Infectious Disease Epidemics Research Articles

Determinants of COVID-19-related knowledge and disrupted habits during epidemic waves among women of childbearing age in urban and rural areas of the Malagasy Middle East

BackgroundWith regard to the coronavirus disease (COVID-19) pandemic in Madagascar, little is known about the knowledge, the perceptions and the impacts of this disease on women of childbearing age. People’s knowledge of COVID-19 can have an impact on their attitudes towards seeking care. The aim of the current study is to determine the knowledge of COVID-19 and associated determinants among women of childbearing age in Moramanga.MethodsA cross-sectional study based on questionnaire administration was used among women of childbearing age. Data collection was conducted from August to October 2021. A scoring method was applied to evaluate their knowledge level and perceptions about COVID-19 and its impacts on their lives. A binary stepwise logistic regression was performed to determine the sociodemographic determinants of their knowledge level about COVID-19.ResultsA total of 885 women of childbearing age from urban and rural Moramanga areas were interviewed. Approximately 49.8% (441/885) lived in urban areas, and 50.2% (444/885) lived in rural areas. Approximately 35.3% (322/885) of the participants had a good level of knowledge of COVID-19. Multivariate analysis showed that the probability of having a good level of knowledge of COVID-19 had a significant statistical association (p value < 0.05) with living in an urban area [AOR: 2.89; 95% CI (1.89–4.42)], telephone ownership [AOR: 1.71; 95% CI (1.16–2.53)], radio ownership [AOR 2.2; 95% CI (1.43–3.38)], watching TV [AOR = 1.95; 95% CI (1.34–2.83)] and reading journal papers [AOR = 3.74 95% CI (1.69–8.27)].ConclusionsAlmost a third of the sampled women of childbearing age had a good level of knowledge of COVID-19. Access to information through telecommunications technologies increases the chances of being better informed about the disease. To avoid the negative repercussions of infectious disease epidemics, it is necessary to improve the awareness of childbearing women about these diseases by taking demographic features of the population into account.

Impact of human mobility on the epidemic spread during holidays

COVID-19 has posed formidable challenges as a significant global health crisis. Its complexity stems from factors like viral contagiousness, population density, social behaviors, governmental regulations, and environmental conditions, with interpersonal interactions and large-scale activities being particularly pivotal. To unravel these complexities, we used a modified SEIR epidemiological model to simulate various outbreak scenarios during the holiday season, incorporating both inter-regional and intra-regional human mobility effects into the parameterization scheme. In addition, evaluation metrics were used to evaluate the accuracy of the model simulation by comparing the congruence between simulated results and recorded confirmed cases. The findings suggested that intra-city mobility led to an average surge of 57.35% in confirmed cases of China, while inter-city mobility contributed to an average increase of 15.18%. In the simulation for Tianjin, China, a one-week delay in human mobility attenuated the peak number of cases by 34.47% and postponed the peak time by 6 days. The simulation for the United States revealed that human mobility played a more pronounced part in the outbreak, with a notable disparity in peak cases when mobility was considered. This study highlights that while inter-regional mobility acted as a trigger for the epidemic spread, the diffusion effect of intra-regional mobility was primarily responsible for the outbreak. We have a better understanding on how human mobility and infectious disease epidemics interact, and provide empirical evidence that could contribute to disease prevention and control measures.

A Novel and Accurate Method for Estimating Deaths and Cases During Outbreaks of Infectious Diseases Including COVID-19.

Epidemiological modelling of infectious diseases plays an important role in driving public health policy. Commonly used models are described, including those based on exponential growth (Laplace and related distributions); susceptible-infected-removed; the Gompertz distribution; and the skew-reflected-Gompertz distribution. These are all sensitive to the timing of peak infection. The development of a novel method for forecasting the number of deaths occurring during epidemics of infectious diseases is described. The mathematical development of the authors' novel asymmetric difference model is detailed in this paper. Its predictions for mortality rates associated with the COVID-19 pandemic for 14 countries were compared with the corresponding published mortality data. Forecasts by the asymmetric difference model of deaths from SARS-CoV-2 in different countries, actual recorded deaths to 30th June 2020, and corresponding errors included UK (42,700; 55,904; -24%); Poland (1490; 1444; +3%); Denmark (580; 605; -4%); Netherlands (6510; 6189; +5%); France (34,280; 29,836; +15%); Canada (1500; 8591; -78%); USA (44,540; 124,734; -64%); and Italy (22,020; 34,980; -37%). The model output was dependent upon forecast date accuracy for the peak of the disease outbreak. For Spain, the forecast date was one day early and for 10 (71%) countries the forecast peak occurred within seven days (inclusive) of the actual date. Mortality prediction by the asymmetric difference model is relatively accurate. Furthermore, this new model does not appear to be as unduly sensitive to the timing of peak infection as other models. Indeed, its prediction of peak infection also appears to be relatively accurate.

The role of temperature in the start of seasonal infectious disease epidemics

Many infectious diseases display strong seasonal dynamics. When both hosts and parasites are influenced by seasonal variables, it is unclear if the start of an epidemic is limited by host or parasite factors or both. The Daphnia–Pasteuria host–parasite system exhibits seasonal epidemics. We aimed to ascertain how temperature contributes to the timing of P. ramosa epidemics in early spring. To this aim, we experimentally disentangled this effect from the effects of temperature on host development and phenology and from that of host traits on parasite time to visible infection. We hypothesized that the parasite is additionally directly limited by low temperatures beyond its need for available hosts. We found that parasite time to visible infection decreased with increasing temperature at a faster rate than host time to hatching and maturity did, consistent with this hypothesis. We also found that hosts hatched from sexual resting stages are less likely to become infected than those produced clonally, and that hosts resistant to many known parasite strains are slower to show signs of visible infection compared to those susceptible to many. Together, these results imply that climate change could lead to earlier seasonal epidemics for this host–parasite system, which may also impact longer‐term population dynamics.

The history of louse-borne typhus and geomedizine

The experience of World War I made popular the concept of medical geography (geomedicine in English, geomedizine in German), which became part of Nazism's philosophy of national welfare, safety, and solidarity. The Nazis used it to create propaganda to show some groups as rats, vermin, and Untermenschen (subhumans). In this way, more than 10 million people were killed under the Nazi regime: 6 million Jews, plus more than 5 million Gypsies, Jehovah's Witnesses, and other individuals who were not part of the German theory of “master race.” The Germans’ fear of typhus that spread in the Wehrmacht was so immense that during the occupation, Polish doctors used this phobia to organize a resistance movement. Contemporarily, the scope of geographic medicine encompasses the following research areas: spatial differentiation of disease incidents and the process of disease diffusion, geographic inequalities in the population's health level, and morbidity determinants among the inhabitants of developing countries. In the first half of the 19th century, it played an essential role in the activities aimed against epidemics of infectious diseases, including louse-borne typhus (epidemic typhus), cholera, and typhoid, linking these diseases to cultural determinants. Under the influence of this idea, the concept of doctor-hygienist emerged, and social medicine began to evolve.

A tale of two countries: Optimal control and cost-effectiveness analysis of monkeypox disease in Germany and Nigeria

The Monkeypox (Mpox) virus started developing as potentially fatal in Spring 2022. Mpox is a zoonotic disease that can spread between animals and people. While the cases in Nigeria are on the rise, Germany has become one of Europe’s most impacted nations. Mathematical modeling is useful for monitoring, managing, and predicting infectious disease epidemics. This study incorporates the transmission rate of human-to-animal and animal-to-animal in a compartmental mathematical model of Mpox to capture the current trend in transmission for wildlife and human preservation. Parameters were estimated while the model was fitted to reported case data of Mpox from Nigeria and Germany to capture the trend in Europe and West Africa. Analyses such as optimal control, sensitivity, and cost-effectiveness were carried out. The results show that the best strategy to combat the spread of the virus is through changing behavior and personal hygiene among humans.

Governing with contagion: Pandemic politics, COVID-19, and undermining public health in Florida.

The United States approached the COVID-19 pandemic with inconsistent responses that varied by state. In Florida, legislators passed laws contrary to mitigating the pandemic. These laws included banning county and municipal efforts to control the spread of COVID-19 through mask mandates, social distancing, and prohibiting vaccination mandates during infectious disease epidemics. Moreover, the Legislature simultaneously prioritized policies of social exclusion, passing bills that constrained the rights of transgender individuals, Black Lives Matter protestors, and educators. In this article, I use the perspectives of critical medical anthropology and "governing through contagion" to examine Florida's COVID-19 response. I argue the COVID-19 pandemic provided an opportunity for legislators to obfuscate their political power and advance a politics of social division while simultaneously passing policies that undermined human health. I refer to this process as governing with contagion: Using a pandemic as a politically expedient backdrop to conceal power and simultaneously harm human health.

Effect of a Family Pharmacist System on Medication Adherence of Patients with Dyslipidemia during a COVID-19 Epidemic

The pharmacy pharmacist's function as a family pharmacist is expected to improve adherence to medication in patients suffering from chronic diseases, including dyslipidemia. This is true even in infectious disease epidemics. In this study, using anonymously processed receipt data from 700 insurance pharmacies in our group, we evaluated medication adherence in patients taking statin drugs before, during the first and second years of coronavirus disease 2019 (COVID-19) epidemic in terms of medication persistence and medication possession, and compared the results between the family pharmacist group (FP group) and non-family pharmacist group (NoFP group). The odds ratios of good medication adherence (medication persistence and medication possession) rates for the FP group relative to the NoFP group were 1.446 [95% confidence interval (CI): 1.210-1.727] in the pre-epidemic period, 1.428 (1.192-1.710) in the first year of the epidemic, and 1.270 (1.113-1.450) in the second year of the epidemic. The FP group was significantly higher in all time periods. Therefore, it is suggested that the family pharmacist function improves adherence to statins not only before but also during the COVID-19 epidemic.

Construction of influencing factors model for public information avoidance behavior in major infectious disease outbreaks based on meta-ethnography

ObjectiveMajor infectious disease outbreaks are highly susceptible to diffuse outbreaks due to their sudden and more widespread nature. Compared to previous outbreaks such as the Spanish flu and SARS in China, COVID-19 has greatly affected the health of citizens and the economic development of countries worldwide, and is representative of major infectious disease outbreaks in many ways. Information avoidance, a common information behaviour during major infectious disease outbreaks, can alleviate the stress caused by information overload as a strategy to reduce negative emotions and maintain optimism. However, it can also bias risk perceptions and avoid content of greater value. Therefore, a deeper understanding of public information behaviour, particularly how and why relevant information is circumvented, places a demand on researchers. MethodsA meta-ethnographic qualitative research methodology was used, and the seven steps of the methodology were strictly followed, including identifying integration themes, defining the connotations of integration themes, reading original studies, identifying relationships between studies, inter-translation between studies, synthetic translation, and presenting integration results. 26 original studies were integrated in a unified research framework, with a macro perspective that integrates consistent as well as complex and even contradictory findings and identifies dominant factors. ConclusionsIdentify demographic factors, information literacy, risk perception, cognitive structure, information quality, information sources, external characteristics of information, and environmental characteristics sub-dimensions around the dimensions of ‘individual’, ‘information’ and ‘environment’. The study also explored the factors under each sub-dimension. The study finally identified three dimensions, nine sub-dimensions and 26 factors, and obtained a more complete theoretical framework to construct a “model of factors influencing public information avoidance behaviour in major infectious disease epidemics”, with a view to providing a theoretical basis and practical reference for relevant departments in guiding public information behaviour and health practices in major infectious disease epidemics.

Efficacy and Safety of Vaccinations in Geriatric Patients: A Literature Review.

With the progressive lengthening of the average age of the population, especially in some countries such as Italy, vaccination of the elderly is a fixed point on which most of the public health efforts are concentrating as epidemic infectious diseases, especially those of the winter, have a major impact on the progression of severe disease, hospitalization, and death. The protection of the elderly against acute infectious diseases should not only limit mortality but also have a positive impact on the fragility of these people in terms of less disability and fewer care needs. However, vaccination of the elderly population differs in efficacy and safety compared to that of other population categories since aging and the consequent loss of efficiency of the immune system lead to a reduction in the immunogenicity of vaccines without achieving a lasting antibody coverage. There are various strategies to avoid the failure of immunization by vaccines such as resorting to supplementary doses with adjuvant vaccines, increasing the dosage of the antigen used, or choosing to inoculate the serum relying on various routes of administration of the vaccine. Vaccination in the elderly is also an important factor in light of growing antibiotic resistance because it can indirectly contribute to combating antibiotic resistance, reducing theoretically the use of those agents. Furthermore, vaccination in old age reduces mortality from infectious diseases preventable with vaccines and reduces the same rate of resistance to antibiotics. Given the importance and complexity of the topic, in this review, we will deal with the main aspects of vaccination in the elderly and how it can influence mortality and healthcare costs, especially in those countries where population aging is more evident. Therefore, we conducted a systematic literature search in PubMed to identify all types of studies published up to 31 May 2023 that examined the association between vaccination and the elderly. Data extraction and quality assessment were conducted by two reviewers (PC and TC) who independently extracted the following data and assessed the quality of each study.

Medical and social problem and organization of medical care for people with disabilities due to respiratory diseases due to the development of COVID-19 infection

Respiratory diseases require the close attention of medical specialists at all levels of providing medical and diagnostic care to patients, as well as improving preventive measures. In recent years, there has been an increase in the incidence of respiratory diseases, an increase in the number of cases of temporary disability and the disability rate of the population. Disabled people due to respiratory diseases need complex treatment and rehabilitation to improve the quality of life. Purpose of the study. To study the organization of medical care for people with disabilities with respiratory diseases in 2019-2021. given the spread of COVID-19. Materials and methods. For the analysis, the primary registration forms of the State Budgetary Institution of Healthcare of the Republic of Bashkortostan “City Hospital No. 21” in Ufa and the Main Bureau of Medical and Social Expertise of the Republic of Bashkortostan were used. Results. It was found that all disabled people included in the study were hospitalized in 2019 (168.9 hospitalizations per 100 disabled people). The average duration of inpatient treatment was 17.6 days. All disabled people were consulted by general practitioners – 324.2 consultations per 100 disabled people, the least often consultation of a general practitioner was received by disabled people about bronchiectasis – 228.6 per 100 disabled people. Of the total number of disabled people, only 85.6 % were consulted by a pulmonologist (frequency 118.9 consultations per 100 disabled people). Despite the fact that all disabled people underwent certain clinical and laboratory examinations, their frequency was lower than that provided for by regulatory legal acts. During the COVID-19 pandemic, the level of hospitalization of people with disabilities has significantly decreased, the length of stay in the hospital has decreased, and the volume of consultative, diagnostic and rehabilitation assistance has decreased. Conclusion. The analysis carried out indicates the need to improve medical care for the disabled and to plan measures to increase the volume of medical and diagnostic measures during the outbreak of epidemics of infectious diseases.

Etiotropic therapy of COVID-19 disease in the work of nursing staff

The novel coronavirus infection, or COVID-19 (from «Coronavirus disease 2019»), is a new epidemic infectious disease that poses a danger to the population due to its high contagiousness and the development of life-threatening complications for the patient, such as respiratory and multiple organ failure. In 2021, it became clear that the reasonable use of antiviral therapy drugs is necessary for a favorable outcome of the disease. The review considers the main antiviral drugs proposed by the WHO for the treatment of the novel coronavirus infection (COVID-19). They are based on studies with statistically significant data that allow fully assessing their effectiveness and make it possible to make an adequate decision on the prescription of these drugs. Based on the data obtained from in vitro studies and clinical trials, the paper considers the prospects of using these drugs in the treatment of the novel coronavirus infection, their effectiveness in clinical practice, as well as the feasibility of their use and possible combinations for prescribing these drugs that can be used to treat and prevent the novel coronavirus infection. The article discusses the efficacy of the following drugs: remdesivir, interferon, lopinavir and ritonavir, umifenovir, darunavir and cobicistat, favipiravir, chloroquine and hydroxychloroquine, ivermectin and intravenous immunoglobulins.

Research on the early warning and prevention system of infectious diseases based on large cruise ships

In order to improve the ability of large cruise ships to deal with infectious disease epidemics and reduce the losses caused by outbreaks on cruise ships, this project has designed the design of infectious disease early warning and prevention and control systems for large luxury cruise ships. The system consists of a large cruise ship infected person identification and tracking system, an infectious disease prevention and isolation system, and an infectious disease treatment system. It can quickly identify and isolate suspected infected persons on large cruise ships, and at the same time, it can reduce the ability of the virus to spread in the air, effectively reduce the probability of outbreaks of infectious diseases on cruise ships, and ensure the health of boarding personnel.

Hantavirus Infections among Military Forces.

Hantaviruses cause two kinds of clinical syndromes. Hemorrhagic fever with renal syndrome is caused by Hantaan virus in Asia, Puumala virus (PUUV) and Dobrava virus in Europe, and Seoul virus worldwide. Hantavirus cardiopulmonary syndrome is caused by Sin Nombre virus in North America and Andes virus and related viruses in Latin America. All hantaviruses are carried by rodents and insectivores. Humans are infected via inhaled aerosols of rodent excreta. In the history, there are several epidemics of acute infectious diseases during many wars, which have been suggested or proven to be caused by various hantaviruses. Literature review of 41 original publications and reviews published between 1943 and 2022 was performed. Among them, 23 publications handle hantavirus infections among military forces, and the rest 17 hantavirus infections themselves. A large epidemic during World War II in 1942 among German and Finnish soldiers in Northern Finland with more than 1,000 patients was most probably caused by PUUV. During Korean War in 1951-1954,∼ 3,200 cases occurred among United Nations soldiers in an epidemic caused by Hantaan virus. During Balkan war from 1991 to 1995, numerous soldiers got ill because of hantavirus infection caused by PUUV and Dobrava virus. Several other reports of cases of various hantavirus infections especially among U.S. soldiers acting in South Korea, Germany, Bosnia, and Kosovo have been described in the literature. Military maneuvers usually include soil removal, spreading, digging with accompanied dust, and living in field and other harsh conditions, which easily expose soldiers to rodents and their excreta. Therefore, the risks of hantavirus infections in military context are obvious. All military infections have been caused by hantaviruses leading to hemorrhagic fever with renal syndrome.

Reddit and Google Activity Related to Non-COVID Epidemic Diseases Surged at Start of COVID-19 Pandemic: Retrospective Study.

Resources such as Google Trends and Reddit provide opportunities to gauge real-time popular interest in public health issues. Despite the potential for these publicly available and free resources to help optimize public health campaigns, utilization for this purpose has been limited. To determine whether early public awareness of COVID-19 correlated with elevated public interest in other infectious diseases of public health importance. Google Trends search data and Reddit comment data were analyzed from 2018 through 2020 for the frequency of keywords "Chikungunya", "Ebola", "H1N1", "MERS", "SARS", and "Zika", six highly publicized epidemic diseases in recent decades. After collecting Google Trends relative popularity scores for each of these six terms, unpaired T-tests were used to compare the 2020 weekly scores for each term to its average level over the 3-year study period. The number of Reddit comments per month with each of these six terms was collected and then adjusted for total estimated Reddit monthly comment volume to derive a measure of relative usage, analogous to the Google Trends popularity score. The relative monthly incidence of comments with each search term was then compared to the corresponding search term's pre-COVID monthly comment data, again using unpaired T-tests. P-value cutoffs for statistical significance were determined a priori with a Bonferroni correction. Google Trends and Reddit data both demonstrate large and statistically significant increases in the usage of each evaluated disease term through at least the initial months of the pandemic. Google searches and Reddit comments that included any of the evaluated infectious disease search terms rose significantly in the first months of 2020 above their baseline usage, all peaking in March 2020. Google searches for "SARS" and "MERS" remained elevated for the entirety of the 2020 calendar year, as did Reddit comments with the words "Ebola", "H1N1", "MERS" and "SARS" (P<.001, for each weekly or monthly comparison, respectively). Google Trends and Reddit can readily be used to evaluate real-time general interest levels in public health related topics, providing a tool to better time and direct public health initiatives that require a receptive target audience. The start of the COVID-19 pandemic correlated with increased public interest in other epidemic infectious diseases. We have demonstrated that for six distinct infectious causes of epidemics over the last two decades, public interest rose substantially and rapidly with the outbreak of COVID-19. Our data suggests that for at least several months after the initial outbreak, the public may have been particularly receptive to dialogue on these topics. Public health officials should consider utilizing Google Trends and social media data to identify to patterns of engagement with public health topics in real-time, and to optimize timing of public health campaigns.

Analysis of the Optimal Use of Fabric Masks and Disposable Medical Masks During the COVID-19

Medical waste is one of the biggest concerns today due to the need to prevent COVID-19. How to properly handle the large amount of discarded disposable medical masks generated during and after the epidemic, fully understand the need for recycling and disposal of discarded masks, and accelerate the development of new technologies for value-added use have become important issues arising from the new crown epidemic and other respiratory infectious diseases, as well as an urgent requirement to protect the ecological environment. This paper outlines the materials of disposable medical masks and cloth masks, and analyses their impact on society and the environment from the perspective of their own characteristics, so as to give advice on how to choose masks. This paper compares cloth masks and traditional disposable medical masks, discussing the similarities and differences between them in terms of epidemic prevention, the environment, the economics of the product, the psychological burden on the public and the production of the company. The recommendations are based on the effectiveness of the two types of masks and their different handling methods. Finally, the challenges associated with the current use of masks are outlined and a personal view on the replacement of disposable medical masks with cloth masks is given. In the future, the government should expand the use of cloth masks by raising public awareness of the use of sustainable masks, in order to save resources and protect the environment. The aim of this paper is to reduce the environmental and socio-economic impact of masks by discussing the effectiveness, social and economic impact of the two types of masks, so that more people will be guided to use cloth masks.

A Statistical Definition of Epidemic Waves.

The timely identification of expected surges of cases during infectious disease epidemics is essential for allocating resources and preparing interventions. Failing to detect critical phases in time may lead to delayed implementation of interventions and have serious consequences. This study describes a simple way to evaluate whether an epidemic wave is likely to be present based solely on daily new case count data. The proposed measure compares two models that assume exponential or linear dynamics, respectively. The most important assumption of this approach is that epidemic waves are characterized rather by exponential than linear growth in the daily number of new cases. Technically, the coefficient of determination of two regression analyses is used to approximate a Bayes factor, which quantifies the support for the exponential over the linear model and can be used for epidemic wave detection. The trajectory of the coronavirus epidemic in three countries is analyzed and discussed for illustration. The proposed measure detects epidemic waves at an early stage, which are otherwise visible only by inspecting the development of case count data retrospectively. Major limitations include missing evidence on generalizability and performance compared to other methods. Nevertheless, the outlined approach may inform public health decision-making and serve as a starting point for scientific discussions on epidemic waves.

Medical and sanitary service of northern part of Bukovyna after the First World War (1918-1928)

The article deals with the main trends in the restoration and development of the medical and sanitary service in the territory of Northern Bukovyna in 1918-1928, during which martial law continued here, after which the territory became part of the Kingdom of Romania.In the first post-war period the population of the region found itself almost entirely without healthcare. Collapsed health system could not fight the spread of epidemic diseases through the region that also led to a complicated demographic situation in the post-war Bukovyna. The enduring spread of diseases among the population and, to a certain extent, the wish of Romanian authorities to use medicine for propaganda purposes forced the start of a comprehensive work to improve health and sanitary conditions in the region. The primary task that had to be urgently solved by the health service in the early post-war years has become the overcoming of the epidemics of infectious diseases that at the end of World War I led to great mortality among the population. Quite common among the residents of the region were dysentery, typhoid, typhus, relapsing fever, tuberculosis, and a number of pediatric respiratory infections – scarlet fever, measles, whooping cough, diphtheria, contagious parotitis, varicella and others. Some years there was an urgent need for the establishment of health centres, dispensaries. According to the law of 1923, the Health Service was divided into two parts: sanitary and hospital. The Sanitary Service was engaged in supervision, control and study of the health status of the settlements, the use of general and special preventive measures and prevention of epidemics, to provide medical care outside hospitals, educate the population about prevention and treatment of social diseases etc. The Hospital Service was responsible for hospital treatment and medical supervision of patients in hospitals. Bukovyna along with Khotyn district and the northern part of Moldova was included in the VIII sanitary region under the guidance of General Sanitary Inspectorate. For the operation of health service, Bukovyna was divided into five health areas, each headed by a Chief Physician. Areas were divided into sanitary districts. At the head of each one was the district doctor who had assistants, district midwives, and health agents. The duty of medical personnel was to countercheck social diseases. In this regard, 9 infirmaries and 27 dispensaries were founded in Bukovyna within 10 years (1918-1928).To avoid the spread of infectious diseases from abroad – an official centre «Grigore Ghica Vodӑ» was created to examine travellers at the border at the railway station in Nepolokivtsi.Also, in the first post-war decade for health services of the land the Sanitary Inspectorate has founded in Chernivtsi: Regional warehouse of medical instruments and devices; Regional warehouse of drugs, serums, vaccines and bandages, and the Institute of Hygiene.Compulsory preventive vaccination against smallpox and other infectious diseases was introduced. Doctors held free consultations in towns and villages both at home and in hospitals. At the same time, in the first post-war decade a decrease of doctors and paramedical staff is observed.Taking into consideration the shortage of a sufficient number of hospitals, clinics, doctors, nurses, lack of medicines, vaccines, therapeutic sera in Bukovyna, it should be ascertained that the state of epidemic diseases in the region in the early post-war years remained extremely hard. Only in the mid-20s such diseases as smallpox, typhus, and dysentery had been largely overcome thanks to vaccination, organizational and educational measures taken by the authorities. However, there remained high death rate from heart diseases, pneumonia, tuberculosis, due to difficult living conditions and inaccessibility of health care to the most.

The economic value of personal protective equipment for healthcare workers.

In this paper, we examine the cost effectiveness of investment in personal protective equipment (PPE) for protecting health care workers (HCWs) against two infectious diseases: Ebola virus and methicillin-resistant Staphylococcus aureus (MRSA). This builds on similar work published for COVID-19 in 2020. We developed two separate decision-analytic models using a payer perspective to compare the costs and effects of multiple PPE use scenarios for protection of HCW against Ebola and MRSA. Bayesian multivariate sensitivity analyses were used to consider the uncertainty surrounding all key parameters for both diseases. We estimate the cost to provide adequate PPE for a HCW encounter with an Ebola patient is $13.04, which is associated with a 97% risk reduction in infections. The mean incremental cost-effectiveness ratio (ICER) is $3.98 per disability-adjusted life year (DALY) averted. Because of lowered infection and disability rates, this investment is estimated to save $132.27 in averted health systems costs, a financial ROI of 1,014%. For MRSA, the cost of adequate PPE for one HCW encounter is $0.88, which is associated with a 53% risk reduction in infections. The mean ICER is $362.14 per DALY averted. This investment is estimated to save $20.18 in averted health systems costs, a financial ROI of 2,294%. In terms of total health savings per death averted, investing in adequate PPE is the dominant strategy for Ebola and MRSA, suggesting that it is both more costly and less clinically optimal to not fully invest in PPE for these diseases. There are many compelling reasons to invest in PPE to protect HCWs. This analysis examines the economic case, building on previous evidence that protecting HCWs with PPE is cost-effective for COVD-19. Ebola and MRSA scenarios were selected to allow assessment of both endemic and epidemic infectious diseases. While PPE is cost-effective for both conditions, compared to our analysis for COVID-19, PPE is relatively more cost-effective for Ebola and relatively less so for MRSA. Further research is needed to assess shortfalls in the PPE supply chain identified during the COVID-19 pandemic to ensure an efficient and resilient supply in the face of future pandemics.

A stochastic SIS epidemic infectious diseases model with double stochastic perturbations

In this paper, a stochastic SIS epidemic infectious diseases model with double stochastic perturbations is proposed. First, the existence and uniqueness of the positive global solution of the model are proved. Second, the controlling conditions for the extinction and persistence of the disease are obtained. Besides, the effects of the intensity of volatility [Formula: see text] and the speed of reversion [Formula: see text] on the dynamical behaviors of the model are discussed. Finally, some numerical examples are given to support the theoretical results. The results show that if the basic reproduction number [Formula: see text], the disease will be extinct, that is to say that we can control the threshold [Formula: see text] to suppress the disease outbreak.