S. Momenyan, A. Kavousi, T. Baghfalaki, J. Poorolajal
n some studies, survival data are arranged spatially such as geographical regions. Incorporating spatial associationin these data not only can increase the accuracy and efficiency of the parameter estimation, but it also investigatesthe spatial patterns of survivorship. In this paper, we considered a Bayesian hierarchical survival model in thesetting of competing risks for the spatially clustered HIV/AIDS data. In this model, a Weibull Parametric distributionwith the spatial random effects in the form of county-failure type-level was used. A multivariate intrinsic conditionalautoregressive (MCAR) distribution was employed to model the areal spatial random effects. Comparison amongcompeting models was performed by the deviance information criterion and log pseudo-marginal likelihood. Weillustrated the gains of our model through the simulation studies and application to the HIV/AIDS data.
{"title":"Bayesian modeling of clustered competing risks survival times with spatial random effects","authors":"S. Momenyan, A. Kavousi, T. Baghfalaki, J. Poorolajal","doi":"10.2427/13301","DOIUrl":"https://doi.org/10.2427/13301","url":null,"abstract":"n some studies, survival data are arranged spatially such as geographical regions. Incorporating spatial associationin these data not only can increase the accuracy and efficiency of the parameter estimation, but it also investigatesthe spatial patterns of survivorship. In this paper, we considered a Bayesian hierarchical survival model in thesetting of competing risks for the spatially clustered HIV/AIDS data. In this model, a Weibull Parametric distributionwith the spatial random effects in the form of county-failure type-level was used. A multivariate intrinsic conditionalautoregressive (MCAR) distribution was employed to model the areal spatial random effects. Comparison amongcompeting models was performed by the deviance information criterion and log pseudo-marginal likelihood. Weillustrated the gains of our model through the simulation studies and application to the HIV/AIDS data.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79720464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Calabrò, E. Carini, M. Basile, P. Bonanni, R. D. De Vincenzo, A. Ghelardi, S. Tafuri, M. Conversano, C. Favaretti, A. Cicchetti
Human Papillomavirus (HPV) vaccination is able to reduce the risk of relapse in women undergoing surgery for HPVrelated lesions. The surgical treatment of these lesions can correlate with a greater risk of preterm parts. The extension of the recommendation of HPV vaccination to patients treated for a previous HPV-related lesion would entail a lower expense for the Health System. Therefore, an increase in the use of HPV vaccination is desirable also in this target population as well as the implementation of a care pathway dedicated to women treated for HPV lesions that includes vaccination in the prevention activities of relapses.
{"title":"Anti-HPV vaccination in women treated for HPV-related lesions: effective vaccination strategy for achieving HPV-related diseases control","authors":"G. Calabrò, E. Carini, M. Basile, P. Bonanni, R. D. De Vincenzo, A. Ghelardi, S. Tafuri, M. Conversano, C. Favaretti, A. Cicchetti","doi":"10.2427/13302","DOIUrl":"https://doi.org/10.2427/13302","url":null,"abstract":"Human Papillomavirus (HPV) vaccination is able to reduce the risk of relapse in women undergoing surgery for HPVrelated lesions. The surgical treatment of these lesions can correlate with a greater risk of preterm parts. The extension of the recommendation of HPV vaccination to patients treated for a previous HPV-related lesion would entail a lower expense for the Health System. Therefore, an increase in the use of HPV vaccination is desirable also in this target population as well as the implementation of a care pathway dedicated to women treated for HPV lesions that includes vaccination in the prevention activities of relapses.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90781376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Supadmi, A. Suwantika, D. A. Perwitasari, R. Abdulah
Despite the fact that Dengue Hemorrhagic Fever (DHF) is one of diseases with the highest incidence rate in Indonesia, its prevention strategies remain ineffective. One of the most cost-effective strategies to prevent DHF is through vaccination. This study aimed to investigate correlations between the knowledge of DHF, the behavior of DHF prevention and the knowledge of vaccine with the acceptance of dengue vaccine and willingness-to-pay (WTP) of dengue vaccine in Yogyakarta and Jakarta, Indonesia. A cross-sectional study was conducted by collecting data from people visiting primary healthcare centers (PHCs) through a valid and reliable questionnaire. A purposive sampling was applied, which resulted in 838 respondents among PHCs in Yogyakarta (two selected districts: Bantul and Kulon Progo) and Jakarta (two selected districts: West Jakarta and Central Jakarta). The result showed that the percentage of respondents who had good knowledge of vaccine was estimated to be 67-77% in all districts. The percentage of respondent who had good acceptance of vaccine was estimated to be 68-81%. WTP of dengue vaccine among respondents was estimated to be IDR 10,000-50,000. The result showed that the knowledge of DHF was significantly correlated (p<0.05) with the acceptance of dengue vaccine in districts of West Jakarta, Bantul and Kulon Progo. In particular, the behavior of DHF prevention and the knowledge of dengue vaccine were significantly correlated (p<0.05) with the acceptance of dengue vaccine in all districts. Additionally, the knowledge and acceptance of vaccine were significantly correlated (p<0.05) with WTP in West Jakarta only. It can be concluded that correlation among variables in all districts are not the same. Hence, specific approach is required to be applied in each district.
{"title":"Knowledge, acceptance and willingness to pay for Dengue vaccine in Yogyakarta and Jakarta","authors":"W. Supadmi, A. Suwantika, D. A. Perwitasari, R. Abdulah","doi":"10.2427/13274","DOIUrl":"https://doi.org/10.2427/13274","url":null,"abstract":"\u0000Despite the fact that Dengue Hemorrhagic Fever (DHF) is one of diseases with the highest incidence rate in Indonesia, its prevention strategies remain ineffective. One of the most cost-effective strategies to prevent DHF is through vaccination. This study aimed to investigate correlations between the knowledge of DHF, the behavior of DHF prevention and the knowledge of vaccine with the acceptance of dengue vaccine and willingness-to-pay (WTP) of dengue vaccine in Yogyakarta and Jakarta, Indonesia. A cross-sectional study was conducted by collecting data from people visiting primary healthcare centers (PHCs) through a valid and reliable questionnaire. A purposive sampling was applied, which resulted in 838 respondents among PHCs in Yogyakarta (two selected districts: Bantul and Kulon Progo) and Jakarta (two selected districts: West Jakarta and Central Jakarta). The result showed that the percentage of respondents who had good knowledge of vaccine was estimated to be 67-77% in all districts. The percentage of respondent who had good acceptance of vaccine was estimated to be 68-81%. WTP of dengue vaccine among respondents was estimated to be IDR 10,000-50,000. The result showed that the knowledge of DHF was significantly correlated (p<0.05) with the acceptance of dengue vaccine in districts of West Jakarta, Bantul and Kulon Progo. In particular, the behavior of DHF prevention and the knowledge of dengue vaccine were significantly correlated (p<0.05) with the acceptance of dengue vaccine in all districts. Additionally, the knowledge and acceptance of vaccine were significantly correlated (p<0.05) with WTP in West Jakarta only. It can be concluded that correlation among variables in all districts are not the same. Hence, specific approach is required to be applied in each district. \u0000","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79591102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: We aimed to determine the level of health literacy (HL), and its association with general health. In addition, we investigated the direct and indirect association of socioeconomic status (SES) and general health among the adult population in Iran.
Methods: This cross-sectional study involved 750 literate adults' people. The SES was assessed based on the owning of assets. HL was evaluated using a validated questionnaire in Iran. General health was assessed using the WHO general health questionnaire. The simple and adjusted linear regression models, and structural equation modeling (SEM) were used for data analysis.
Results: In adjusted model, female gender, higher level of education, use of books, pamphlets, or brochures as a source of health information, the higher level of SES were positively associated with higher HL. In addition, the HL was significantly associated with higher scores of general health. Results of SEM showed that the direct effect of SES on general health was not significant, but the indirect effect via HL was significant (path coefficient: 0.24; p<0.001).
Conclusion: Results of our study indicated HL is strongly associated with general health among the adult population. SES had a significant indirect association with general health via the effect on health literacy.
{"title":"Socioeconomic status and health literacy as the important predictors of general health in Iran: a structural equation modeling approach","authors":"Tayebeh Nadi, Jalal Poorolajal, Amin Doosti-Irani","doi":"10.2427/13312","DOIUrl":"https://doi.org/10.2427/13312","url":null,"abstract":"
 Background: We aimed to determine the level of health literacy (HL), and its association with general health. In addition, we investigated the direct and indirect association of socioeconomic status (SES) and general health among the adult population in Iran.
 Methods: This cross-sectional study involved 750 literate adults' people. The SES was assessed based on the owning of assets. HL was evaluated using a validated questionnaire in Iran. General health was assessed using the WHO general health questionnaire. The simple and adjusted linear regression models, and structural equation modeling (SEM) were used for data analysis.
 Results: In adjusted model, female gender, higher level of education, use of books, pamphlets, or brochures as a source of health information, the higher level of SES were positively associated with higher HL. In addition, the HL was significantly associated with higher scores of general health. Results of SEM showed that the direct effect of SES on general health was not significant, but the indirect effect via HL was significant (path coefficient: 0.24; p<0.001).
 Conclusion: Results of our study indicated HL is strongly associated with general health among the adult population. SES had a significant indirect association with general health via the effect on health literacy.
","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135554015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-03DOI: 10.54103/2282-0930/20742
M. Valenti, M. Attanasio, I. Le Donne, Antony Bologna, F. Masedu, M. Mazza
Autism spectrum disorder (ASD) is a neurodevelopment disorder characterised by a range of deficits in two specific domains: social communication and social interaction and repetitive patterns of behaviour. Several studies have explored the link between ASD and STEM (science, technology, engineering and mathematics, or other mathematics-grounded disciplines), but results are still uncertain. Objective of the study was to estimate the potential role of systemising abilities in parents as a risk factor for ASD in the offspring, using the achievement of a degree in STEM disciplines as a proxy characteristic of the exposure. There were 1,316 participants overall. There were 658 incident consecutive cases of definite ASD, diagnosed in a Reference Centre for ASD in Italy, from 2001 to 2020. The main exposure variable was parental education level. The risk of ASD in the offspring associated with the main exposure variable and the exposure covariates (e.g. use of neurotropic drugs during the first trimester of the mother’s pregnancy, perinatal outcomes of participants and/or preterm birth) was studied by using conditional logistic regression analysis. In addition, we carried out a mediation analysis to investigate whether and the extent to which covariates significantly associated with ASD risk mediate the relationship between parental education level and ASD in offspring. A STEM degree in parents was significantly associated with risk of ASD in offspring (OR 1.43, 95% CI 1.03-2.54). Familiarity was weakly associated with the risk of ASD (OR 1.33, 95% CI 1.00-1.66) and is the stronger mediator (PME 28%). Sensitivity analysis did not show deviations related to gender or ASD level. Our study moves in the direction of confirming the risk of occurrence of ASD in the offspring of parents with elevated systemising abilities.
自闭症谱系障碍(ASD)是一种神经发育障碍，其特征是在两个特定领域的一系列缺陷:社会沟通和社会互动以及重复的行为模式。一些研究已经探索了自闭症谱系障碍和STEM(科学、技术、工程和数学，或其他以数学为基础的学科)之间的联系，但结果仍然不确定。该研究的目的是利用STEM学科的学位作为暴露的代理特征，估计父母的系统化能力作为后代ASD风险因素的潜在作用。总共有1316名参与者。从2001年到2020年，在意大利的ASD参考中心确诊了658例明确的ASD病例。主要暴露变量为父母受教育程度。使用条件logistic回归分析研究了与主要暴露变量和暴露协变量(如母亲妊娠前三个月使用神经药物、参与者围产期结局和/或早产)相关的后代ASD风险。此外，我们还进行了中介分析，以调查与ASD风险显著相关的协变量是否以及在多大程度上中介父母教育水平与后代ASD之间的关系。父母的STEM学位与子女患ASD的风险显著相关(OR 1.43, 95% CI 1.03-2.54)。熟悉程度与ASD风险呈弱相关(OR 1.33, 95% CI 1.00-1.66)，是较强的中介(PME为28%)。敏感性分析未发现与性别或ASD水平相关的偏差。我们的研究方向是确认系统化能力高的父母的后代发生ASD的风险。
{"title":"Stem-Skilled Parents and Autism Spectrum Disorder in Offspring: A Case-Control Study","authors":"M. Valenti, M. Attanasio, I. Le Donne, Antony Bologna, F. Masedu, M. Mazza","doi":"10.54103/2282-0930/20742","DOIUrl":"https://doi.org/10.54103/2282-0930/20742","url":null,"abstract":"Autism spectrum disorder (ASD) is a neurodevelopment disorder characterised by a range of deficits in two specific domains: social communication and social interaction and repetitive patterns of behaviour. Several studies have explored the link between ASD and STEM (science, technology, engineering and mathematics, or other mathematics-grounded disciplines), but results are still uncertain. Objective of the study was to estimate the potential role of systemising abilities in parents as a risk factor for ASD in the offspring, using the achievement of a degree in STEM disciplines as a proxy characteristic of the exposure. There were 1,316 participants overall. There were 658 incident consecutive cases of definite ASD, diagnosed in a Reference Centre for ASD in Italy, from 2001 to 2020. The main exposure variable was parental education level. The risk of ASD in the offspring associated with the main exposure variable and the exposure covariates (e.g. use of neurotropic drugs during the first trimester of the mother’s pregnancy, perinatal outcomes of participants and/or preterm birth) was studied by using conditional logistic regression analysis. In addition, we carried out a mediation analysis to investigate whether and the extent to which covariates significantly associated with ASD risk mediate the relationship between parental education level and ASD in offspring. A STEM degree in parents was significantly associated with risk of ASD in offspring (OR 1.43, 95% CI 1.03-2.54). Familiarity was weakly associated with the risk of ASD (OR 1.33, 95% CI 1.00-1.66) and is the stronger mediator (PME 28%). Sensitivity analysis did not show deviations related to gender or ASD level. Our study moves in the direction of confirming the risk of occurrence of ASD in the offspring of parents with elevated systemising abilities.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84762672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-03DOI: 10.54103/2282-0930/19997
P. Trerotoli, M. Minerva, N. Bartolomeo, Massimo Giotta, Ilaria Dargenio, Giammaria Liuzzi, C. Signorelli
Background: In order to be able to access a course of medical or surgical specialization, in addition to the degree and the qualification to the profession it is necessary to perform an entrance test. In this study we wanted to analyze the possible factors that determined the choice of a given graduate school and the place where to attend it in the year 2021.Study design: Cross-sectional study to evaluate the association between the type of graduate school, the score class obtained at the admission test, the location of the graduate school and the location of the degree. Methods: The evaluation of the association between site of specialty admission and degree, score at degree and score at admission test was performed by multiple correspondences analysis (MCA). Then, through a logistic regression model, the Odds Ratios (OR) and the respective confidence interval with 95% (95%CI) confidence level of the covariates on the probability of remaining in the same degree site, or in the same region or in the same geographical area, were estimated.Results The highest admission score and the highest age are significantly and independently associated with the probability of choosing, as a graduate school location, the same location where the degree was obtained.Conclusion: In conclusion, the choice of the course and the location of the specialty course is made in most cases, taking into account the score made in the exam, based on the location where you attended the course of study in medicine and surgery.
{"title":"Choosing a medical specialty course in Italy: explorative analysis of factors related to the choice","authors":"P. Trerotoli, M. Minerva, N. Bartolomeo, Massimo Giotta, Ilaria Dargenio, Giammaria Liuzzi, C. Signorelli","doi":"10.54103/2282-0930/19997","DOIUrl":"https://doi.org/10.54103/2282-0930/19997","url":null,"abstract":"Background: In order to be able to access a course of medical or surgical specialization, in addition to the degree and the qualification to the profession it is necessary to perform an entrance test. In this study we wanted to analyze the possible factors that determined the choice of a given graduate school and the place where to attend it in the year 2021.Study design: Cross-sectional study to evaluate the association between the type of graduate school, the score class obtained at the admission test, the location of the graduate school and the location of the degree. Methods: The evaluation of the association between site of specialty admission and degree, score at degree and score at admission test was performed by multiple correspondences analysis (MCA). Then, through a logistic regression model, the Odds Ratios (OR) and the respective confidence interval with 95% (95%CI) confidence level of the covariates on the probability of remaining in the same degree site, or in the same region or in the same geographical area, were estimated.Results The highest admission score and the highest age are significantly and independently associated with the probability of choosing, as a graduate school location, the same location where the degree was obtained.Conclusion: In conclusion, the choice of the course and the location of the specialty course is made in most cases, taking into account the score made in the exam, based on the location where you attended the course of study in medicine and surgery.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85975118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.54103/2282-0930/20755
Mahfouz Al-Bachir, Husam Ahmad
Background: Overweight and obesity has become a serious public health problem in the world. Changes in daily physical activity (PA) levels may help moderate the health risks of sedentary behavior (SB). The aim of the present study was to determine PA and SB by triaxial accelerometer (ActiGraph GTX3 GT3X+, ActiGraph, Pensacola, FL. 32502 USA) in Syrian adults that affected by age, marital, body mass index (BMI), education, and smoking status.Methods: We used cross-sectional baseline data from 97 participants of adults (18-60 years). Subjects wore an accelerometer for 7 consecutive days. Magnitude counts/minute was extracted to determine time in inactivity, in low-intensity, moderate, and vigorous-to-very-vigorous activity.Results: Higher age was associated with more time in all categories of PA (light, moderate vigorous MVPA with bouts, MVPA without bouts, and step per day), while higher BMI was related to less time in PA, overweight/obese subjects, on daily average, spent less, but not significantly, time standing and little more time spent in sitting than the normal weight groups. Participant comparing to non-smoking peoples tended to spent less time in PA; however, this synchronization was not considerable.Conclusion: Finally, our investigation demonstrated a positive synchronization between sedentary time and educational level. In this cohort of adults, most of men and women fulfilled the WHO recommendations. The levels of PA in 18–60-year-old adults are similar to previous data reported in adults.
{"title":"Using accelerometer Analysis to Assess Physical Activity and Sedentary Behavior in Syrian Adults","authors":"Mahfouz Al-Bachir, Husam Ahmad","doi":"10.54103/2282-0930/20755","DOIUrl":"https://doi.org/10.54103/2282-0930/20755","url":null,"abstract":"Background: Overweight and obesity has become a serious public health problem in the world. Changes in daily physical activity (PA) levels may help moderate the health risks of sedentary behavior (SB). The aim of the present study was to determine PA and SB by triaxial accelerometer (ActiGraph GTX3 GT3X+, ActiGraph, Pensacola, FL. 32502 USA) in Syrian adults that affected by age, marital, body mass index (BMI), education, and smoking status.Methods: We used cross-sectional baseline data from 97 participants of adults (18-60 years). Subjects wore an accelerometer for 7 consecutive days. Magnitude counts/minute was extracted to determine time in inactivity, in low-intensity, moderate, and vigorous-to-very-vigorous activity.Results: Higher age was associated with more time in all categories of PA (light, moderate vigorous MVPA with bouts, MVPA without bouts, and step per day), while higher BMI was related to less time in PA, overweight/obese subjects, on daily average, spent less, but not significantly, time standing and little more time spent in sitting than the normal weight groups. Participant comparing to non-smoking peoples tended to spent less time in PA; however, this synchronization was not considerable.Conclusion: Finally, our investigation demonstrated a positive synchronization between sedentary time and educational level. In this cohort of adults, most of men and women fulfilled the WHO recommendations. The levels of PA in 18–60-year-old adults are similar to previous data reported in adults.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"338 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75935595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.54103/2282-0930/20757
Tsubasa Ito, Takahiro Otani, T. Anzai, T. Okumura, Kunihiko Takahashi
Introduction: Contact tracing surveys are being conducted to identify and isolate close contacts of an identified patient to reduce the spread of coronavirus disease (COVID-19). However, the estimates of risk indexes based on information obtained from the surveys and normally used in practice can have biases comparing with true magnitude of risks of infection and spread.Method: We evaluated whether the estimates of the risk indexes obtained from information of the active epidemiological surveillance, contact tracing surveys in Japan, are suitable for quantitative assessment of the risk factors of COVID-19, using pseudo data via a simulation study. We discussed two types of risks considered in the issue of infectious disease, the probability of infection and that of spreading, and the estimates of these risks.Results and Discussion: A naive method to estimate the risks of infection and spreading of COVID-19 is to calculate the ratio of infected patients to close contacts and the ratio of patients who infected others to all the confirmed patients, respectively. However, these estimates could possibly have significant biases and result in being ineffective for both the exploration and the quantitative assessment of the risk factors in the following ordinary cases: a person contacts closely with many confirmed patients, or a confirmed patient contact closely with many people. Then, some steps are needed to reduce such possible biases for the estimation the risks of both the infection and spreading of COVID-19.
{"title":"Potential Biases of the Transmission Risks of COVID-19 estimated by Contact Tracing Surveys in Japan","authors":"Tsubasa Ito, Takahiro Otani, T. Anzai, T. Okumura, Kunihiko Takahashi","doi":"10.54103/2282-0930/20757","DOIUrl":"https://doi.org/10.54103/2282-0930/20757","url":null,"abstract":"Introduction: Contact tracing surveys are being conducted to identify and isolate close contacts of an identified patient to reduce the spread of coronavirus disease (COVID-19). However, the estimates of risk indexes based on information obtained from the surveys and normally used in practice can have biases comparing with true magnitude of risks of infection and spread.Method: We evaluated whether the estimates of the risk indexes obtained from information of the active epidemiological surveillance, contact tracing surveys in Japan, are suitable for quantitative assessment of the risk factors of COVID-19, using pseudo data via a simulation study. We discussed two types of risks considered in the issue of infectious disease, the probability of infection and that of spreading, and the estimates of these risks.Results and Discussion: A naive method to estimate the risks of infection and spreading of COVID-19 is to calculate the ratio of infected patients to close contacts and the ratio of patients who infected others to all the confirmed patients, respectively. However, these estimates could possibly have significant biases and result in being ineffective for both the exploration and the quantitative assessment of the risk factors in the following ordinary cases: a person contacts closely with many confirmed patients, or a confirmed patient contact closely with many people. Then, some steps are needed to reduce such possible biases for the estimation the risks of both the infection and spreading of COVID-19.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88691500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.54103/2282-0930/20754
Eustes Kigongo, Eve Achan, B. Opio, Anne Ruth Akello, Marvin Musinguzi, Raymond Tumwesigye, Amir Kabunga, Sean Steven Puleh
Background: As of November 26, 2021, at least seven different vaccines across three platforms have been distributed globally. These vaccines include Pfizer/BioNTech released on December 31, 2020, AstraZeneca on February 16, 2021, Janssen by Johnson and Johnson on March 12, 2021, Moderna on April 30, 2021, Sinopharm on May 7, 2021, Sinovac CoronaVac on July 1, 2021, and COVAXIN on November 3, 2021. Despite this unprecedented scientific discovery, vaccine hesitancy is seen as a stumbling block towards achieving herd immunity in the battle to control this global pandemic. The effectiveness of vaccines has been based on the principle that the community was willing to take up the vaccine to achieve herd immunity. This study aimed to assess COVID-19 vaccination hesitancy and associated factors among the business community in Lira City, Uganda.Methods: Descriptive cross-sectional design was conducted among the business community from Lira City in Northern Uganda. The sample size was 421, however, only 407 members of the business community who responded were included in the analysis.Results: Of the 407 participants, 57.3% were females, 52.5% were married, 88.4% were Langi by Tribe, 43.5% had tertiary education, 33.4% were Anglicans, and 40.1% were market vendors. Results also show that about 32.3% of the respondents had either delayed or refused to take the COVID-19 vaccine. The correlates of vaccination hesitance were education level (aOR; 3.63, 95%CI; 1.49-8.79, p=0.04), having a chronic medical condition (aOR; 2.7, 95%CI; 1.39-5.38, p=0.04) and certainty in the COVID-19 vaccines (aOR; 0.27, 95%CI; 0.017-0.51, p=0.02). Respondents who had primary level education had a more than 2-fold increased odds of acceptance of COVID-19 vaccination compared to those who had not attained any formal education. Individuals who had chronic medical conditions had more than 2-fold increased odds of accepting the COVID-19 vaccine compared to those who did not have any chronic medical conditions. Those who were certain about the COVID-19 vaccine were 73% less likely to hesitate vaccination as compared to their counterparts who were uncertain. Conclusion: The study found a substantially high level of COVID-19 vaccination hesitancy in Lira City and its predictors were level of education, chronic medical conditions and certainty in COVID-19 vaccines. For this reason, it is important to raise awareness among the business community about the vaccine. To increase uptake, policymakers and other stakeholders need to create effective communication techniques for behavior change.
{"title":"COVID-19 vaccination hesitancy and associated factors among the business community in Lira City, Uganda: a cross-sectional research","authors":"Eustes Kigongo, Eve Achan, B. Opio, Anne Ruth Akello, Marvin Musinguzi, Raymond Tumwesigye, Amir Kabunga, Sean Steven Puleh","doi":"10.54103/2282-0930/20754","DOIUrl":"https://doi.org/10.54103/2282-0930/20754","url":null,"abstract":"Background: As of November 26, 2021, at least seven different vaccines across three platforms have been distributed globally. These vaccines include Pfizer/BioNTech released on December 31, 2020, AstraZeneca on February 16, 2021, Janssen by Johnson and Johnson on March 12, 2021, Moderna on April 30, 2021, Sinopharm on May 7, 2021, Sinovac CoronaVac on July 1, 2021, and COVAXIN on November 3, 2021. Despite this unprecedented scientific discovery, vaccine hesitancy is seen as a stumbling block towards achieving herd immunity in the battle to control this global pandemic. The effectiveness of vaccines has been based on the principle that the community was willing to take up the vaccine to achieve herd immunity. This study aimed to assess COVID-19 vaccination hesitancy and associated factors among the business community in Lira City, Uganda.Methods: Descriptive cross-sectional design was conducted among the business community from Lira City in Northern Uganda. The sample size was 421, however, only 407 members of the business community who responded were included in the analysis.Results: Of the 407 participants, 57.3% were females, 52.5% were married, 88.4% were Langi by Tribe, 43.5% had tertiary education, 33.4% were Anglicans, and 40.1% were market vendors. Results also show that about 32.3% of the respondents had either delayed or refused to take the COVID-19 vaccine. The correlates of vaccination hesitance were education level (aOR; 3.63, 95%CI; 1.49-8.79, p=0.04), having a chronic medical condition (aOR; 2.7, 95%CI; 1.39-5.38, p=0.04) and certainty in the COVID-19 vaccines (aOR; 0.27, 95%CI; 0.017-0.51, p=0.02). Respondents who had primary level education had a more than 2-fold increased odds of acceptance of COVID-19 vaccination compared to those who had not attained any formal education. Individuals who had chronic medical conditions had more than 2-fold increased odds of accepting the COVID-19 vaccine compared to those who did not have any chronic medical conditions. Those who were certain about the COVID-19 vaccine were 73% less likely to hesitate vaccination as compared to their counterparts who were uncertain. Conclusion: The study found a substantially high level of COVID-19 vaccination hesitancy in Lira City and its predictors were level of education, chronic medical conditions and certainty in COVID-19 vaccines. For this reason, it is important to raise awareness among the business community about the vaccine. To increase uptake, policymakers and other stakeholders need to create effective communication techniques for behavior change.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78716762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.54103/2282-0930/20636
X. Chen, Ying Zhang, A. Fretts, T. Ali, J. Umans, R. B. Devereux, Elisa Lee, S. Cole, Yan D. Zhao
Background: Because of its convenience and robustness, the generalized estimating equations (GEE) method has been commonly used to fit marginal models of continuous outcomes in family studies. However, unbalanced family sizes and complex pedigree structures within each family may challenge the GEE method, which treats families as clusters with the same correlation structure. The appropriateness of using the GEE method to analyze continuous outcomes in family studies remains unclear. In this paper, we performed simulation studies to evaluate the performance of GEE in the analysis of family study data. Methods: In simulation studies, we generated data from a linear mixed effects model with individual random effects. The random effects covariance matrix is specified as twice that of the pedigree matrix from the Strong Heart Family Study (SHFS) and other hypothetical pedigree structures. A Bayesian approach that utilizes the pedigree matrix was also conducted as a benchmark to compare with GEE methods with either independent or exchangeable correlation structures. Finally, analysis with a real data example was included. Results: Our simulation results showed that GEE with independent correlation structure worked well for family data with continuous outcomes. Real data analysis revealed that all GEE and Bayesian approaches produced similar results. Conclusion: GEE model performs well on continuous outcome in family studies, and it yields estimated coefficients similar to a Bayesian model, which takes genetic relationship into account. Overall, GEE is robust to misspecification of genetic relationships among family members.
{"title":"Assessing the Use of GEE Methods for Analyzing Continuous Outcomes from Family Studies: Strong Heart Family Study","authors":"X. Chen, Ying Zhang, A. Fretts, T. Ali, J. Umans, R. B. Devereux, Elisa Lee, S. Cole, Yan D. Zhao","doi":"10.54103/2282-0930/20636","DOIUrl":"https://doi.org/10.54103/2282-0930/20636","url":null,"abstract":"Background: Because of its convenience and robustness, the generalized estimating equations (GEE) method has been commonly used to fit marginal models of continuous outcomes in family studies. However, unbalanced family sizes and complex pedigree structures within each family may challenge the GEE method, which treats families as clusters with the same correlation structure. The appropriateness of using the GEE method to analyze continuous outcomes in family studies remains unclear. In this paper, we performed simulation studies to evaluate the performance of GEE in the analysis of family study data. \u0000Methods: In simulation studies, we generated data from a linear mixed effects model with individual random effects. The random effects covariance matrix is specified as twice that of the pedigree matrix from the Strong Heart Family Study (SHFS) and other hypothetical pedigree structures. A Bayesian approach that utilizes the pedigree matrix was also conducted as a benchmark to compare with GEE methods with either independent or exchangeable correlation structures. Finally, analysis with a real data example was included. \u0000Results: Our simulation results showed that GEE with independent correlation structure worked well for family data with continuous outcomes. Real data analysis revealed that all GEE and Bayesian approaches produced similar results. \u0000Conclusion: GEE model performs well on continuous outcome in family studies, and it yields estimated coefficients similar to a Bayesian model, which takes genetic relationship into account. Overall, GEE is robust to misspecification of genetic relationships among family members.","PeriodicalId":45811,"journal":{"name":"Epidemiology Biostatistics and Public Health","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79819870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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