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1.
Przegl Epidemiol ; 76(2): 243-254, 2022.
Article in English | MEDLINE | ID: covidwho-2067623

ABSTRACT

OBJECTIVE: Aim of the study was the assessment of hepatitis B epidemiological situation in Poland in 2019 compared to previous years, taking into consideration the impact of the COVID-19 pandemic during that time. MATERIAL AND METHODS: Data for 2020 included in individual reports on hepatitis B and HBV infections recorded by sanitary and epidemiological stations at EpiBaza, i.e. in the electronic epidemiological surveillance system on infectious diseases, were analyzed. In the assessment of the epidemiological situation, data published in the annual bulletins: "Infectious diseases and poisonings in Poland in 2020" and "Vaccinations in Poland in 2020" were also used. Data on deaths were obtained from the Statistics Poland (GUS). RESULTS: In 2020, 2,854 cases of hepatitis B were reported, which corresponds to the incidence of 2.59 per 100,000 population, lower by 65.1% than in 2019. 14 cases of acute hepatitis B were reported, constituting 1.4% of all registered cases. The incidence of acute hepatitis B was 0.04 per 100,000 population and was lower by 67% compared to 2019 and lower by 71% compared to the median for the years 2014-2018. There were no cases of acute disease in the age group 0-29 years. A total of 978 chronic and unknown hepatitis B cases (UNK) were registered and the diagnosis rate was 2.56 per 100,000 population, lower by 64.2% than in 2019. Compared to the median diagnosis rate of chronic hepatitis B in 2014-2018, a decrease of 70.4% was observed. In the age group 0-19 years, there was no case reported. In 2020, 24 people died due to hepatitis B, including 22 from chronic hepatitis B. CONCLUSIONS: The COVID-19 pandemic resulted in a significant reduction in the number of HBV tests performed and, consequently, a reduction in the number of diagnosed infections. A decrease in the number of detected infections was observed from the second quarter of 2020, i.e. from the beginning of the COVID-19 pandemic, although already in the first quarter of 2020 the number of registered hepatitis B cases was lower than in the same period in 2019. No acute cases were reported among people who were vaccinated against hepatitis B during childhood. Vaccination with three doses of hepatitis B vaccine in children in the second year of life was only slightly lower than in 2019, which proves the stability of the implementation of the preventive vaccination program, despite the limited access to primary health care during the pandemic.


Subject(s)
COVID-19 , Communicable Diseases , Hepatitis B, Chronic , Hepatitis B , Adolescent , Age Distribution , COVID-19/epidemiology , Child , Child, Preschool , Communicable Diseases/epidemiology , Disease Outbreaks , Hepatitis B/epidemiology , Hepatitis B/prevention & control , Hepatitis B Vaccines/therapeutic use , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/prevention & control , Humans , Incidence , Infant , Infant, Newborn , Pandemics , Poland/epidemiology , Registries , Rural Population , Urban Population , Young Adult
2.
Przegl Epidemiol ; 76(2): 233-242, 2022.
Article in English | MEDLINE | ID: covidwho-2067622

ABSTRACT

BACKGROUND: The year 2020 in the extent of HCV infection was set for the first milestones on the road to the eradication of HCV infection in 2030. In addition, in 2020 there was a global public health crisis - the COVID-19 pandemic. The aim of this paper was to assess the epidemiological situation of HCV infection based on epidemiological surveillance data in Poland in 2020. MATERIAL AND METHODS: Analysis of: 1) individual data from surveillance in 2020 conducted by EpiBaza system; 2) diagnosis rate from bulletins "Infectious diseases and poisonings in Poland" for the years 2014-2020; and 3) data about deaths due to hepatitis C from the Demographic Surveys and Labour Market Department of Statistics Poland. RESULTS: In 2020, there was a significant decrease in the number of reported cases and thus in the diagnosis rate of HCV infection in Poland - 955 HCV infections were reported (2.49/100,000 - in comparison with 2019, 3.5 times less). The decrease occurred in all voivodeships (ranging from 0.50 to 6.37/100,000), we observe more districts in which HCV infections were not detected (in 2020 - 35.3%; in 2019 - 16.8%). The diagnosis rate of HCV infection in women and men was at a similar level. However, large disproportions are visible if age groups are considered in addition to gender. For years, we have observed a variation of the diagnosis rate of HCV infection depending on the environment of residence - also in 2020, higher values were reported overall in residents of urban than in rural areas (2.90 vs. 1.88/100,000). In 2.9% of newly diagnosed HCV infections, at the same time cirrhosis was already present, 0.4% had liver failure, and 0.1% had hepatocellular carcinoma. Among exposures of HCV infection, those related to nosocomial transmission still dominate (59%), also in acute hepatitis C (60%). One-third of reported infections were diagnosed in primary health care, and one in four were diagnosed during hospitalization. CONCLUSIONS: The data presented in this paper show that the COVID-19 pandemic deepened the inequalities observed for years in HCV areas. Establishing a diverse system of testing and linking to care in Poland, reaching those in the greatest risk of ongoing transmission of HCV infection, and providing methodologically correct studies to assess progress in the eradication of HCV infection is becoming increasingly urgent to achieve the planned 2030 WHO targets.


Subject(s)
COVID-19 , Hepatitis C , Age Distribution , COVID-19/epidemiology , Disease Outbreaks , Female , Hepacivirus , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Humans , Incidence , Infant , Male , Pandemics , Poland/epidemiology , Registries , Rural Population , Sex Distribution , Urban Population
3.
Transbound Emerg Dis ; 69(5): e2485-e2494, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2053021

ABSTRACT

An outbreak of canine leptospirosis commenced in Sydney, Australia in 2017. The aim of this retrospective study was to determine if clusters of leptospirosis occurred during this outbreak, and if these were associated with host factors, to assist investigation of the drivers of emerging leptospirosis at this location. Within the City of Sydney local government area, 13 cases were reported during the outbreak. Administrative data on the canine population were collected and mapped. Clusters of leptospirosis cases were detected using a retrospective space-time analysis and a discrete Poisson probability statistical model. Sydney dog population registration [55.6%, 95% confidence interval (CI) 51.8-58.1%] was lower than the Australian national average (80%). The distribution of dog types, based on the United Kennel Club standards, was significantly (p < .0001) different to that of the national profile: there was a distinct preference in Sydney for companion dogs. The age distribution of dogs in Sydney did not reflect a typical right-skewed curve; instead, a relatively uniform distribution was observed between the age group of 1 to 8 years. A primary disease cluster (radius 1.1 km) in the eastern area of the Sydney City Council was identified (4 cases observed between 24 May and 9 August 2019 vs. 0.10 cases expected), p = .0450. When adjusted for the age, breed type and sex distribution of the population, similar clusters were identified; in the case of age-adjustment, the spatiotemporal cluster identified was larger and of longer duration (seven cases observed between 28 June and 11 November 2019 versus 0.34 cases expected), p = .0025. The presence of clusters of canine leptospirosis in the City of Sydney during this outbreak, which persisted after adjustment for demographics (age, sex, breed type), suggest that environmental factors - rather than host or pathogen factors - might be responsible for the emergence of leptospirosis. Environmental factors that potentially might be linked to this outbreak of canine leptospirosis and the clusters observed require investigation.


Subject(s)
Dog Diseases , Leptospira , Leptospirosis , Age Distribution , Animals , Australia , Dog Diseases/epidemiology , Dogs , Leptospirosis/epidemiology , Leptospirosis/veterinary , Retrospective Studies
4.
PLoS One ; 17(4): e0265509, 2022.
Article in English | MEDLINE | ID: covidwho-1968853

ABSTRACT

BACKGROUND: Opioid-related mortality continues to rise across North America, and mortality rates have been further exacerbated by the COVID-19 pandemic. This study sought to provide an updated picture of trends of opioid-related mortality for Ontario, Canada between January 2003 and December 2020, in relation to age and sex. METHODS: Using mortality data from the Office of the Chief Coroner for Ontario, we applied Bayesian Poisson regression to model age/sex mortality per 100,000 person-years, including random walks to flexibly capture age and time effects. Models were also used to explore how trends might continue into 2022, considering both pre- and post-COVID-19 courses. RESULTS: From 2003 to 2020, there were 11,633 opioid-related deaths in Ontario. A shift in the age distribution of mortality was observed, with the greatest mortality rates now among younger individuals. In 2003, mortality rates reached maximums at 5.5 deaths per 100,000 person-years (95% credible interval: 4.0-7.6) for males around age 44 and 2.2 deaths per 100,000 person-years (95% CI: 1.5-3.2) for females around age 51. As of 2020, rates have reached maximums at 67.2 deaths per 100,000 person-years (95% CI: 55.3-81.5) for males around age 35 and 16.8 deaths per 100,000 person-years (95% CI: 12.8-22.0) for females around age 37. Our models estimate that opioid-related mortality among the younger population will continue to grow, and that current conditions could lead to male mortality rates that are more than quadruple those of pre-pandemic estimations. CONCLUSIONS: This analysis may inform a refocusing of public health strategy for reducing rising rates of opioid-related mortality, including effectively reaching both older and younger males, as well as young females, with health and social supports such as treatment and harm reduction measures.


Subject(s)
Analgesics, Opioid , COVID-19 , Adult , Age Distribution , Analgesics, Opioid/adverse effects , Bayes Theorem , Female , Humans , Male , Middle Aged , Mortality , Ontario/epidemiology , Pandemics
5.
Andes Pediatr ; 92(6): 854-861, 2021 Dec.
Article in Spanish | MEDLINE | ID: covidwho-1918329

ABSTRACT

INTRODUCTION: COVID-19 pandemic has meant adapting to a different reality, with long-term lockdowns that might cause an increase of burns in children at home. OBJECTIVE: To compare the epidemiological situation of patients admitted to the Corporación de Ayuda al Niño Quemado (COANIQUEM) due to out patient burn injuries management at the beginning of COVID-19 lockdown with the same period the year before. PATIENTS AND METHODS: Analytical and cross-sectional study. A population of 2,027 patients under the age of 20, who were admitted to COANIQUEM for the first time with burn inju ries, between April and July of 2019 and 2020 was analyzed. The number of patients admitted each month was registered as well as their demographic, social, and clinical characteristics. The monthly percentage variation was calculated by comparing patient data in both years. RESULTS: During 2020, there was a 48.7% decrease in overall outpatient admissions. There was a relative increase of 10.5% in burns in patients under 5 years old, 18.3% in scalds, 33.1% in the number of burns in 3 or more body locations, and 16.8% in burns occurring at home. These parameters were not influenced by geographic location, sex, or socioeconomic level. CONCLUSIONS: In the first period of the COVID-19 pandemic, with strict lockdown strategies, there was a decrease in the demand for burn care, affecting both outpatients with acute burns and those who were admitted for sequelae rehabilitation, as a result of the effective decrease in the burns incidence and the reduced access to health care.


Subject(s)
Burns , COVID-19 , Adolescent , Age Distribution , Burns/epidemiology , Burns/etiology , Burns/therapy , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Chile/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Delivery of Health Care , Humans , Outpatients , Pandemics/prevention & control
6.
J Safety Res ; 82: 463-468, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1914733

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, one study in Australia showed an increase in drowning deaths in certain settings, while a study in China showed a decrease in drowning deaths. The impact of the COVID-19 pandemic on drowning deaths in the United States is unknown. OBJECTIVE: To report on unintentional drowning deaths among U.S. persons aged ≤29 years by demographic characteristics and compare 2020 fatal drowning rates with rates from 2010 to 2019. METHODS: Data from CDC WONDER were analyzed to calculate unintentional drowning death rates among persons aged ≤29 years by age group, sex, race/ethnicity, and location of drowning. These rates were compared to drowning death rates for the previous 10 years (2010-2019). RESULTS: In 2020, 1.26 per 100,000 persons aged ≤29 years died from unintentional drowning, a 16.79% increase from 2019. Drowning death rates decreased 1.81% per year on average (95% CI: -3.02%, -0.59%) from 2010 to 2019. The largest increases in unintentional drowning deaths from 2019 to 2020 occurred among young adults aged 20 to 24 years (44.12%), Black or African American persons (23.73%), and males (19.55%). The location with the largest increase in drowning was natural water (26.44%). CONCLUSION: Drowning death rates among persons aged ≤29 years significantly increased from 2019 to 2020. Further research is needed to understand the impacts of the COVID-19 pandemic on drowning and identify how drowning prevention strategies can be adapted and strengthened. PRACTICAL APPLICATIONS: Drowning remains a leading cause of injury death among persons aged ≤29 years. However, drowning is preventable. Interventions such as learning basic swimming and water safety skills, and consistent use of lifejackets on boats and among weaker swimmers in natural water, have the potential to reduce drowning deaths. Developing strategies that ensure equitable access to these interventions may prevent future drowning.


Subject(s)
COVID-19 , Drowning , Adult , Age Distribution , Ethnicity , Humans , Infant , Male , Pandemics , United States , Water , Young Adult
7.
Arch Iran Med ; 25(4): 201-208, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1904197

ABSTRACT

BACKGROUND: Mental disorders are the most common health problems that affect different population groups. According to the national survey in 2015 based on General Health Questionnaire-28 (GHQ-28), 23.44% of Iranians older than 15 years were suspected of having a mental disorder. The study aimed to determine the mental health status of the population over 15 years of age in the Islamic Republic of Iran, one year after the outbreak of COVID-19 in 2020. METHODS: The population-based study was performed on 24584 individuals over 15 years of age in Iran between December and February, 2020. The GHQ-28 was completed through telephone interviews. Data were analyzed using descriptive statistics, chi-square test, independent t-test, and multiple logistic regression at 95% confidence level. RESULTS: The results showed that the mean age of participants was 44.18±16.47 years. The prevalence of mental disorders was 29.7%. Mental disorder was associated with female gender (OR=1.195, 95% CI 1.10-1.29), 25-44 years (OR=1.206, 95% CI 1.06-1.36), urban life (OR=1.116, 95% CI 1.04-1.19), illiteracy (OR=1.286, 95% CI 1.11-1.48), being divorced (OR=1.924, 95% CI 1.50- 2.45), and unemployment (OR=1.657, 95% CI 1.40-1.94). Among the participants and their families, 14.7% and 32.3% were infected with the disease, respectively. The COVID-19 mortality rate in their families was 13.2%. The prevalence of mental disorders in infected people (40% vs. 27.3%) and bereaved families (39.6% vs. 35.3%) was more than the non-infected groups. CONCLUSION: Our results showed that in Iran, the mental health of the general population had a rising trend compared to 2015, especially in people infected with COVID-19 and bereaved families. The observed difference may be due to the prevalence of the COVID-19 epidemic and rapid demographic, social, and economic changes in Iran. Planning to improve mental health in the mentioned population should be considered for the post COVID-19 era.


Subject(s)
COVID-19 , Mental Disorders , Adolescent , Adult , Age Distribution , COVID-19/epidemiology , Cross-Sectional Studies , Disease Outbreaks , Female , Forecasting , Health Status , Health Surveys , Humans , Iran/epidemiology , Mental Disorders/epidemiology , Middle Aged , Rural Population , Sampling Studies , Sex Distribution , Surveys and Questionnaires , Urban Population
8.
Przegl Epidemiol ; 75(4): 604-612, 2021.
Article in English | MEDLINE | ID: covidwho-1904173

ABSTRACT

INTRODUCTION: Pertussis is an endemic, highly contagious disease that can be prevented through vaccination. In Poland, since the second half of the nineties, changes in the epidemiology of pertussis have been observed - an increase in the number of cases, despite the high level of vaccination of the population. The highest percentage of registered cases of pertussis concerned people aged 15 and over. The causes of the increased incidence of pertussis are a complex problem. Immunity after pertussis vaccination is unstable, disappears within 4-12 years, and the risk of the disease increases with time after the last dose of the vaccine. Due to the loss of protection against pertussis in adults, it is important to repeat immunization with dTpa every 10 years. OBJECTIVE: The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2018-2019 compared to the situation in previous years, with particular emphasis on the assessment of the vaccination status of children against pertussis. MATERIAL AND METHODS: The assessment of the epidemiological situation of pertussis in Poland was performed on the basis of the results of the analysis of unit reports of pertussis registered in the NIPH-NIH through the SRWE system and data from the bulletins "Infectious diseases and poisonings in Poland" for 2018 and 2019 and the bulletins "Vaccinations in Poland" for 2018 and 2019. RESULTS: In 2018, 1 548 were registered, and in 2019 - 1 629 cases of pertussis. The incidence was respectively: 4.0 and 4.2 per 100 000 population and was lower compared to the incidence in 2017 (8.0). The highest incidence of pertussis was in the age group 0-4 years (20.6 and 23.6 respectively), and high in children and adolescents aged 5-9 (10.9 and 11.5 respectively) and 10-14 years (respectively: 12.2 and 11.2 - per 100 000 population). About half of the cases concerned people over 15 years of age. In general, a higher incidence among women was observed than in men, as well as a higher incidence in cities than in rural areas. In 2018, among people with pertussis, 434 people (i.e. 28%) and in 2019 - 482 people (i.e. 29.6%) were hospitalized. In 2019, one fatal case of the disease was reported to the epidemiological surveillance system. SUMMARY AND CONCLUSIONS: In Poland, in the years 2018-2019, there was a decrease in the number of cases of pertussis, the most common were children under the age of four (the highest incidence). A worrying trend is the decreasing number of vaccinations in children aged 2 years against pertussis covered by compulsory primary vaccinations in individual provinces. In the current epidemiological situation, the best way to prevent new cases of pertussis is to use vaccination according to the current regimen and to recommend to adults a single dose of dTpa vaccination, which should be repeated every 10 years.


Subject(s)
Communicable Diseases , Whooping Cough , Adolescent , Adult , Age Distribution , Child , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Female , Humans , Incidence , Infant , Male , Pentetic Acid , Pertussis Vaccine/therapeutic use , Poland/epidemiology , Registries , Rural Population , Urban Population , Whooping Cough/epidemiology , Whooping Cough/prevention & control
9.
Clin Chim Acta ; 533: 42-47, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1885664

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARSCoV2) is a global public health emergency. Age and gender are two important factors related to the risk and outcome of various diseases. Cycle threshold (Ct) value is believed to have relation with age and gender. OBJECTIVE: This study has been conducted to investigates the association between SARS-CoV-2 cycle threshold to age and gender of COVID-19 patients, to investigate whether the population-wide change of SARSCoV2 RTPCR Ct value over time is corelated to the number of new COVID19 cases and to investigate the dynamic of RdRp and N genes. METHODS: 72,811 individuals from second wave of COVID19, were observed in current study at Pure Health Lab, Mafraq Hospital, Abu Dhabi, UAE. RESULTS: 15,201/72,811 (21 %) positivity was observed. COVID-19 were more prevalent in males (59.35%) as compared to female (40.65%). The Positivity rate were significantly higher in Male than in Female cases (p-Value = 0.04). The Ct values for both targets of all the samples were ranged from 4.57 to 29.73. Longitudinal analysis showed significant increased during the study period from starting to end as were hypothesized. Interestingly, both the targets (RdRp and N) were present in age < 1 year. Which may indicate that mutated strains are not prevalent in children's < 1 year. CONCLUSION: There was no statistically significant difference in viral loads in between age-groups. Males were tending to higher viral load compared to females. The findings have implications for preventive strategies.


Subject(s)
COVID-19 , Coronavirus Nucleocapsid Proteins/genetics , SARS-CoV-2 , Age Distribution , Child , Female , Humans , Male , RNA, Viral , RNA-Dependent RNA Polymerase , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Sex Characteristics
10.
J Korean Med Sci ; 37(22): e175, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879451

ABSTRACT

BACKGROUND: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. METHODS: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients' electronic medical records were reviewed to identify clinical characteristics. RESULTS: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m². Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754-18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439-35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321-37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061-18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m²), and the one remaining patient died from a secondary infection. CONCLUSION: About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m²) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.


Subject(s)
COVID-19 , Adult , Age Distribution , Aged , COVID-19/mortality , COVID-19/therapy , Female , Hospitalization , Humans , Male , Middle Aged , Obesity/complications , Risk Factors , SARS-CoV-2 , Young Adult
11.
Lancet ; 399(10334): 1489-1512, 2022 04 16.
Article in English | MEDLINE | ID: covidwho-1867909

ABSTRACT

BACKGROUND: National rates of COVID-19 infection and fatality have varied dramatically since the onset of the pandemic. Understanding the conditions associated with this cross-country variation is essential to guiding investment in more effective preparedness and response for future pandemics. METHODS: Daily SARS-CoV-2 infections and COVID-19 deaths for 177 countries and territories and 181 subnational locations were extracted from the Institute for Health Metrics and Evaluation's modelling database. Cumulative infection rate and infection-fatality ratio (IFR) were estimated and standardised for environmental, demographic, biological, and economic factors. For infections, we included factors associated with environmental seasonality (measured as the relative risk of pneumonia), population density, gross domestic product (GDP) per capita, proportion of the population living below 100 m, and a proxy for previous exposure to other betacoronaviruses. For IFR, factors were age distribution of the population, mean body-mass index (BMI), exposure to air pollution, smoking rates, the proxy for previous exposure to other betacoronaviruses, population density, age-standardised prevalence of chronic obstructive pulmonary disease and cancer, and GDP per capita. These were standardised using indirect age standardisation and multivariate linear models. Standardised national cumulative infection rates and IFRs were tested for associations with 12 pandemic preparedness indices, seven health-care capacity indicators, and ten other demographic, social, and political conditions using linear regression. To investigate pathways by which important factors might affect infections with SARS-CoV-2, we also assessed the relationship between interpersonal and governmental trust and corruption and changes in mobility patterns and COVID-19 vaccination rates. FINDINGS: The factors that explained the most variation in cumulative rates of SARS-CoV-2 infection between Jan 1, 2020, and Sept 30, 2021, included the proportion of the population living below 100 m (5·4% [4·0-7·9] of variation), GDP per capita (4·2% [1·8-6·6] of variation), and the proportion of infections attributable to seasonality (2·1% [95% uncertainty interval 1·7-2·7] of variation). Most cross-country variation in cumulative infection rates could not be explained. The factors that explained the most variation in COVID-19 IFR over the same period were the age profile of the country (46·7% [18·4-67·6] of variation), GDP per capita (3·1% [0·3-8·6] of variation), and national mean BMI (1·1% [0·2-2·6] of variation). 44·4% (29·2-61·7) of cross-national variation in IFR could not be explained. Pandemic-preparedness indices, which aim to measure health security capacity, were not meaningfully associated with standardised infection rates or IFRs. Measures of trust in the government and interpersonal trust, as well as less government corruption, had larger, statistically significant associations with lower standardised infection rates. High levels of government and interpersonal trust, as well as less government corruption, were also associated with higher COVID-19 vaccine coverage among middle-income and high-income countries where vaccine availability was more widespread, and lower corruption was associated with greater reductions in mobility. If these modelled associations were to be causal, an increase in trust of governments such that all countries had societies that attained at least the amount of trust in government or interpersonal trust measured in Denmark, which is in the 75th percentile across these spectrums, might have reduced global infections by 12·9% (5·7-17·8) for government trust and 40·3% (24·3-51·4) for interpersonal trust. Similarly, if all countries had a national BMI equal to or less than that of the 25th percentile, our analysis suggests global standardised IFR would be reduced by 11·1%. INTERPRETATION: Efforts to improve pandemic preparedness and response for the next pandemic might benefit from greater investment in risk communication and community engagement strategies to boost the confidence that individuals have in public health guidance. Our results suggest that increasing health promotion for key modifiable risks is associated with a reduction of fatalities in such a scenario. FUNDING: Bill & Melinda Gates Foundation, J Stanton, T Gillespie, J and E Nordstrom, and Bloomberg Philanthropies.


Subject(s)
COVID-19 , Age Distribution , COVID-19/epidemiology , COVID-19 Vaccines , Global Health , Humans , Pandemics , SARS-CoV-2
12.
Ann Epidemiol ; 72: 57-64, 2022 08.
Article in English | MEDLINE | ID: covidwho-1866848

ABSTRACT

PURPOSE: To examine whether declines in the crude U.S. COVID-19 case fatality ratio is due to improved clinical care and/or other factors. METHODS: We used multivariable logistic regression, adjusted for age and other individual-level characteristics, to examine associations between report month and mortality among confirmed and probable COVID-19 cases and hospitalized cases in Georgia reported March 2, 2020 to March 31, 2021. RESULTS: Compared to August 2020, mortality risk among cases was lowest in November 2020 (OR = 0.84; 95% CI: 0.78-0.91) and remained lower until March 2021 (OR = 0.86; 95% CI: 0.77-0.95). Among hospitalized cases, mortality risk increased in December 2020 (OR = 1.16, 95% CI: 1.07-1.27) and January 2021 (OR = 1.25; 95% CI: 1.14-1.36), before declining until March 2021 (OR = 0.90, 95% CI: 0.78-1.04). CONCLUSIONS: After adjusting for other factors, including the shift to a younger age distribution of cases, we observed lower mortality risk from November 2020 to March 2021 compared to August 2020 among cases. This suggests that improved clinical management may have contributed to lower mortality risk. Among hospitalized cases, mortality risk increased again in December 2020 and January 2021, but then decreased to a risk similar to that among all cases by March 2021.


Subject(s)
COVID-19 , Epidemics , Age Distribution , Georgia/epidemiology , Hospitalization , Humans
13.
Am J Public Health ; 112(1): 165-168, 2022 01.
Article in English | MEDLINE | ID: covidwho-1841237

ABSTRACT

Objectives. To test whether distortions in the age distribution of deaths can track pandemic activity. Methods. We compared weekly distributions of all-cause deaths by age during the COVID-19 pandemic in the United States from March to December 2020 with corresponding prepandemic weekly baseline distributions derived from data for 2015 to 2019. We measured distortions via Kolmogorov-Smirnov (K-S) and χ2 goodness-of-fit statistics as well as deaths among individuals aged 65 years or older as a percentage of total deaths (PERC65+). We computed bivariate correlations between these measures and the number of recorded COVID-19 deaths for the corresponding weeks. Results. Elevated COVID-19-associated fatalities were accompanied by greater distortions in the age structure of mortality. Distortions in the age distribution of weekly US COVID-19 deaths in 2020 relative to earlier years were highly correlated with COVID fatalities (K-S: r = 0.71, P < .001; χ2: r = 0.90, P < .001; PERC65+: r = 0.85, P < .001). Conclusions. A population-representative sample of age-at-death data can serve as a useful means of pandemic activity surveillance when precise cause-of-death data are incomplete, inaccurate, or unavailable, as is often the case in low-resource environments. (Am J Public Health. 2022;112(1):165-168. https://doi.org/10.2105/AJPH.2021.306567).


Subject(s)
COVID-19/mortality , Mortality , Adult , Age Distribution , Aged , Aged, 80 and over , Humans , Middle Aged , Statistics as Topic , Statistics, Nonparametric , United States/epidemiology
14.
Lancet Glob Health ; 10(3): e390-e397, 2022 03.
Article in English | MEDLINE | ID: covidwho-1747373

ABSTRACT

BACKGROUND: Universal health coverage is one of the WHO End TB Strategy priority interventions and could be achieved-particularly in low-income and middle-income countries-through the expansion of primary health care. We evaluated the effects of one of the largest primary health-care programmes in the world, the Brazilian Family Health Strategy (FHS), on tuberculosis morbidity and mortality using a nationwide cohort of 7·3 million individuals over a 10-year study period. METHODS: We analysed individuals who entered the 100 Million Brazilians Cohort during the period Jan 1, 2004, to Dec 31, 2013, and compared residents in municipalities with no FHS coverage with residents in municipalities with full FHS coverage. We used a cohort design with multivariable Poisson regressions, adjusted for all relevant demographic and socioeconomic variables and weighted with inverse probability of treatment weighting, to estimate the effect of FHS on tuberculosis incidence, mortality, cure, and case fatality. We also performed a range of stratifications and sensitivity analyses. FINDINGS: FHS exposure was associated with lower tuberculosis incidence (rate ratio [RR] 0·78, 95% CI 0·72-0·84) and mortality (0·72, 0·55-0·94), and was positively associated with tuberculosis cure rates (1·04, 1·00-1·08). FHS was also associated with a decrease in tuberculosis case-fatality rates, although this was not statistically significant (RR 0·84, 95% CI 0·55-1·30). FHS associations were stronger among the poorest individuals for all the tuberculosis indicators. INTERPRETATION: Community-based primary health care could strongly reduce tuberculosis morbidity and mortality and decrease the unequal distribution of the tuberculosis burden in the most vulnerable populations. During the current marked rise in global poverty due to the COVID-19 pandemic, investments in primary health care could help protect against the expected increases in tuberculosis incidence worldwide and contribute to the attainment of the End TB Strategy goals. FUNDING: TB Modelling and Analysis Consortium (Bill & Melinda Gates Foundation), Wellcome Trust, and Brazilian Ministry of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.


Subject(s)
Community Health Services/statistics & numerical data , Primary Health Care/statistics & numerical data , Tuberculosis/epidemiology , Tuberculosis/therapy , Universal Health Insurance/statistics & numerical data , Adolescent , Adult , Age Distribution , Brazil/epidemiology , Cohort Studies , Community Health Services/methods , Female , Humans , Incidence , Longitudinal Studies , Male , Poverty/statistics & numerical data , Primary Health Care/methods , Young Adult
15.
PLoS One ; 17(3): e0263679, 2022.
Article in English | MEDLINE | ID: covidwho-1742002

ABSTRACT

BACKGROUND: Reported cases of COVID-19 may be underestimated due to mild or asymptomatic cases and a low testing rate in the general population. RESEARCH QUESTION: What is the seroprevalence of SARS-CoV-2 infection in the general population and how it compares with the data on SARS-CoV-2 cases reported by a national health surveillance system (SNVS 2.0). STUDY DESIGN AND METHODS: This was a population-based, seroepidemiological, cross-sectional study in the city of Puerto Madryn, a middle size city in the Province of Chubut, Argentina. The study period was between March 3 and April 17, 2021. The sample size was calculated using the technique of calculation of confidence intervals for a proportion. Participants were selected using stratified and cluster probability sampling. A total of 1405 subjects were invited to participate in the study. Participants were divided into the following four age groups: 1) 0 to 14, 2) 15 to 39, 3) 40 to 64, and 4) 65 or older. After informed consent was obtained, a blood sample was taken by puncture of the fingertip, and a structured questionnaire was administered to evaluate demographics, socioeconomic status, level of education, comorbidities and symptoms suggestive of COVID-19. COVID-19 seroprevalence was documented using an immunoenzymatic test for the in vitro detection of IgG antibodies specific to the spike protein of SARS-CoV-2. RESULTS: A total of 987 participants completed the survey. Seropositivity in the full study population was 39,2% and in those under 15 years of age, 47.1%. Cases reported by the SNSV 2.0 amounted to 9.35% of the total population and 1.4% of those under 15 years of age. INTERPRETATION: The prevalence of COVID-19 infection in the general population is four times higher than the number of cases reported by the SNVS 2.0 in the city of Puerto Madryn. For each child under the age of 15 identified by the SNVS 2.0 with COVID-19, there are more than 30 unrecognized infections. Seroepidemiological studies are important to define the real extent of SARS-CoV-2 infection in a particular community. Children may play a significant role in the progression of the current pandemic.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , Immunoglobulin G/blood , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Adolescent , Adult , Age Distribution , Aged , Argentina/epidemiology , COVID-19/blood , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Prevalence , Sample Size , Seroepidemiologic Studies , Young Adult
16.
Can J Psychiatry ; 66(7): 634-644, 2021 07.
Article in English | MEDLINE | ID: covidwho-1741795

ABSTRACT

OBJECTIVES: The coronavirus 2019 (COVID-19) pandemic has resulted in profound global impact, with older adults at greater risk of serious physical health outcomes. It is essential to also understand generational differences in psychosocial impacts to identify appropriate prevention and intervention targets. Across generational groups, this study examined: (1) rates of precautions and adaptive and maladaptive health behaviors, (2) differences in levels of anxiety, and (3) rates of COVID-related concerns during Wave 1 of COVID-19 in Canada. PARTICIPANTS: We analyzed data from 2 Canadian population-based data sets: the Canadian Perspective Survey Series: Impact of COVID-19 survey (N = 4,627; March 29 to April 3, 2020), and Crowdsourcing: Impacts of COVID-19 on Canadians-Your Mental Health (N = 45,989; April 24 to May 11, 2020). MEASURES: We categorized generational age group. Participants self-reported changes in behaviors and COVID-related concerns, and a validated measure assessed anxiety symptoms. RESULTS: There are generational differences in behavioral responses to the pandemic. Adaptive health habits (e.g., exercise) were comparable across groups, while changes in maladaptive health habits (e.g., substance use) were highest among younger age groups, particularly Millennials (15 to 34 years old). COVID-related precautions were also highest among the younger generations, with Generation X (35 to 54 years old) exhibiting the highest rate of precautionary behavior. Results also revealed that the highest rate of clinically significant anxiety is among Millennials (36.0%; severe anxiety = 15.7%), and the younger generations have the highest rates of COVID-related concerns. CONCLUSION: These early data are essential in understanding at-risk groups given the unpredictable nature of the pandemic and its potential long-term implications.


Subject(s)
Anxiety/psychology , COVID-19 , Mental Health/statistics & numerical data , Pandemics , Adolescent , Adult , Age Distribution , Age Factors , Aged , Aged, 80 and over , Anxiety/epidemiology , COVID-19/epidemiology , Canada/epidemiology , Female , Health Behavior , Humans , Male , Middle Aged , Population Surveillance , SARS-CoV-2 , Young Adult
17.
Tohoku J Exp Med ; 250(4): 271-278, 2020 04.
Article in English | MEDLINE | ID: covidwho-1725119

ABSTRACT

The present study provides an overview of the coronavirus disease 2019 (COVID-19) outbreak which has rapidly extended globally within a short period. COVID-19 is a highly infectious respiratory disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). SARS-CoV-2 is different from usual coronaviruses responsible for mild sickness such as common cold among human beings. It is crucial to understand the impact and outcome of this pandemic. We therefore overview the changes in the curves of COVID-19 confirmed cases and fatality rate in China and outside of China from 31st of December 2019 to 25th of March 2020. We also aimed to assess the temporal developments and death rate of COVID-19 in China and worldwide. More than 414,179 confirmed cases of COVID-19 have been reported in 197 countries, including 81,848 cases in China and 332,331 outside of China. Furthermore, 18,440 infected patients died from COVID-19 infection; 3,287 cases were from China and 15,153 fatalities were reported worldwide. Among the worldwide infected cases, 113,802 patients have been recovered and discharged from different hospitals. Effective prevention and control measures should be taken to control the disease. The presented Chinese model (protocol) of disease prevention and control could be utilized in order to curb the pandemic situation.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Age Distribution , Animals , COVID-19 , Disease Outbreaks , Humans , SARS-CoV-2 , Sex Characteristics
19.
Medicine (Baltimore) ; 101(8): e29009, 2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1713784

ABSTRACT

ABSTRACT: The purpose of analyzing changes in the use of emergency departments (EDs) was to better understand how to use ED resources efficiently during infectious disease outbreaks.Our study was a retrospective observational study. We analyzed the patterns of visits of adult and pediatric patients to separate EDs during 2020 coronavirus disease 2019 (COVID-19) outbreak to know the changes in the ED utilization. We collected the patient's demographics and time of visit, patients' acuity level at triage, cause of visit, transportation used, disposition, symptom to visit time, length of stay, and top 10 most common complaints. We compared pediatric and adult EDs before and after COVID-19.The total number of patients who visited the EDs was 197,152 over 3 years. During the COVID-19 outbreak in 2020, the number of visits decreased significantly, especially the number of pediatric patients. The number of ED visits decreased in correlation with a surge in the number of confirmed COVID patients. The proportion of severe cases in pediatric emergency department (PED) visits increased, but there was no difference in adult emergency department. The number of hospitalized PED patients increased, and the number of hospitalized adult emergency department patients decreased. However, both types of ED patients increased in intensive care unit hospitalizations, proportion of deaths, and use of ambulances. The proportion of trauma patients in the PED increased significantly (P  < .001). The time from symptom onset to ED visit time was reduced for patients. The ED length of stay increased in adults, and decreased for pediatric patients.COVID-19 brought about many changes to ED utilization. A greater reduction in ED utilization occurred in pediatric patients compared to adult patients. Our study showed changes in the number and characteristics of patients visiting the ED during the COVID-19 period compared to 2018 and 2019.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Pandemics , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Emergency Service, Hospital/organization & administration , Humans , Middle Aged , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
20.
MMWR Morb Mortal Wkly Rep ; 71(8): 306-312, 2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1707039

ABSTRACT

Suicide was among the 10 leading causes of death in the United States in 2020 among persons aged 10-64 years, and the second leading cause of death among children and adolescents aged 10-14 and adults aged 25-34 years (1). During 1999-2020, nearly 840,000 lives were lost to suicide in the United States. During that period, the overall suicide rate peaked in 2018 and declined in 2019 and 2020 (1). Despite the recent decline in the suicide rate, factors such as social isolation, economic decline, family stressors, new or worsening mental health symptoms, and disruptions to work and school associated with the COVID-19 pandemic have raised concerns about suicide risk in the United States. During 2020, a total of 12.2 million U.S. adults reported serious thoughts of suicide and 1.2 million attempted suicide (2). To understand how changes in suicide death rates might have varied among subpopulations, CDC analyzed counts and age-adjusted suicide rates during 2019 and 2020 by demographic characteristics, mechanism of injury, county urbanization level, and state. From 2019 to 2020, the suicide rate declined by 3% overall, including 8% among females and 2% among males. Significant declines occurred in seven states but remained stable in the other states and the District of Columbia. Despite two consecutive years of declines, the overall suicide rate remains 30% higher compared with that in 2000 (1). A comprehensive approach to suicide prevention that uses data driven decision-making and implements prevention strategies with the best available evidence, especially among disproportionately affected populations (3), is critical to realizing further declines in suicide and reaching the national goal of reducing the suicide rate by 20% by 2025 (4).


Subject(s)
Suicide/statistics & numerical data , Suicide/trends , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Population Surveillance , Sex Distribution , United States/epidemiology , Urbanization , Young Adult
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