scholarly journals Management tool to guide rabies elimination programmes

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristyna Rysava ◽  
Tamara Mancero ◽  
Eduardo Caldas ◽  
Mary Carvalho ◽  
Veronica Gutierrez ◽  
...  
Keyword(s):  
State Level ◽  
Cost Effective ◽  
Management Tool ◽  
Human Rabies ◽  
Socioeconomic Indicators ◽  
Classification Framework ◽  
Level Data ◽  
High Prevalence ◽  
Vaccination Campaigns ◽  
Risk Investment

ObjectiveTo provide surveillance tools to support policymakers andpractitioners to identify epidemiological situations and inform theprogressive implementation of rabies elimination programmes.IntroductionGlobal targets for elimination of human rabies mediated by dogshave been set for 2030. In the Americas countries are progressingtowards interruption of transmission and declaration of rabiesfreedom1. Guidance for managing elimination programmes toensure continued progress during the endgame is critical, yet oftenlimited and lacking in specific recommendations. Characteristicspatiotemporal incidence patterns are indicative of progress, andthrough their identification, tailored guidance can be provided.MethodsUsing SIRVERA, a surveillance database for rabies in theAmericas2, we developed a classification framework for identificationof epidemiological situations at subnational level. Each situationexhibits a characteristic pattern identified via a set of objective criteriaincluding trends in case detection, assessment of virus variants, caselocations and measures of incursion risk.We refined our framework through application to Mexico inconsultation with stakeholders. To understand factors predictingincursions we analysed state-level data on vaccination campaigns,populations and socioeconomic indicators employing multivariateregression models.ResultsWe were able to classify all states in Mexico and providecorrespondingly tailored guidance. Control efforts have resultedin progress towards elimination; however rabies still circulatesendemically in one state Chiapas, putting its neighbours at risk ofre-emergence.Epidemiological and socioeconomic factors associated withincursions were primarily geographic proximity to endemic and high-prevalence states, and inconsistent vaccination campaigns associatedwith a low human development index.ConclusionsOur management tool can support rabies programme managersat subnational levels to identify their epidemiological situation,develop tailored plans to meet targets, and sustainably maintainrabies freedom, as demonstrated for Mexico. Effective surveillanceis critical for disease elimination. Control options differ dependingon whether disease circulates intermittently through reintroductionsor persists focally, but with poor detection these situations mightbe indistinguishable. Our analysis enables identification of at-riskareas and methods to reduce risk. Investment in remaining endemicareas, through improved implementation and monitoring of mass dogvaccinations, is expected to provide the most cost-effective approachto elimination whilst preventing re-emergence elsewhere.Decision-tree framework.Rabies incursions in Mexico, 2005-2015. Blue circles indicate incursionlocations, and resulting outbreak sizes, with darker shading for more recentincursions. Red shading indicates the duration of endemic circulation over theten-year period.

scholarly journals The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amber Kunkel ◽  
Seonghye Jeon ◽  
Haim C. Joseph ◽  
Pierre Dilius ◽  
Kelly Crowdis ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vaccination Campaign ◽  
Cost Effective ◽  
Fold Increase ◽  
Surveillance Data ◽  
Capital City ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Program Costs ◽  
Vaccination Campaigns

AbstractDog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the last nation-wide dog vaccination campaign occurred in 2018. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005 to 2025, with varying assumptions about when dog vaccinations resume. We compared model outputs to surveillance data on human rabies deaths from 2005 to 2020 and animal rabies cases from 2018 to 2020. Model predictions and surveillance data both suggest a 5- to 8-fold increase in animal rabies cases occurred in Haiti’s capital city between Fall 2019 and Fall 2020. Restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6541 human rabies exposures over a five-year period. It may also decrease program costs due to reduced need for human post-exposure prophylaxis. These results show that interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.

scholarly journals New Rabies Vaccines for Use in Humans

Vaccines ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 54 ◽  
Author(s):  
Hildegund C. J. Ertl
Keyword(s):  
Cost Effective ◽  
Central American ◽  
Human Rabies ◽  
Clinical Testing ◽  
Vaccination Programs ◽  
Rabies Control ◽  
Surveillance Programs ◽  
Vaccination Campaigns ◽  
Animal Vaccination ◽  
Rabid Animal

Although vaccines are available, rabies still claims more than 55,000 human lives each year. In most cases, rabies vaccines are given to humans after their exposure to a rabid animal; pre-exposure vaccination is largely reserved for humans at high risk for contacts with the virus. Most cases of human rabies are transmitted by dogs. Dog rabies control by mass canine vaccination campaigns combined with intensive surveillance programs has led to a decline of human rabies in many countries but has been unsuccessful in others. Animal vaccination programs are also not suited to control human rabies caused by bat transmission, which is common in some Central American countries. Alternatively, or in addition, more widespread pre-exposure vaccination, especially in highly endemic remote areas, could be implemented. With the multiple dose regimens of current vaccines, pre-exposure vaccination is not cost effective for most countries and this warrants the development of new rabies vaccines, which are as safe as current vaccines, but achieve protective immunity after a single dose, and most importantly, are less costly. This chapter discusses novel rabies vaccines that are in late stage pre-clinical testing or have undergone clinical testing and their potential for replacing current vaccines.

scholarly journals Hysterectomy in India: Spatial and multilevel analysis

2021 ◽  
Vol 17 ◽  
pp. 174550652110170
Author(s):  
Angad Singh ◽  
Dipti Govil
Keyword(s):  
Spatial Association ◽  
Family Health ◽  
State Level ◽  
Informed Choice ◽  
Multivariate Techniques ◽  
Life Cycle Approach ◽  
Private Hospitals ◽  
Level Data ◽  
High Prevalence ◽  
Arc Gis

Objective: Using the unit-level data of women aged 15–49 years from National Family Health Survey-IV (2015–2016), the article maps the prevalence of hysterectomy across districts in India and examines its determinants. Methods: Descriptive statistics, multivariate techniques, Moran’s Index and Local indicators of Spatial Association were used to understand the objectives. The data were analysed in STATA 14.2, Geo-Da and Arc-GIS. Results: In India, the prevalence of hysterectomy operation was 3.2%, the highest in Andhra Pradesh (8.9%) and the lowest in Assam (0.9%). Rural India had higher a prevalence than urban India. The majority of women underwent the operation in private hospitals. Hysterectomy prevalence ranged between 3% and 5% in 126 districts, 5% and 7% in 47 districts and more than 7% in 26 districts. Moran’s Index (0.58) indicated the positive autocorrelation for the prevalence of hysterectomy among districts; a total of 202 districts had significant neighbourhood association. Variation in the prevalence of hysterectomy was attributed to the factors at the primary sampling unit, district and state level. Age, parity, wealth and insurance were positively associated with the prevalence of hysterectomy, whereas education and sterilization was negatively associated. Conclusion: Hysterectomy operation in India presented the geographical, socio-economic, demographic and medical phenomenon. The high prevalence of hysterectomy in many parts of the country suggested conducting in-depth studies, considering the life cycle approach and providing counselling and education to women about their reproductive rights and informed choice. Surveillance and medical audits and promoting the judicial use of health insurance can be of great help.

Engagement Through the Diaspora Channel

2017 ◽  
Author(s):  
Michael S. Danielson
Keyword(s):  
Civil Society ◽  
Statistical Models ◽  
State Level ◽  
The State ◽  
Multivariate Statistical ◽  
Political Factors ◽  
Data Set ◽  
Level Data ◽  
Municipal Level

The first empirical task is to identify the characteristics of municipalities which US-based migrants have come together to support financially. Using a nationwide, municipal-level data set compiled by the author, the chapter estimates several multivariate statistical models to compare municipalities that did not benefit from the 3x1 Program for Migrants with those that did, and seeks to explain variation in the number and value of 3x1 projects. The analysis shows that migrants are more likely to contribute where migrant civil society has become more deeply institutionalized at the state level and in places with longer histories as migrant-sending places. Furthermore, the results suggest that political factors are at play, as projects have disproportionately benefited states and municipalities where the PAN had a stronger presence, with fewer occurring elsewhere.

Legalization of Medical Cannabis and Site of Death: Evidence From National Vital Statistics Mortality Data

2021 ◽  
pp. 073346482110587
Author(s):  
Divya Bhagianadh ◽  
Kanika Arora
Keyword(s):  
State Level ◽  
Positive Association ◽  
Vital Statistics ◽  
Mortality Data ◽  
Medical Cannabis ◽  
Difference In Differences ◽  
Early Adopters ◽  
Level Data ◽  
Hospital Deaths ◽  
Poor Outcomes

We examined whether Medical Marijuana Legislation (MML) was associated with site of death. Using state-level data (1992–2018) from the National Vital Statistics System (NVSS), we employed difference-in-differences method to compare changes in death rate among older adults at four sites—nursing home (NH), hospital, home, hospice/other—over time in states with and without MML. Heterogeneity analyses were conducted by timing of MML adoption, and by decedent characteristics. Results show a negative association between MML implementation and NH deaths. Among early adopters (states with weakly regulated programs) and decedents with musculoskeletal disorders, there was a positive association between MML implementation and hospital deaths, whereas among late adopters (states with “medicalized” programs), there was a positive association between MML implementation and hospice deaths. Decline in NH deaths may reflect increased likelihood of transfers due to threat of Federal enforcement, penalties for poor outcomes, and liability concerns. Future studies should examine these associations further.

scholarly journals The Socioeconomic Profile of Well-Funded Public Libraries: A Regression Analysis

2018 ◽  
Vol 13 (2) ◽  
pp. 13-26
Author(s):  
Michael Carlozzi
Keyword(s):  
Socioeconomic Factors ◽  
Public Libraries ◽  
Public Library ◽  
State Level ◽  
Linear Regression Models ◽  
Library Funding ◽  
Level Data ◽  
Socioeconomic Profile ◽  
Socioeconomic Data ◽  
To Receive

Abstract Objective – This study aimed to explore the well-established link between public library funding and activity, specifically to what extent socioeconomic factors could explain the correlation. Methods – State-level data from the Massachusetts Board of Library Commissioners were analyzed for 280 public libraries using two linear regression models. These public libraries were matched with socioeconomic data for their communities. Results – Confirming prior research, a library’s municipal funding correlated strongly with its direct circulation. In terms of library outputs, the municipal funding appeared to represent a library’s staffing and number of annual visitations. For socioeconomic factors, the strongest predictor of a library’s municipal appropriation was its “number of educated residents.” Other socioeconomic factors were far less important. Conclusion – Although education correlated strongly with library activity, variation within the data suggests that public libraries are idiosyncratic and that their funding is not dictated exclusively by the community’s socioeconomic profile. Library administrators and advocates can examine what libraries of similar socioeconomic profiles do to receive additional municipal funding.

scholarly journals Characterizing the mechanism behind the progression of NAFLD to hepatocellular carcinoma

2020 ◽  
pp. HEP36
Author(s):  
Pierre Nahon ◽  
Manon Allaire ◽  
Jean-Charles Nault ◽  
Valérie Paradis
Keyword(s):  
Hepatocellular Carcinoma ◽  
Fatty Liver Disease ◽  
Association Studies ◽  
Cost Effective ◽  
Genome Wide Association Studies ◽  
Alcoholic Fatty Liver ◽  
Genome Wide ◽  
High Prevalence ◽  
Prevalence Of Obesity ◽  
Alcoholic Fatty Liver Disease

Hepatocellular carcinoma (HCC) developed in non-alcoholic fatty liver disease (NAFLD) individuals presents substantial clinical and biological characteristics, which remain to be elucidated. Its occurrence in noncirrhotic patients raises issues regarding surveillance strategies, which cannot be considered as cost-effective given the high prevalence of obesity and metabolic syndrome, and furthermore delineates specific oncogenic process that could be targeted in the setting of primary or secondary prevention. In this context, the identification of a genetic heterogeneity modulating HCC risk as well as specific biological pathways have been made possible through genome-wide association studies, development of animal models and in-depth analyses of human samples at the pathological and genomic levels. These advances must be confirmed and pursued to pave the way for personalized management of NAFLD-related HCC.

scholarly journals Chronic back pain and mental disorders

2019 ◽  
Vol 11 (2S) ◽  
pp. 17-24
Author(s):  
B. A. Volel ◽  
D. S. Petelin ◽  
D. O. Rozhkov
Keyword(s):  
Back Pain ◽  
Mental Disorders ◽  
Chronic Back Pain ◽  
Negative Impact ◽  
Clinical Manifestations ◽  
Somatoform Disorder ◽  
Socioeconomic Indicators ◽  
Post Traumatic Stress ◽  
High Prevalence ◽  
Post Traumatic

Chronic back pain is a significant biomedical problem due to its high prevalence and negative impact on quality of life and socioeconomic indicators. Mental disorders play a substantial role in the genesis of chronic pain. This review discusses the issues of back pain comorbid with depressive, anxiety disorders, post-traumatic stress disorder, and somatoform disorder. It also considers the features of the clinical manifestations of pain associated with mental disorders. There are data on the neurobiological relationship between pain and mental disorders and on the personality traits of patients with chronic back pain.

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