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1.
PLoS Med ; 18(10): e1003831, 2021 10.
Article in English | MEDLINE | ID: covidwho-1477511

ABSTRACT

BACKGROUND: UNAIDS has established new program targets for 2025 to achieve the goal of eliminating AIDS as a public health threat by 2030. This study reports on efforts to use mathematical models to estimate the impact of achieving those targets. METHODS AND FINDINGS: We simulated the impact of achieving the targets at country level using the Goals model, a mathematical simulation model of HIV epidemic dynamics that includes the impact of prevention and treatment interventions. For 77 high-burden countries, we fit the model to surveillance and survey data for 1970 to 2020 and then projected the impact of achieving the targets for the period 2019 to 2030. Results from these 77 countries were extrapolated to produce estimates for 96 others. Goals model results were checked by comparing against projections done with the Optima HIV model and the AIDS Epidemic Model (AEM) for selected countries. We included estimates of the impact of societal enablers (access to justice and law reform, stigma and discrimination elimination, and gender equality) and the impact of Coronavirus Disease 2019 (COVID-19). Results show that achieving the 2025 targets would reduce new annual infections by 83% (71% to 86% across regions) and AIDS-related deaths by 78% (67% to 81% across regions) by 2025 compared to 2010. Lack of progress on societal enablers could endanger these achievements and result in as many as 2.6 million (44%) cumulative additional new HIV infections and 440,000 (54%) more AIDS-related deaths between 2020 and 2030 compared to full achievement of all targets. COVID-19-related disruptions could increase new HIV infections and AIDS-related deaths by 10% in the next 2 years, but targets could still be achieved by 2025. Study limitations include the reliance on self-reports for most data on behaviors, the use of intervention effect sizes from published studies that may overstate intervention impacts outside of controlled study settings, and the use of proxy countries to estimate the impact in countries with fewer than 4,000 annual HIV infections. CONCLUSIONS: The new targets for 2025 build on the progress made since 2010 and represent ambitious short-term goals. Achieving these targets would bring us close to the goals of reducing new HIV infections and AIDS-related deaths by 90% between 2010 and 2030. By 2025, global new infections and AIDS deaths would drop to 4.4 and 3.9 per 100,000 population, and the number of people living with HIV (PLHIV) would be declining. There would be 32 million people on treatment, and they would need continuing support for their lifetime. Incidence for the total global population would be below 0.15% everywhere. The number of PLHIV would start declining by 2023.


Subject(s)
Disease Eradication , Global Health , Goals , HIV Infections/prevention & control , Models, Biological , Models, Theoretical , Public Health , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/therapy , Adolescent , Adult , COVID-19 , Cause of Death , Epidemics , Female , HIV Infections/epidemiology , HIV Infections/therapy , Humans , Incidence , Male , SARS-CoV-2 , Social Determinants of Health , United Nations , Young Adult
2.
Clin Gastroenterol Hepatol ; 19(7): 1512, 2021 07.
Article in English | MEDLINE | ID: covidwho-1306894
3.
Zool Res ; 42(3): 335-338, 2021 May 18.
Article in English | MEDLINE | ID: covidwho-1231642

ABSTRACT

The global outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as of 8 May 2021, has surpassed 150 700 000 infections and 3 279 000 deaths worldwide. Evidence indicates that SARS-CoV-2 RNA can be detected on particulate matter (PM), and COVID-19 cases are correlated with levels of air pollutants. However, the mechanisms of PM involvement in the spread of SARS-CoV-2 remain poorly understood. Here, we found that PM exposure increased the expression level of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in several epithelial cells and increased the adsorption of the SARS-CoV-2 spike protein. Instillation of PM in a hACE2 mouse model significantly increased the expression of ACE2 and Tmprss2 and viral replication in the lungs. Furthermore, PM exacerbated the pulmonary lesions caused by SARS-CoV-2 infection in the hACE2 mice. In conclusion, our study demonstrated that PM is an epidemiological factor of COVID-19, emphasizing the necessity of wearing anti-PM masks to cope with this global pandemic.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/chemically induced , COVID-19/immunology , Particulate Matter/adverse effects , SARS-CoV-2 , Adsorption/drug effects , Animals , Disease Susceptibility/chemically induced , Disease Susceptibility/immunology , Epithelial Cells/metabolism , Mice , Mice, Inbred Strains , Particulate Matter/chemistry , RNA, Viral/analysis , SARS-CoV-2/genetics , Serine Endopeptidases/metabolism , Spike Glycoprotein, Coronavirus/metabolism , Virus Internalization/drug effects
4.
Appl Clin Inform ; 12(2): 266-273, 2021 03.
Article in English | MEDLINE | ID: covidwho-1171630

ABSTRACT

OBJECTIVE: The coronavirus disease (COVID-19) is an emerging infectious disease with strong infectious power and fatality rate. To protect national health, government agencies have regulations on hospital chaperoning and visiting. This article presents the development and implementation of a monitoring system for hospital visiting and chaperoning during the COVID-19 pandemic. The study aimed to create a hospital visiting and chaperoning monitor system that uses nation-wide data sources to more accurately screen hospital visitors and chaperones, assist contract tracing, and prevent transmission of severe acute respiratory syndrome coronavirus 2. METHODS: This project was implemented in 57 ward units of an academic medical center. The system was connected to the National Health Insurance (NHI) system and Hospital Information System (HIS), and built on the data of everyone who accessed either the hospital or ward using an NHI smart card or national identification card. To shorten the time for manual identification, we also developed a new system of "app for appointment visits and chaperones" to make appointments online. RESULTS: After the implementation of the system, data from visitors and chaperones in the nursing information system could be accessed. Given that all data were registered in the HIS visiting/chaperoning monitor system, an epidemic investigation could be performed whenever there was a confirmed case. CONCLUSION: Through the establishment of this system, people entering the ward can be accurately controlled, and all the contacts of potential cases can be traced.


Subject(s)
COVID-19/epidemiology , Hospitals , Medical Chaperones , Pandemics , Visitors to Patients , Humans , SARS-CoV-2/physiology
5.
Lancet HIV ; 7(9): e629-e640, 2020 09.
Article in English | MEDLINE | ID: covidwho-695906

ABSTRACT

BACKGROUND: The COVID-19 pandemic could lead to disruptions to provision of HIV services for people living with HIV and those at risk of acquiring HIV in sub-Saharan Africa, where UNAIDS estimated that more than two-thirds of the approximately 38 million people living with HIV resided in 2018. We aimed to predict the potential effects of such disruptions on HIV-related deaths and new infections in sub-Saharan Africa. METHODS: In this modelling study, we used five well described models of HIV epidemics (Goals, Optima HIV, HIV Synthesis, an Imperial College London model, and Epidemiological MODeling software [EMOD]) to estimate the effect of various potential disruptions to HIV prevention, testing, and treatment services on HIV-related deaths and new infections in sub-Saharan Africa lasting 6 months over 1 year from April 1, 2020. We considered scenarios in which disruptions affected 20%, 50%, and 100% of the population. FINDINGS: A 6-month interruption of supply of antiretroviral therapy (ART) drugs across 50% of the population of people living with HIV who are on treatment would be expected to lead to a 1·63 times (median across models; range 1·39-1·87) increase in HIV-related deaths over a 1-year period compared with no disruption. In sub-Saharan Africa, this increase amounts to a median excess of HIV deaths, across all model estimates, of 296 000 (range 229 023-420 000) if such a high level of disruption occurred. Interruption of ART would increase mother-to-child transmission of HIV by approximately 1·6 times. Although an interruption in the supply of ART drugs would have the largest impact of any potential disruptions, effects of poorer clinical care due to overstretched health facilities, interruptions of supply of other drugs such as co-trimoxazole, and suspension of HIV testing would all have a substantial effect on population-level mortality (up to a 1·06 times increase in HIV-related deaths over a 1-year period due to disruptions affecting 50% of the population compared with no disruption). Interruption to condom supplies and peer education would make populations more susceptible to increases in HIV incidence, although physical distancing measures could lead to reductions in risky sexual behaviour (up to 1·19 times increase in new HIV infections over a 1-year period if 50% of people are affected). INTERPRETATION: During the COVID-19 pandemic, the primary priority for governments, donors, suppliers, and communities should focus on maintaining uninterrupted supply of ART drugs for people with HIV to avoid additional HIV-related deaths. The provision of other HIV prevention measures is also important to prevent any increase in HIV incidence. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
Anti-HIV Agents/supply & distribution , Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , HIV Infections/epidemiology , Models, Statistical , Pandemics , Pneumonia, Viral/epidemiology , Africa South of the Sahara/epidemiology , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active , COVID-19 , Condoms/supply & distribution , Coronavirus Infections/mortality , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Global Health/trends , HIV Infections/mortality , HIV Infections/transmission , HIV Infections/virology , HIV-1/drug effects , HIV-1/growth & development , Humans , Incidence , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , Pneumonia, Viral/mortality , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Survival Analysis
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