Asthma and clinical outcomes of COVID-19 in a community setting.

OBJECTIVES: The association between asthma and COVID-19 mortality remains inconclusive. We examined the association between asthma and clinical outcomes of patients with COVID-19. STUDY DESIGN: A case-control study based on a surveillance cohort in Harris County, Texas. METHODS: Using the data of 21,765 patients who reported having at least one chronic health condition, we investigated the association between asthma and COVID-19 severity, characterized primarily by hospitalization and death. Unconditional logistic regression models were used to estimate the multivariable odds ratio (mOR) and its 95 % confidence interval (CI) of COVID-19 severity associated with asthma and other chronic lung diseases, adjusting for demographic and other comorbidities. A P-value < 0.005 was considered statistically significant after correcting multiple testing. RESULTS: In total, 3034 patients (13.9 %) had asthma, and 774 (3.56 %) had other chronic lung diseases. The case death rate among patients with asthma and other chronic lung diseases was 0.75 % and 19.0 %, respectively. Compared to patients without the respective conditions, patients with asthma had lower odds of death (mOR = 0.44, 95 % CI: 0.27-0.69), while patients with other chronic lung diseases had higher odds of hospitalization (mOR = 2.02, 95 % CI: 1.68-2.42) and death (mOR = 1.95, 95 % CI: 1.52-2.49) (P-values < 0.005). Risk factors for COVID-19 mortality included older age, male gender, diabetes, obesity, hypertension, cardiovascular disease, active cancer, and chronic kidney disease. CONCLUSIONS: The public health surveillance data suggested that preexisting asthma was inversely associated with COVID-19 mortality.

A comparative study of the spatial distribution of HIV prevalence in the metropolis of Kermanshah, Iran, in 1996-2014 using geographical information systems.

OBJECTIVES: Geographical information systems (GISs) have made spatiotemporal understanding of geographical patterns possible and have contributed to the identification and analysis of factors relating to health care behaviours and outcomes. The present study is the first to examine the spatial distribution of HIV prevalence in the metropolis of Kermanshah, Iran, using GISs. METHODS: The research methods were descriptive, analytical and comparative. Additionally, data recorded for HIV-infected patients in 1996-2014 were used and then the loci of HIV infection in the metropolis of Kermanshah were identified and analysed spatially using ArcGIS (Esri, New York, NY, USA). RESULTS: HIV prevalence in the metropolis of Kermanshah increased from 1996 to 2014. Analysis of the spatial distribution of the prevalence of HIV using ArcGIS indicated the presence of clusters of HIV infection. The findings demonstrate that there were many clusters of high HIV prevalence throughout the city of Kermanshah and that these clusters increased in size during the study period. Furthermore, the statistics are indicative of a growing number of HIV-infected women as well as a significant reduction in the mean age of the HIV-infected female population. CONCLUSIONS: The spatial differences in HIV prevalence across the city of Kermanshah, as well as the identification of the resulting spatial clusters in different parts of the city, suggest that measures should be put in place to prevent the growth of these clusters and to reduce the number of women being infected with HIV.

Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis.

Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution.

Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran:a geographic information systems analysis

إن تحليل نظم المعلومات الجغرافية لم يستخدم على نطاق واسع في البلدان النامية للتأكد من إمكانية وصول الفئات الضعيفة من السكان إلى خدمات الرعاية الصحية الأولية. إن هذه الدراسة طبقت طرق نظم المعلومات الجغرافية لتحليل إمكانية الوصول إلى مراكز الرعاية الصحية الأولية الحضرية بالنسبة للسكان الذين يعيشون في مدينة كرمنشاه بجمهورية إيران الإسلامية، وذلك بحسب الفئات العمرية والجنس. ففي دراسة وصفية تحليلية على مدى 3 فترات زمنية تم تطبيق طريقة تحليل الشبكات وطريقة المركز الوسطي وطريقة المسافة القياسية باستخدام نظام ArcGIS 9.3.وكان التحليل يستند إلى دائرة ذات نصف قطر قياسي يبعد 750 متراً عن المراكز الصحية، وسرعة مشي تبلغ 1 متراً واحداً لكل ثانية، وزمن وصول منشود إلى المراكز الصحية مقداره 12.5 دقيقة. إن نسبة السكان الذين يصعب عليهم الوصول الجغرافي إلى المراكز الصحية ارتفعت من 47.3% في عام 1997 إلى 58.4% في عام 2012.ولقد أظهر رسم خرائط المركز الوسطي والمسافة القياسية أن التوزيع المكاني للمراكز الصحية في كرمنشاه يحتاج إلى تعديل يتناسب مع التغيرات في توزيع السكان

Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution.

L'analyse des systèmes d'information géographique n'a pas été très utilisée dans les pays en développement pour garantir que les populations vulnérables ont accès aux services de soins de santé primaires.La présente étude a appliqué des méthodes des systèmes d'information géographique pour analyser l'accessibilitéspatiale aux centres de soins de santé primaires urbains pour la population de la ville de Kermanshah (République islamique d'Iran) par tranche d'âge et par sexe. Dans une étude analytique-descriptive sur trois périodes, une analyse des réseaux et des méthodes de mesure des distances moyenne et standard jusqu'aux centres ont été appliquées à l'aide du logiciel d'information géographique ArcGIS 9.3. L'analyse reposait sur un rayon standard de 750 mètres de distance à partir des centres de soins, à une vitesse de marche d'un mètre par seconde et untemps d'accès souhaité aux centres de soins de santé de 12,5 minutes. La proportion de la population ayant un accès géographique inadéquat aux centres de soins a augmenté, passant de 47,3 % en 1997 à 58,4 % en 2012. Lacartographie de la distance moyenne et standard jusqu'aux centres a révélé que la répartition spatiale des centres de soins de santé à Kermanshah devait être ajustée aux changements dans la répartition de la population.