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1.
J Acquir Immune Defic Syndr ; 85(1): 1-5, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-2323677

ABSTRACT

BACKGROUND: Given the magnitude of the global COVID-19 pandemic, persons living with HIV (PLWH) may become coinfected with SARS-CoV-2. SETTING: We conducted a survey in Wuhan, China, to characterize the status of coinfected PLWH, their time to clinical improvement, and clinical prognoses. METHODS: Using a Wuhan shipping service for antiretroviral medications, the Wuhan LGBT Center screened 2900 PLWH shipping addresses and cross-referenced 36 of them to quarantine sites or hospitals, suggesting possible COVID-19 cases. Through telephone calls and WeChat (social media) messaging, we conducted a survey after obtaining online informed consent. RESULTS: We had 12 HIV-infected respondents (10 men and 2 women) who also reported COVID-19. The median age was 36 years (interquartile range: 33.0-56.3), mean age 42.4 years, and range 25-66 years of age. Nine of 10 persons on antiretroviral therapy (ART) presented with only mild COVID-19 symptoms. The 10th person on ART was a 56-year-old man who died at home early in the outbreak when health care services were overwhelmed. Two additional cases who had been in intensive care with acute COVID-19 were both men, aged 25 and 37 years; both were ART-naive until this hospitalization. Excluding the deceased man, 6 of 11 coinfected persons reported feeling depressed even after clinical improvements. CONCLUSION: Twelve coinfected persons were identified in Wuhan; 9 of 10 were on long-term ART and had favorable outcomes. Two men identified as having started ART only recently were found to have severe symptoms. Our case series suggests the value of ART for potential mitigation of COVID-19 coinfection.


Subject(s)
Betacoronavirus , Coinfection/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , HIV Infections/complications , HIV Infections/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Adult , Aged , COVID-19 , China/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2
2.
Trans R Soc Trop Med Hyg ; 117(6): 470-472, 2023 06 02.
Article in English | MEDLINE | ID: covidwho-2311381

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has dominated global health discourse since early 2020. By early 2021, the unprecedented speed of vaccine development against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by government, academia and industry contributed biotechnological tools to reduce severe COVID-19 infections, hospitalizations and deaths. However, vaccine distribution has not been equitable. We address one element of this challenge, namely the low COVID-19 vaccination rates in African countries, which lag behind higher-income nations. We evaluate key obstacles to initiatives addressing this inequity and emphasize Africa-based research and development as a sustainable solution to ensuring vaccine equity in Africa.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Africa/epidemiology , Hospitalization
3.
Open Forum Infect Dis ; 10(3): ofad075, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2276201

ABSTRACT

Background: A continuing nationwide vaccination campaign began in the Dominican Republic on February 16, 2021 to prevent severe consequences of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Estimates of vaccine effectiveness under real-world conditions are needed to support policy decision making and inform further vaccine selection. Methods: We conducted a test-negative case-control study to assess the real-world effectiveness of nationwide coronavirus disease 2019 (COVID-19) vaccination program using an inactivated vaccine (CoronaVac) on preventing symptomatic SARS-CoV-2 infections and hospitalizations from August to November 2021 in the Dominican Republic. Participants were recruited from 10 hospitals in 5 provinces to estimate the effectiveness of full immunization (≥14 days after receipt of the second dose) and partial immunization (otherwise with at least 1 dose ≥14 days after receipt of the first dose). Results: Of 1078 adult participants seeking medical care for COVID-19-related symptoms, 395 (36.6%) had positive polymerase chain reaction (PCR) tests for SARS-CoV-2; 142 (13.2%) were hospitalized during 15 days of follow up, including 91 (23%) among 395 PCR-positive and 51 (7.5%) among 683 PCR-negative participants. Full vaccination was associated with 31% lower odds of symptomatic infection (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.52-0.93) and partial vaccination was associated with 49% lower odds (OR, 0.51; CI, 0.30-0.86). Among 395 PCR-positive participants, full vaccination reduced the odds of COVID-19-related hospitalization by 85% (OR, 0.15; 95% CI, 0.08-0.25) and partial vaccination reduced it by 75% (OR, 0.25; 95% CI, 0.08-0.80); full vaccination was associated with reduced use of assisted ventilation by 73% (OR, 0.27; 95% CI, 0.15-0.49). Conclusions: Given the ancestral and delta viral variants circulating during this study period, our results suggest that the inactivated COVID-19 vaccine offered moderate protection against symptomatic SARS-CoV-2 infections and high protection against COVID-19-related hospitalizations and assisted ventilation. This is reassuring given that, as of August 2022, an estimated 2.6 billion inactivated CoronaVac vaccine doses had been administered worldwide. This vaccine will become a basis for developing multivalent vaccine against the currently circulating omicron variant.

4.
Sci Transl Med ; 15(683): eade6023, 2023 02 15.
Article in English | MEDLINE | ID: covidwho-2240695

ABSTRACT

The emergence of the SARS-CoV-2 Omicron sublineages resulted in increased transmission rates and reduced protection from vaccines. To counteract these effects, multiple booster strategies were used in different countries, although data comparing their efficiency in improving protective immunity remain sparse, especially among vulnerable populations, including older adults. The inactivated CoronaVac vaccine was among the most widely distributed vaccine worldwide and was essential in the early control of SARS-CoV-2-related hospitalizations and deaths. However, it is not well understood whether homologous versus heterologous booster doses in those fully vaccinated with CoronaVac induce distinct humoral responses or whether these responses vary across age groups. We analyzed plasma antibody responses from CoronaVac-vaccinated younger or older individuals who received a homologous CoronaVac or heterologous BNT162b2 or ChAdOx1 booster vaccine. All three evaluated boosters resulted in increased virus-specific IgG titers 28 days after the booster dose. However, we found that both IgG titers against SARS-CoV-2 Spike or RBD and neutralization titers against Omicron sublineages were substantially reduced in participants who received homologous CoronaVac compared with the heterologous BNT162b2 or ChAdOx1 booster. This effect was specifically prominent in recipients >50 years of age. In this group, the CoronaVac booster induced low virus-specific IgG titers and failed to elevate neutralization titers against any Omicron sublineage. Our results point to the notable inefficiency of CoronaVac immunization and boosting in mounting protective antiviral humoral immunity, particularly among older adults, during the Omicron wave. These observations also point to benefits of heterologous regimens in high-risk populations fully vaccinated with CoronaVac.


Subject(s)
Antibody Formation , COVID-19 , Humans , Aged , BNT162 Vaccine , SARS-CoV-2 , Immunoglobulin G , Antibodies, Viral
5.
Sci Rep ; 12(1): 20763, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2133618

ABSTRACT

This meta-analysis aims to synthesize global evidence on the risk of reinfection among people previously infected with SARS-CoV-2. We systematically searched PubMed, Scopus, Embase and Web of Science as of April 5, 2021. We conducted: (1) meta-analysis of cohort studies containing data sufficient for calculating the incidence rate of SARS-CoV-2 reinfection; (2) systematic review of case reports with confirmed SARS-CoV-2 reinfection cases. The reinfection incidence was pooled by zero-inflated beta distribution. The hazard ratio (HR) between reinfection incidence among previously infected individuals and new infection incidence among infection-naïve individuals was calculated using random-effects models. Of 906 records retrieved and reviewed, 11 studies and 11 case reports were included in the meta-analysis and the systematic review, respectively. The pooled SARS-CoV-2 reinfection incidence rate was 0.70 (standard deviation [SD] 0.33) per 10,000 person-days. The incidence of reinfection was lower than the incidence of new infection (HR = 0.12, 95% confidence interval 0.09-0.17). Our meta-analysis of studies conducted prior to the emergency of the more transmissible Omicron variant showed that people with a prior SARS-CoV-2 infection could be re-infected, and they have a lower risk of infection than those without prior infection. Continuing reviews are needed as the reinfection risk may change due to the rapid evolution of SARS-CoV-2 variants.


Subject(s)
COVID-19 , Reinfection , Humans , Reinfection/epidemiology , SARS-CoV-2 , COVID-19/epidemiology , PubMed
6.
Expert Rev Vaccines ; 21(9): 1269-1287, 2022 09.
Article in English | MEDLINE | ID: covidwho-1873754

ABSTRACT

INTRODUCTION: Migration can be linked to the transmission of vaccine-preventable diseases. Hence, monitoring migrants' vaccination-related concerns can inform needed interventions to support vaccine acceptance. AREAS COVERED: Along with Google and Google Scholar, we searched 13 bibliographic databases between 1 January 2000 and 10 October 2020, to identify published studies of vaccine hesitancy among migrant populations. From a total of 8,915 records, we screened 745 abstracts and included 112 eligible articles. We summarized extracted data using figures, tables, and narrations. Of the 112 articles, 109 were original quantitative (48%), qualitative (45%), and mixed-methods (7%) research, originating mainly from the United States (US) (68%), the United Kingdom (UK) (12%), and Scandinavia (6%). Most articles addressed human papillomavirus (63%), measles (13%), and influenzas (9%) vaccinations, and the leading sponsor of funded research was the US National Institutes of Health (50%). Discernable migrant groups with vaccine-specific concerns included Somali diasporas, UK-based Poles and Romanians, and US-based Haitians and Koreans. Among US-based Latina/Latino immigrants, lower vaccine uptake frequency was mostly associated with awareness levels, knowledge gaps, and uninsured status. EXPERT OPINION: Migrants' vaccine-related apprehensions may cascade well beyond their proximate social connections and influence vaccine attitudes and behaviors in their countries-of-origin.


Subject(s)
Transients and Migrants , Vaccine-Preventable Diseases , Vaccines , Humans , United States , Vaccination , Vaccination Hesitancy
7.
PLoS Biol ; 20(5): e3001506, 2022 05.
Article in English | MEDLINE | ID: covidwho-1862232

ABSTRACT

The impact of Coronavirus Disease 2019 (COVID-19) mRNA vaccination on pregnancy and fertility has become a major topic of public interest. We investigated 2 of the most widely propagated claims to determine (1) whether COVID-19 mRNA vaccination of mice during early pregnancy is associated with an increased incidence of birth defects or growth abnormalities; and (2) whether COVID-19 mRNA-vaccinated human volunteers exhibit elevated levels of antibodies to the human placental protein syncytin-1. Using a mouse model, we found that intramuscular COVID-19 mRNA vaccination during early pregnancy at gestational age E7.5 did not lead to differences in fetal size by crown-rump length or weight at term, nor did we observe any gross birth defects. In contrast, injection of the TLR3 agonist and double-stranded RNA mimic polyinosinic-polycytidylic acid, or poly(I:C), impacted growth in utero leading to reduced fetal size. No overt maternal illness following either vaccination or poly(I:C) exposure was observed. We also found that term fetuses from these murine pregnancies vaccinated prior to the formation of the definitive placenta exhibit high circulating levels of anti-spike and anti-receptor-binding domain (anti-RBD) antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) consistent with maternal antibody status, indicating transplacental transfer in the later stages of pregnancy after early immunization. Finally, we did not detect increased levels of circulating anti-syncytin-1 antibodies in a cohort of COVID-19 vaccinated adults compared to unvaccinated adults by ELISA. Our findings contradict popular claims associating COVID-19 mRNA vaccination with infertility and adverse neonatal outcomes.


Subject(s)
COVID-19 , Animals , Antibodies, Viral , COVID-19/prevention & control , Female , Fetus , Gene Products, env , Humans , Mice , Placenta/metabolism , Pregnancy , Pregnancy Proteins , RNA, Messenger/genetics , RNA, Messenger/metabolism , SARS-CoV-2 , Vaccination
8.
Curr HIV/AIDS Rep ; 19(3): 167-176, 2022 06.
Article in English | MEDLINE | ID: covidwho-1782945

ABSTRACT

PURPOSE OF REVIEW: The impact of HIV infection on the natural history of COVID-19 is unknown, given the recency of the human spread of SARS-CoV-2 (CoV). We reviewed published case series/reports of CoV-HIV coinfections to clarify epidemiologic and clinical features in China, the first nation with pandemic experience. RECENT FINDINGS: Assuming that HIV-infected persons were at average risk of CoV infection in Wuhan, we estimated HIV-CoV coinfected persons to number 412 (95%CI: 381-442); our review encompassed an estimated 16.7% (69/412) of Wuhan. Men (many of whom reported sex with other men) accounted for 71.1% (54/76) of the cases reported in China. The median age was 48.0 years old (range 24-77, interquartile:37-57). The median CD4+ cell count at the last clinical visit was 421 cells/µL; 83.0% had an undetectable viral load. Among 31 patients with clinical details reported, fatigue (41.9%), respiratory distress (41.9%), and gastrointestinal symptoms (26.7%) were most common. Among the 52 cases reporting COVID-19 clinical severity, 46.2% were severe, 44.2% mild, and 9.6% asymptomatic COVID-19. Late antiretroviral therapy (ART) was reported by 30.4% (7/23) among whom 57.1% (4/7) were confirmed as severe COVID-19. The case fatality rate was 9.1% (3/33). Severe disease and death were less common among persons who took ART prior to the COVID-19 diagnosis. Of 16 reported IL-6 results, 68.7% were within the normal range. Earlier use of ART was associated with a better COVID-19 prognosis with CoV-HIV co-infection reported from China through early 2021, but small sample sizes limit definitive conclusions.


Subject(s)
COVID-19 , HIV Infections , Adult , Aged , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing , China/epidemiology , HIV Infections/complications , HIV Infections/diagnosis , HIV Infections/drug therapy , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Young Adult
9.
BMJ Open ; 12(2): e054292, 2022 02 02.
Article in English | MEDLINE | ID: covidwho-1765123

ABSTRACT

OBJECTIVE: The objective of this scoping review is to provide an overview of existing studies and evidence on the impact of school closures and reopenings during the pandemic. INTRODUCTION: The COVID-19 pandemic has necessitated widespread school closures, and reopening schools safely has a pivotal role in the well-being of children and teachers, SARS-CoV-2 transmission control and optimal societal functioning. Widespread school closures in response to the COVID-19 pandemic have caused adverse effects on the education, physical health and mental well-being of children. An understanding of the impact of school closures and reopenings as well as factors influencing school safety is critical to bringing schools' operational status back to normal. Despite the implication of individual concerns and knowledge on disease prevention practices, there is a paucity of research on individual knowledge, needs and behaviours in the context of school reopenings. In the proposed study, we will conduct a scoping review to identify and provide inventory of the current research and evidence on the impact of COVID-19 on K-12 schools (primary and secondary schools) and vice versa. METHODS AND ANALYSIS: Eligible studies/literature include members of K-12 (primary and secondary) schools (students, parents, staff, faculty, COVID-19 coordinator, school nurses) in countries affected by the COVID-19 pandemic. We will exclude university or college students. There will be no exclusion based on methods, timing or school operational status.All concepts regarding school closures and reopenings will be considered, and all types of research will be considered.This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews. Sources of evidence published from 2020 to 31 October 2021 will be included. The search will include PubMed, preprints in EuropePMC, ERIC, Scopus, Web of Science Core Collection, PsycINFO, Embase, CINAHL and VHL. We will cover grey literature in Harvard Think Tank Database, COVID-19 Evidence Hub like COVID-END and Google Scholar. The abstract and title screening, full-text screening and data extraction will be done by two independent reviewers.Disagreements will be resolved by an independent third reviewer. Data extract will be done on Qualtrics form to ensure accurate extraction. Citation chaining will be performed on key articles identified. A critical appraisal will be performed.The scoping review will take place from 1 August 2021 to 15 November 2021. We will perform a final round of updated search and citation chaining. ETHICS AND DISSEMINATION: The review will be based on published works and grey literature, thus it is exempt from formal ethical approval. This protocol cannot be registered in the Prospective Register of Systematic Reviews because this registry is not for scoping reviews. We will register it in OSF Registration. The paper will appear in a peer-reviewed, open-access journal to ensure a broad dissemination.


Subject(s)
COVID-19 , Child , Humans , Pandemics/prevention & control , Research Design , Review Literature as Topic , SARS-CoV-2 , Schools , Systematic Reviews as Topic
10.
Vaccines (Basel) ; 10(3)2022 Mar 15.
Article in English | MEDLINE | ID: covidwho-1742770

ABSTRACT

To address the novel coronavirus disease (COVID-19) pandemic, development and regulatory evaluations have been accelerated for vaccines, authorizing emergency use. To anticipate vaccine preparedness in adolescents, we studied COVID-19 vaccination awareness and willingness to vaccinate before the vaccine became available. We conducted a cross-sectional survey among 9153 (4575 boys, 50%) students with a mean age of 14.2 years old in four cities in China to collect information on demographic characteristics and their COVID-19 vaccination concerns. Multinomial logistic regression was used to analyze the influencing factors of vaccine hesitancy ("not sure") and resistance ("do not want it"). The results showed that 2891 (31.6%) were hesitant and 765 (8.4%) were resistant to being vaccinated. Additionally, multivariable analyses showed that vaccine hesitancy and vaccine resistance were associated with living in the Beijing area (OR = 1.62; 95% CI: 1.40-1.88; OR = 1.81; 95% CI: 1.44-2.28), lack of influenza vaccination experience (OR = 1.33; 95% CI: 1.14-1.55; OR = 1.57; 95% CI: 1.25-1.98), no perceived susceptibility (OR = 1.72; 95% CI: 1.50-1.97; OR = 3.57; 95% CI: 2.86-4.46), and perceiving no cues to action (OR = 3.24; 95% CI: 2.56-4.11; OR = 27.68; 95% CI: 21.81-35.13). Postulating a highly effective vaccine (OR = 0.84; 95% CI: 0.72-0.98; OR = 0.66; 95% CI: 0.52-0.83) decreased both vaccine hesitancy and resistance. Vaccine hesitancy alone was associated with girls (OR = 1.21; 95% CI: 1.09-1.36) and was less common among students boarding at school (OR = 0.79; 95% CI: 0.68-0.92), postulating convenient vaccine access (OR = 0.84; 95% CI: 0.73-0.96), and having doctors' recommendation (OR = 0.86; 95% CI: 0.76-0.98). In conclusion, the results of the study showed that vaccine hesitancy among students in China was associated with limited health literacy and lower risk awareness. Our findings in China suggest that educating youth regarding COVID-19 and the safety and effectiveness of immunization help reduce concerns and increase vaccine confidence and acceptance.

11.
Curr HIV/AIDS Rep ; 19(1): 1-4, 2022 02.
Article in English | MEDLINE | ID: covidwho-1700041

ABSTRACT

PURPOSE OF REVIEW: This editorial introduces this special Global Health Section on the interface of the HIV/AIDS and COVID-19 pandemics. RECENT FINDINGS: Authors of articles in this special issue take on a variety of topics that capture how the acute COVID-19 pandemic affected global efforts towards HIV control, and how co-infection, stigma, and social determinants of disease have affected populations on multiple continents. Two historic pandemics -- HIV/AIDS and COVID-19 -- have affected the world in our lifetimes at a level reminiscent of the 1918-1919 H1N1 influenza pandemic. We have much to learn from both experiences to optimize pandemic disease control, prevention, and management.


Subject(s)
COVID-19 , HIV Infections , Influenza A Virus, H1N1 Subtype , COVID-19/epidemiology , HIV Infections/epidemiology , Humans , Pandemics , SARS-CoV-2
12.
Nat Med ; 28(3): 481-485, 2022 03.
Article in English | MEDLINE | ID: covidwho-1636460

ABSTRACT

The recent emergence of the SARS-CoV-2 Omicron variant is raising concerns because of its increased transmissibility and its numerous spike mutations, which have the potential to evade neutralizing antibodies elicited by COVID-19 vaccines. Here we evaluated the effects of a heterologous BNT162b2 mRNA vaccine booster on the humoral immunity of participants who had received a two-dose regimen of CoronaVac, an inactivated vaccine used globally. We found that a heterologous CoronaVac prime vaccination of two doses followed by a BNT162b2 booster induces elevated virus-specific antibody levels and potent neutralization activity against the ancestral virus and the Delta variant, resembling the titers obtained after two doses of mRNA vaccines. Although neutralization of Omicron was undetectable in participants who had received a two-dose regimen of CoronaVac, the BNT162b2 booster resulted in a 1.4-fold increase in neutralization activity against Omicron compared with the two-dose mRNA vaccine. Despite this increase, neutralizing antibody titers were reduced by 7.1-fold and 3.6-fold for Omicron compared with the ancestral strain and the Delta variant, respectively. These findings have immediate implications for multiple countries that previously used a CoronaVac regimen and reinforce the idea that the Omicron variant is associated with immune escape from vaccines or infection-induced immunity, highlighting the global need for vaccine boosters to combat the impact of emerging variants.


Subject(s)
BNT162 Vaccine , COVID-19 , Antibodies, Neutralizing , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines , Humans , SARS-CoV-2/genetics , Vaccination , Vaccines, Synthetic , mRNA Vaccines
13.
Int J Environ Res Public Health ; 18(20)2021 10 13.
Article in English | MEDLINE | ID: covidwho-1470834

ABSTRACT

In Sub-Saharan Africa, communicable and other tropical infectious diseases remain major challenges apart from the continuing HIV/AIDS epidemic. Recognition and prevalence of non-communicable diseases have risen throughout Africa, and the reimagining of healthcare delivery is needed to support communities coping with not only with HIV, tuberculosis, and COVID-19, but also cancer, cardiovascular disease, diabetes, and depression. Many non-communicable diseases can be prevented or treated with low-cost interventions, yet implementation of such care has been limited in the region. In this Perspective piece, we argue that deployment of an integrated service delivery model is an urgent next step, propose a South African model for integration, and conclude with recommendations for next steps in research and implementation. An approach that is inspired by South African experience would build on existing HIV-focused infrastructure that has been developed by Ministries of Health with strong support from the U.S. President's Emergency Response for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. An integrated chronic healthcare model holds promise to sustainably deliver infectious disease and non-communicable disease care. Integrated care will be especially critical as health systems seek to cope with the unprecedented challenges associated with COVID-19 and future pandemic threats.


Subject(s)
COVID-19 , HIV Infections , Africa South of the Sahara/epidemiology , Chronic Disease , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Humans , Pandemics , SARS-CoV-2
15.
Front Public Health ; 9: 720264, 2021.
Article in English | MEDLINE | ID: covidwho-1456302

ABSTRACT

Socially and economically disadvantaged racial and ethnic minorities have experienced comparatively severe clinical outcomes from the coronavirus disease (COVID-19) pandemic in the United States. Disparities in health outcomes arise from a myriad of synergistic biomedical and societal factors. Syndemic theory provides a useful framework for examining COVID-19 and other diseases that disproportionately affect vulnerable populations. Syndemic models ground research inquiries beyond individual clinical data to include non-biological community-based drivers of SARS-CoV-2 infection risk and severity of disease. Given the importance of such economic, environmental, and sociopolitical drivers in COVID-19, our aim in this Perspective is to examine entrenched racial and ethnic health inequalities and the magnitude of associated disease burdens, economic disenfranchisement, healthcare barriers, and hostile sociopolitical contexts-all salient syndemic factors brought into focus by the pandemic. Systemic racism persists within long-term care, health financing, and clinical care environments. We present proximal and distal public policy strategies that may mitigate the impact of this and future pandemics.


Subject(s)
COVID-19 , Ethnicity , Humans , Minority Groups , SARS-CoV-2 , Syndemic , United States/epidemiology
16.
Int J Infect Dis ; 104: 510-525, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1454176

ABSTRACT

BACKGROUND: Human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV) are substantial public health threats in the region of Central Asia and the Caucasus, where the prevalence of these infections is currently rising. METHODS: A systematic review of MEDLINE, Embase and PsycINFO was conducted with no publication date or language restrictions through October 2019. Additional data were also harvested from national surveillance reports, references found in discovered sources, and other "grey" literature. It included studies conducted on high-risk populations (people who inject drugs (PWID), female sex workers (FSW), men who have sex with men (MSM), prisoners, and migrants) in Central Asia: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan; and the Caucasus: Armenia, Azerbaijan, Georgia, and Northern Caucasus region of the Russian Federation. RESULTS: Wide ranges were noted for HIV prevalence: PWID 0-30.1%, MSM 0-25.1%, prisoners 0-22.8%, FSW 0-10.0%, and migrants 0.06-1.5%, with the highest prevalence of these high-risk groups reported in Kazakhstan (for PWID), Georgia (for MSM and prisoners) and Uzbekistan (for migrants). HCV prevalence also had a wide range: PWID 0.3-92.1%, MSM 0-18.9%, prisoners 23.8-49.7%, FSW 3.3-17.8%, and migrants 0.5-26.5%, with the highest prevalence reported in Georgia (92.1%), Kyrgyzstan (49.7%), and migrants from Tajikistan and Uzbekistan (26.5%). Similarly, HBV prevalence had a wide range: PWID 2.8-79.7%, MSM 0-22.2%, prisoners 2.7-6.2%, FSW 18.4% (one study), and migrants 0.3-15.7%. CONCLUSION: In Central Asia and the Caucasus, prevalence of HIV, HCV and HBV remains exceedingly high among selected populations, notably PWID and MSM.


Subject(s)
HIV Infections/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Asia, Central/epidemiology , Female , Homosexuality, Male , Humans , Male , Prevalence , Prisoners , Risk Factors , Russia/epidemiology , Sex Workers , Sexual and Gender Minorities , Substance-Related Disorders/complications , Transcaucasia/epidemiology
18.
Adv Exp Med Biol ; 1318: 785-813, 2021.
Article in English | MEDLINE | ID: covidwho-1222747

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic shook the world in ways not seen since the pandemic influenza of 1918-1919. As of late August 2020, over 25 million persons had been infected, and we will see the global death toll exceed one million by the end of 2020. Both are minimum estimates. All segments of society have been drastically affected. Schools worldwide have been forced to close due to illness and absenteeism, transmission and risk to vulnerable members of the school community, and community concerns. The decision to reopen school during a pandemic will have a tremendous impact on children's safety, growth, and well-being. Not opening invites social isolation and suboptimal educational experiences, especially for youth whose computing assets and online access are limited and those with special needs. The opening has hazards as well, and the mitigation of these risks is the topic of this chapter. Opening schools requires careful considerations of benefits, risks, and precautions. Guiding principles for safety and strategic application of the principles in each educational niche are critical issues to consider during school reopening. The fundamental principles of disease control involve school-directed initiatives (physical distancing and mask use, hand/face and surface cleansing, administrative controls, engineering controls) and individual-level risk reduction approaches to maximize adherence to new guidelines. The school-initiated "top-down" approaches and the individual-level "bottom-up" approaches must be synergized, as no single method will ensure safety. We discuss how to effectively layer strategies in each educational space to increase safety. Since the vulnerability of children has been heightened during this pandemic crisis, we highlight the special considerations for mental health support that should be considered by schools. The safety principles, disease control strategies, and other critical issues discussed here will serve as a starting point for developing a safe, comprehensive, and feasible reopening plan.


Subject(s)
COVID-19 , Influenza, Human , Adolescent , Child , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , SARS-CoV-2 , Schools
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