Prevalence and surveillance of tuberculosis in Yemen from 2006 to 2018.

Tuberculosis is a major public health issue in Yemen, a country located at the southwestern tip of the Arabian Peninsula, while the situation of tuberculosis had been further exacerbated since the war started in 2015. The objective of this study is to investigate the incidence of tuberculosis in Yemen before the outbreak of COVID-19, from 2006 to 2018. During the 13-year period, 92 482 patients were enrolled in the TB programme records from the 22 governorates. Almost equal number of cases were diagnosed between males and females (a male to female ratio, 1.03:1). A notable rising incidence was observed in all age groups starting from 2011. The sharpest increase occurred in children under age 15, rising by 8.0-fold from 0.5 in the period 2006-2010 to 4.1 in the period 2011-2018. Paediatric TB accounted for 9.6% of all reported cases. In terms of the patient residence, incidence has more than doubled in Sana'a city, Sana'a Gov., Hajjah and Saadah. Concomitant diseases with tuberculosis included diabetes mellitus (14.0%), brucellosis (6.1%), hepatitis (6.0%), rheumatoid arthritis (4.3%), renal disorders (2.5%) and HIV infection (2.5%). Development of interventions to reduce tuberculosis incidence in children and concomitant communicable diseases is urgently needed.

Optimization of medical waste recycling network considering disposal capacity bottlenecks under a novel coronavirus pneumonia outbreak.

The sudden outbreak and prolonged impact of the global novel coronavirus disease (COVID-19) epidemic has caused an increase in demand for medical products, such as masks and protective clothing, leading to an exponential increase in the generation of medical waste. As medical waste under the epidemic is highly infectious, it poses a great danger to human health. Therefore, with the proliferation of medical waste, it has become crucial to construct a reverse logistics recycling network that can handle medical waste quickly and efficiently. In this study, we construct a multi-period medical waste emergency reverse logistics network siting model with the objectives of minimum cost, minimum safety risk, and minimum time for the safe and quick disposal of medical waste. The model considers disposal capacity bottlenecks of existing facilities. Based on an empirical analysis using the COVID-19 epidemic in New York City, USA, as a case study, we find that the use of a suitable number of synergistic facilities and the establishment of temporary medical waste disposal centers are viable options for handling the dramatic increase in medical waste during the peak of the COVID-19 epidemic.