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Comparing different machine learning techniques for predicting COVID-19 severity. 比较预测COVID-19严重程度的不同机器学习技术。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-02-17 DOI: 10.1186/s40249-022-00946-4
Yibai Xiong, Yan Ma, Lianguo Ruan, Dan Li, Cheng Lu, Luqi Huang

Background: Coronavirus disease 2019 (COVID-19) is still ongoing spreading globally, machine learning techniques were used in disease diagnosis and to predict treatment outcomes, which showed favorable performance. The present study aims to predict COVID-19 severity at admission by different machine learning techniques including random forest (RF), support vector machine (SVM), and logistic regression (LR). Feature importance to COVID-19 severity were further identified.

Methods: A retrospective design was adopted in the JinYinTan Hospital from January 26 to March 28, 2020, eighty-six demographic, clinical, and laboratory features were selected with LassoCV method, Spearman's rank correlation, experts' opinions, and literature evaluation. RF, SVM, and LR were performed to predict severe COVID-19, the performance of the models was compared by the area under curve (AUC). Additionally, feature importance to COVID-19 severity were analyzed by the best performance model.

Results: A total of 287 patients were enrolled with 36.6% severe cases and 63.4% non-severe cases. The median age was 60.0 years (interquartile range: 49.0-68.0 years). Three models were established using 23 features including 1 clinical, 1 chest computed tomography (CT) and 21 laboratory features. Among three models, RF yielded better overall performance with the highest AUC of 0.970 than SVM of 0.948 and LR of 0.928, RF also achieved a favorable sensitivity of 96.7%, specificity of 69.5%, and accuracy of 84.5%. SVM had sensitivity of 93.9%, specificity of 79.0%, and accuracy of 88.5%. LR also achieved a favorable sensitivity of 92.3%, specificity of 72.3%, and accuracy of 85.2%. Additionally, chest-CT had highest importance to illness severity, and the following features were neutrophil to lymphocyte ratio, lactate dehydrogenase, and D-dimer, respectively.

Conclusions: Our results indicated that RF could be a useful predictive tool to identify patients with severe COVID-19, which may facilitate effective care and further optimize resources.

背景:2019冠状病毒病(COVID-19)仍在全球持续传播,机器学习技术被用于疾病诊断和预测治疗结果,并显示出良好的效果。本研究旨在通过不同的机器学习技术,包括随机森林(RF)、支持向量机(SVM)和逻辑回归(LR),预测入院时COVID-19的严重程度。进一步确定特征对COVID-19严重程度的重要性。方法:采用回顾性设计,采用LassoCV法、Spearman秩相关法、专家意见法和文献评价法,选取金银潭医院2020年1月26日至3月28日的86例人口统计学、临床和实验室特征。采用RF、SVM和LR预测重症COVID-19,通过曲线下面积(AUC)比较模型的性能。此外,通过最佳性能模型分析特征对COVID-19严重程度的重要性。结果:共纳入287例患者,重症病例占36.6%,非重症病例占63.4%。年龄中位数为60.0岁(四分位数间距为49.0 ~ 68.0岁)。3个模型采用23个特征,包括1个临床特征、1个胸部CT特征和21个实验室特征。三种模型中,RF的综合性能优于SVM, AUC为0.970,最大AUC为0.948,LR为0.928,灵敏度为96.7%,特异度为69.5%,准确率为84.5%。SVM的灵敏度为93.9%,特异度为79.0%,准确率为88.5%。LR的敏感性为92.3%,特异性为72.3%,准确性为85.2%。此外,胸部ct对疾病严重程度的重要性最高,以下特征分别是中性粒细胞与淋巴细胞比例、乳酸脱氢酶和d -二聚体。结论:我们的研究结果表明射频可作为一种有用的预测工具来识别COVID-19重症患者,有助于有效的护理和进一步优化资源。
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引用次数: 24
Triatoma williami in intradomiciliary environments of urban areas in Mato Grosso State, Brazil: domiciliation process of a wild species? 巴西马托格罗索州市区住宅环境中的三角瘤:一种野生物种的定居过程?
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-02-14 DOI: 10.1186/s40249-022-00938-4
Mirian Francisca Martins, Sinara Cristina de Moraes, Jader Oliveira, Janaina Cipriana Dos Santos, Ludier Kesser Santos-Silva, Cleber Galvão

Background: Triatomines in Latin America are natural Chagas disease (ChD) vectors. Triatomine domiciliation is one of the main factors increasing the occurrence risk of this disease in humans. There are 66 triatomine species in Brazil, with three genera of significant epidemiological importance-Panstrongylus, Rhodnius, and Triatoma. Among the Triatoma species, Triatoma williami, a wild species, has been reported in Goiás, Mato Grosso, and Mato Grosso do Sul. In the Barra do Garças, Mato Grosso, the invasion by triatomines has been reported, with T. williami being the most common species. This study aimed to survey triatomine fauna and determine the Trypanosoma cruzi natural infection rates in triatomines in the urban area of Barra do Garças, Mato Grosso, Brazil.

Methods: Triatomine specimens were sampled by passive surveillance or active search by agents combating endemic diseases from 2019 to 2020. A parasitological feces diagnosis was performed to detect the presence of T. cruzi after the specimens were identified. Concerning T. cruzi identification, molecular diagnosis and genetic sequencing were performed to determine the strain, also called discrete typing units (DTUs).

Results: The 211 triatomines were collected, distributed in specimens of T. williami (84.4%), P. geniculatus (3.3%), P. diasi (1.4%), and R. neglectus (10.9%). Two colonies of T. williami were found through morphological analyses. These insects were sampled inside domiciles in an urban area neighboring Jardim Pitaluga (15° 51'57.7″ N, 052° 16' 04.5 E). The records were sampled in September 2019 and January 2021. The rate of natural infection by T. cruzi was 39.4%. Two T. williami specimens from the sampled colonies were positive for the T. cruzi strain DTU IV.

Conclusions: This is the first time that T. williami has been confirmed in an urban area of Barra do Garças, Mato Grosso, Brazil. Further studies are needed for a clearer understanding of the ecology of this species for prevention and control mechanisms since its sampled specimens had a high rate of natural infection by T. cruzi.

背景:拉丁美洲的锥蝽是恰加斯病(ChD)的天然媒介。Triatomine户籍是增加人类本病发生风险的主要因素之一。巴西有66种三角蝽,其中3属(panstrongylus、Rhodnius和Triatoma)具有重要的流行病学意义。其中,在Goiás、马托格罗索州和南马托格罗索州均有报道的野生种Triatoma williami。在马托格罗索州的Barra do garas,已经报道了三棱蝽的入侵,其中T. williami是最常见的物种。本研究旨在调查巴西马托格罗索州Barra do garas城区的锥蝽区系,确定锥蝽自然感染率。方法:2019 - 2020年,采用地方病防治人员主动搜索或被动监测的方法采集狐耳螨标本。标本鉴定后进行粪便寄生虫学诊断,以检测克氏锥虫的存在。在克氏体鉴定方面,通过分子诊断和基因测序来确定菌株,也称为离散分型单位(DTUs)。结果:共检获triatomines 211只,分别分布在黄颡鱼(84.4%)、黄颡鱼(3.3%)、黄颡鱼(1.4%)、黄颡鱼(10.9%)中。通过形态学分析,发现了2个美洲大蠊群落。这些昆虫在邻近Jardim Pitaluga(15°51'57.7″N, 052°16' 04.5 E)的城市地区的住宅内取样,记录于2019年9月和2021年1月取样。克氏体自然感染率为39.4%。结论:这是巴西马托格罗索州Barra do garas城市地区首次发现威廉氏T.。由于其标本自然感染克氏锥虫率高,因此需要进一步研究该物种的生态学和防治机制。
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引用次数: 2
From concept to action: a united, holistic and One Health approach to respond to the climate change crisis. 从概念到行动:以统一、全面和一个健康的方式应对气候变化危机。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-02-10 DOI: 10.1186/s40249-022-00941-9
Renhe Zhang, Xu Tang, Jian Liu, Martin Visbeck, Huadong Guo, Virginia Murray, Catherine Mcgillycuddy, Bing Ke, Gretchen Kalonji, Panmao Zhai, Xiaoming Shi, Jiahai Lu, Xiaonong Zhou, Haidong Kan, Qunli Han, Qian Ye, Yong Luo, Jianmin Chen, Wenjia Cai, Huiling Ouyang, Riyanti Djalante, Alexander Baklanov, Lu Ren, Guy Brasseur, George Fu Gao, Lei Zhou

It is unequivocal that human influence has warmed the planet, which is seriously affecting the planetary health including human health. Adapting climate change should not only be a slogan, but requires a united, holistic action and a paradigm shift from crisis response to an ambitious and integrated approach immediately. Recognizing the urgent needs to tackle the risk connection between climate change and One Health, the four key messages and recommendations that with the intent to guide further research and to promote international cooperation to achieve a more climate-resilient world are provided.

毫无疑问,人类的影响使地球变暖,这严重影响到包括人类健康在内的地球健康。适应气候变化不应只是一句口号,而应采取统一、全面的行动,并立即将应对危机的模式转变为雄心勃勃的综合方法。认识到迫切需要处理气候变化与“同一个健康”之间的风险联系,兹提出四项关键信息和建议,旨在指导进一步的研究和促进国际合作,以实现一个更具气候适应能力的世界。
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引用次数: 13
Long-term case-fatality rate of nontuberculous mycobacterial disease in people living with HIV. 艾滋病毒感染者非结核分枝杆菌病的长期病死率。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-02-07 DOI: 10.1186/s40249-022-00942-8
Jingjing Hu, Ling Gu, Yueming Shao, Renfang Zhang, Tangkai Qi, Jianjun Sun, Zhenyan Wang, Wei Song, Yang Tang, Jiangrong Wang, Shuibao Xu, Junyang Yang, Yinzhong Shen, Li Liu, Jun Chen, Hongzhou Lu

Background: Few data are available regarding the long-term case-fatality rate (CFR) among people living with HIV (PLWH) with nontuberculous mycobacteria (NTM) disease. The aim of this study is to analyze the long-term CFR in patients with NTM disease and to identify risk factors for their death.

Methods: A retrospective cohort study of 379 cases of microbiologically confirmed NTM disease in PLWH was conducted from January 1, 2012, to December 31, 2020, in Shanghai, China. We used Kaplan-Meier survival analysis and the log-rank test to compare the long-term CFR in patients with disseminated NTM (DNTM) and localized NTM disease. Univariate Cox proportional hazards regression analysis and a stepwise Cox proportional hazards regression model were used to estimate the predictors of long-term CFR.

Results: The cohort was followed up for a median of 26 months. The total CFR was 15.7% by one year and increased to 22.6% at 5 years after the diagnosis of NTM disease. The 5-year CFR of PLWH with DNTM was significantly higher than that of PLWH with localized NTM (26.7% vs 19.6% for DNTM and localized NTM disease, respectively). Older age [hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.02-1.06, P < 0.001], comorbidity (HR = 2.05, 95% CI: 1.21-3.49, P < 0.01), DNTM (HR = 2.08, 95% CI: 1.17-3.68, P < 0.05), and HIV viral load (HR = 1.32, 95% CI: 1.12-1.55, P < 0.001) were all independent risk factors for long-term CFR. In the subgroup analysis, time to culture positivity was negatively correlated with CFR in patients with DNTM (HR = 0.90, 95% CI: 0.82-0.98, P < 0.05).

Conclusions: NTM was associated with a high long-term CFR in PLWH. Further approaches to prevent NTM disease in PLWH are urgently needed.

背景:很少有关于非结核分枝杆菌(NTM)病的HIV感染者(PLWH)的长期病死率(CFR)的数据。本研究的目的是分析NTM患者的长期CFR,并确定其死亡的危险因素。方法:对2012年1月1日至2020年12月31日在中国上海PLWH中微生物学证实的379例NTM病进行回顾性队列研究。我们采用Kaplan-Meier生存分析和log-rank检验比较播散性NTM (DNTM)和局限性NTM患者的长期CFR。采用单因素Cox比例风险回归分析和逐步Cox比例风险回归模型估计长期CFR的预测因子。结果:该队列随访时间中位数为26个月。总CFR为15.7%,诊断为NTM疾病后5年升至22.6%。PLWH合并DNTM的5年CFR明显高于PLWH合并局限性NTM的5年CFR (DNTM和局限性NTM分别为26.7%和19.6%)。高龄[危险比(HR) = 1.04, 95%可信区间(CI): 1.02-1.06, P]结论:NTM与PLWH患者较高的长期CFR相关。迫切需要采取进一步措施,在公共卫生机构中预防NTM疾病。
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引用次数: 3
Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients. 临床和抗体特征显示重症和非重症SARS-CoV-2患者的不同特征。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-02-02 DOI: 10.1186/s40249-022-00940-w
Hongye Wang, Dongshan Yan, Ya Li, Yanfei Gong, Yulin Mai, Bingxiang Li, Xiaoyong Zhu, Xinrui Wan, Liyun Xie, HuaKe Jiang, Min Zhang, Ming Sun, Yufeng Yao, Yongzhang Zhu

Background: COVID-19 pandemic continues, clarifying signatures in clinical characters and antibody responses between severe and non-severe COVID-19 cases would benefit the prognosis and treatment.

Methods: In this study, 119 serum samples from 37 severe or non-severe COVID-19 patients from the First People's Hospital of Yueyang were collected between January 25 and February 18 2020. The clinical features, antibody responses targeting SARS-CoV-2 spike protein (S) and its different domains, SARS-CoV-2-specific Ig isotypes, IgG subclasses, ACE2 competitive antibodies, binding titers with FcγIIa and FcγIIb receptors, and 14 cytokines were comprehensively investigated. The differences between severe and non-severe groups were analyzed using Mann-Whitney U test or Fisher's exact test.

Results: Severe group including 9 patients represented lower lymphocyte count, higher neutrophil count, higher level of LDH, total bile acid (TBA) (P < 1 × 10-4), r-glutaminase (P = 0.011), adenosine deaminase (P < 1 × 10-4), procalcitonin (P = 0.004), C-reactive protein (P < 1 × 10-4) and D-dimer (P = 0.049) compared to non-severe group (28 patients). Significantly, higher-level Igs targeting S, different S domains (RBD, RBM, NTD, and CTD), FcγRIIa and FcγRIIb binding capability were observed in a severe group than that of a non-severe group, of which IgG1 and IgG3 were the main IgG subclasses. RBD-IgG were strongly correlated with S-IgG both in severe and non-severe group. Additionally, CTD-IgG was strongly correlated with S-IgG in a non-severe group. Positive RBD-ACE2 binding inhibition was strongly associated with high titers of antibody (S-IgG1, S-IgG3, NTD-IgG, RBD-IgA, NTD-IgA, and CTD-IgA) especially RBD-IgG and CTD-IgG in the severe group, while in the non-severe group, S-IgG3, RBD-IgG, NTD-IgG, and NTD-IgM were correlated with ACE2 blocking rate. S-IgG1, NTD-IgM and S-IgM were negatively associated with illness day in a severe group, while S-IgG3, RBD-IgA, CTD-IgA in the severe group (r = 0.363, P = 0.011) and S-IgG1, NTD-IgA, CTD-IgA in the non-severe group were positively associated with illness day. Moreover, GRO-α, IL-6, IL-8, IP-10, MCP-1, MCP-3, MIG, and BAFF were also significantly elevated in the severe group.

Conclusion: Antibody detection provides important clinical information in the COVID-19 process. The different signatures in Ig isotypes, IgG subclasses, antibody specificity between the COVID-19 severe and non-severe group will contribute to future therapeutic and preventive measures development.

背景:COVID-19大流行仍在继续,明确重症和非重症病例的临床特征和抗体反应特征将有利于预后和治疗。方法:收集2020年1月25日至2月18日在岳阳市第一人民医院就诊的37例新冠肺炎重症和非重症患者的119份血清样本。全面观察临床特征、针对SARS-CoV-2刺突蛋白(S)及其不同结构域的抗体应答、SARS-CoV-2特异性Ig同型、IgG亚类、ACE2竞争抗体、与FcγIIa和FcγIIb受体的结合滴度以及14种细胞因子。重度组与非重度组间差异分析采用Mann-Whitney U检验或Fisher精确检验。结果:重症组9例患者淋巴细胞计数较低,中性粒细胞计数较高,LDH、总胆汁酸(TBA) (P -4)、r-谷氨酰胺酶(P = 0.011)、腺苷脱氨酶(P -4)、降钙素原(P = 0.004)、c反应蛋白(P -4)、d -二聚体(P = 0.049)水平高于非重症组(28例)。值得注意的是,与非严重组相比,严重组观察到更高水平的IgG靶向S,不同的S结构域(RBD, RBM, NTD和CTD), FcγRIIa和FcγRIIb结合能力,其中IgG1和IgG3是主要的IgG亚类。严重组和非严重组RBD-IgG均与S-IgG呈强相关。此外,在非严重组中,CTD-IgG与S-IgG呈强相关。RBD-ACE2结合抑制阳性与高滴度抗体(S-IgG1、S-IgG3、NTD-IgG、RBD-IgA、NTD-IgA、CTD-IgA)密切相关,严重组尤其与RBD-IgG、CTD-IgG相关,非严重组S-IgG3、RBD-IgG、NTD-IgG、NTD-IgM与ACE2阻断率相关。重度组S-IgG1、NTD-IgM、S-IgM与发病天数呈负相关,重度组S-IgG3、RBD-IgA、CTD-IgA与发病天数呈正相关(r = 0.363, P = 0.011),非重度组S-IgG1、NTD-IgA、CTD-IgA与发病天数呈正相关。严重组GRO-α、IL-6、IL-8、IP-10、MCP-1、MCP-3、MIG、BAFF均显著升高。结论:抗体检测在COVID-19过程中提供了重要的临床信息。COVID-19重症组和非重症组之间IgG同型、IgG亚类和抗体特异性的不同特征将有助于未来治疗和预防措施的制定。
{"title":"Clinical and antibody characteristics reveal diverse signatures of severe and non-severe SARS-CoV-2 patients.","authors":"Hongye Wang,&nbsp;Dongshan Yan,&nbsp;Ya Li,&nbsp;Yanfei Gong,&nbsp;Yulin Mai,&nbsp;Bingxiang Li,&nbsp;Xiaoyong Zhu,&nbsp;Xinrui Wan,&nbsp;Liyun Xie,&nbsp;HuaKe Jiang,&nbsp;Min Zhang,&nbsp;Ming Sun,&nbsp;Yufeng Yao,&nbsp;Yongzhang Zhu","doi":"10.1186/s40249-022-00940-w","DOIUrl":"https://doi.org/10.1186/s40249-022-00940-w","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic continues, clarifying signatures in clinical characters and antibody responses between severe and non-severe COVID-19 cases would benefit the prognosis and treatment.</p><p><strong>Methods: </strong>In this study, 119 serum samples from 37 severe or non-severe COVID-19 patients from the First People's Hospital of Yueyang were collected between January 25 and February 18 2020. The clinical features, antibody responses targeting SARS-CoV-2 spike protein (S) and its different domains, SARS-CoV-2-specific Ig isotypes, IgG subclasses, ACE2 competitive antibodies, binding titers with FcγIIa and FcγIIb receptors, and 14 cytokines were comprehensively investigated. The differences between severe and non-severe groups were analyzed using Mann-Whitney U test or Fisher's exact test.</p><p><strong>Results: </strong>Severe group including 9 patients represented lower lymphocyte count, higher neutrophil count, higher level of LDH, total bile acid (TBA) (P < 1 × 10<sup>-4</sup>), r-glutaminase (P = 0.011), adenosine deaminase (P < 1 × 10<sup>-4</sup>), procalcitonin (P = 0.004), C-reactive protein (P < 1 × 10<sup>-4</sup>) and D-dimer (P = 0.049) compared to non-severe group (28 patients). Significantly, higher-level Igs targeting S, different S domains (RBD, RBM, NTD, and CTD), FcγRIIa and FcγRIIb binding capability were observed in a severe group than that of a non-severe group, of which IgG1 and IgG3 were the main IgG subclasses. RBD-IgG were strongly correlated with S-IgG both in severe and non-severe group. Additionally, CTD-IgG was strongly correlated with S-IgG in a non-severe group. Positive RBD-ACE2 binding inhibition was strongly associated with high titers of antibody (S-IgG1, S-IgG3, NTD-IgG, RBD-IgA, NTD-IgA, and CTD-IgA) especially RBD-IgG and CTD-IgG in the severe group, while in the non-severe group, S-IgG3, RBD-IgG, NTD-IgG, and NTD-IgM were correlated with ACE2 blocking rate. S-IgG1, NTD-IgM and S-IgM were negatively associated with illness day in a severe group, while S-IgG3, RBD-IgA, CTD-IgA in the severe group (r = 0.363, P = 0.011) and S-IgG1, NTD-IgA, CTD-IgA in the non-severe group were positively associated with illness day. Moreover, GRO-α, IL-6, IL-8, IP-10, MCP-1, MCP-3, MIG, and BAFF were also significantly elevated in the severe group.</p><p><strong>Conclusion: </strong>Antibody detection provides important clinical information in the COVID-19 process. The different signatures in Ig isotypes, IgG subclasses, antibody specificity between the COVID-19 severe and non-severe group will contribute to future therapeutic and preventive measures development.</p>","PeriodicalId":13587,"journal":{"name":"Infectious Diseases of Poverty","volume":"11 1","pages":"15"},"PeriodicalIF":8.1,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39881828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Feasibility, acceptability, and effectiveness of non-pharmaceutical interventions against infectious diseases among crisis-affected populations: a scoping review. 在受危机影响的人群中防治传染病的非药物干预措施的可行性、可接受性和有效性:范围审查。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-01-28 DOI: 10.1186/s40249-022-00935-7
Jonathan A Polonsky, Sangeeta Bhatia, Keith Fraser, Arran Hamlet, Janetta Skarp, Isaac J Stopard, Stéphane Hugonnet, Laurent Kaiser, Christian Lengeler, Karl Blanchet, Paul Spiegel

Background: Non-pharmaceutical interventions (NPIs) are a crucial suite of measures to prevent and control infectious disease outbreaks. Despite being particularly important for crisis-affected populations and those living in informal settlements, who typically reside in overcrowded and resource limited settings with inadequate access to healthcare, guidance on NPI implementation rarely takes the specific needs of such populations into account. We therefore conducted a systematic scoping review of the published evidence to describe the landscape of research and identify evidence gaps concerning the acceptability, feasibility, and effectiveness of NPIs among crisis-affected populations and informal settlements.

Methods: We systematically reviewed peer-reviewed articles published between 1970 and 2020 to collate available evidence on the feasibility, acceptability, and effectiveness of NPIs in crisis-affected populations and informal settlements. We performed quality assessments of each study using a standardised questionnaire. We analysed the data to produce descriptive summaries according to a number of categories: date of publication; geographical region of intervention; typology of crisis, shelter, modes of transmission, NPI, research design; study design; and study quality.

Results: Our review included 158 studies published in 85 peer-reviewed articles. Most research used low quality study designs. The acceptability, feasibility, and effectiveness of NPIs was highly context dependent. In general, simple and cost-effective interventions such as community-level environmental cleaning and provision of water, sanitation and hygiene services, and distribution of items for personal protection such as insecticide-treated nets, were both highly feasible and acceptable. Logistical, financial, and human resource constraints affected both the implementation and sustainability of measures. Community engagement emerged as a strong factor contributing to the effectiveness of NPIs. Conversely, measures that involve potential restriction on personal liberty such as case isolation and patient care and burial restrictions were found to be less acceptable, despite apparent effectiveness.

Conclusions: Overall, the evidence base was variable, with substantial knowledge gaps which varied between settings and pathogens. Based on the current landscape, robust evidence-based guidance is not possible, and a research agenda is urgently required that focusses on these specific vulnerable populations. Although implementation of NPIs presents unique practical challenges in these settings, it is critical that such an agenda is put in place, and that the lessons learned from historical and present experiences are documented to build a firm evidence base.

背景:非药物干预措施(NPIs)是预防和控制传染病暴发的一套关键措施。尽管对受危机影响的人口和生活在非正规住区的人特别重要,因为这些人通常居住在拥挤和资源有限的环境中,无法获得充分的医疗保健,但关于实施新方案的指导很少考虑到这些人口的具体需求。因此,我们对已发表的证据进行了系统的范围审查,以描述研究前景,并确定有关危机影响人群和非正式定居点的npi的可接受性、可行性和有效性的证据差距。方法:我们系统地回顾了1970年至2020年间发表的同行评议文章,以整理有关npi在受危机影响人群和非正式定居点中的可行性、可接受性和有效性的现有证据。我们使用标准化问卷对每项研究进行质量评估。我们对数据进行了分析,并根据以下几个类别生成了描述性摘要:出版日期;干预的地理区域;危机类型、庇护所、传播方式、新产品导入、研究设计;研究设计;还有学习质量。结果:我们的综述包括了发表在85篇同行评议文章中的158项研究。大多数研究采用了低质量的研究设计。npi的可接受性、可行性和有效性高度依赖于上下文。一般来说,简单和具有成本效益的干预措施,如社区一级的环境清洁和提供水、环境卫生和个人卫生服务,以及分发驱虫蚊帐等个人防护用品,都是高度可行和可接受的。后勤、财政和人力资源方面的限制影响了各项措施的执行和可持续性。社区参与成为促进国家倡议机构有效性的一个重要因素。相反,可能限制人身自由的措施,如病例隔离和病人护理以及埋葬限制,虽然效果明显,但被认为不太可接受。结论:总体而言,证据基础是可变的,在环境和病原体之间存在着巨大的知识差距。根据目前的情况,不可能有强有力的基于证据的指导,迫切需要一个研究议程,重点关注这些特定的弱势群体。虽然在这些情况下实施国家自主行动方案提出了独特的实际挑战,但至关重要的是,必须制定这样一个议程,并记录从历史和当前经验中吸取的教训,以建立坚实的证据基础。
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引用次数: 9
World NTD Day 2022 and a new Kigali Declaration to galvanise commitment to end neglected tropical diseases. 2022年世界热带病日和新的《基加利宣言》,以激励各方承诺消除被忽视的热带病。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-01-28 DOI: 10.1186/s40249-021-00932-2
Thoko Elphick-Pooley, Dirk Engels

The World Health Organization's first roadmap and the London Declaration on neglected tropical diseases (NTDs) have allowed an unprecedented expansion of interventions to control and eliminate this group of infectious diseases that primarily affects vulnerable or marginalised communities. The 2021-2030 NTD roadmap sustains a further acceleration of interventions but also introduces a broader and more ambitious agenda, calling to be accompanied by a new political declaration. Sponsored by the Government of Rwanda, the Kigali Declaration on neglected tropical diseases will be launched in 2022 to renew and reinvigorate commitments to end NTDs, also in the wake of the current setback caused by the COVID-19 pandemic. Starting on World NTD Day 2022, a global campaign "100% Committed" will call on a broad range of stakeholders to sign the declaration and make bold financial and political commitments towards achieving the 2030 roadmap and Sustainable Development Goals' targets for NTDs.

世界卫生组织的首份路线图和《被忽视热带病伦敦宣言》使控制和消除这类主要影响脆弱或边缘化社区的传染病的干预措施得到了前所未有的扩大。《2021-2030年新结核样疾病路线图》支持进一步加快干预措施,但也提出了一个更广泛、更雄心勃勃的议程,要求伴随一项新的政治宣言。在卢旺达政府的赞助下,将于2022年发布《关于被忽视热带病的基加利宣言》,重申并重振终止被忽视热带病的承诺,同时也是在当前COVID-19大流行造成挫折之后。从2022年世界被忽视的热带病日开始,一项“100%承诺”的全球运动将呼吁广泛的利益攸关方签署宣言,并为实现2030年路线图和可持续发展目标中有关被忽视的热带病的具体目标作出大胆的财政和政治承诺。
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引用次数: 6
Social innovation based on collaboration between government and non-governmental organizations in COVID-19 crisis: evidence from Iran. 基于COVID-19危机中政府和非政府组织合作的社会创新:来自伊朗的证据。
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-01-25 DOI: 10.1186/s40249-021-00923-3
Mehrnaz Moeenian, Abbas Khamseh, Maziyar Ghazavi

Background: One of the effective ways to attract social collaboration to provide effective, prompt, and coordinated interventions in emergencies is through social innovation. The present study seeks to identify the factors affecting the implementation of the social innovation plan based on the collaboration between government and non-governmental organizations (NGOs) for saving people's lives in crises. The initial idea of this research was obtained from the best practice "Every Home Is a Health Base" which was implemented in Iran.

Methods: The Grounded Theory strategy has been used in this study. The statistical population of the study is health experts from the Ministry of Health and Medical Education of Iran. The study time span is during the first half of 2020. Exploratory analysis was used to identify the factors of social innovation. By selecting and reviewing 68 research in-depth, the initial framework was prepared. Then, through a semi-structured interview with experts, the framework was adapted and reviewed. Based on the analysis of the collected data, 39 open codes were extracted and the factors affecting the implementation of the social innovation were identified.

Results: The eight axis codes as the factors affecting the implementation of the social innovation plan based on the collaboration between government and NGOs are as follows: Paying attention to the components of the NGOs collaboration effectiveness, investment to attract NGOs collaboration, the ability to manage the implementation, the ability of networking, the ability of policymaking, providing the necessary cultural and educational infrastructure; Existence of capable legal organizations to solve the executive problems of the plan and facilitate coordination, and controlling, containing and reducing the effects of the crisis, as consequences.

Conclusions: Lessons learned from the COVID-19 pandemic have shown the world that the current governmental and social structures are not efficient enough to respond quickly to the emergence of global challenges. Social innovation is a solution to this problem. The findings of this study also confirm this and identify the factors affecting the implementation of the social innovation plan based on collaboration between governments and NGOs in crises. The results of this research give governments and policymakers an efficient solution by involving NGOs, especially in times of widespread crises. Also, they can be used in planning for social development.

背景:吸引社会协作,在突发事件中提供有效、及时和协调的干预措施的有效途径之一是通过社会创新。本研究旨在以政府与非政府组织(ngo)在危机中拯救生命的合作为基础,找出影响社会创新计划实施的因素。这项研究的最初想法来自于在伊朗实施的"每个家庭都是一个健康基地"的最佳做法。方法:本研究采用扎根理论策略。本研究的统计对象是伊朗卫生和医学教育部的卫生专家。研究时间跨度为2020年上半年。采用探索性分析的方法,确定社会创新的影响因素。通过对68项深入研究的选择和回顾,初步编制了框架。然后,通过与专家的半结构化访谈,对该框架进行了调整和审查。在对收集到的数据进行分析的基础上,提取了39条开放规范,并对影响社会创新实施的因素进行了识别。结果:政府与非政府组织合作的社会创新计划实施的影响因素为:关注非政府组织合作有效性、吸引非政府组织合作的投资、管理实施能力、网络能力、政策制定能力、提供必要的文教基础设施;存在有能力的法律组织,以解决执行问题的计划和促进协调,并控制,遏制和减少危机的影响,作为后果。结论:从2019冠状病毒病大流行中吸取的教训向世界表明,目前的政府和社会结构不足以有效应对全球挑战的出现。社会创新是解决这一问题的一种方法。本研究的结果也证实了这一点,并确定了基于危机中政府与非政府组织合作的社会创新计划实施的影响因素。这项研究的结果为政府和政策制定者提供了一个有效的解决方案,让非政府组织参与进来,特别是在危机蔓延的时候。此外,它们还可用于规划社会发展。
{"title":"Social innovation based on collaboration between government and non-governmental organizations in COVID-19 crisis: evidence from Iran.","authors":"Mehrnaz Moeenian,&nbsp;Abbas Khamseh,&nbsp;Maziyar Ghazavi","doi":"10.1186/s40249-021-00923-3","DOIUrl":"https://doi.org/10.1186/s40249-021-00923-3","url":null,"abstract":"<p><strong>Background: </strong>One of the effective ways to attract social collaboration to provide effective, prompt, and coordinated interventions in emergencies is through social innovation. The present study seeks to identify the factors affecting the implementation of the social innovation plan based on the collaboration between government and non-governmental organizations (NGOs) for saving people's lives in crises. The initial idea of this research was obtained from the best practice \"Every Home Is a Health Base\" which was implemented in Iran.</p><p><strong>Methods: </strong>The Grounded Theory strategy has been used in this study. The statistical population of the study is health experts from the Ministry of Health and Medical Education of Iran. The study time span is during the first half of 2020. Exploratory analysis was used to identify the factors of social innovation. By selecting and reviewing 68 research in-depth, the initial framework was prepared. Then, through a semi-structured interview with experts, the framework was adapted and reviewed. Based on the analysis of the collected data, 39 open codes were extracted and the factors affecting the implementation of the social innovation were identified.</p><p><strong>Results: </strong>The eight axis codes as the factors affecting the implementation of the social innovation plan based on the collaboration between government and NGOs are as follows: Paying attention to the components of the NGOs collaboration effectiveness, investment to attract NGOs collaboration, the ability to manage the implementation, the ability of networking, the ability of policymaking, providing the necessary cultural and educational infrastructure; Existence of capable legal organizations to solve the executive problems of the plan and facilitate coordination, and controlling, containing and reducing the effects of the crisis, as consequences.</p><p><strong>Conclusions: </strong>Lessons learned from the COVID-19 pandemic have shown the world that the current governmental and social structures are not efficient enough to respond quickly to the emergence of global challenges. Social innovation is a solution to this problem. The findings of this study also confirm this and identify the factors affecting the implementation of the social innovation plan based on collaboration between governments and NGOs in crises. The results of this research give governments and policymakers an efficient solution by involving NGOs, especially in times of widespread crises. Also, they can be used in planning for social development.</p>","PeriodicalId":13587,"journal":{"name":"Infectious Diseases of Poverty","volume":"11 1","pages":"13"},"PeriodicalIF":8.1,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39857016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Update of transmission modelling and projections of gambiense human African trypanosomiasis in the Mandoul focus, Chad. 乍得曼杜勒重点地区冈比亚非洲锥虫病传播模型和预测的更新。
IF 4.8 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-01-24 DOI: 10.1186/s40249-022-00934-8
Kat S Rock, Ching-I Huang, Ronald E Crump, Paul R Bessell, Paul E Brown, Inaki Tirados, Philippe Solano, Marina Antillon, Albert Picado, Severin Mbainda, Justin Darnas, Emily H Crowley, Steve J Torr, Mallaye Peka

Background: In recent years, a programme of vector control, screening and treatment of gambiense human African trypanosomiasis (gHAT) infections led to a rapid decline in cases in the Mandoul focus of Chad. To represent the biology of transmission between humans and tsetse, we previously developed a mechanistic transmission model, fitted to data between 2000 and 2013 which suggested that transmission was interrupted by 2015. The present study outlines refinements to the model to: (1) Assess whether elimination of transmission has already been achieved despite low-level case reporting; (2) quantify the role of intensified interventions in transmission reduction; and (3) predict the trajectory of gHAT in Mandoul for the next decade under different strategies.

Method: Our previous gHAT transmission model for Mandoul was updated using human case data (2000-2019) and a series of model refinements. These include how diagnostic specificity is incorporated into the model and improvements to the fitting method (increased variance in observed case reporting and how underreporting and improvements to passive screening are captured). A side-by-side comparison of fitting to case data was performed between the models.

Results: We estimated that passive detection rates have increased due to improvements in diagnostic availability in fixed health facilities since 2015, by 2.1-fold for stage 1 detection, and 1.5-fold for stage 2. We find that whilst the diagnostic algorithm for active screening is estimated to be highly specific (95% credible interval (CI) 99.9-100%, Specificity = 99.9%), the high screening and low infection levels mean that some recently reported cases with no parasitological confirmation might be false positives. We also find that the focus-wide tsetse reduction estimated through model fitting (95% CI 96.1-99.6%, Reduction = 99.1%) is comparable to the reduction previously measured by the decline in tsetse catches from monitoring traps. In line with previous results, the model suggests that transmission was interrupted in 2015 due to intensified interventions.

Conclusions: We recommend that additional confirmatory testing is performed in Mandoul to ensure the endgame can be carefully monitored. More specific measurement of cases, would better inform when it is safe to stop active screening and vector control, provided there is a strong passive surveillance system in place.

背景:近年来,病媒控制、筛查和治疗冈比亚非洲锥虫病(gHAT)感染的计划使乍得曼都勒病区的病例迅速减少。为了体现人类与采采蝇之间传播的生物学特性,我们之前开发了一个机理传播模型,该模型与 2000 年至 2013 年的数据相匹配,表明传播到 2015 年已经中断。本研究概述了对模型的改进,以便(1)评估尽管病例报告数量较少,但是否已经消除了传播;(2)量化强化干预措施在减少传播中的作用;以及(3)预测未来十年不同策略下曼杜尔的 gHAT 传播轨迹:方法:利用人类病例数据(2000-2019 年)和一系列模型改进,更新了我们以前的曼都勒 gHAT 传播模型。其中包括如何将诊断特异性纳入模型,以及对拟合方法的改进(观察到的病例报告差异增加,以及如何捕捉报告不足和被动筛查的改进)。我们对两个模型的病例数据拟合情况进行了并列比较:我们估计,自 2015 年以来,由于固定医疗机构的诊断服务有所改善,被动检测率有所提高,第一阶段检测率提高了 2.1 倍,第二阶段提高了 1.5 倍。我们发现,虽然主动筛查的诊断算法估计具有很高的特异性(95% 可信区间 (CI) 99.9-100%,特异性 = 99.9%),但高筛查率和低感染率意味着最近报告的一些未得到寄生虫学确认的病例可能是假阳性。我们还发现,通过模型拟合(95% CI 96.1-99.6%,Reduction = 99.1%)估算出的重点地区采采蝇减少量与之前通过监测陷阱采采蝇捕获量的减少量相当。与之前的结果一致,该模型表明,由于加强了干预措施,2015 年的传播中断了:我们建议在曼杜尔进行更多的确证测试,以确保能够仔细监测终局。如果有一个强大的被动监测系统,对病例进行更具体的测量将能更好地告知何时停止主动筛查和病媒控制是安全的。
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引用次数: 0
Epidemiological characteristics and temporal-spatial analysis of overseas imported dengue fever cases in outbreak provinces of China, 2005-2019. 2005-2019年中国境外输入登革热病例流行病学特征及时空分析
IF 8.1 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2022-01-24 DOI: 10.1186/s40249-022-00937-5
Xinchang Lun, Yiguan Wang, Chunchun Zhao, Haixia Wu, Caiying Zhu, Delong Ma, Mingfang Xu, Jun Wang, Qiyong Liu, Lei Xu, Fengxia Meng

Background: Overseas imported dengue fever is an important factor in local outbreaks of this disease in the mainland of China. To better prevent and control such local outbreaks, the epidemiological characteristics and temporal-spatial distribution of overseas imported dengue fever cases in provincial-level administrative divisions (PLADs) where dengue fever is outbreak in the mainland of China were explored.

Methods: Using the Chinese National Notifiable Infectious Disease Reporting Information System (CNNDS), we identified overseas imported dengue fever cases in dengue fever outbreak areas in the mainland of China from 2005 to 2019 to draw the epidemic curve and population characteristic distribution of overseas imported cases in each PLAD. Based on spatial autocorrelation analysis of ArcGIS 10.5 and temporal-spatial scanning analysis of SaTScan 9.5, we analyzed the temporal-spatial distribution of overseas imported dengue fever in dengue fever outbreak areas in the mainland of China.

Results: A total of 11,407 imported cases, mainly from Southeast Asia, were recorded from 2005 to 2019 in these 13 PLADs. Of which 62.1% were imported into Yunnan and Guangdong Provinces. Among the imported cases, there were more males than females, mainly from the 21-50 age group. The hot spots were concentrated in parts of Yunnan, Guangdong and Fujian Provinces. We found the cluster of infected areas were expanding northward.

Conclusions: Based on the analysis of overseas imported dengue cases in 13 PLADs of the mainland of China from 2005 to 2019, we obtained the epidemiological characteristics and spatial distribution of imported dengue cases. Border controls need to pay attention to key population sectors, such as 21-50 years old men and education of key populations on dengue prevention. There is a need to improve the awareness of the prevention and control of imported cases in border areas. At the same time, northern regions cannot relax their vigilance.

背景:境外输入性登革热是中国大陆本地登革热疫情发生的重要因素。为更好地预防和控制登革热本地疫情,对中国大陆登革热疫区境外输入登革热病例的流行病学特征和时空分布进行了调查。方法:利用中国国家法定传染病报告信息系统(CNNDS)对2005 - 2019年中国大陆登革热疫区境外输入登革热病例进行统计,绘制各疫区境外输入病例流行曲线和人口特征分布。基于ArcGIS 10.5空间自相关分析和SaTScan 9.5时空扫描分析,对中国大陆登革热疫区境外输入性登革热的时空分布进行了分析。结果:2005 - 2019年,13个疫区共报告输入性病例11407例,主要来自东南亚。其中62.1%输入云南和广东。输入性病例中男性多于女性,主要集中在21-50岁年龄组。热点集中在云南、广东和福建的部分地区。我们发现感染区正在向北扩展。结论:通过对2005 - 2019年中国大陆13个疫区境外输入登革热病例的分析,掌握了境外输入登革热病例的流行病学特征和空间分布。边境管制需要关注关键人群,如21-50岁的男性,并对关键人群进行登革热预防教育。有必要提高边境地区预防和控制输入性病例的认识。与此同时,北方地区也不能放松警惕。
{"title":"Epidemiological characteristics and temporal-spatial analysis of overseas imported dengue fever cases in outbreak provinces of China, 2005-2019.","authors":"Xinchang Lun,&nbsp;Yiguan Wang,&nbsp;Chunchun Zhao,&nbsp;Haixia Wu,&nbsp;Caiying Zhu,&nbsp;Delong Ma,&nbsp;Mingfang Xu,&nbsp;Jun Wang,&nbsp;Qiyong Liu,&nbsp;Lei Xu,&nbsp;Fengxia Meng","doi":"10.1186/s40249-022-00937-5","DOIUrl":"https://doi.org/10.1186/s40249-022-00937-5","url":null,"abstract":"<p><strong>Background: </strong>Overseas imported dengue fever is an important factor in local outbreaks of this disease in the mainland of China. To better prevent and control such local outbreaks, the epidemiological characteristics and temporal-spatial distribution of overseas imported dengue fever cases in provincial-level administrative divisions (PLADs) where dengue fever is outbreak in the mainland of China were explored.</p><p><strong>Methods: </strong>Using the Chinese National Notifiable Infectious Disease Reporting Information System (CNNDS), we identified overseas imported dengue fever cases in dengue fever outbreak areas in the mainland of China from 2005 to 2019 to draw the epidemic curve and population characteristic distribution of overseas imported cases in each PLAD. Based on spatial autocorrelation analysis of ArcGIS 10.5 and temporal-spatial scanning analysis of SaTScan 9.5, we analyzed the temporal-spatial distribution of overseas imported dengue fever in dengue fever outbreak areas in the mainland of China.</p><p><strong>Results: </strong>A total of 11,407 imported cases, mainly from Southeast Asia, were recorded from 2005 to 2019 in these 13 PLADs. Of which 62.1% were imported into Yunnan and Guangdong Provinces. Among the imported cases, there were more males than females, mainly from the 21-50 age group. The hot spots were concentrated in parts of Yunnan, Guangdong and Fujian Provinces. We found the cluster of infected areas were expanding northward.</p><p><strong>Conclusions: </strong>Based on the analysis of overseas imported dengue cases in 13 PLADs of the mainland of China from 2005 to 2019, we obtained the epidemiological characteristics and spatial distribution of imported dengue cases. Border controls need to pay attention to key population sectors, such as 21-50 years old men and education of key populations on dengue prevention. There is a need to improve the awareness of the prevention and control of imported cases in border areas. At the same time, northern regions cannot relax their vigilance.</p>","PeriodicalId":13587,"journal":{"name":"Infectious Diseases of Poverty","volume":"11 1","pages":"12"},"PeriodicalIF":8.1,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8785556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39856583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
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Infectious Diseases of Poverty
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