Results from a malaria indicator survey highlight the importance of routine data capture in high-risk forest and farm transmission sites in Vietnam to tailor location-specific malaria elimination interventions

In-line with the World Health Organization’s (WHO) Global Technical Strategy for Malaria (2016–2030), Vietnam is striving to eliminate malaria by 2030. Targeting appropriate interventions in high-risk populations such as forest and forest-fringe communities is a critical component of malaria elimination efforts in Vietnam. In 2016, a household-level malaria indicator survey was conducted in Phu Yen Province, Vietnam with the aim of assessing the knowledge, behaviors and associated risks of malaria infection among priority mobile and migrant populations (MMPs) working and sleeping in forests and on farms. A total of 4211 people were included in the survey, comprised of 1074 heads of households and 3137 associated household members. Of the 1074 head-of-household respondents, 472 slept in a forest, 92 slept on a farm, 132 slept in both forests and farms, and 378 slept at their villages within the last 12 months. Age, literacy, and occupation were significantly different among those who slept in a forest versus on a farm. Of 301 respondents who answered questions about malaria risk factors at sleeping sites, 35% were somewhat aware of malaria prevention practices, but only 4% could recall at least four malaria prevention messages. Among the same group of 301 respondents, only 29% used nets and only 11% used treated nets. Ownership and use of nets among forest-goers was significantly lower than those who slept on a farm or in their village. Huts without walls were significantly prominent forest sleeping site locations (POR = 10.3; 95% CI 4.67–22.7). All respondents who slept in a forest requested standby malaria drugs and one-third of them self-treated without blood testing. Results from this study highlight the importance of capturing relevant location-specific data among priority populations such as remote forest and farm going mobile and migrant populations in Vietnam. Data regarding behavioral practices, knowledge, preventative measures, and intervention coverage at remote-area transmission sites must be routinely captured to effectively monitor progress and refine targeted intervention strategies accordingly.

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The promise, problems and pitfalls of mass drug administration for malaria elimination: a qualitative study with scientists and policymakers

International Health ◽

10.1093/inthealth/ihy079 ◽

2018 ◽

Vol 11 (3) ◽

pp. 166-176 ◽

Cited By ~ 9

Author(s):

Nils Kaehler ◽

Bipin Adhikari ◽

Phaik Yeong Cheah ◽

Nicholas P J Day ◽

Daniel H Paris ◽

...

Keyword(s):

Drug Administration ◽

Mass Drug Administration ◽

Malaria Elimination ◽

Artemisinin Resistance ◽

Malaria Prevention ◽

Evidence Base ◽

World Health ◽

Pilot Studies ◽

Target Populations ◽

Health Organization

Abstract Background The emergence of artemisinin resistance in the Greater Mekong Subregion (GMS) has prompted urgent containment measures. One possible approach is mass drug administration (MDA). This article explores attitudes towards and perceptions of MDA for malaria elimination among policymakers and leading malariologists. Methods Thirty-two semistructured interviews (SSI) were conducted with policymakers (n=17) and principal investigators (n=15) selected based on their involvement in malaria prevention, control and elimination in the GMS. Interviews were audio recorded and transcribed for qualitative content (thematic) analysis using NVivo (QSR International, Doncaster, Victoria, Australia). Results Researchers and policymakers described reluctance and consequently delays to pilot MDA for malaria elimination. Most policymakers and some researchers reported concerns around the evidence base, citing a lack of data on its effectiveness and appropriate target populations. There were also worries about promoting resistance. Other issues included a previous lack of support from the World Health Organization, past MDAs, the remoteness of target populations and challenges explaining the rationale for MDA. Conclusions The complex rationale for MDA for malaria elimination, mistaking pilot studies for implementation, past experiences with MDA, difficulties in selecting appropriate sites and the WHO’s lack of clear backing undermined the support for MDA for malaria elimination.

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A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

Orvosi Hetilap ◽

10.1556/oh.2012.29329 ◽

2012 ◽

Vol 153 (17) ◽

pp. 649-654

Author(s):

Piroska Orosi ◽

Judit Szidor ◽

Tünde Tóthné Tóth ◽

József Kónya

Keyword(s):

High Risk ◽

Influenza Season ◽

National Level ◽

Organ Transplant ◽

High Risk Patient ◽

Risk Groups ◽

Health Sciences ◽

World Health ◽

Transplant Patients ◽

Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

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Progression to and Prevention of Diabetes: Disparity of Impaired Fasting Glucose and Impaired Glucose Tolerance - Review Article

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.08.11222 ◽

2020 ◽

Vol 103 (8) ◽

pp. 829-836

Keyword(s):

High Risk ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Lifestyle Intervention ◽

Impaired Fasting Glucose ◽

Diabetes Prevention ◽

Lifestyle Modification ◽

Fasting Glucose ◽

World Health ◽

Risk Of Progression

It is well established that individuals who have prediabetes either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) have high risk to develop diabetes. However, it is unclear whether the rate of progression to diabetes is different between these two categories. Lifestyle modification has been recommended for diabetes prevention in these high-risk groups. However, given the differences in their pathophysiology, it is possible that these subtypes of prediabetes condition may have different responses to lifestyle modification. The present review was to summarize the risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention in individuals who have isolated IGT or isolated IFG or combined. The risk of progression to diabetes is highest in combined IFG and IGT subtype. Individuals who have isolated IFG by the American Diabetes Association criteria (100 to 125 mg/dl) has lower risk of progression to diabetes than those with World Health Organization criteria (110 to 125 mg/dl) and the latter has similar or higher risk of incident diabetes than those with isolated IGT. Lifestyle modification is most effective in individuals with IGT (with or without IFG) but is less effective in those with isolated IFG. In conclusion, The risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention are disparate between prediabetes subtypes. Given the paucity of diabetes prevention data in individuals with isolated IFG, more studies dedicated to this subtype is required. Keywords: Impaired fasting glucose, Impaired glucose tolerance, Prediabetes, Type 2 diabetes, Lifestyle intervention, Diabetes prevention

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Household and Population-Level Behavioural Changes Due to COVID-19 Pandemic: A Smart Thermostat Based Comparative Data Analysis

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101057 ◽

2021 ◽

Vol 10 (1) ◽

pp. 1-6

Author(s):

Kirti Sundar Sahu ◽

Arlene Oetomo ◽

Niloofar Jalali ◽

Plinio P. Morita

Keyword(s):

Data Analysis ◽

Population Level ◽

World Health ◽

Motion Sensors ◽

Household Level ◽

Work From Home ◽

Significant Difference ◽

Health Organization ◽

Smart Thermostat ◽

The Impact

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.

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Comparison of the ColiPlate™ Kit with Two Common E. coli Enumeration Methods for Water

Water ◽

10.3390/w13131804 ◽

2021 ◽

Vol 13 (13) ◽

pp. 1804

Author(s):

Cassi J. Gibson ◽

Abraham K. Maritim ◽

Jason W. Marion

Keyword(s):

High Risk ◽

Natural Water ◽

Membrane Filtration ◽

Fecal Contamination ◽

Reference Method ◽

World Health ◽

Risk Levels ◽

E Coli ◽

Field Samples ◽

Very High

Quantitatively assessing fecal indicator bacteria in drinking water from limited resource settings (e.g., disasters, remote areas) can inform public health strategies for reducing waterborne illnesses. This study aimed to compare two common approaches for quantifying Escherichia coli (E. coli) density in natural water versus the ColiPlate™ kit approach. For comparing methods, 41 field samples from natural water sources in Kentucky (USA) were collected. E. coli densities were then determined by (1) membrane filtration in conjunction with modified membrane-thermotolerant E. coli (mTEC) agar, (2) Idexx Quanti-Tray® 2000 with the Colilert® substrate, and (3) the Bluewater Biosciences ColiPlate kit. Significant correlations were observed between E. coli density data for all three methods (p < 0.001). Paired t-test results showed no difference in E. coli densities determined by all the methods (p > 0.05). Upon assigning modified mTEC as the reference method for determining the World Health Organization-assigned “very high-risk” levels of fecal contamination (> 100 E. coli CFU/100 mL), both ColiPlate and Colilert exhibited excellent discrimination for screening very high-risk levels according to the area under the receiver operating characteristic curve (~89%). These data suggest ColiPlate continues to be an effective monitoring tool for quantifying E. coli density and characterizing fecal contamination risks from water.

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688 Pediatric Obstructive Sleep Apnea (OSA) and COVID-19-Related Adverse Clinical Outcomes

SLEEP ◽

10.1093/sleep/zsab072.686 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A269-A269

Author(s):

Vaishal Shah ◽

Nancy Foldvary-Schaefer ◽

Lu Wang ◽

Lara Jehi ◽

Cynthia Pena Obrea ◽

...

Keyword(s):

High Risk ◽

Clinical Outcome ◽

Clinical Outcomes ◽

Pediatric Patients ◽

Control Design ◽

Supplemental Oxygen ◽

Case Control ◽

World Health ◽

Invasive Ventilation ◽

High Flow Oxygen

Abstract Introduction The relationship of OSA and human coronavirus (COVID-19) in the pediatric population is unknown. We postulate that OSA is associated with SARS-CoV-2 positivity and with adverse COVID-19 outcomes in children. Methods A retrospective review of 120 consecutive patients (<18 years) with prior polysomnogram (PSG) and COVID-19 testing from the Cleveland Clinic COVID-19 registry was conducted. Using a case control design of SARS-CoV-2 positive and negative pediatric patients, we examined COVID-19 and pre-existing OSA (dichotomized AHI≥1) using logistic (OR,95%CI) regression and as continuous measures: AHI, oxygen(SpO2) nadir, %time SpO2<90%) using linear regression(beta+/-SE). In those positive for SARS-CoV-2(cases only), we assessed the association of OSA and World Health Organization(WHO) COVID-19 clinical outcome composite score (hospitalization, requiring supplemental oxygen, non-invasive ventilation/high-flow oxygen, invasive ventilation/ECMO or death) using Wilcoxon rank sum test for ordinal data. Results Cases (n=36) were 11.8±4.4 years, 61% male, 27.8% black and 88.9% with OSA, while 85.7% of controls (n=84) had OSA. OSA was not associated with increased SARS-CoV-2 positivity: OR=1.33(0.40, 4.45,p=0.64). No significant difference between cases and controls for mean AHI 3.7(1.5,6.0) vs 3.5(1.5,7.1),p=0.91,SpO2 nadir 88.6±5.4 vs 89.1±4.4,p=0.58,%time SpO2<90% 0.05[0.00,1.00) vs 0.10 (0.00,1.00, p=0.65) respectively was noted. WHO-7 COVID-19 clinical outcome did not meet statistical significance in relation to OSA due to the low event frequency (p=0.49). Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 12.5 vs 0% respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included: 75% obesity, 50% asthma, 25% sickle cell disease and 25% hypoplastic left heart. Conclusion In this first report of which we are aware focused on COVID-19 in pediatric OSA, we use a case control design leveraging COVID-19 and sleep laboratory registries. Albeit not statistically significant, pediatric patients with OSA had a higher percentage of worse clinical outcomes. Larger network studies are needed to clarify whether poorer COVID-19 outcomes may be attributable to OSA or modulated via high risk health conditions. Support (if any):

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Disability in people clinically at high risk of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.109.075036 ◽

2010 ◽

Vol 197 (4) ◽

pp. 278-284 ◽

Cited By ~ 88

Author(s):

Eva Velthorst ◽

Dorien H. Nieman ◽

Don Linszen ◽

Hiske Becker ◽

Lieuwe de Haan ◽

...

Keyword(s):

High Risk ◽

Help Seeking ◽

Cox Regression ◽

World Health ◽

Disability Assessment ◽

Community Activities ◽

Transition Group ◽

The World ◽

Health Organization

BackgroundDecline in social functioning occurs in individuals who later develop psychosis.AimsTo investigate whether baseline differences in disability are present in those who do and those who do not make a transition to psychosis in a group clinically at high risk and whether disability is a risk factor for transition.MethodProspective multicentre, naturalistic field study with an 18-month follow-up period on 245 help-seeking individuals clinically at high risk. Disability was assessed with the Disability Assessment Schedule of the World Health Organization (WHODAS–II).ResultsAt baseline, the transition group displayed significantly greater difficulties in making new friends (z =−3.40, P = 0.001), maintaining a friendship (z =−3.00, P = 0.003), dealing with people they do not know (z =−2.28, P = 0.023) and joining community activities (z =−2.0, P = 0.05) compared with the non-transition group. In Cox regression, difficulties in getting along with people significantly contributed to the prediction of transition to psychosis in our sample (β = 0.569, s.e. = 0.184, Wald = 9.548, P = 0.002, hazard ratio (HR) = 1.767, 95% CI 1.238–2.550).ConclusionsCertain domains of social disability might contribute to the prediction of psychosis in a sample clinically at high risk.

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Which Clinical Scoring Systems Are Most Useful in Showing Severity in COVID-19 Patients?

10.21203/rs.3.rs-362665/v1 ◽

2021 ◽

Author(s):

Ishak San ◽

Emin Gemcioglu ◽

Salih Baser ◽

Nuray Yilmaz Cakmak ◽

Abdulsamet Erden ◽

...

Keyword(s):

High Risk ◽

Clinical Outcomes ◽

Predictive Value ◽

Independent Predictor ◽

Severe Disease ◽

Scoring Systems ◽

High Risk Group ◽

World Health ◽

Severe Group ◽

Clinical Scoring

Abstract IntroductionIn this study, we compare the predictive value of clinical scoring systems that are already in use in patients with COVID-19, including the BCRSS, qSOFA, SOFA, MuLBSTA and HScore, for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians.Materials and MethodsWe classified the patients into two groups according to the stage of the disease (severe and non-severe) by using the slightly modified and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 hours.ResultsOf the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR: 6.1, 95% CI: 2.105–17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR: 4.757, 95% CI: 1.438–15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively.ConclusionCalculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. With early identification of the high-risk group using BRCSS and qSOFA, early interventions for high-risk patients can improve clinical outcomes in COVID-19.

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Co-exploring the effects of COVID-19 pandemic on the livelihood of persons with disabilities in Bangladesh

Disability Studies Quarterly ◽

10.18061/dsq.v41i3.8377 ◽

2021 ◽

Vol 41 (3) ◽

Author(s):

Adity Shayontony Das ◽

Fatema Akter Bonny ◽

Arifa Bente Mohosin ◽

Sabina Faiz Rashid ◽

Md Tanvir Hasan

Keyword(s):

Social Life ◽

World Health ◽

Vulnerable Groups ◽

Formal Sector ◽

Economic Activities ◽

Middle Income ◽

Persons With Disabilities ◽

Household Level ◽

The Government ◽

Health Organization

Background: According to World Health Organization (WHO), vulnerable groups such as persons with disabilities are facing severe impacts of the pandemic. There has always been significant challenges and hurdles in terms of achieving adequate and equitable inclusivity of persons with disabilities in all sections of social life. Education and employment of persons with disabilities were least focused which created more marginalization for the community. The long term impact of these marginalization has also led to the lack of jobs and social security of persons with disabilities, which is very clear now given the crisis in place. In low and middle income countries like Bangladesh the situation is even worse. To better understand the conditions of persons with disabilities in this crisis situation, the present study was initiated to explore the dimensions of livelihood with respect to income and wellbeing of persons with disabilities and to generate evidence for developing policies around these issues.Methods: A qualitative study was undertaken among 30 persons with disabilities from 8 different geographical divisions of Bangladesh. The interviews were conducted through telephone calls due to the existing COVID-19 crisis and mobility restrictions. The respondents were purposively selected based on gender, type of disability, area of resident (urban, rural) and their ability to communicate, therefore most (25/30) respondents were persons with physical disability. Thematic analysis was conducted to generate the findings of the study.Findings: Study findings revealed that majority of the respondents were involved in informal jobs. Predominantly males were daily wage-earners and often the sole breadwinner of the families, very few females were involved in economic activities. Since they had no stable income, the economic shock from the COVID-19 pandemic had affected them badly even leading to household level famine. The study identifies low level of education and informal job security as the primary causes of socio-economic insecurity among persons with disabilities, resulting in challenges in ensuring a stable livelihood during crisis situations, such as COVID-19.Conclusion: Constant alienation of persons of disabilities from the formal sector results in the deterioration of their livelihood standards which even worsen during any emergency crisis such as COVID-19. The study pinpoints that only aided services are not adequate to ensure persons with disabilities' rights rather there is an urgent need of disability inclusion in formal job sector and livelihood training for persons with disabilities. To achieve the Sustainable Development Goals 2030 and to irradiate the inequality towards persons with disabilities in the society it is important for the Government and concern bodies to focus on the inclusiveness with better implementation and monitoring strategies.

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Linking child travel routes and routine health data

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.302 ◽

2017 ◽

Vol 1 (1) ◽

Author(s):

Amy Mizen ◽

Sarah Rodgers ◽

Richard Fry ◽

Ronan Lyons

Keyword(s):

Large Scale ◽

Data Linkage ◽

Routine Data ◽

Environmental Exposures ◽

Health Data ◽

Walking Distance ◽

Complete Analysis ◽

Natural Experiments ◽

Older Children ◽

Household Level

ABSTRACTObjectivesLinking routinely collected health and environment data can allow for large scale evaluations of how our environment impacts our health. Our data linkage approach advances previous research where residence-based environmental exposures were anonymously linked in the SAIL databank using Residential Anonymous Linking Fields (RALFs). The dose-response relationship between exposure to food and dietary intake has not been widely investigated. Previous research found conflicting views on whether increased environmental exposure to unhealthy food contributes to higher BMIs. This may have been due to different methodological approaches, including imprecise exposures, small numbers, and the use of self-reported BMIs. ApproachThis investigation calculated food exposure environments for routes from all homes to and from school. A Geographic Information System was used to calculate the environmental exposures along all potential routes up to a maximum age-appropriate walking distance from each school. Once within the SAIL databank we selected relevant routes using linked demographic and pupil datasets. To maintain privacy, the primary (doctoral) researcher generating the environmental exposures, did not have access to the final household-level exposure data in their identifiable form. The researcher automated their method so a second researcher could run the GIS analysis. Accuracy of modelled exposures will be compared with actual routes collected from GPS traces of children walking to school. ResultsRemoving access to the final identifiable household-level route exposures enabled the primary researcher to complete analysis on the combined household and individual-level data within the secure environment. The environmental exposures were linked with routine health data from the SAIL databank; including BMI as an indicator of obesity. BMI data for 4-5 year olds, and a sample of 1300 13-14 year olds were linked to associated environmental exposures. ConclusionDepending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.

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