Overview of the Healthcare Systems of the Maghreb Countries: Issues and Progress

Objectives: To provide an update overview on the current status of healthcare systems in the Maghreb region (Algeria, Morocco, and Tunisia) and to emphasize the progress made in the midst of the challenges facing these countries. Method(s): A descriptive comparative approach of healthcare systems in the three countries, based on data from sources with an established methodology, including descriptive healthcare data from the WHO database. Result(s): The population of the Maghreb will increase from 102 million to 132 million by 2050. The current population is mostly centered in Algeria and Morocco, accounting for 77%. Annual healthcare expenditure per capita is 447.9$, 776.8$ and 854.6$ in Morocco, Tunisia and Algeria, respectively. The average infant mortality rate per 1000 live improved to 10.9 in Tunisia, 16.8 in Morocco and 18.9 in Algeria. Maternal mortality rates have dropped to 43 and 48.5/100 000 births in Tunisia and Algeria, respectively while remaining relatively high in Morocco: 72.6. Number of hospital beds/1000 inhabitants is only 1.1 in Morocco, 1.9 and 2.9 in Algeria and Tunisia, respectively. The number of physicians/1000 people was 0.73 in Morocco, 1.3 in Tunisia and 1.72 in Algeria. This remains considerably low compared to the 3.9/1000 in Europe. The Maghreb countries are currently facing an exodus of physicians, mainly to France, which represents 7.1% and 10.7% of Tunisians and Moroccans, respectively, and more than 24% for Algerians. The Maghreb countries were very early mobilized (governments, ministries of health, civil society) to fight against COVID-19 and have successfully controlled the pandemic, according to pre-established control strategies and the strongly commitment of health professional. Conclusion(s): Despite the considerable progress made, the Maghreb countries still face major challenges. Physicians migration, rising cost of care and endemic infectious disease outbreaks constitute a huge hurdle on the already overburdened and resilient healthcare systems.Copyright © 2023

Research progress on influence of environmental and meteorological parameters on transmission of coronavirus disease 2019

Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is spreading rapidly around the world and has become a global pandemic. Meteorological factors have been recognized as one of the critical factors that influence the epidemiology and transmission of infectious diseases. In this context, the World Meteorological Organization and scholars at home and abroad have paid extensive attention to the relationships of environment and meteorology with COVID-19. This paper systematically collected and sorted out relevant domestic and foreign studies, and reviewed the latest research progress on the impact of environmental and meteorological factors on COVID-19, classifying them into typical meteorological factors (such as temperature, humidity, and wind speed), local environmental factors (such as indoor enclosed environment, ventilation, disinfection, and air conditioning), and air pollution. Current research evidence suggests that typical meteorological factors, local environmental factors, and air pollutants are closely related to the transmission of COVID-19. However, the results of different studies are still divergent due to uncertainty about the influencing mechanism, and differences in research areas and methods. This review elucidated the importance of environmental and meteorological factors to the spread of COVID-19, and provided useful implications for the control of further large-scale transmission of COVID-19 and the development of prevention and control strategies under different environmental and meteorological conditions.Copyright © 2022, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

The stochastic evolutionary game analysis of public prevention and control strategies in public health emergencies

PurposeThe COVID-19 epidemic is still spreading globally and will not be completely over in a short time. Wearing a mask is an effective means to combat the spread of COVID-19. However, whether the public wear a mask for epidemic prevention and control will be affected by stochastic factors such as vaccination, cultural differences and irrational emotions, which bring a high degree of uncertainty to the prevention and control of the epidemic. The purpose of this study is to explore and analyze the epidemic prevention and control strategies of the public in an uncertain environment.Design/methodology/approachBased on the stochastic evolutionary game model of the Moran process, the study discusses the epidemic prevention and control strategies of the public under the conditions of the dominance of stochastic factors, expected benefits and super-expected benefits.FindingsThe research shows that the strategic evolution of the public mainly depends on stochastic factors, cost-benefit and the number of the public. When the stochastic factors are dominant, the greater the perceived benefit, the lower the cost and the greater the penalty for not wearing masks, the public will choose to wear a mask. Under the dominance of expected benefits and super-expected benefits, when the number of the public is greater than a certain threshold, the mask-wearing strategy will become an evolutionary stable strategy. From the evolutionary process, the government's punishment measures will slow down the speed of the public choosing the strategy of not wearing masks. The speed of the public evolving to the stable strategy under the dominance of super-expected benefits is faster than that under the dominance of expected benefits.Practical implicationsThe study considers the impact of stochastic factors on public prevention and control strategies and provides decision-making support and theoretical guidance for the scientific prevention of the normalized public.Originality/valueTo the best of the authors' knowledge, no research has considered the impact of different stochastic interference intensities on public prevention and control strategies. Therefore, this paper can be seen as a valuable resource in this field.

Assessing the Extent of Covid-19 Transmission in French Guiana

Intro: The emergence of SARS-CoV-2 was accompanied by great uncertainty regarding the main epidemiological characteristics of the transmission. In a context where epidemiological surveillance was mainly targeted on symptomatic patients, we assessed the extent of SARS-CoV-2 transmission in French Guiana conducting an intra-household transmission study and population-based seroprevalence surveys repeated over time. Method(s): Household monitoring included virological and clinical follow-up for all household members for the first 28 days after the date of confirmation of the index case and serological follow-up over a 12-month period. Three seroprevalence surveys were conducted in July and September 2020 and in September 2021. Finding(s): A total of 57 dwellings including 245 individuals were included in the intra-household study. The average time between the date of onset of symptoms and the date of confirmation of diagnosis and inclusion in the study was 4.2 days and 7.2 days respectively. Secondary transmission was found in three quarters of households with a secondary infection rate of 35%. The highest transmission rate were observed in the most disadvantaged populations, within couples and from adults to children. Population-based seroprevalence studies have made it possible to monitor seroprevalence rates, which have varied from 15% at the time of the epidemic peak of the first epidemic wave to 65% of the population at the beginning of the fourth wave, despite the low impact of vaccination in French Guiana. Conclusion(s): The results obtained highlighted a high transmission of the virus in French Guiana associated with a low severity rate linked to the structure of the particularly young population. The project has provided health authorities with useful data to support prevention and control strategies and has allowed to evaluate the impact of interventions implemented during the pandemic.Copyright © 2023

Coronavirus (COVID-19): control and prevention in endoscopy department.

Currently, the number of people infected with novel coronavirus infection (COVID-19) worldwide is growing exponentially, which requires immediate measures to prevent its spread. Endoscopy departments are at daily risk of spreading aerosol-transmissible viruses. This review highlights actions that are necessary to prevent further spread of COVID-19 infection in endoscopy departments. All recommendations are approved by the Scientific Expert Council of the Moscow Department of Health (Protocol No. 2 03/05/2020).Copyright © 2020, Media Sphera Publishing Group. All rights reserved.

The situation of gynecological cancer before and after COVID-19 pandemic years in Kosovo

Background: On March 2020, the federal government of Kosovo declared a nationwide lockdown due to the COVID-19 pandemic until May 2020. Since the lockdown, examinations and routine checkups have been restricted. This resulted in a severe decline in patient referrals to the hospitals. We want to assess the impact of the COVID-19 pandemic on the rate of newly diagnosed gynecological cancers. Method(s): The data are taken from our patient database. Data from 752 patients from the only cancer centre in Kosovo with newly diagnosed gynaecological cancer between 2019, 2020 and 2021 were collected. Incidence, age group, stages of diagnosis and geographical distribution were compared between the time before and after the COVID-19 outbreak. Result(s): Our results showed a slight decline in newly diagnosed cancers in 2020 as compared with 2019 and 2021: -17 % in 2020 versus an increase of 18% in 2019. We expected to have a major increase in 2021 but data shows that it was a slight increase of 17%. As we not expected after the COVID-19 pandemic we have a strong decline of metastatic new cases of 39% in 2021 compared to 2020 and a 60% decline in 2020 compared to 2019. The results show a slight increase of 13 % in the early stages from 2020 to 2021 and the same rates come up from 2019 to 2020. In all three years in a row the dominant type of cancer according to localization is corpus uteri then cervix uteri and ovarian cancer with respectively 39%, 26%, and 33% in 2019, 36%, 33%, and 29% in 2020 and the last, 40%, 26% and 32% in 2021. The groupages have a slight shift from 45-49 years old the peak of new cases in 2021. Conclusion(s): The lockdown led to a slight decrease in the number of newly diagnosed cases. The decreased accessibility of the medical services has not led to significant higher number of metastatic new diagnosed cases, on contrary lower metastatic cases and higher number of early cases and slight increase on advanced cases were presented in 2021. The impact on incidence were not significantly higher in 2021 despite the lockdown. Therefore, new strategies to manage early cancer detection are needed to optimize cancer care in a time of pandemic in the future. Effective, appropriate and affordable cancer prevention and control strategies are urgently needed in Kosovo for gynaecological cancer especially cervical cancer. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.Copyright © 2023 European Society for Medical Oncology

Comparison of the transmission of COVID -19 between Hebei and Heilongjiang in early 2021

Objective To compare the diversity of transmission of COVID -19 in Hebei and Heilongjiang Province in early 2021, and to provide theoretical support for the formulation of prevention and control strategies for COVID -19. Methods A dynamical model with staged control strategies was constructed based on the number of existing asymptomatic cases, the number of existing confirmed cases and the cumulative number of removed cases in Hebei and Heilongjiang at the beginning of 2021. Parameters of the model were estimated by the nonlinear least square method. Sensitivity analysis was used to explore the impact of key parameters on the peak number and peak time of existing confirmed cases in the two regions. We respectively analyzed the influence of the change for the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection on the number of existing asymptomatic cases, the number of existing confirmed cases and the number of cumulative cases in the two regions. Results The model fitting results of the two regions were good. Compared the results of Hebei with those of Heilongjiang, there was a larger proportion of asymptomatic infected persons. When the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection separately decreased by 10%, the average decrease for the peak number of existing asymptomatic and existing confirmed cases, and the cumulative removed cases in Heilongjiang were more than those in Hebei. Conclusions In early 2021, the transmissions of COVID -19 in Hebei and Heilongjiang were significantly different. In particular, the impact of control measures on the development of the epidemic is different in different areas. © 2023, Publication Centre of Anhui Medical University. All rights reserved.

Modeling particulate nitrate in China: Current findings and future directions.

Particulate nitrate (pNO3) is now becoming the principal component of PM2.5 during severe winter haze episodes in many cities of China. To gain a comprehensive understanding of the key factors controlling pNO3 formation and driving its trends, we reviewed the recent pNO3 modeling studies which mainly focused on the formation mechanism and recent trends of pNO3 as well as its responses to emission controls in China. The results indicate that although recent chemical transport models (CTMs) can reasonably capture the spatial-temporal variations of pNO3, model-observation biases still exist due to large uncertainties in the parameterization of dinitrogen pentoxide (N2O5) uptake and ammonia (NH3) emissions, insufficient heterogeneous reaction mechanism, and the predicted low sulfate concentrations in current CTMs. The heterogeneous hydrolysis of N2O5 dominates nocturnal pNO3 formation, however, the contribution to total pNO3 varies among studies, ranging from 21.0% to 51.6%. Moreover, the continuously increasing PM2.5 pNO3 fraction in recent years is mainly due to the decreased sulfur dioxide emissions, the enhanced atmospheric oxidation capacity (AOC), and the weakened nitrate deposition. Reducing NH3 emissions is found to be the most effective control strategy for mitigating pNO3 pollution in China. This review suggests that more field measurements are needed to constrain the parameterization of heterogeneous N2O5 and nitrogen dioxide (NO2) uptake. Future studies are also needed to quantify the relationships of pNO3 to AOC, O3, NOx, and volatile organic compounds (VOCs) in different regions of China under different meteorological conditions. Research on multiple-pollutant control strategies involving NH3, NOX, and VOCs is required to mitigate pNO3 pollution, especially during severe winter haze events.

A differential epidemic Model for Information, Misinformation, and disinformation in online Social Networks: CoVId-19 Vaccination

These days the online social network has become a huge source of data. People are actively sharing information on these platforms. The data on online social networks can be misinformation, information, and disinformation. Because online social networks have become an important part of our lives, the information on online social networks makes a great impact on us. Here a differential epidemic model for information, misinformation, and disinformation on online social networks is proposed. The expression for basic reproduction number has been developed. Again, the stability condition for the system at both infection-free and endemic equilibriums points has been discussed. The numerical simulation has been performed to validate the theoretical results. Data available on Twitter related to COVID-19 vaccination is used to perform the experiment. Finally, the authors discuss the control strategy to minimize the misinformation and disinformation related to vaccination. © 2022 Authors. All rights reserved.

Comparison of the transmission of COVID -19 between Hebei and Heilongjiang in early 2021.

Objective To compare the diversity of transmission of COVID -19 in Hebei and Heilongjiang Province in early 2021, and to provide theoretical support for the formulation of prevention and control strategies for COVID -19. Methods A dynamical model with staged control strategies was constructed based on the number of existing asymptomatic cases, the number of existing confirmed cases and the cumulative number of removed cases in Hebei and Heilongjiang at the beginning of 2021. Parameters of the model were estimated by the nonlinear least square method. Sensitivity analysis was used to explore the impact of key parameters on the peak number and peak time of existing confirmed cases in the two regions. We respectively analyzed the influence of the change for the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection on the number of existing asymptomatic cases, the number of existing confirmed cases and the number of cumulative cases in the two regions. Results The model fitting results of the two regions were good. Compared the results of Hebei with those of Heilongjiang, there was a larger proportion of asymptomatic infected persons. When the number of initial contacts, the probability of initial contacts, the relative infectivity correction factor of the latent and the composition ratio of the symptomatic infection separately decreased by 10%, the average decrease for the peak number of existing asymptomatic and existing confirmed cases, and the cumulative removed cases in Heilongjiang were more than those in Hebei. Conclusions In early 2021, the transmissions of COVID -19 in Hebei and Heilongjiang were significantly different. In particular, the impact of control measures on the development of the epidemic is different in different areas.Copyright © 2023, Publication Centre of Anhui Medical University. All rights reserved.

How big of an impact do asymptomatic people have on the dynamics of an epidemic?

Asymptomatic carriers serve as a potential source of transmission of epidemic diseases. Exposed people who develop symptoms only get tested and remain isolated in their homes or sometimes in hospitals when needed. In contrast, the asymptomatic individuals go untested and spread the disease silently as they roam freely throughout their entire infectious lifetime. The work intends to explore the role of asymptomatic carriers in the transmission of epidemic diseases and investigate suitable optimal control strategies. We propose a SEIAQR compartmental model subdividing the total population into six different compartments. To illustrate the model's implication, we estimate the number of asymptomatic individuals using COVID-19 data during June 9–July 18, 2021 from Bangladesh. We then analyze the model to explore whether the epidemic subsides if the asymptomatic individuals are tested randomly and isolated. Finally, to gain a better understanding of the potential of this unidentified transmission route, we propose an optimal control model considering two different control strategies: personal protective measures and isolation of asymptomatic carriers through random testing. Our results show that simultaneous implementation of both control strategies can reduce the epidemic early. Most importantly, sustained effort in identifying and isolation of asymptotic individuals allows relaxation in personal protective measures. © 2023

Cost-effectiveness of a mathematical modeling with optimal control approach of spread of COVID-19 pandemic: A case study in Peru

COVID-19 pandemic affects 213 countries and regions around the world. Which the number of people infected with the virus exceeded 26 millions infected and more than 870 thousand deaths until september 04, 2020, in the world, and Peru among the countries most affected by this pandemic. So we proposed a mathematical model describes the dynamics of spread of the COVID-19 pandemic in Peru. The optimal control strategy based on the model is proposed, and several reasonable and suitable control strategies are suggested to the prevention and reduce the spread COVID-19 virus, by conducting awareness campaigns and quarantine with treatment. coronavirus 2019 (COVID-19). Pontryagin's maximum principle is used to characterize the optimal controls and the optimality system is solved by an iterative method. Finally, some numerical simulations are performed to verify the theoretical analysis using Matlab. © 2022

Risk management in gynaecology

Healthcare providers are obliged to reduce the risk of harm to patients using their services. Robust risk management embraces a blame-free reporting culture and learning from clinical errors whilst adopting a proactive approach to the measurement of patient safety indicators. A good safety culture within an organisation provides assurance to service users, staff, and the public, that there is commitment to provision of high quality safe and effective care. Risk management is everybody's responsibility. Therefore, all clinicians must possess an understanding of risk management processes. This review outlines the key elements of risk management within gynaecology and explains how risks are identified, assessed, quantified and managed. Examples from within the gynaecological setting and the challenges and the emergent risks posed by the COVID19 pandemic, are also discussed. © 2022

Dynamical analysis of a discrete-time COVID-19 epidemic model.

In this paper, we explore local dynamics with topological classifications, bifurcation analysis, and chaos control in a discrete-time COVID-19 epidemic model in the interior of ℝ + 4 . It is explored that for all involved parametric values, discrete-time COVID-19 epidemic model has boundary equilibrium solution and also it has an interior equilibrium solution under definite parametric condition. We have explored the local dynamics with topological classifications about boundary and interior equilibrium solutions of the discrete-time COVID-19 epidemic model by linear stability theory. Further, for the discrete-time COVID-19 epidemic model, existence of periodic points and convergence rate are also investigated. It is also studied the existence of possible bifurcations about boundary and interior equilibrium solutions and proved that there exists no flip bifurcation about boundary equilibrium solution. Moreover, it is proved that about interior equilibrium solution, there exist Hopf and flip bifurcations, and we have studied these bifurcations by utilizing explicit criterion. Moreover, by feedback control strategy, chaos in the discrete COVID-19 epidemic model is also explored. Finally, theoretical results are verified numerically.

Providing preventative care during the SARS-CoV-2 pandemic: Street medicine interventions amongst those experiencing unsheltered homelessness in the City of Detroit

Background. In 2021, there were approximately 1300 people on a given day who have experienced homelessness within the city of Detroit, Michigan. Sheltered beds within the 24 homeless shelters in the city were drastically cut in half during the COVID-19 pandemic due to concerns of overcrowding perpetuating SARS-CoV-2 outbreaks. We aimed to describe the outreach efforts made by Street Medicine Organizations (SMO) of Detroit during the SARS-CoV-2 pandemic, highlighting infection prevention and control strategies, and promotion of COVID-19 vaccinations amongst the unsheltered homeless. Methods. Health promotion interventions were directed at individuals who were unsheltered (defined as those living on the streets of Detroit, encampment sites and abandoned buildings). Education, which was provided through in-person sessions, as well as targeted COVID-19 informational pamphlets were distributed with every street-based run. Hygiene kits, which included masks, hand sanitizer and gloves were distributed thrice weekly at shelters and encampment sites. Since access to hand hygiene was drastically limited, the SMO constructed 10 hand washing stations throughout the city. COVID-19 vaccination in people experiencing homelessness started in April 2021. Results. SMO prioritized a 60 square mile range within the city of Detroit, providing care to approximately 500 persons over the months of April 2020 to April 2021. Demographics for this population varied;age ranged from 23 to 76 years old, sex was 70% males, race were 67% Black, 29% White and 4% Hispanic. More than 2000 hygiene kits were distributed throughout this period. Ninety-one individuals experiencing unsheltered homelessness were provided the COVID-19 vaccine in April 2021. Conclusion. Individuals experiencing unsheltered homelessness face unique challenges to accessing timely medical care, which has been further exacerbated during the pandemic. These individuals have limited or no access to necessary measures needed to prevent the spread and severity of diseases of SARS-CoV-2. We describe a focused and effective approach to preventing infection among these individuals as a model for organizations nationally.

Optimal Control Strategy of an Online Game Addiction Model with Incomplete Recovery.

Since the global COVID-19 pandemic in 2020, some people who have dropped out of online game have become re-addicted to it due to the order of stay-at-home, making the phenomenon of online game addiction even worse. Controlling the prevalence of online game addiction is of great significance to protect people's healthy life. For this purpose, a mathematical model of online game addiction with incomplete recovery and relapse is established. First, we analyze the basic properties of the model and obtain the expression of the basic reproduction number and all equilibria. By constructing suitable Lyapunov functions, the global asymptotical stability of the equilibria are proved. Then in the numerical simulation, we use the least squares estimation method to fit the real data of e-sports users in China from 2010 to 2020, and obtain the estimated value of all parameters. The approximation value of the basic reproduction number is obtained as R 0 ≈ 5.05 . The result reflects that the spread of game addiction in China is very serious. The stability of the equilibria are proved by using the estimated parameter values. Finally, the simulation results between with control and without control during 2020 to 2050 are compared, and the optimal control strategy is found by comparing the total infectious people. The results of optimal control suggest that if we increase our continuous attention to incompletely recovered people, we can prevent more people from becoming addicted to games. The findings in this paper reveal new mechanisms of game addiction transmission and demonstrate a more detailed and reliable control strategy.

The Impact of COVID-19 Quarantine on Tuberculosis and Diabetes Mellitus Cases: A Modelling Study.

COVID-19 has currently become a global pandemic and caused a high number of infected people and deaths. To restrain the coronavirus spread, many countries have implemented restrictions on people's movement and outdoor activities. The enforcement of health emergencies such as quarantine has a positive impact on reducing the COVID-19 infection risk, but it also has unwanted influences on health, social, and economic sectors. Here, we developed a compartmental mathematical model for COVID-19 transmission dynamic accommodating quarantine process and including tuberculosis and diabetic people compartments. We highlighted the potential negative impact induced by quarantine implementation on the increasing number of people with tuberculosis and diabetes. The actual COVID-19 data recorded in Indonesia during the Delta and Omicron variant attacks were well-approximated by the model's output. A positive relationship was indicated by a high value of Pearson correlation coefficient, r=0.9344 for Delta and r=0.8961 for Omicron with a significance level of p<0.05. By varying the value of the quarantine parameter, this study obtained that quarantine effectively reduces the number of COVID-19 but induces an increasing number of tuberculosis and diabetic people. In order to minimize these negative impacts, increasing public awareness about the dangers of TB transmission and implementing a healthy lifestyle were considered the most effective strategies based on the simulation. The insights and results presented in this study are potentially useful for relevant authorities to increase public awareness of the potential risk of TB transmission and to promote a healthy lifestyle during the implementation of quarantine.

The analysis of the characteristics of imported COVID-19 cases from January to April in 2020: a cross-sectional study.

Background: Since the first case reported in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an outbreak of coronavirus disease 2019 (COVID-19) worldwide. The global case count continued to rise and the WHO declared a Public Health Emergency of International Concern (PHEIC), causing a growing risk of imported COVID-19 infection. This study aimed to provide descriptive and quantitative epidemiological characteristics of imported COVID-19 cases in China. Methods: This cross-sectional study examined all imported COVID-19 cases in Mainland China from 22 January to 21 April 2020. Ratios, Median and percentile were used for descriptive analysis. Spearman's correlation analysis was performed between daily new imported cases in Mainland China and the country of origin. The chi-square test was used to evaluate the difference between home quarantine and compulsory centralized quarantine on native transmission. Results: A total of 1,610 cases of COVID-19 were imported from 49 countries to 27 provincial administrative regions in China; 79.8% were from European countries and the United States of America (the USA). Before 29 March 2020, the imported cases were mainly from the USA (27.7%) and United Kingdom (UK; 42.6%). After 29 March 2020, the daily newly imported cases from Russia rapidly grew. After 12 April 2020, the number of daily newly imported cases gradually decreased and remained at a low level (12±7 cases per day). Airport entry was encouraged, and ground border crossing was limited. Among the 1,610 cases, 54.0% were in the asymptomatic incubation period on arrival in Mainland China. Conclusions: The transmissions by imported COVID-19 were gradually and effectively curbed in Mainland China, despite a disproportionally high number of cases worldwide. Entry screening measures must be implemented universally to all inbound travelers at a point of entry or targeted to specific travel routes or to specific travelers. Compulsory centralized quarantine should be recommended in the prevention of the imported COVID-19 epidemic.