Challenges in reported COVID-19 data: best practices and recommendations for future epidemics.

The proliferation of composite data sources tracking the COVID-19 pandemic emphasises the need for such databases during large-scale infectious disease events as well as the potential pitfalls due to the challenges of combining disparate data sources. Multiple organisations have attempted to standardise the compilation of disparate data from multiple sources during the COVID-19 pandemic. However, each composite data source can use a different approach to compile data and address data issues with varying results.We discuss some best practices for researchers endeavouring to create such compilations while discussing three key categories of challenges: (1) data dissemination, which includes discrepant estimates and varying data structures due to multiple agencies and reporting sources generating public health statistics on the same event; (2) data elements, such as date formats and location names, lack standardisation, and differing spatial and temporal resolutions often create challenges when combining sources; and (3) epidemiological factors, including missing data, reporting lags, retrospective data corrections and changes to case definitions that cannot easily be addressed by the data compiler but must be kept in mind when reviewing the data.Efforts to reform the global health data ecosystem should bear such challenges in mind. Standards and best practices should be developed and incorporated to yield more robust, transparent and interoperable data. Since no standards exist yet, we have highlighted key challenges in creating a comprehensive spatiotemporal view of outbreaks from multiple, often discrepant, reporting sources and provided guidelines to address them. In general, we caution against an over-reliance on fully automated systems for integrating surveillance data and strongly advise that epidemiological experts remain engaged in the process of data assessment, integration, validation and interpretation to identify, diagnose and resolve data challenges.

A 10-year study of factors associated with alcohol treatment use and non-use in a U.S. population sample.

BACKGROUND: This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991-92 and 2001-02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. METHODS: Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: (1) perceived treatment barriers for subjects who thought they should get help for their drinking, and (2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. RESULTS: In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001-02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991-92 but was significant and positive in 2001-02, although the effect of this change on treatment use was small. CONCLUSIONS: Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment.

Dental infection control and occupational safety in the Russian Federation.

BACKGROUND: In the recent past, the Russian Federation has seen a considerable increase in HIV caseload. A high level committee was formed to assess the status of dental infection control and safety (IC&S) in Russia. This article is one of the outcomes to assess the status of IC&S and is the research of a doctoral student (PhD) in public health. PURPOSE: To assess needs in Dental Infection Control and Occupational Safety in the Moscow Metropolitan Region of the Russian Federation. MATERIALS AND METHODS: A survey with variables assessing knowledge, attitude and practice of IC&S was administered to dentists practicing and or teaching in Moscow city and suburban areas on a convenience sample of dental practitioners. RESULTS: The total number of completed questionnaires were 303. Over 67% had up to three significant exposures to blood and potentially infectious materials (OPIM), but less than 30% got tested for HIV in the previous 3 months. Use of personal protective equipment was not based on anticipated exposure. Less than 10% had an understanding of Spaulding's classification with respect to sanitization, disinfection and sterilization. Only about 34% stated that there was a potential for infectious disease transmission through a percutaneous route and about 61% double gloved while treating patients with infectious diseases. Only about 61% disinfected impressions and most (83%) used alcohol for disinfection purposes. While 34% still used glass-bead sterilizers, about 13% did not sterilize handpieces between patients. CONCLUSION: Results from this study indicated a disparity in the practice of infection control and safety procedures requiring formulation of nationwide dental safety standards. Further, there is a need in implementation of a standardized dental safety curriculum for dental schools and continuing dental education requirements in dental safety for practicing dentists in the Russian Federation.

Comparison of knowledge, attitudes and practice of dental safety from eight countries at the turn of the century.

OBJECTIVE: To compare infection control (IC) knowledge, attitudes and practice of dentists across eight countries. METHODS: Self-administered infection control surveys were completed by 1,874 clinicians in eight countries. Practitioner's knowledge, attitudes, and practice of infection control were examined using over 100 variables. Chi-squared statistics (α = 0.05) were used to compare respondents from different national groups. RESULTS: Immunizations rates varied significantly across the eight countries (p < 0.01) with Asian countries having a lower rate of immunization against HBV than the United States practitioners. Perceived risk of acquiring HIV varied significantly across the study groups (p < 0.01); China had the lowest portion (75%). Dentists in the US reported 92% surface barrier use; only 15% in China reported use. Only 58% of practitioners in Pakistan reportedly used disposable exam gloves; 97% of US practitioners regularly use these gloves. For all groups assessed, including the United States, little over 50% of practitioners understood and practiced Universal/Standard (UP/SP) precautions effectively. CONCLUSION: Analyses from this study suggest that the dental IC knowledge and practice varied widely across the eight countries of interest. Many of the countries were found to have barriers to access IC materials. Results indicate that all eight countries could use improved education standards for universal precautions. CLINICAL SIGNIFICANCE: Knowledge, attitudes and practice of dental safety vary in different parts of the world. This study compares the compliance rates in dental safety among countries and pegs them to the level of practice in the United States. This study also provides evidence-based data on the needs in the regions surveyed and could be used to implement remedial educational measures in improving safe practices.