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1.
Evol Hum Sci ; 6: e2, 2024.
Article in English | MEDLINE | ID: mdl-38516366

ABSTRACT

Could cooperation among strangers be facilitated by adaptations that use sparse information to accurately predict cooperative behaviour? We hypothesise that predictions are influenced by beliefs, descriptions, appearance and behavioural history available for first and second impressions. We also hypothesise that predictions improve when more information is available. We conducted a two-part study. First, we recorded thin-slice videos of university students just before their choices in a repeated Prisoner's Dilemma with matched partners. Second, a worldwide sample of raters evaluated each player using videos, photos, only gender labels or neither images nor labels. Raters guessed players' first-round Prisoner's Dilemma choices and then their second-round choices after reviewing first-round behavioural histories. Our design allows us to investigate incremental effects of gender, appearance and behavioural history gleaned during first and second impressions. Predictions become more accurate and better-than-chance when gender, appearance or behavioural history is added. However, these effects are not incrementally cumulative. Predictions from treatments showing player appearance were no more accurate than those from treatments revealing gender labels and predictions from videos were no more accurate than those from photos. These results demonstrate how people accurately predict cooperation under sparse information conditions, helping explain why conditional cooperation is common among strangers.

2.
Article in English | MEDLINE | ID: mdl-37510572

ABSTRACT

Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a "high" exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.


Subject(s)
Air Pollutants , Female , Humans , Pregnancy , Air Pollutants/analysis , Cohort Studies , Environmental Exposure/analysis , Environmental Health , Hispanic or Latino , Outcome Assessment, Health Care , White , Black or African American
3.
Malar J ; 22(1): 208, 2023 Jul 07.
Article in English | MEDLINE | ID: mdl-37420265

ABSTRACT

BACKGROUND: Understanding temporal and spatial dynamics of malaria transmission will help to inform effective interventions and strategies in regions approaching elimination. Parasite genomics are increasingly used to monitor epidemiologic trends, including assessing residual transmission across seasons and importation of malaria into these regions. METHODS: In a low and seasonal transmission setting of southern Zambia, a total of 441 Plasmodium falciparum samples collected from 8 neighbouring health centres between 2012 and 2018 were genotyped using molecular inversion probes (MIPs n = 1793) targeting a total of 1832 neutral and geographically informative SNPs distributed across the parasite genome. After filtering for quality and missingness, 302 samples and 1410 SNPs were retained and used for downstream population genomic analyses. RESULTS: The analyses revealed most (67%, n = 202) infections harboured one clone (monogenomic) with some variation at local level suggesting low, but heterogenous malaria transmission. Relatedness identity-by-descent (IBD) analysis revealed variable distribution of IBD segments across the genome and 6% of pairs were highly-related (IBD ≥ 0.25). Some of the highly-related parasite populations persisted across multiple seasons, suggesting that persistence of malaria in this low-transmission region is fueled by parasites "seeding" across the dry season. For recent years, clusters of clonal parasites were identified that were dissimilar to the general parasite population, suggesting parasite populations were increasingly fragmented at small spatial scales due to intensified control efforts. Clustering analysis using PCA and t-SNE showed a lack of substantial parasite population structure. CONCLUSION: Leveraging both genomic and epidemiological data provided comprehensive picture of fluctuations in parasite populations in this pre-elimination setting of southern Zambia over 7 years.


Subject(s)
Malaria, Falciparum , Malaria , Parasites , Animals , Humans , Plasmodium falciparum/genetics , Malaria, Falciparum/parasitology , Zambia/epidemiology , Spatial Analysis , Genomics
4.
Prev Med ; 172: 107536, 2023 07.
Article in English | MEDLINE | ID: mdl-37169304

ABSTRACT

Few studies have examined associations between the retail food environment and weight maintenance. This study examined the residential Retail Food Environment Index (RFEI) of weight loss maintainers and associations with weight maintenance duration, perceived effort and difficulty managing weight, and coping and monitoring strategies. Participants were 6947 members of the WW Success Registry (enrolled January 2018-February 2020), a nationwide (United States) convenience sample of individuals who lost weight using Weight Watchers (WW) and maintained a ≥ 9.1 kg weight loss for ≥1 year (Mean 24.7 kg loss for 3.4 years). Home addresses were geo-coded and the RFEI (ratio of unhealthy [fast-food and convenience stores] to healthy [supermarkets, grocery stores, and fruit/vegetable vendors] outlets) was used to classify the healthfulness of the food environments. Validated questionnaires measured psychological coping and self-monitoring. Compared to individuals living in the healthiest food environments (RFEI<1.6), those in the least healthy food environments (RFEI ≥4.0) maintained weight loss for 0.5 years less (3.2 vs 3.7 years; 95% CI between-group difference = 0.20, 0.80), reported statistically higher scores but not clinically relevant differences on perceived effort (4.6 vs. 4.5; 95% between-group difference = 0.01, 0.21) and difficulty managing their weight (3.1 vs. 3.0; 95% CI between-group difference = 0.01, 0.17) and practice of self-monitoring (2.7 vs. 2.6; 95% CI between-group difference = 0.01, 0.14). No differences in psychological coping were observed. Weight loss maintainers living in the least healthy retail food environments maintained weight loss for a shorter duration compared to those in the healthiest food environments.


Subject(s)
Commerce , Environment , Humans , United States , Marketing , Fruit , Weight Loss , Food Supply , Residence Characteristics
5.
Am J Surg ; 225(6): 1062-1068, 2023 06.
Article in English | MEDLINE | ID: mdl-36702734

ABSTRACT

BACKGROUND: The relationship between individual/socioeconomic characteristics and firearm injury risk in an urban center was evaluated. METHODS: A hospital registry was used to identify individuals in Baltimore City who experienced interpersonal firearm injury in 2019 (FA). Injuries that did not satisfy this criterion were used as a comparison group (NF). Socioeconomic characteristics were linked to home address at the block group level. Regression analysis was used to determine predictors of firearm injury. Clusters of high and low firearm relative to non-firearm injuries were identified. RESULTS: A total of 1293 individuals were included (FA = 277, NF = 1016). The FA group lived in communities with lower income (p = 0.005), higher poverty (p = 0.007), and more Black residents (p < 0.001). Individual level factors were stronger predictors of firearm injury than community factors on multivariate regression with Black race associated with 5x higher odds of firearm injury (p < 0.001). Firearm injury clustered in areas of low socioeconomic status. CONCLUSIONS: Individual versus community factors have a greater influence on firearm injury risk. Prevention efforts should target young, Black men in urban centers.


Subject(s)
Firearms , Socioeconomic Factors , Wounds, Gunshot , Humans , Male , Income , Wounds, Gunshot/epidemiology , Black or African American , Baltimore
6.
Clin Infect Dis ; 76(3): e1104-e1113, 2023 02 08.
Article in English | MEDLINE | ID: mdl-35640824

ABSTRACT

BACKGROUND: Malaria is a leading cause of morbidity and mortality in refugee children in high-transmission parts of Africa. Characterizing the clinical features of malaria in refugees can inform approaches to reduce its burden. METHODS: The study was conducted in a high-transmission region of northern Zambia hosting Congolese refugees. We analyzed surveillance data and hospital records of children with severe malaria from refugee and local sites using multivariable regression models and geospatial visualization. RESULTS: Malaria prevalence in the refugee settlement was similar to the highest burden areas in the district, consistent with the local ecology and leading to frequent rapid diagnostic test stockouts. We identified 2197 children hospitalized for severe malaria during the refugee crisis in 2017 and 2018. Refugee children referred from a refugee transit center (n = 63) experienced similar in-hospital mortality to local children and presented with less advanced infection. However, refugee children from a permanent refugee settlement (n = 110) had more than double the mortality of local children (P < .001), had lower referral rates, and presented more frequently with advanced infection and malnutrition. Distance from the hospital was an important mediator of the association between refugee status and mortality but did not account for all of the increased risk. CONCLUSIONS: Malaria outcomes were more favorable in refugee children referred from a highly outfitted refugee transit center than those referred later from a permanent refugee settlement. Refugee children experienced higher in-hospital malaria mortality due in part to delayed presentation and higher rates of malnutrition. Interventions tailored to the refugee context are required to ensure capacity for rapid diagnosis and referral to reduce malaria mortality.


Subject(s)
Malaria , Malnutrition , Refugees , Child , Humans , Malaria/diagnosis , Malaria/epidemiology , Prevalence , Africa South of the Sahara/epidemiology
7.
BMC Infect Dis ; 22(1): 942, 2022 Dec 15.
Article in English | MEDLINE | ID: mdl-36522643

ABSTRACT

BACKGROUND: Human mobility is a driver for the reemergence or resurgence of malaria and has been identified as a source of cross-border transmission. However, movement patterns are difficult to measure in rural areas where malaria risk is high. In countries with malaria elimination goals, it is essential to determine the role of mobility on malaria transmission to implement appropriate interventions. METHODS: A study was conducted in Mutasa District, Zimbabwe, to investigate human movement patterns in an area of persistent transmission along the Mozambique border. Over 1 year, a convenience sample of 20 participants/month was recruited from active malaria surveillance cohorts to carry an IgotU® GT-600 global positioning system (GPS) data logger during all daily activities. Consenting participants were tested for malaria at data logger distribution using rapid antigen diagnostic tests and completed a survey questionnaire. GPS data were analyzed using a trajectory analysis tool, and participant movement patterns were characterized throughout the study area and across the border into Mozambique using movement intensity maps, activity space plots, and statistical analyses. RESULTS: From June 2016-May 2017, 184 participants provided movement tracks encompassing > 350,000 data points and nearly 8000 person-days. Malaria prevalence at logger distribution was 3.7%. Participants traveled a median of 2.8 km/day and spent a median of 4.6 h/day away from home. Movement was widespread within and outside the study area, with participants traveling up to 500 km from their homes. Indices of mobility were higher in the dry season than the rainy season (median km traveled/day = 3.5 vs. 2.2, P = 0.03), among male compared to female participants (median km traveled/day = 3.8 vs. 2.0, P = 0.0008), and among adults compared to adolescents (median total km traveled = 104.6 vs. 59.5, P = 0.05). Half of participants traveled outside the study area, and 30% traveled into Mozambique, including 15 who stayed in Mozambique overnight. CONCLUSIONS: Study participants in Mutasa District, Zimbabwe, were highly mobile throughout the year. Many participants traveled long distances from home, including overnight trips into Mozambique, with clear implications for malaria control. Interventions targeted at mobile populations and cross-border transmission may be effective in preventing malaria introductions in this region.


Subject(s)
Geographic Information Systems , Malaria , Adult , Adolescent , Humans , Male , Female , Zimbabwe/epidemiology , Mozambique/epidemiology , Malaria/prevention & control , Travel
8.
Malar J ; 21(1): 325, 2022 Nov 11.
Article in English | MEDLINE | ID: mdl-36369086

ABSTRACT

BACKGROUND: Seasonal patterns of malaria cases in many parts of Africa are generally associated with rainfall, yet in the dry seasons, malaria transmission declines but does not always cease. It is important to understand what conditions support these periodic cases. Aerial moisture is thought to be important for mosquito survival and ability to forage, but its role during the dry seasons has not been well studied. During the dry season aerial moisture is minimal, but intermittent periods may arise from the transpiration of peri-domestic trees or from some other sources in the environment. These periods may provide conditions to sustain pockets of mosquitoes that become active and forage, thereby transmitting malaria. In this work, humidity along with other ecological variables that may impact malaria transmission have been examined. METHODS: Negative binomial regression models were used to explore the association between peri-domestic tree humidity and local malaria incidence. This was done using sensitive temperature and humidity loggers in the rural Southern Province of Zambia over three consecutive years. Additional variables including rainfall, temperature and elevation were also explored. RESULTS: A negative binomial model with no lag was found to best fit the malaria cases for the full year in the evaluated sites of the Southern Province of Zambia. Local tree and granary night-time humidity and temperature were found to be associated with local health centre-reported incidence of malaria, while rainfall and elevation did not significantly contribute to this model. A no lag and one week lag model for the dry season alone also showed a significant effect of humidity, but not temperature, elevation, or rainfall. CONCLUSION: The study has shown that throughout the dry season, periodic conditions of sustained humidity occur that may permit foraging by resting mosquitoes, and these periods are associated with increased incidence of malaria cases. These results shed a light on conditions that impact the survival of the common malaria vector species, Anopheles arabiensis, in arid seasons and suggests how they emerge to forage when conditions permit.


Subject(s)
Anopheles , Malaria , Animals , Humans , Malaria/epidemiology , Humidity , Seasons , Mosquito Vectors , Zambia/epidemiology
9.
Am J Trop Med Hyg ; 107(4_Suppl): 55-67, 2022 10 11.
Article in English | MEDLINE | ID: mdl-36228903

ABSTRACT

For a decade, the Southern and Central Africa International Center of Excellence for Malaria Research has operated with local partners across study sites in Zambia and Zimbabwe that range from hypo- to holoendemic and vary ecologically and entomologically. The burden of malaria and the impact of control measures were assessed in longitudinal cohorts, cross-sectional surveys, passive and reactive case detection, and other observational designs that incorporated multidisciplinary scientific approaches: classical epidemiology, geospatial science, serosurveillance, parasite and mosquito genetics, and vector bionomics. Findings to date have helped elaborate the patterns and possible causes of sustained low-to-moderate transmission in southern Zambia and eastern Zimbabwe and recalcitrant high transmission and fatality in northern Zambia. Cryptic and novel mosquito vectors, asymptomatic parasite reservoirs in older children, residual parasitemia and gametocytemia after treatment, indoor residual spraying timed dyssynchronously to vector abundance, and stockouts of essential malaria commodities, all in the context of intractable rural poverty, appear to explain the persistent malaria burden despite current interventions. Ongoing studies of high-resolution transmission chains, parasite population structures, long-term malaria periodicity, and molecular entomology are further helping to lay new avenues for malaria control in southern and central Africa and similar settings.


Subject(s)
Insecticides , Malaria , Parasites , Africa, Central , Animals , Child , Cross-Sectional Studies , Humans , Malaria/epidemiology , Malaria/prevention & control , Mosquito Control , Zambia/epidemiology , Zimbabwe/epidemiology
10.
Am J Trop Med Hyg ; 107(4_Suppl): 68-74, 2022 10 11.
Article in English | MEDLINE | ID: mdl-36228913

ABSTRACT

The International Centers of Excellence for Malaria Research (ICEMR) were established by the National Institute of Allergy and Infectious Diseases more than a decade ago to provide multidisciplinary research support to malaria control programs worldwide, operating in endemic areas and contributing technology, expertise, and ultimately policy guidance for malaria control and elimination. The Southern and Central Africa ICEMR has conducted research across three main sites in Zambia and Zimbabwe that differ in ecology, entomology, transmission intensity, and control strategies. Scientific findings led to new policies and action by the national malaria control programs and their partners in the selection of methods, materials, timing, and locations of case management and vector control. Malaria risk maps and predictive models of case detection furnished by the ICEMR informed malaria elimination programming in southern Zambia, and time series analyses of entomological and parasitological data motivated several major changes to indoor residual spray campaigns in northern Zambia. Along the Zimbabwe-Mozambique border, temporal and geospatial data are currently informing investigations into a recent resurgence of malaria. Other ICEMR findings pertaining to parasite and mosquito genetics, human behavior, and clinical epidemiology have similarly yielded immediate and long-term policy implications at each of the sites, often with generalizable conclusions. The ICEMR programs thereby provide rigorous scientific investigations and analyses to national control and elimination programs, without which the impediments to malaria control and their potential solutions would remain understudied.


Subject(s)
Malaria , Mosquito Vectors , Africa, Central , Animals , Humans , Malaria/epidemiology , Malaria/prevention & control , Mosquito Control/methods , Policy , Zambia/epidemiology , Zimbabwe/epidemiology
11.
Am J Trop Med Hyg ; 107(5): 1145-1153, 2022 11 14.
Article in English | MEDLINE | ID: mdl-36252797

ABSTRACT

Human movement drives spatial transmission patterns of infectious diseases. Population-level mobility patterns are often quantified using aggregated data sets, such as census migration surveys or mobile phone data. These data are often unable to quantify individual-level travel patterns and lack the information needed to discern how mobility varies by demographic groups. Individual-level datasets can capture additional, more precise, aspects of mobility that may impact disease risk or transmission patterns and determine how mobility differs across cohorts; however, these data are rare, particularly in locations such as sub-Saharan Africa. Using detailed GPS logger data collected from three sites in southern Africa, we explore metrics of mobility such as percent time spent outside home, number of locations visited, distance of locations, and time spent at locations to determine whether they vary by demographic, geographic, or temporal factors. We further create a composite mobility score to identify how well aggregated summary measures would capture the full extent of mobility patterns. Although sites had significant differences in all mobility metrics, no site had the highest mobility for every metric, a distinction that was not captured by the composite mobility score. Further, the effects of sex, age, and season on mobility were all dependent on site. No factor significantly influenced the number of trips to locations, a common way to aggregate datasets. When collecting and analyzing human mobility data, it is difficult to account for all the nuances; however, these analyses can help determine which metrics are most helpful and what underlying differences may be present.


Subject(s)
Cell Phone , Communicable Diseases , Humans , Travel , Surveys and Questionnaires
12.
Am J Trop Med Hyg ; 107(6): 1210-1217, 2022 12 14.
Article in English | MEDLINE | ID: mdl-36122682

ABSTRACT

Mapping asymptomatic malaria infections, which contribute to the transmission reservoir, is important for elimination programs. This analysis compared the spatiotemporal patterns of symptomatic and asymptomatic Plasmodium falciparum malaria infections in a cohort study of ∼25,000 people living in a rural hypoendemic area of about 179 km2 in a small area of the Chittagong Hill Districts of Bangladesh. Asymptomatic infections were identified by active surveillance; symptomatic clinical cases presented for care. Infections were identified by a positive rapid diagnostic test and/or microscopy. Fifty-three subjects with asymptomatic P. falciparum infection were compared with 572 subjects with symptomatic P. falciparum between mid-October 2009 and mid-October 2012 with regard to seasonality, household location, and extent of spatial clustering. We found increased spatial clustering of symptomatic compared with asymptomatic infections, and the areas of high intensity were only sometimes overlapping. Symptomatic cases had a distinct seasonality, unlike asymptomatic infections, which were detected year-round. In a comparison of 42 symptomatic Plasmodium vivax and 777 symptomatic P. falciparum cases from mid-October 2009 through mid-March 2015, we found substantial spatial overlap in areas with high infection rates, but the areas with the greatest concentration of infection differed. Detection of both symptomatic P. falciparum and symptomatic P. vivax infections was greater during the May-to-October high season, although a greater proportion of P. falciparum cases occurred during the high season compared with P. vivax. These findings reinforce that passive malaria surveillance and treatment of symptomatic cases will not eliminate the asymptomatic reservoirs that occur distinctly in time and space.


Subject(s)
Malaria, Falciparum , Malaria, Vivax , Malaria , Humans , Asymptomatic Infections/epidemiology , Plasmodium falciparum , Cohort Studies , Bangladesh/epidemiology , Prevalence , Malaria, Falciparum/diagnosis , Malaria, Falciparum/epidemiology , Malaria, Vivax/diagnosis , Malaria, Vivax/epidemiology , Plasmodium vivax
13.
Health Place ; 76: 102858, 2022 07.
Article in English | MEDLINE | ID: mdl-35872389

ABSTRACT

Limited studies examine how prenatal environmental and social exposures jointly impact perinatal health. Here we investigated relationships between a neighborhood-level combined exposure (CE) index assessed during pregnancy and perinatal outcomes, including birthweight, gestational age, and preterm birth. Across all participants, higher CE index scores were associated with small decreases in birthweight and gestational age. We also observed effect modification by race; infants born to Black pregnant people had a greater risk of preterm birth for higher CE values compared to White infants. Overall, our results suggest that neighborhood social and environmental exposures have a small but measurable joint effect on neonatal indicators of health.


Subject(s)
Premature Birth , Birth Weight , Cohort Studies , Female , Gestational Age , Humans , Infant , Infant, Newborn , Pregnancy , Premature Birth/epidemiology
14.
Am J Trop Med Hyg ; 2022 Mar 28.
Article in English | MEDLINE | ID: mdl-35344932

ABSTRACT

Malaria transmission has declined substantially in Southern Province, Zambia, which is considered a low-transmission setting. The Zambian government introduced a reactive test-and-treat strategy to identify active zones of transmission and treat parasitemic residents. This study was conducted in the Choma District, Southern Province, Zambia, concurrently with an evaluation of this strategy to identify vectors responsible for sustaining transmission, and to identify entomological, spatial, and ecological risk factors associated with increased densities of mosquitoes. Anophelines were collected with CDC light traps indoors and near animal pens in index cases and neighboring households. Outdoor collections captured significantly more anophelines than indoor traps, and 10 different anopheline species were identified. Four species (Anopheles arabiensis, An. rufipes, An. squamosus, and An. coustani) were positive for Plasmodium falciparum circumsporozoite protein by ELISA, and 61% of these 26 anophelines were captured outdoors. Bloodmeal assays confirm plasticity in An. arabiensis foraging, feeding both on humans and animals, whereas An. rufipes, An. squamosus, and An. coustani were largely zoophilic and exophilic. Linear regression of count data for indoor traps revealed that households with at least one parasitemic resident by polymerase chain reaction testing was associated with higher female anopheline counts. This suggests that targeting households with parasitemic individuals for vector interventions may reduce indoor anopheline populations. However, many vectors species responsible for transmission may not be affected by indoor interventions because they are primarily exophilic and forage opportunistically. These data underscore the necessity for further evaluation of vector surveillance and control tools that are effective outdoors, in conjunction with current indoor-based interventions.

15.
PLoS One ; 16(12): e0260122, 2021.
Article in English | MEDLINE | ID: mdl-34851988

ABSTRACT

With the incidence of Lyme and other tickborne diseases on the rise in the US and globally, there is a critical need for data-driven tools that communicate the magnitude of this problem and help guide public health responses. We present the Johns Hopkins Lyme and Tickborne Disease Dashboard (https://www.hopkinslymetracker.org/), a new tool that harnesses the power of geography to raise awareness and fuel research and scientific collaboration. The dashboard is unique in applying a geographic lens to tickborne diseases, aiming not only to become a global tracker of tickborne diseases but also to contextualize their complicated geography with a comprehensive set of maps and spatial data sets representing a One Health approach. We share our experience designing and implementing the dashboard, describe the main features, and discuss current limitations and future directions.


Subject(s)
Communicable Disease Control/methods , Lyme Disease/epidemiology , Software , Awareness , Geography, Medical , Humans , Intersectoral Collaboration , Lyme Disease/prevention & control
17.
Sci Rep ; 11(1): 4660, 2021 02 25.
Article in English | MEDLINE | ID: mdl-33633250

ABSTRACT

Coronavirus SARS-COV-2 infections continue to spread across the world, yet effective large-scale disease detection and prediction remain limited. COVID Control: A Johns Hopkins University Study, is a novel syndromic surveillance approach, which collects body temperature and COVID-like illness (CLI) symptoms across the US using a smartphone app and applies spatio-temporal clustering techniques and cross-correlation analysis to create maps of abnormal symptomatology incidence that are made publicly available. The results of the cross-correlation analysis identify optimal temporal lags between symptoms and a range of COVID-19 outcomes, with new taste/smell loss showing the highest correlations. We also identified temporal clusters of change in taste/smell entries and confirmed COVID-19 incidence in Baltimore City and County. Further, we utilized an extended simulated dataset to showcase our analytics in Maryland. The resulting clusters can serve as indicators of emerging COVID-19 outbreaks, and support syndromic surveillance as an early warning system for disease prevention and control.


Subject(s)
COVID-19/epidemiology , Mobile Applications , Sentinel Surveillance , Adolescent , Adult , Aged , Aged, 80 and over , Ageusia/epidemiology , Anosmia/epidemiology , Body Temperature , Cluster Analysis , Female , Humans , Male , Middle Aged , SARS-CoV-2/isolation & purification , Smartphone , United States/epidemiology , Young Adult
18.
Am J Trop Med Hyg ; 104(2): 683-694, 2020 12 21.
Article in English | MEDLINE | ID: mdl-33350376

ABSTRACT

The global malaria burden has decreased substantially, but gains have been uneven both within and between countries. In Zambia, the malaria burden remains high in northern and eastern regions of the country. To effectively reduce malaria transmission in these areas, evidence-based intervention strategies are needed. Zambia's National Malaria Control Centre conducted targeted indoor residual spraying (IRS) in 40 high-burden districts from 2014 to 2016 using the novel organophosphate insecticide pirimiphos-methyl. The Southern and Central Africa International Centers of Excellence for Malaria Research conducted an evaluation of the impact of the IRS campaign on household vector abundance in Nchelenge District, Luapula Province. From April 2012 to July 2017, field teams conducted indoor overnight vector collections from 25 to 30 households per month using Centers for Disease Control light traps. Changes in indoor anopheline counts before versus after IRS were assessed by species using negative binomial regression models with robust standard errors, controlling for geographic and climatological covariates. Counts of Anopheles funestus declined by approximately 50% in the study area and within areas targeted for IRS, and counts of Anopheles gambiae declined by approximately 40%. Within targeted areas, An. funestus counts declined more in sprayed households than in unsprayed households; however, this relationship was not observed for An. gambiae. The moderate decrease in indoor vector abundance indicates that IRS with pirimiphos-methyl is an effective vector control measure, but a more comprehensive package of interventions is needed with sufficient coverage to effectively reduce the malaria burden in this setting.


Subject(s)
Anopheles/drug effects , Insecticides/pharmacology , Malaria/prevention & control , Malaria/transmission , Mosquito Control/methods , Mosquito Vectors/drug effects , Organothiophosphorus Compounds/pharmacology , Animals , Family Characteristics , Female , Malaria/epidemiology , Mosquito Control/standards , Time Factors , Zambia/epidemiology
19.
Am J Trop Med Hyg ; 104(2): 671-679, 2020 11 23.
Article in English | MEDLINE | ID: mdl-33236715

ABSTRACT

Malaria elimination strategies are designed to more effectively identify and treat infected individuals to interrupt transmission. One strategy, reactive screen-and-treat, starts with passive detection of symptomatic cases at health facilities. Individuals residing within the index case and neighboring households are screened with a malaria rapid diagnostic test (RDT) and treated if positive. However, it is unclear to what extent this strategy is effective in reducing transmission. Reactive screen-and-treat was implemented in Choma district, Southern Province, Zambia, in 2013, in which residents of the index case and neighboring households within 140 m were screened with an RDT. From March 2016 to July 2018, the screening radius was extended to 250-m, and additional follow-up visits at 30 and 90 days were added to evaluate the strategy. Plasmodium falciparum parasite prevalence was measured using an RDT and by quantitative PCR (qPCR). A 24-single nucleotide polymorphism molecular bar-code assay was used to genotype parasites. Eighty-four index case households with 676 residents were enrolled between March 2016 and March 2018. Within each season, parasite prevalence declined significantly in index households at the 30-day visit and remained low at the 90-day visit. However, parasite prevalence was not reduced to zero. Infections identified by qPCR persisted between study visits and were not identified by RDT. Parasites identified within the same household were most genetically related; however, overall parasite relatedness was low and similar across time and space. Thus, despite implementation of a reactive screen-and-treat program, parasitemia was not eliminated, and persisted in targeted households for at least 3 months.


Subject(s)
Antimalarials/therapeutic use , Malaria, Falciparum/diagnosis , Malaria, Falciparum/transmission , Mass Screening/standards , Plasmodium falciparum/genetics , Adolescent , Adult , Animals , Anopheles/parasitology , Child , Child, Preschool , Cross-Sectional Studies , Family Characteristics , Female , Genotype , Humans , Malaria, Falciparum/drug therapy , Malaria, Falciparum/epidemiology , Male , Mass Screening/statistics & numerical data , Parasitemia , Prevalence , Young Adult , Zambia/epidemiology
20.
Hum Nat ; 31(3): 296-321, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32915411

ABSTRACT

Gender differences in dishonesty and mistrust have been reported across cultures and linked to stereotypes about females being more trustworthy and trusting. Here we focus on fundamental issues of trust-based communication that may be affected by gender: the decisions whether to honestly deliver private information and whether to trust that this delivered information is honest. Using laboratory experiments that model trust-based strategic communication and response, we examined the relationship between gender, gender stereotypes, and gender discriminative lies and challenges. Drawing from a student sample, we presented males and females (N = 80) with incentivized stereotype elicitation tasks that reveal their expectations of lies and challenges from each gender, followed by a series of strategic communication interactions within and between genders. Before interacting, both genders stereotyped females as more trustworthy (expected to send more honest messages) and more trusting (expected to accept and not challenge others' messages) than males, in accord with cross-cultural gender differences. In best response to these stereotypes, both genders discriminately accepted or challenged messages based on the sender's gender. However, we find no differences between males' and females' overall rates of lies and challenges. After learning the results of their strategic interactions, males and females revised their stereotypes about lies and challenges expected of each gender; these stereotype revisions resulted in greater predictive accuracy and less disparate gender discrimination. This suggests an important facultative feature of human trust-based communication and gender stereotyping: while the delivery and trust of private information is informed by gender stereotypes, these stereotypes are recalibrated with experience.


Subject(s)
Communication , Deception , Social Perception , Stereotyping , Trust , Adult , Female , Humans , Male , Sex Factors , Young Adult
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