries may be abetting global efforts towards containing the virus. Therefore, this review x-rayed these peculiarities in the light of their current concern in public health as per their contribution to the persistent surge in CFR in most developing nations. Given that the virus is transmitted via droplets, the review focused on how the state of public and environmental challenges such as air as well as water pollution and personal hygiene could be abetting the surge in coronavirus infections and morbidity. The review revealed, among other things, that challenges associated with poor sanitary conditions, lack of potable water, unventilated environments, air pollution, and poor inter-personal hygiene are devastating challenges in the fight against the pandemic. The implication is that since these conditions are systematic in nature, it may take more than average effort and public sacrifice to checkmate the case-fatality rate of the virus in the third world. Therefore, call for studies is necessary to establish empiricism for CFR patterns and ratio across areas in deplorable environmental and sanitary conditions.

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Subway-Related Trauma: An Urban Public Health Issue with a High Case-Fatality Rate

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2018.04.015 ◽

2018 ◽

Vol 55 (2) ◽

pp. 165-171.e1 ◽

Cited By ~ 1

Author(s):

Simon G. Rodier ◽

Charles J. DiMaggio ◽

Stephen Wall ◽

Vasiliy Sim ◽

Spiros G. Frangos ◽

...

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Case Fatality ◽

Health Issue ◽

Public Health Issue ◽

Fatality Rate ◽

High Case Fatality Rate

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COVID-19, Australia: Epidemiology Report 15: Reporting week to 2359 AEST 10 May 2020

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.43 ◽

2020 ◽

Vol 44 ◽

Author(s):

Keyword(s):

Public Health ◽

Low Income ◽

Case Fatality Rate ◽

Case Fatality ◽

International Travel ◽

Low Income Countries ◽

Fatality Rate ◽

Public Health Action ◽

The Past ◽

Global Rate

Confirmed cases in Australia notified up to 10 May 2020: notifications = 6,971; deaths = 98. The incidence of new cases of COVID-19 has reduced dramatically since a peak in mid-march. The reduction in international travel, social distancing measures and public health action have likely been effective in slowing the spread of the disease, in the Australian community. Cases of COVID-19 continue to be notified by jurisdictions, albeit at a slowed rate. Testing rates over the past week have increased markedly, with a very low proportion of people testing positive. These low rates of detection are indicative of low levels of COVID-19 transmission. It is important that testing rates and community adherence to public health measures remain high to support the continued suppression of the virus, particularly in vulnerable high-risk groups and settings. In the past reporting week new cases in Australia are mostly considered to be locally acquired, consistent with the drop in international travel. Most locally-acquired cases can be linked back to a known case or cluster. Although the proportion of locally-acquired cases has increased, the overall rate of cases, regardless of place of acquisition, continues to decrease. The crude case fatality rate in Australia remains low (1.4%), compared with the WHO reported global rate (6.9%). The low case fatality rate is likely reflective of high case detection and high quality of health care services in Australia. Deaths from COVID-19 in Australia have occurred predominantly among the elderly and those with comorbidities, with no deaths occurring in those under 40 years. The highest rate of COVID-19 continues to be among people aged 60-79 years, with a third of these cases associated with several outbreaks linked to cruise ships. The lowest rate of disease is in young children, a pattern reflected in international reports. Internationally, cases continue to increase, with some areas such as Brazil and India showing a dramatic rise in reported cases. Although some low-income countries have currently reported few cases, it is possible that this is due to limited diagnostic and public health capacity, and may not be reflective of disease occurrence.

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COVID-19 (NOVEL CORONA VIRUS-2019)- TRENDS OF CORONA PANDEMIC OVER A PERIOD OF ONE YEAR IN HIMALAYAN REGION IN INDIA.

10.36106/2909673 ◽

2021 ◽

pp. 12-14

Author(s):

Kamlesh Sharma ◽

Ram Lal Sharma

Keyword(s):

Public Health ◽

Recovery Rate ◽

Case Fatality Rate ◽

Preventive Measures ◽

Case Fatality ◽

Himalayan Region ◽

Fatality Rate ◽

Public Health Threat ◽

One Year ◽

Authentic Data

COVID-19 is a emerging disease and is of public health importance.This study was done to analyse the trends of corona pandemic over a period of one year in Himalayan region in India. Data regarding state statistics from January 2020 to January 2021,was gathered from various sources. Since objective and authentic data was released by different agencies daily and reported to WHO, so the state prole of new cases, cumulative cases, recoveries, cumulative deaths, samples tested, positive samples was taken based on availability of information from National Health Mission site, other state websites and news papers and analysed for various parameters. The current study conducted in Himachal Pradesh showed Case fatality rate as 1.7%, recovery rate 99% and positivity rate 6.1% with Shimla having highest CFR 2.5%. Population wise most affected district was Lahul & Spiti with affected population 4.0%.It may be considered as a severe public health threat of this decade. COVID-19 trends, pattern and its analysis will be very important for control and preventive measures.

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Economic development and road traffic injuries and fatalities in Thailand: an application of spatial panel data analysis, 2012–2016

BMC Public Health ◽

10.1186/s12889-019-7809-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Rapeepong Suphanchaimat ◽

Vorasith Sornsrivichai ◽

Supon Limwattananon ◽

Panithee Thammawijaya

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Negative Binomial ◽

Road Traffic ◽

Statistical Significance ◽

Case Fatality ◽

Gdp Per Capita ◽

Fatality Rate ◽

Incidence Proportion ◽

Per Capita

Abstract Background Road traffic injuries (RTIs) have been one of the most critical public health problems in Thailand for decades. The objective of this study was to examine to what extent provincial economy was associated with RTIs, road traffic deaths and case fatality rate in Thailand. Methods A secondary data analysis on time-series data was applied. The unit of analysis was a panel of 77 provinces during 2012–2016. Data were obtained from relevant public authorities, including the Ministry of Public Health. Descriptive statistics and econometric models, using negative binomial (NB) regression, negative binomial regression with random-effects (RE) model, and spatial Durbin model (SDM) were employed. The main predictor variable was gross domestic product (GDP) per capita and the outcome variables were incidence proportion of RTIs, traffic deaths and case fatality rate. The analysis was adjusted for key covariates. Results The incidence proportion of RTIs rose from 449.0 to 524.9 cases per 100,000 population from 2012 till 2016, whereas the incidence of traffic fatalities fluctuated between 29.7 and 33.2 deaths per 100,000 population. Case fatality rate steadily stood at 0.06–0.07 deaths per victim. RTIs and traffic deaths appeared to be positively correlated with provincial economy in the NB regression and the RE model. In the SDM, a log-Baht increase in GDP per capita (equivalent to a growth of GDP per capita by about 2.7 times) enlarged the incidence proportion of injuries and deaths by about a quarter (23.8–30.7%) with statistical significance. No statistical significance was found in case fatality rate by the SDM. The SDM also presented the best model fitness relative to other models. Conclusion The incidence proportion of traffic injuries and deaths appeared to rise alongside provincial prosperity. This means that RTIs-preventive measures should be more intensified in economically well-off areas. Furthermore, entrepreneurs and business sectors that gain economic benefit in a particular province should share responsibility in RTIs prevention in the area where their businesses are running. Further studies that explore others determinants of road safety, such as patterns of vehicles used, attitudes and knowledge of motorists, investment in safety measures, and compliance with traffic laws, are recommended.

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Excess Mortality from COVID-19: Lessons Learned from the Italian Experience

10.20944/preprints202004.0065.v2 ◽

2020 ◽

Cited By ~ 2

Author(s):

Paolo Pasquariello ◽

Saverio Stranges

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Case Fatality ◽

Lessons Learned ◽

Fatality Rate ◽

Lombardy Region ◽

Italian Experience ◽

Health Authorities ◽

Public Health Authorities

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

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Global Pandemic Trends of COVID-19 in 2020

10.21203/rs.3.rs-625008/v1 ◽

2021 ◽

Author(s):

Hai-Zhen Chen ◽

Bo Cai ◽

Jian-Guo Chen

Keyword(s):

Public Health ◽

United States ◽

Mortality Rate ◽

Incidence Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

The United States ◽

Cumulative Number ◽

Fatality Rate ◽

The World

Abstract Background: The novel coronavirus pneumonia (COVID-19) has been global threaten to public health. This paper provides perspective to the decision-making for public health control of the pandemic or the spread of epidemic.Methods: According to the WHO global reported database, we developed and used the number of cumulative cases, and the number of cumulative deaths to calculate and analyze rates of incidence, mortality, and fatality by country, with respect to the 30 highest outbreak (Top 30) countries.Results： As of December 31, 2020, of the global population of 7.585 billion, the cumulative number of reported cases was 81,475,053, and the cumulative number of deaths was 1,798,050. The incidence rate of COVID-19 was 1074.13 per 100,000 population, the mortality rate was 23.70 per 100,000, and the case fatality rate was 2.21%. Among the Top 30 countries, the five countries with the highest number of reported cumulative cases were, in rank, the United States (19,346,790 cases), India (10,266,674), Brazil (7,563,551), Russia (3,159,297) and France (2,556,708), and the five countries with the highest number of cumulative deaths were the United States (335,789 cases), Brazil (192,681), India (148,738), Mexico (123,845) and Italy (73,604). Globally, the countries with the highest incidence rate were, in rank, Andorra, Luxembourg, Montenegro, San Marino, and Czechia; the countries with the highest mortality rate were, in rank, San Marino, Belgium, Slovenia, Italy, and North Macedonia. The highest fatality rate was found in Yemen, Mexico, Montserrat, Isle of Man, and Ecuador, respectively. In China, 96,673 cases of COVID-19 and 4788 deaths were reported in 2020, ranking the 78th and the 43rd, respectively, in the world. The incidence rate and mortality rate were 6.90/105 and 0.34/105, respectively, ranking 207th and 188th in the world. The case fatality rate was 4.95%, ranking 11th in the world.Conclusions： The COVID-19 prevalence is still on the rise, and the turning points of incidence and mortality are not yet forecasted. Personal protection, anti-epidemic measures and efforts from public health personnel, medical professionals, biotechnology R&D personnel, effectiveness of the vaccination programs and the governments, are the important factors to determine the future prevalence of this coronavirus disease.

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Towards Understanding the COVID-19 Case Fatality Rate

10.1101/2021.03.01.21252698 ◽

2021 ◽

Author(s):

Donghui Yan ◽

Aiyou Chen ◽

Buqing Yang

Keyword(s):

Public Health ◽

Case Fatality Rate ◽

Exploratory Data Analysis ◽

Age Groups ◽

Case Fatality ◽

Age Effect ◽

Fatality Rate ◽

Apparent Discrepancy ◽

Exploratory Data ◽

Second Wave

AbstractAn important parameter for COVID-19 is the case fatality rate (CFR). It has been applied to wide applications, including the measure of the severity of the infection, the estimation of the number of infected cases, risk assessment etc. However, there remains a lack of understanding on several aspects of CFR, including population factors that are important to CFR, the apparent discrepancy of CFRs in different countries, and how the age effect comes into play. We analyze the CFRs at two different time snapshots, July 6 and Dec 28, with one during the first wave and the other a second wave of the COVID-19 pandemic. We consider two important population covariates, age and GDP as a proxy for the quality and abundance of public health. Extensive exploratory data analysis leads to some interesting findings. First, there is a clear exponential age effect among different age groups, and, more importantly, the exponential index is almost invariant across countries and time in the pandemic. Second, the roles played by the age and GDP are a little surprising: during the first wave, age is a more significant factor than GDP, while their roles have switched during the second wave of the pandemic, which may be partially explained by the delay in time for the quality and abundance of public health and medical research to factor in.

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Identification of spatial variations in COVID-19 epidemiological data using K-Means clustering algorithm: a global perspective

10.1101/2020.06.03.20121194 ◽

2020 ◽

Author(s):

Viswa Chandu

Keyword(s):

Public Health ◽

Health Expenditure ◽

Case Fatality Rate ◽

Case Fatality ◽

Epidemiological Data ◽

Fatality Rate ◽

Background Characteristics ◽

Public Health Expenditure ◽

Cluster 2 ◽

Country Specific

Background: Discerning spatial variations of COVID-19 through quantitative analysis operating on the geographically designated datasets relating to socio-demographics and epidemiological data facilitate strategy planning in curtailing the transmission of the disease and focus on articulation of necessary interventions in an informed manner. Methods: K-means clustering was employed on the available country-specific COVID-19 epidemiological data and the influential background characteristics. Country-specific case fatality rates and the average number of people tested positive for COVID-19 per every 10,000 population in each country were derived from the WHO COVID-19 situation report 107, and were used for clustering along with the background characteristics of proportion of countrys population aged >65 years and percentage GDP spent as public health expenditure. Results: The algorithm grouped the 89 countries into cluster 1 and Cluster 2 of sizes 54 and 35, respectively. It is apparent that Americas, European countries, and Australia formed a major part of cluster 2 with high COVID-19 case fatality rate, higher proportion of countrys population tested COVID-19 positive, higher percentage of GDP spent as public health expenditure, and greater percentage of population being more than 65 years of age. Conclusion: In spite of the positive correlation between high public health expenditure (%GDP) and COVID-19 incidence, case fatality rate, the immediate task ahead of most of the low and middle income countries is to strengthen their public health systems realizing that the correlation found in this study could be spurious in light of the underreported number of cases and poor death registration.

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Scarce Health-care Resources and Higher Case-fatality Rates Early in an Epidemic: Analysis of Hospitalized Patients with COVID-19 in Tianmen.

10.21203/rs.3.rs-22958/v1 ◽

2020 ◽

Author(s):

Jijia Hu ◽

Zongwei Zhang ◽

Wei Wang ◽

Yingang Zhang ◽

Juan Tian ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Case Fatality Rate ◽

Early Stage ◽

Case Fatality ◽

Fatality Rate ◽

Medical Resources ◽

Health Care Resources ◽

Public Health Emergencies ◽

Per Capita

Abstract Background Tianmen had the highest case-fatality rate (CFR) among all the cities in China early in the transmission of SARS-CoV-2, but little is known about the details of the epidemic in Tianmen. Our study aims to reveal the causes of the high CFR from the aspects of clinical features, medical resources, and epidemic situation.Methods In this study, we report the admission and outcomes of 341 patients with confirmed COVID-19 who were admitted and hospitalized in the hospital (The First People's Hospital of Tianmen) from January 14 to February 25, 2020. Epidemic information and medical resources across different regions were collected and compared. Results All deaths from COVID-19 in Tianmen occurred in the hospital, and the proportion of patients with critical (8.5%) symptoms in the hospital is higher than the average in China. In addition, the number of affected patients in Tianmen is quite low, but the hospital and the whole city had the highest CFR in the early stage of the epidemic. Completely different from the stable CFR in Hubei Province, the CFR of COVID-19 in the hospital and city dropped dramatically, from the largest value in China to a more average level, within a few days. Analysis of government public documents showed that the per capita medical resources in Tianmen are worse than those of Wuhan and Hubei. Conclusions Our findings suggest that the inadequate capacity to respond to public health emergencies caused by relatively scarce health-care resources is a crucial factor contributing to the higher CFR of infectious diseases in regions with lower economic levels. Such countries and territories should implement strategies earlier to minimize the danger of COVID-19.

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