Pub Date : 2024-09-12DOI: 10.1101/2024.09.11.24313521
Robertus Dole Guntur, Jusrry Rosalina Pahnael, Keristina Br Ginting, Yulianti Paula Bria, Damai Kusumaningrum, Fakir MA Islam
Introduction Malaria is a global health issue including in Indonesia. Currently, most of the cases was in the rural of eastern part of the country. However, malaria risk factors amongst rural adult were less documented. This study investigated malaria risk factors amongst rural adults in East Nusa Tenggara Province (ENTP). Methods A community based cross –sectional study was conducted to interview 1495 rural adults in ENTP. A multi-stage cluster random sampling technique was applied to collect data on malaria history, demographic, behavioural and environmental factors of malaria of participants. Logistic regression model was applied to decide significant factors associated with malaria. Results The prevalence of malaria was 13.4%. The prevalence of malaria was significantly higher for adults with low level of malaria knowledge (Adjusted odd ratio (AOR): 2.43, 95% confidence interval (CI): 1.38 — 4.27) compared to those with high malaria knowledge level, having moderate malaria knowledge level (AOR: 1.99, 95% CI: 1.11 — 3.57) compared to those high malaria knowledge level, having no education (AOR: 2.18, 95% CI: 1.37 — 3.45) compared to those junior high school or above education level, outdoor occupation (AOR: 1.81, 95% CI: 1.22 — 2.68) compared to indoor occupation, having family size > 4 (AOR 2.08, 95% CI: 1.52 —2.87) compared to those ≤ 4 Conclusion The study revealed the prevalence of malaria amongst rural adults in this province was high. The study highlights the power of malaria knowledge level on the prediction of malaria prevalence amongst rural adults. Health education intervention is critical for vulnerable groups to reduce malaria prevalence in the province.
{"title":"Malaria prevalence and its associated factors amongst rural adults: Cross-sectional study in East Nusa Tenggara Province Indonesia","authors":"Robertus Dole Guntur, Jusrry Rosalina Pahnael, Keristina Br Ginting, Yulianti Paula Bria, Damai Kusumaningrum, Fakir MA Islam","doi":"10.1101/2024.09.11.24313521","DOIUrl":"https://doi.org/10.1101/2024.09.11.24313521","url":null,"abstract":"Introduction Malaria is a global health issue including in Indonesia. Currently, most of the cases was in the rural of eastern part of the country. However, malaria risk factors amongst rural adult were less documented. This study investigated malaria risk factors amongst rural adults in East Nusa Tenggara Province (ENTP). Methods\u0000A community based cross\t–sectional study was conducted to interview 1495 rural adults in ENTP. A multi-stage cluster random sampling technique was applied to collect data on malaria history, demographic, behavioural and environmental factors of malaria of participants. Logistic regression model was applied to decide significant factors associated with malaria. Results\u0000The prevalence of malaria was 13.4%. The prevalence of malaria was significantly higher for adults with low level of malaria knowledge (Adjusted odd ratio (AOR): 2.43, 95% confidence interval (CI): 1.38 — 4.27) compared to those with high malaria knowledge level, having moderate malaria knowledge level (AOR: 1.99, 95% CI: 1.11 — 3.57) compared to those high malaria knowledge level, having no education (AOR: 2.18, 95% CI: 1.37 — 3.45) compared to those junior high school or above education level, outdoor occupation (AOR: 1.81, 95% CI: 1.22 — 2.68) compared to indoor occupation, having family size > 4 (AOR 2.08, 95% CI: 1.52 —2.87) compared to those ≤ 4 Conclusion\u0000The study revealed the prevalence of malaria amongst rural adults in this province was high. The study highlights the power of malaria knowledge level on the prediction of malaria prevalence amongst rural adults. Health education intervention is critical for vulnerable groups to reduce malaria prevalence in the province.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213602","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 : 2024-09-12DOI: 10.1101/2024.08.28.24312706
Nandakumar Ravichandran
Background Monkeypox (mpox) is a zoonotic disease originating from the Congo Basin (Clade I) and West Africa (Clade II). In 2022, mpox spread to non-endemic European countries, predominantly through human transmission associated with sexual contact. The outbreak in Europe was primarily with the Clade IIb lineage, which is less virulent. The World Health Organization (WHO) declared this outbreak a Public Health Emergency of International Concern (PHEIC) in 2022, which ended in May 2023 after a decline in cases. However, in July 2024, a resurgence of the more virulent Clade I occurred in the Democratic Republic of Congo (DRC), leading WHO to declare mpox a PHEIC again, due to the risk of global spread. Understanding epidemiology and risk factors of mpox is vital for effective public health measures. Methodology and principal findings A search conducted from 2014 to 2024 across PubMed, Scopus and Embase identified 46 studies on mpox in Europe, which were included for qualitative analysis. The key themes identified were epidemiology, risk factors, and implications for public health actions. High-risk behaviors include sexual contact among men who have sex with men (MSM) with multiple partners, living with HIV, and frequent travel to endemic regions. Conclusions and significance With no definitive cure for mpox, public health measures such as surveillance, monitoring, and contact tracing are essential. Additionally, encouraging case-control studies is crucial for exploring other potential risk behaviors and design behavioral interventions, vaccination campaigns and awareness programs aimed at reducing high-risk behaviors among these populations. Although the number of cases in Europe did not surge in August 2024, proactive measures are necessary to prevent further spread.
{"title":"Monkeypox in Europe: Epidemiology, Risk Factors and Implications for Public Health Actions : A Scoping Review Study","authors":"Nandakumar Ravichandran","doi":"10.1101/2024.08.28.24312706","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312706","url":null,"abstract":"Background\u0000Monkeypox (mpox) is a zoonotic disease originating from the Congo Basin (Clade I) and West Africa (Clade II). In 2022, mpox spread to non-endemic European countries, predominantly through human transmission associated with sexual contact. The outbreak in Europe was primarily with the Clade IIb lineage, which is less virulent. The World Health Organization (WHO) declared this outbreak a Public Health Emergency of International Concern (PHEIC) in 2022, which ended in May 2023 after a decline in cases. However, in July 2024, a resurgence of the more virulent Clade I occurred in the Democratic Republic of Congo (DRC), leading WHO to declare mpox a PHEIC again, due to the risk of global spread. Understanding epidemiology and risk factors of mpox is vital for effective public health measures.\u0000Methodology and principal findings\u0000A search conducted from 2014 to 2024 across PubMed, Scopus and Embase identified 46 studies on mpox in Europe, which were included for qualitative analysis. The key themes identified were epidemiology, risk factors, and implications for public health actions. High-risk behaviors include sexual contact among men who have sex with men (MSM) with multiple partners, living with HIV, and frequent travel to endemic regions.\u0000Conclusions and significance\u0000With no definitive cure for mpox, public health measures such as surveillance, monitoring, and contact tracing are essential. Additionally, encouraging case-control studies is crucial for exploring other potential risk behaviors and design behavioral interventions, vaccination campaigns and awareness programs aimed at reducing high-risk behaviors among these populations. Although the number of cases in Europe did not surge in August 2024, proactive measures are necessary to prevent further spread.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213388","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 : 2024-09-12DOI: 10.1101/2024.09.10.24313453
Le Wei, Matthew Ahmadi, Joanna M Blodgett, Elroy J. Aguiar, Raaj Kishore Biswas, Borja del Bozo Cruz, Emmanuel Stamatakis
Abstract Background: Research on the health effects of stepping intensity in free–living environments is limited and inconclusive. Inconsistent use of stepping intensity estimation metrics could explain current equivocal results. We aimed to examine and compare a range of different cadence–based metrics in terms of their multivariable–adjusted associations with all–cause (ACM) cardiovascular disease (CVD), cancer and physical–activity (PA)–related cancer mortality. Methods: This prospective cohort study included participants with valid wrist–worn accelerometer data from the UK Biobank. We estimated stepping intensity using ten different cadence–based metrics, including eight peak–cadence metrics (defined as averaged steps / min of the highest but not necessarily consecutive minutes) that most of whom have appeared in prior literature, plus two non–peak–cadence metrics: 1) average daily cadence, defined as steps/accelerometer wearing mins, and 2) average cadence of purposeful steps, defined as averaged steps / min of minutes with ≥ 40 steps. We rescaled each metric into a standardised cadence scale with mean of 0 and standard deviation (SD) of 1, using (absolute–mean)/SD. We compared the dose–response associations of each stepping intensity estimation metrics with mortality outcomes using previously published modelling involving Cox–restricted–cubic–spline model, presented as overlay plots on standardised and absolute cadence scales. Results: Among 70,336 participants (age [SD], 61.6 [7.8] years; female, 40,933 [58%]) followed up for a median of 8.0 years, all cadence–based metrics, besides the average cadence of purposeful steps, exhibited a comparable beneficial dose–response association with ACM/CVD/cancer mortality, with 95% CI largely overlapped (e.g., at –0.2 standardised steps/min, the hazard ratio (HR) of ACM for peak 1– and peak 30–min cadence were: 0.72, 95%CI [0.65, 0.82] and 0.66 [0.60, 0.73], respectively). The average cadence of purposeful steps only did not show dose–response associations with mortality outcomes (e.g., the HR that corresponds to the standardised median for the average cadence of purposeful steps in ACM was 0.98 [95% CI: 0.86, 1.12]. Conclusion: Besides the average cadence of purposeful steps, all stepping intensity estimation metrics demonstrated comparable beneficial dose–response associations with mortality of all–cause, CVD and cancer, suggesting these cadence–based metrics may be used interchangeably for estimating associations of free–living stepping intensity with health outcomes and applied in different research scenarios accordingly.
{"title":"Does the choice of stepping intensity metric influence dose-response associations with mortality? A UK population cohort study of 70,174 adults","authors":"Le Wei, Matthew Ahmadi, Joanna M Blodgett, Elroy J. Aguiar, Raaj Kishore Biswas, Borja del Bozo Cruz, Emmanuel Stamatakis","doi":"10.1101/2024.09.10.24313453","DOIUrl":"https://doi.org/10.1101/2024.09.10.24313453","url":null,"abstract":"Abstract Background:\u0000Research on the health effects of stepping intensity in free–living environments is limited and inconclusive. Inconsistent use of stepping intensity estimation metrics could explain current equivocal results. We aimed to examine and compare a range of different cadence–based metrics in terms of their multivariable–adjusted associations with all–cause (ACM) cardiovascular disease (CVD), cancer and physical–activity (PA)–related cancer mortality.\u0000Methods: This prospective cohort study included participants with valid wrist–worn accelerometer data from the UK Biobank. We estimated stepping intensity using ten different cadence–based metrics, including eight peak–cadence metrics (defined as averaged steps / min of the highest but not necessarily consecutive minutes) that most of whom have appeared in prior literature, plus two non–peak–cadence metrics: 1) average daily cadence, defined as steps/accelerometer wearing mins, and 2) average cadence of purposeful steps, defined as averaged steps / min of minutes with ≥ 40 steps. We rescaled each metric into a standardised cadence scale with mean of 0 and standard deviation (SD) of 1, using (absolute–mean)/SD. We compared the dose–response associations of each stepping intensity estimation metrics with mortality outcomes using previously published modelling involving Cox–restricted–cubic–spline model, presented as overlay plots on standardised and absolute cadence scales. Results: Among 70,336 participants (age [SD], 61.6 [7.8] years; female, 40,933 [58%]) followed up for a median of 8.0 years, all cadence–based metrics, besides the average cadence of purposeful steps, exhibited a comparable beneficial dose–response association with ACM/CVD/cancer mortality, with 95% CI largely overlapped (e.g., at –0.2 standardised steps/min, the hazard ratio (HR) of ACM for peak 1– and peak 30–min cadence were: 0.72, 95%CI [0.65, 0.82] and 0.66 [0.60, 0.73], respectively). The average cadence of purposeful steps only did not show dose–response associations with mortality outcomes (e.g., the HR that corresponds to the standardised median for the average cadence of purposeful steps in ACM was 0.98 [95% CI: 0.86, 1.12].\u0000Conclusion:\u0000Besides the average cadence of purposeful steps, all stepping intensity estimation metrics demonstrated comparable beneficial dose–response associations with mortality of all–cause, CVD and cancer, suggesting these cadence–based metrics may be used interchangeably for estimating associations of free–living stepping intensity with health outcomes and applied in different research scenarios accordingly.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226813","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 : 2024-09-12DOI: 10.1101/2024.09.11.24313477
Peter D Kirwan, Sarah D Foulkes, Katie Munro, Dominic Sparkes, Jasleen Singh, Amanda Henry, Angela Dunne, Jean Timeyin, Sophie Russell, Jameel Khawam, Debbie Blick, Ashley D Otter, Nipunadi Hettiarachchi, Michelle Cairns, Christopher H Jackson, Shaun Seaman, Colin S Brown, SIREN Study Group, Ana Atti, Jasmin Islam, Andre Charlett, Daniela De Angelis, Anne M Presanis, Victoria Jane Hall, Susan Hopkins
Objective To estimate the protection of COVID-19 vaccine boosters against mild/asymptomatic and moderate SARS-CoV-2 infection over a 6-month period of XBB.1.5 and JN.1 variant circulation. Design Multi-state model applied to cohort study, adjusted for vaccination, prior infection, and demographic covariates. Setting National Health Services (NHS) hospitals in the UK. Participants Healthcare worker cohort including 2,867 eligible people with >6 months since a previous booster who tested fortnightly for SARS-CoV-2 between October 2023 and March 2024 and completed symptoms questionnaires. Main outcome measures Vaccine effectiveness (VE) of vaccine boosters received in October 2023 (baseline: booster >6 months prior), and durability of protection from a recent (past 6 months) previous infection (baseline: last infection >2 years prior) against mild/asymptomatic and moderate SARS-CoV-2 infection. Mild symptoms included acute respiratory symptoms for <5 days, moderate symptoms included influenza-like illness, acute respiratory symptoms for 5+ days, or sick-leave. VE and acquired protection were estimated from the multi-state model as: 1 - adjusted hazard ratio. Interventions Receipt of a COVID-19 bivalent original/BA.4-5 or monovalent XBB.1.5 booster during October 2023. Results Half of eligible participants (1,422) received a booster during October 2023 (280 bivalent, 1,142 monovalent) and 536 (19%) had at least one PCR-confirmed infection over the study period. For the monovalent booster, VE against infection was 44.2% (95% confidence interval 21.7 to 60.3%) at 0-2 months, and 24.1% (-0.7 to 42.9%) at 2-4 months post-vaccination, with no evidence of protection by 4-6 months. For the bivalent booster, VE against infection was 15.1% (-55.4 to 53.6%) at 0-2 months and 4.2% (-46.4 to 37.3%) at 2-4 months. VE (monovalent or bivalent) against moderate infection was 39.7% (19.9 to 54.6%), and against mild/asymptomatic infection was 14.0% (-12.1 to 34.0%). Controlling for vaccination, compared to those with an infection >2 years prior, infection within the past 6 months was associated with 58.6% (30.3 to 75.4%) increased protection against moderate infection, and 38.5% (5.8 to 59.8%) increased protection against mild/asymptomatic infection. Conclusions Monovalent XBB.1.5 boosters provided short-term protection against SARS-CoV-2 infection, particularly against moderate symptoms. Vaccine formulations which target the circulating variant may be suitable for inclusion in seasonal vaccination campaigns among healthcare workers.
{"title":"Protection of vaccine boosters and prior infection against mild/asymptomatic and moderate COVID-19 infection in the UK SIREN healthcare worker cohort: October 2023 to March 2024","authors":"Peter D Kirwan, Sarah D Foulkes, Katie Munro, Dominic Sparkes, Jasleen Singh, Amanda Henry, Angela Dunne, Jean Timeyin, Sophie Russell, Jameel Khawam, Debbie Blick, Ashley D Otter, Nipunadi Hettiarachchi, Michelle Cairns, Christopher H Jackson, Shaun Seaman, Colin S Brown, SIREN Study Group, Ana Atti, Jasmin Islam, Andre Charlett, Daniela De Angelis, Anne M Presanis, Victoria Jane Hall, Susan Hopkins","doi":"10.1101/2024.09.11.24313477","DOIUrl":"https://doi.org/10.1101/2024.09.11.24313477","url":null,"abstract":"<strong>Objective</strong> To estimate the protection of COVID-19 vaccine boosters against mild/asymptomatic and moderate SARS-CoV-2 infection over a 6-month period of XBB.1.5 and JN.1 variant circulation.\u0000<strong>Design</strong> Multi-state model applied to cohort study, adjusted for vaccination, prior infection, and demographic covariates.\u0000<strong>Setting</strong> National Health Services (NHS) hospitals in the UK.\u0000<strong>Participants</strong> Healthcare worker cohort including 2,867 eligible people with >6 months since a previous booster who tested fortnightly for SARS-CoV-2 between October 2023 and March 2024 and completed symptoms questionnaires. <strong>Main outcome measures</strong> Vaccine effectiveness (VE) of vaccine boosters received in October 2023 (baseline: booster >6 months prior), and durability of protection from a recent (past 6 months) previous infection (baseline: last infection >2 years prior) against mild/asymptomatic and moderate SARS-CoV-2 infection. Mild symptoms included acute respiratory symptoms for <5 days, moderate symptoms included influenza-like illness, acute respiratory symptoms for 5+ days, or sick-leave. VE and acquired protection were estimated from the multi-state model as: 1 - adjusted hazard ratio.\u0000<strong>Interventions</strong> Receipt of a COVID-19 bivalent original/BA.4-5 or monovalent XBB.1.5 booster during October 2023.\u0000<strong>Results</strong> Half of eligible participants (1,422) received a booster during October 2023 (280 bivalent, 1,142 monovalent) and 536 (19%) had at least one PCR-confirmed infection over the study period. For the monovalent booster, VE against infection was 44.2% (95% confidence interval 21.7 to 60.3%) at 0-2 months, and 24.1% (-0.7 to 42.9%) at 2-4 months post-vaccination, with no evidence of protection by 4-6 months. For the bivalent booster, VE against infection was 15.1% (-55.4 to 53.6%) at 0-2 months and 4.2% (-46.4 to 37.3%) at 2-4 months. VE (monovalent or bivalent) against moderate infection was 39.7% (19.9 to 54.6%), and against mild/asymptomatic infection was 14.0% (-12.1 to 34.0%). Controlling for vaccination, compared to those with an infection >2 years prior, infection within the past 6 months was associated with 58.6% (30.3 to 75.4%) increased protection against moderate infection, and 38.5% (5.8 to 59.8%) increased protection against mild/asymptomatic infection.\u0000<strong>Conclusions</strong> Monovalent XBB.1.5 boosters provided short-term protection against SARS-CoV-2 infection, particularly against moderate symptoms. Vaccine formulations which target the circulating variant may be suitable for inclusion in seasonal vaccination campaigns among healthcare workers.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213596","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 : 2024-09-12DOI: 10.1101/2024.09.11.24313456
Sara Jimeno Ruiz, Adrian Pelaez Laderas, Angeles Calle Gomez, Mercedes Villarreal Garcia-Lomas, Silvina Natalini Martinez
Respiratory illnesses frequently lead to hospitalisation in adults aged 60 and older, especially due to respiratory virus infectious (RVIs). This study investigates hospitalisation patterns and characteristics of RVIs at HM Hospitals from October 2023 to March 2024. We retrospectively explored hospitalisations of patients aged 60 years and older with RVIs, gathering data on demographics, clinical profiles, comorbidities, and treatments. Outcomes included hospitalisation, ICU admissions, and mortality, independent factors associated with outcomes were identified using a multi-state model. From October 2023 to March 2024, from a total of 3,258 hospitalisation, 1,933 (59.3%) were identified as positive for RVIs. Overall, SARS-CoV-2 was the most prevalent (52.6%), followed by influenza (32.7%) and RSV (11.8%). Most RVIs involved single infections (88.2%). Hospitalisation rates increased with age for SARS-CoV-2, influenza, and RSV, with SARS-CoV-2 showing the highest rate, followed by influenza and RSV. In the multi-state model, RSV infection significantly increased ICU admission risk (HR: 2.1, 95%, p = 0.037). Age on admission (HR: 1.1, 95%, p < 0.001) and Charlson score (HR: 1.4, 95%, p = 0.001) were associated with transitioning from admission to death. ICU to death risks included age at admission (HR: 1.7, 95%, p < 0.001). RVIs in adults 60 years and older are associated with high hospitalisation and mortality rates, primarily driven by influenza and SARS-CoV-2, followed by RSV. Age and comorbidities significantly impact disease severity, emphasising the need for targeted prevention and management strategies for RSV in this vulnerable population.
{"title":"Impact of Respiratory Syncytial Virus (RSV) in adults 60 years and older in Spain.","authors":"Sara Jimeno Ruiz, Adrian Pelaez Laderas, Angeles Calle Gomez, Mercedes Villarreal Garcia-Lomas, Silvina Natalini Martinez","doi":"10.1101/2024.09.11.24313456","DOIUrl":"https://doi.org/10.1101/2024.09.11.24313456","url":null,"abstract":"Respiratory illnesses frequently lead to hospitalisation in adults aged 60 and older, especially due to respiratory virus infectious (RVIs). This study investigates hospitalisation patterns and characteristics of RVIs at HM Hospitals from October 2023 to March 2024.\u0000We retrospectively explored hospitalisations of patients aged 60 years and older with RVIs, gathering data on demographics, clinical profiles, comorbidities, and treatments. Outcomes included hospitalisation, ICU admissions, and mortality, independent factors associated with outcomes were identified using a multi-state model.\u0000From October 2023 to March 2024, from a total of 3,258 hospitalisation, 1,933 (59.3%) were identified as positive for RVIs. Overall, SARS-CoV-2 was the most prevalent (52.6%), followed by influenza (32.7%) and RSV (11.8%). Most RVIs involved single infections (88.2%). Hospitalisation rates increased with age for SARS-CoV-2, influenza, and RSV, with SARS-CoV-2 showing the highest rate, followed by influenza and RSV. In the multi-state model, RSV infection significantly increased ICU admission risk (HR: 2.1, 95%, p = 0.037). Age on admission (HR: 1.1, 95%, p < 0.001) and Charlson score (HR: 1.4, 95%, p = 0.001) were associated with transitioning from admission to death. ICU to death risks included age at admission (HR: 1.7, 95%, p < 0.001).\u0000RVIs in adults 60 years and older are associated with high hospitalisation and mortality rates, primarily driven by influenza and SARS-CoV-2, followed by RSV. Age and comorbidities significantly impact disease severity, emphasising the need for targeted prevention and management strategies for RSV in this vulnerable population.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213601","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 : 2024-09-12DOI: 10.1101/2024.09.10.24313440
Portia Boakye Okyere, Sampson Twumasi-Ankrah, Sam Newton, Samuel Nkansah Darko, Michael Owusu Ansah, Eric Darko, Francis Opoku Agyapong, Hyon Jin Jeon, Yaw Adu-Sarkodie, Florian Marks, Ellis Owusu-Dabo
Background and Aim: Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving the transmission of infection is critical for developing effective control strategies and resource allocation. This comprehensive desk review aimed at synthesizing evidence from 1928 to 2023 on risk factors associated with typhoid fever transmission. Method: We conducted article searches in PubMed, Scopus, Google Scholar, and Semantic Scholar, using keywords related to risk, contributors, determinants, causes etc. associated with typhoid fever. We followed a registered protocol to support our search and triangulated the results. Results: We retrieved 1614 articles, of which 216 were reviewed. Of these articles reviewed, 106 provided data on typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, about 72% (76/106) originated from the Asian (48.1%, 51/106) and African (23.6%, 25/106) continents. A higher proportion, 47.2% (50/106) of the articles indicated risk factors related to socio-economic and housing transmission. Additional risk factors included foodborne transmissions (45.3%, 48/106), WASH: Waterborne transmissions (42.5%, 45/106), Sanitation and Hygiene practices (32.1%, 34/106), travel-related risk (16.0%, 17/106), antimicrobial agents (13.2%, 14/106), climate (13.2%, 14/106), environmental (8.5%, 9/106), typhoid carriers (10.4%, 11/106), and host risk (5.7%, 6/106) factors to disease transmission. Conclusion: These findings highlight the necessity for targeted and combined interventions including improved sanitation infrastructure, enhanced WASH practices and the use of vaccines in endemic areas. Implementing effective strategies informed by this review can aid clinicians, public health experts, and policymakers in efficiently mitigating the burden of typhoid fever.
{"title":"Risk factors for typhoid fever: A desk review","authors":"Portia Boakye Okyere, Sampson Twumasi-Ankrah, Sam Newton, Samuel Nkansah Darko, Michael Owusu Ansah, Eric Darko, Francis Opoku Agyapong, Hyon Jin Jeon, Yaw Adu-Sarkodie, Florian Marks, Ellis Owusu-Dabo","doi":"10.1101/2024.09.10.24313440","DOIUrl":"https://doi.org/10.1101/2024.09.10.24313440","url":null,"abstract":"Background and Aim: Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving the transmission of infection is critical for developing effective control strategies and resource allocation. This comprehensive desk review aimed at synthesizing evidence from 1928 to 2023 on risk factors associated with typhoid fever transmission. Method: We conducted article searches in PubMed, Scopus, Google Scholar, and Semantic Scholar, using keywords related to risk, contributors, determinants, causes etc. associated with typhoid fever. We followed a registered protocol to support our search and triangulated the results. Results: We retrieved 1614 articles, of which 216 were reviewed. Of these articles reviewed, 106 provided data on typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, about 72% (76/106) originated from the Asian (48.1%, 51/106) and African (23.6%, 25/106) continents. A higher proportion, 47.2% (50/106) of the articles indicated risk factors related to socio-economic and housing transmission. Additional risk factors included foodborne transmissions (45.3%, 48/106), WASH: Waterborne transmissions (42.5%, 45/106), Sanitation and Hygiene practices (32.1%, 34/106), travel-related risk (16.0%, 17/106), antimicrobial agents (13.2%, 14/106), climate (13.2%, 14/106), environmental (8.5%, 9/106), typhoid carriers (10.4%, 11/106), and host risk (5.7%, 6/106) factors to disease transmission. Conclusion: These findings highlight the necessity for targeted and combined interventions including improved sanitation infrastructure, enhanced WASH practices and the use of vaccines in endemic areas. Implementing effective strategies informed by this review can aid clinicians, public health experts, and policymakers in efficiently mitigating the burden of typhoid fever.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213595","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 : 2024-09-11DOI: 10.1101/2024.09.09.24313259
Toshiaki R. Asakura, Sung-mok Jung, Shihui Jin, Gang Hu, Akira Endo, Borame Lee Dickens
The novel mpox clade Ib initially identified in the Domestic Republic of Congo has spread to its multiple neighbouring countries as well as countries beyond the African continent. We characterised the global risk of importation of mpox clade Ib, highlighting the need to ramp up surveillance capacity for early detection.
{"title":"Characterising global risk profiles of Mpox clade Ib importation","authors":"Toshiaki R. Asakura, Sung-mok Jung, Shihui Jin, Gang Hu, Akira Endo, Borame Lee Dickens","doi":"10.1101/2024.09.09.24313259","DOIUrl":"https://doi.org/10.1101/2024.09.09.24313259","url":null,"abstract":"The novel mpox clade Ib initially identified in the Domestic Republic of Congo has spread to its multiple neighbouring countries as well as countries beyond the African continent. We characterised the global risk of importation of mpox clade Ib, highlighting the need to ramp up surveillance capacity for early detection.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227821","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}
This article aims to analyse the first-time emergence of African swine fever (ASF) in Mizoram. We collated the outbreak data and identified the time and locations of ASF emergence. To understand the impact of the outbreak, we have calculated the morbidity rate, mortality rate, case fatality rate (CFR) and overall pig depopulation rate. We identified that ASF emerged in total 178 locations in all 11 districts of Mizoram between March-July 2021, after a peak in June, and the disease continued to spread till the end of 2021 before re-emergence in March 2022. The overall morbidity rate and mortality rate of ASF between March-July 2021 in Mizoram were estimated to be 33.8% and 31.1%, while the average morbidity rate and the mortality rate of 10 districts were found to be 29.5% and 27.6% respectively. Overall CFR of ASF between March-July 2021 was estimated to be 92.1% and the average of all 11 districts was found to be 96.1%. Toward the end of 2021, the mortality rate increased by a total of 42.7% change and an average of 25.3% change. We estimated an overall 70% depopulation of susceptible pigs by disease and culling by end of 2021. This report is evidence that ASF has remained catastrophic and, keeping in view the complex nature and history of the virus on genotype adaptability associated with a high propensity for transboundary expansion, the virus continues to be a threat.
{"title":"Dissection of the 'Virgin-soil' epizootic of African swine fever in Mizoram, a Northeast state of India","authors":"Santhalembi Chingtham, Freda Lalrohlui, Abigail Remlalfakawmi, C. Neihthangpuii, Esther Lalzoliani, Parimal Roychoudhury, Prashant Kumar Subudhi, Tapan Kumar Dutta","doi":"10.1101/2024.09.09.24313373","DOIUrl":"https://doi.org/10.1101/2024.09.09.24313373","url":null,"abstract":"This article aims to analyse the first-time emergence of African swine fever (ASF) in Mizoram. We collated the outbreak data and identified the time and locations of ASF emergence. To understand the impact of the outbreak, we have calculated the morbidity rate, mortality rate, case fatality rate (CFR) and overall pig depopulation rate. We identified that ASF emerged in total 178 locations in all 11 districts of Mizoram between March-July 2021, after a peak in June, and the disease continued to spread till the end of 2021 before re-emergence in March 2022. The overall morbidity rate and mortality rate of ASF between March-July 2021 in Mizoram were estimated to be 33.8% and 31.1%, while the average morbidity rate and the mortality rate of 10 districts were found to be 29.5% and 27.6% respectively. Overall CFR of ASF between March-July 2021 was estimated to be 92.1% and the average of all 11 districts was found to be 96.1%. Toward the end of 2021, the mortality rate increased by a total of 42.7% change and an average of 25.3% change. We estimated an overall 70% depopulation of susceptible pigs by disease and culling by end of 2021. This report is evidence that ASF has remained catastrophic and, keeping in view the complex nature and history of the virus on genotype adaptability associated with a high propensity for transboundary expansion, the virus continues to be a threat.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213389","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 : 2024-09-10DOI: 10.1101/2024.09.09.24313375
Angkana T. Huang, Darunee Buddhari, Surachai Kaewhiran, Sopon Iamsirithaworn, Direk Khampaen, Aaron Farmer, Stefan Fernandez, Stephen J. Thomas, Isabel Rodriguez-Barraquer, Taweewun Hunsawong, Anon Srikiatkhachorn, Gabriel Ribeiro dos Santos, Megan O'Driscoll, Marco Hamins-Puertolas, Timothy Endy, Alan L. Rothman, Derek A. T. Cummings, Kathryn Anderson, Henrik Salje
Uncovering rates at which susceptible individuals become infected with a pathogen, i.e. the force of infection (FOI), is essential for assessing transmission risk and reconstructing distribution of immunity in a population. For dengue, reconstructing exposure and susceptibility statuses from the measured FOI is of particular significance as prior exposure is a strong risk factor for severe disease. FOI can be measured via many study designs. Longitudinal serology are considered gold standard measurements, as they directly track the transition of seronegative individuals to seropositive due to incident infections (seroincidence). Cross-sectional serology can provide estimates of FOI by contrasting seroprevalence across ages. Age of reported cases can also be used to infer FOI. Agreement of these measurements, however, have not been assessed. Using 26 years of data from cohort studies and hospital-attended cases from Kamphaeng Phet province, Thailand, we found FOI estimates from the three sources to be highly inconsistent. Annual FOI estimates from seroincidence was 2.46 to 4.33-times higher than case-derived FOI. Correlation between seroprevalence-derived and case-derived FOI was moderate (correlation coefficient=0.46) and no systematic bias. Through extensive simulations and theoretical analysis, we show that incongruences between methods can result from failing to account for dengue antibody kinetics, assay noise, and heterogeneity in FOI across ages. Extending standard inference models to include these processes reconciled the FOI and susceptibility estimates. Our results highlight the importance of comparing inferences across multiple data types to uncover additional insights not attainable through a single data type/analysis.
揭示易感个体感染病原体的比率，即感染力（FOI），对于评估传播风险和重建人群免疫分布至关重要。对于登革热而言，根据测得的 FOI 重建暴露和易感状态尤为重要，因为之前的暴露是导致严重疾病的一个重要风险因素。FOI 可以通过多种研究设计来测量。纵向血清学被认为是金标准测量方法，因为它们可直接跟踪血清阴性个体因偶发感染（血清发生率）而转变为血清阳性个体的过程。横断面血清学可通过对比不同年龄段的血清流行率来估算 FOI。报告病例的年龄也可用于推断 FOI。然而，这些测量方法的一致性尚未得到评估。通过使用来自泰国甘榜披省队列研究和医院就诊病例的 26 年数据，我们发现这三种来源的 FOI 估计值极不一致。从血清发生率估算出的年 FOI 是病例得出的 FOI 的 2.46 至 4.33 倍。血清流行率得出的 FOI 与病例得出的 FOI 之间的相关性适中（相关系数=0.46），不存在系统性偏差。通过大量的模拟和理论分析，我们表明，由于未能考虑登革热抗体动力学、检测噪音和不同年龄段 FOI 的异质性，可能会导致不同方法之间的不一致性。扩展标准推理模型，将这些过程包括在内，可以协调 FOI 和易感性估计值。我们的研究结果凸显了比较多种数据类型的推论以发现单一数据类型/分析无法获得的更多见解的重要性。
{"title":"Reconciling heterogeneous dengue virus infection risk estimates from different study designs","authors":"Angkana T. Huang, Darunee Buddhari, Surachai Kaewhiran, Sopon Iamsirithaworn, Direk Khampaen, Aaron Farmer, Stefan Fernandez, Stephen J. Thomas, Isabel Rodriguez-Barraquer, Taweewun Hunsawong, Anon Srikiatkhachorn, Gabriel Ribeiro dos Santos, Megan O'Driscoll, Marco Hamins-Puertolas, Timothy Endy, Alan L. Rothman, Derek A. T. Cummings, Kathryn Anderson, Henrik Salje","doi":"10.1101/2024.09.09.24313375","DOIUrl":"https://doi.org/10.1101/2024.09.09.24313375","url":null,"abstract":"Uncovering rates at which susceptible individuals become infected with a pathogen, i.e. the force of infection (FOI), is essential for assessing transmission risk and reconstructing distribution of immunity in a population. For dengue, reconstructing exposure and susceptibility statuses from the measured FOI is of particular significance as prior exposure is a strong risk factor for severe disease. FOI can be measured via many study designs. Longitudinal serology are considered gold standard measurements, as they directly track the transition of seronegative individuals to seropositive due to incident infections (seroincidence). Cross-sectional serology can provide estimates of FOI by contrasting seroprevalence across ages. Age of reported cases can also be used to infer FOI. Agreement of these measurements, however, have not been assessed. Using 26 years of data from cohort studies and hospital-attended cases from Kamphaeng Phet province, Thailand, we found FOI estimates from the three sources to be highly inconsistent. Annual FOI estimates from seroincidence was 2.46 to 4.33-times higher than case-derived FOI. Correlation between seroprevalence-derived and case-derived FOI was moderate (correlation coefficient=0.46) and no systematic bias. Through extensive simulations and theoretical analysis, we show that incongruences between methods can result from failing to account for dengue antibody kinetics, assay noise, and heterogeneity in FOI across ages. Extending standard inference models to include these processes reconciled the FOI and susceptibility estimates. Our results highlight the importance of comparing inferences across multiple data types to uncover additional insights not attainable through a single data type/analysis.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213390","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 : 2024-09-10DOI: 10.1101/2024.09.09.24313152
James L Li
Background: Bipolar disorder is a complex psychiatric condition with notable differences among its clinical subtypes including Type 1 and 2 disorders. Several studies have proposed that thyroid hormones may be involved in the etiology of bipolar disorders. Aims: This study employed a two-sample Mendelian Randomization (MR) approach to investigate the causal relationships between six thyroid hormone metrics (TSH, FT4, FT3, TT3, FT3/FT4, and TT3/FT4) and bipolar disorder, as well as Type 1 and 2 disorders, separately. Methods: We used GWAS summary statistics from the Thyroidomics Consortium (involving up to 271,040 individuals of European ancestry) to identify instruments for thyroid function metrics in MR analyses. Additionally, we included GWAS data for bipolar disorder, involving 41,917 cases and 371,549 controls of European ancestry, with 25,060 Type 1 and 6,781 Type 2 bipolar disorder cases. Results: We found that higher FT4 levels may have a protective causal effect against bipolar disorder and a suggestive causal effect on Type 1 bipolar disorder. In contrast, elevated FT3 levels and an increased FT3/FT4 ratio showed a suggestive harmful causal effect on Type 1 bipolar disorder. These associations remained robust across various MR methods, minimizing the likelihood of pleiotropy affecting our results. Conclusion: Our findings align with previous research but uniquely highlight the potentially harmful impact of elevated FT3 on Type 1 bipolar disorder. This study strengthens the evidence for FT4's role in bipolar disorder and highlights the need for further research into targeting thyroid hormone levels as a potential treatment strategy for Type 1 bipolar disorder.
{"title":"The causal role of thyroid hormones in bipolar disorders: a two-sample Mendelian Randomization study","authors":"James L Li","doi":"10.1101/2024.09.09.24313152","DOIUrl":"https://doi.org/10.1101/2024.09.09.24313152","url":null,"abstract":"Background: Bipolar disorder is a complex psychiatric condition with notable differences among its clinical subtypes including Type 1 and 2 disorders. Several studies have proposed that thyroid hormones may be involved in the etiology of bipolar disorders. Aims: This study employed a two-sample Mendelian Randomization (MR) approach to investigate the causal relationships between six thyroid hormone metrics (TSH, FT4, FT3, TT3, FT3/FT4, and TT3/FT4) and bipolar disorder, as well as Type 1 and 2 disorders, separately. Methods: We used GWAS summary statistics from the Thyroidomics Consortium (involving up to 271,040 individuals of European ancestry) to identify instruments for thyroid function metrics in MR analyses. Additionally, we included GWAS data for bipolar disorder, involving 41,917 cases and 371,549 controls of European ancestry, with 25,060 Type 1 and 6,781 Type 2 bipolar disorder cases.\u0000Results: We found that higher FT4 levels may have a protective causal effect against bipolar disorder and a suggestive causal effect on Type 1 bipolar disorder. In contrast, elevated FT3 levels and an increased FT3/FT4 ratio showed a suggestive harmful causal effect on Type 1 bipolar disorder. These associations remained robust across various MR methods, minimizing the likelihood of pleiotropy affecting our results.\u0000Conclusion: Our findings align with previous research but uniquely highlight the potentially harmful impact of elevated FT3 on Type 1 bipolar disorder. This study strengthens the evidence for FT4's role in bipolar disorder and highlights the need for further research into targeting thyroid hormone levels as a potential treatment strategy for Type 1 bipolar disorder.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213393","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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