Health Intervention Strategies Research Articles

Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults

BackgroundType 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortality worldwide, including among Africans. Knowledge of the association between traditional risk factors and both diabetes and pre-diabetes, and whether these differ by age and sex, is important for designing targeted interventions. However, little is known about these associations for African populations.MethodsThe study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746 women) aged 25–64 years, from 5 different West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali (1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare differences in the prevalence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative risks (RR) and 95% confidence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk factor, including obesity [defined by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and smoking. Models for each of these traditional risk factors and interactions with age and sex were fitted.ResultsFactors associated with T2DM and IFG were age, obesity [defined by BMI, WC, WHtR, and WHR], HBP, smoking, physical inactivity, and fruit and vegetable consumption (p < 0.05). Analysis of interaction effects showed few significant differences in associations between risk factors and T2DM according to age or sex. Significant interaction with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p = 0.04)], WHtR*age and T2DM [RR; 1.23, 95% CI: (1.06, 1.44) (p = 0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p = 0.006)]. Some interactions with age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns were observed.ConclusionThe study found that with very few exceptions, associations between traditional risk factors examined and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa.

Evaluating effectiveness of public health intervention strategies for mitigating COVID-19 pandemic.

Coronavirus disease 2019 (COVID‐19) pandemic is an unprecedented global public health challenge. In the United States (US), state governments have implemented various non‐pharmaceutical interventions (NPIs), such as physical distance closure (lockdown), stay‐at‐home order, mandatory facial mask in public in response to the rapid spread of COVID‐19. To evaluate the effectiveness of these NPIs, we propose a nested case‐control design with propensity score weighting under the quasi‐experiment framework to estimate the average intervention effect on disease transmission across states. We further develop a method to test for factors that moderate intervention effect to assist precision public health intervention. Our method takes account of the underlying dynamics of disease transmission and balance state‐level pre‐intervention characteristics. We prove that our estimator provides causal intervention effect under assumptions. We apply this method to analyze US COVID‐19 incidence cases to estimate the effects of six interventions. We show that lockdown has the largest effect on reducing transmission and reopening bars significantly increase transmission. States with a higher percentage of non‐White population are at greater risk of increased Rt associated with reopening bars.

Analysis of the resilience level and associated factors among patients with lumbar disc herniation

This study aims to determine the resilience level and its influence on anxiety among Chinese lumbar disc herniation (LDH) patients, and to determine the critical psychological and non-psychological predictors of resilience among LDH patients. Twenty hundred and fifty LDH patients from a tertiary hospital in Jinzhou, China were included in this survey to answer the Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10). The mean resilience level of LDH patients was 61.96 ± 12.37. Resilience was negatively correlated with anxiety (χ2 = 32.603, p < 0.001), accompanied by a significant linear trend (χ2 = 28.567, p < 0.001). Hope, stress, social support, and medical payment type accounted for 48.7% resilience variance. This study reveals that Chinese LDH patients had low resilience level, and that lower level of resilience was closely associated with higher anxiety level. The predictors for resilience among LDH patients include hope, stress, social support, as well as medical payment types. These findings provide local government and related health-care professionals with a basis for development of targeted mental health management of Chinese LDH patients, and will also help to devise appropriate health intervention strategies for promoting the mental health status of LDH patients.

Human Health and Outdoor Adventure Recreation: Perceived Health Outcomes

Forests and similar types of landscapes offer a myriad of outcomes and benefits often associated with participation in outdoor adventure recreation (OAR) activities. Previous research has shown that OAR participants are able to identify, perceive, and accurately report the effects and benefits of their participation. The health benefits of outdoor experiences, both active and more passive, have received a growing research interest, both as a setting and as a setting/activity complex. Research has identified six primary forms of health and well-being from outdoor and forest-type landscapes, including emotional, environmental, intellectual, social, spiritual, and physical. The preponderance of research in the health and wellness field synthesizes these forms into two primary categories, physical/physiological and mental/psychological. This study considered the health outcomes attributed to highly active OAR participation using three popular OAR activities: mountain biking (MTB), rock climbing (RC) and whitewater paddling (WW; including whitewater kayaking, whitewater canoeing, and whitewater rafting). A survey presented in situ to OAR participants in various areas of the Midwestern and Southeastern United States yielded 288 respondents. Using health perceptions and outcomes instruments as well as semi-structured interviews, the researchers found health to be an important factor for OAR participation. These findings are congruent with previous research that suggest that OAR participants specifically recreate in forested and other natural areas for enhanced physical and psychological health outcomes. The findings in this study also support the efficacy of the participation in OAR activities toward supporting both health improvement and maintenance. With physical and psychological health continuing to be an area of concern in today’s world, this study suggests that participation in OAR on forested and similar landscapes can be a successful health intervention strategy.

Parenting and Lead Mitigation at Home: A Multifaceted Community Partnership Model Promoting Parent Engagement in Lead Exposure Prevention.

Young children are at high risk of lead poisoning, which can damage early cognitive and behavioral development and have long-lasting impacts. Home environments are persistent sources of exposure for children in urban, low-income settings. Community-academic partnerships are essential for public health intervention strategies addressing residential household lead exposure, yet community organization staff and home visitors often experience strain and burnout. We describe Parenting and Lead Mitigation at Home, a multifaceted partnership project to (a) develop and implement a community-based, peer-delivered education program for parents of young children in neighborhoods at risk for home lead exposure and (b) support the home visitors delivering programming. We developed, delivered, and initially evaluated Lead 101, a lead-exposure prevention curriculum informed by the Community Organizing and Family Issues (COFI) model. The goals were to educate parents around lead exposure risks and empower parents to reduce their child's risk. We developed a novel Reflective Practice pilot curriculum designed to provide emotional support to peer educators and community organization staff who delivered home-based programming. We trained 11 peer educators who delivered Lead 101 to 62 families. We pilot-tested the Reflective Practice curriculum with five community organization staff. The implementation process and pilot evaluation data suggest increased parent knowledge and self-efficacy regarding mitigation of home-based lead hazards, and high satisfaction with reflective practice. Using this model to develop multifaceted partnerships among universities, community-based organizations, and focal communities may facilitate community-engaged program development for families and systematic support for individuals working directly with families, thereby indirectly promoting child health and well-being.

A Systematic Review of the Relationships Between Physical Activity and Sleep in Early Childhood.

The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.

No Virus on Me: The Indian Ways of Managing the COVID-19 Pandemic: Marine to Mountain

The case is about the coronavirus disease 2019 (COVID-19) pandemic, and India’s ‘midstream’ social marketing strategies and other strategic approaches to battle the notorious virus, the first known case of which was identified in Wuhan, China, in December 2019. The art and science of social marketing were exploited to promote a healthy lifestyle as a precautionary measure against COVID-19 infection through non-pharmaceutical interventions. Social marketing campaigns promoting healthy behaviour, improving psychological health and ensuring mass well-being were implemented to manage the huge Indian population in the metro cities as well as in the remotest communities in villages during the pandemic. The case study discusses the health intervention and promotion strategies and other preparedness adopted by various stakeholders in India. The case study also discusses the history and experience of severe past health threats in India and what those experiences contributed to India’s preparedness. The crisis worsened when the citizens could not cope with psychological and economic problems; a section of the population disobeyed the government guidelines. The government faced capacity and resource constraints. The case study ends with a dilemma on whether to continue with the lockdown efforts or ease restrictions. The government needs to decide on strategies to ensure the well-being of its citizens and ways to manage citizens and businesses of all forms. The consequence of the decision had huge economic, health as well as governance implications. The case study will provide practitioners with reference to the potential of social marketing and other crisis management strategies to address a complex problem featured with aleatory as well as epistemic uncertainty. The case study is timely and may serve as a reference to the rest of the world as an example to deal with similar problems at an industrial scale.

Risk factors for antimicrobial resistance among Staphylococcus isolated from pets living with a patient diagnosed with methicillin-resistant Staphylococcus aureus infection.

It has been suggested that pets play a critical role in the maintenance of methicillin‐resistant (MR) and multidrug‐resistant (MDR) Staphylococcus spp. in the household. We examined risk factors for carriage of antimicrobial‐resistant coagulase‐positive staphylococci, with particular attention to Staphylococcus aureus and Staphylococcus pseudintermedius isolated from pets living in households of people diagnosed with methicillin‐resistant S. aureus (MRSA) skin or soft‐tissue infection. We analyzed data collected cross‐sectionally from a study conducted in 2012 that evaluated the transmission of MRSA and other staphylococci from humans, their pets and the environment (Pets and Environmental Transmission of Staphylococci [PETS] study). We used unadjusted and adjusted stratified logistic regression analyses with household‐clustered standard errors to evaluate the association between demographic, healthcare‐related, contact‐related and environmental risk factors and MDR Staphylococcus spp. isolated from dogs and cats. Staphylococcal isolates obtained from dogs (n = 63) and cats (n = 47) were included in these analyses. The use of oral or injectable antimicrobials by the pets during the prior year was the main risk factor of interest. Based on our results, 50% (12/24) of S. aureus, 3.3% (1/30) of S. pseudintermedius and 25% (14/56) of other coagulase‐positive staphylococci (CPS) were determined to be MDR. S. aureus isolates were more likely to be MDR compared with S. pseudintermedius. We did not find a significant statistical association between the use of oral or injectable antimicrobials in the prior year and the presence of MDR bacteria. The results suggest that drivers of antimicrobial resistance in household staphylococci may vary by bacterial species, which could have implications for one health intervention strategies for staphylococci and inform the investigation of other reverse zoonoses, such as COVID‐19.

Sustaining the public health intervention strategies in confronting the Covid-19 pandemic

The most effective strategies that any society has while fighting against confronting the pandemic Covid-19 is affecting not just health but also economics, politics, and social order while fighting against its spread. The main intervention strategies in preventing the spread in any society are hand hygiene, wearing masks, social distancing and quarantine. The purpose of this study was to examine the characteristics of strategies and actions aim to sustain the implementation and change of a public behavior intended for facing long-term pandemics or crises. A review-research was done between August and December 2020 on some papers considering the topic of sustainability of strategies, sustainable public health actions and strategies used to face the Covid-19 and similar pandemics in various countries. This study presents the necessity to focus on strategies sustainability especially in pandemic circumstances like Covid-19. The sustainability in implementing large public health strategies is categorized by primary flexibility and vitality. The foremost intervention strategies applied to influence the community in the target of daily activities were to use enhancement guidelines, interactive educating courses, monitoring and evaluations, and dynamic involvement of stakeholders that may sustain these strategies for longer periods. Public health intervention strategies comprise different approaches depending on types of actors, shifts in the pandemic situation, contextual aspects, progress over time, and the ability for sustainability. It is necessary to guarantee that public health strategies are effectively embedded in their settings, depending on more evidence-based approaches and understanding how valuable interventions can be sustainable.

District-Level Analysis of Inequality in Malnutrition Among Children: Evidence from Maharashtra, India

Background and Objective: India currently faces the triple burden of malnutrition characterized by the coexistence of undernutrition and overnutrition along with micronutrient deficiencies. The unequal distribution of child health outcomes in the population may affect the goal of a ‘malnutrition free world’. The nutritional status and its inequalities among post under-five age have rarely been assessed in the country. This study examines the degree and extent of asset-based household wealth inequalities in malnutrition among preschool and school children in the Maharashtra state of India. Methods: The study utilizes the fourth round of the District Level Health Survey 2012-2013 to provide district-level estimates of the inequalities in five malnutrition indicators-stunting, wasting, underweight, overweight, and anemia among children. Concentration curves, normalized concentration index, geographical maps and correlation matrix are used to analyze the data by districts, rural-urban residence and gender. Results: Considerable proportion of children are malnourished in Maharashtra, even with its advanced economic status. Malnutrition levels among school going children are as high as those of children under six years of age. The findings indicate that malnutrition inequalities manifest primarily among the weaker sections of society. However, children from affluent households are more likely to suffer from overweight and obesity issues. The prevalence of malnutrition is higher in rural areas, but inequality is significantly higher in urban regions. The nutritionally backward areas are concentrated in the tribal districts of the Marathwada division and a few others from Vidarbha and Amravati. Many districts of Maharashtra have multiple burdens of malnutrition and have high inequalities on more than one indicator. A negative correlation is observed between the prevalence of malnutrition and human development indicators. Conclusion: There is a need to capture broader age groups in the nutrition monitoring frameworks. Recognizing the regional heterogeneity in the malnutrition prevalence and distribution calls for unique health intervention strategies to specific district targets.

Analysis of Risk of Death due to COVID-19 in Cameroon

Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.

Midwest rural-urban disparities in use of patient online services for COVID-19.

PurposeRural populations are disproportionately affected by the COVID‐19 pandemic. We characterized urban‐rural disparities in patient portal messaging utilization for COVID‐19, and, of those who used the portal during its early stage in the Midwest.MethodsWe collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient‐generated messages (PGMs) on COVID‐19 by urban‐rural locality and incorporated patients’ sociodemographic factors into the analysis.FindingsThe urban‐rural ratio of portal users, message senders, and COVID‐19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban‐rural ratio (1.69) of PGMs on COVID‐19 was higher than that (1.43) of general PGMs. The urban‐rural ratios of messaging were 1.72‐1.85 for COVID‐19‐related care and 1.43‐1.66 for other health care issues on COVID‐19. Compared with urban patients, rural patients sent fewer messages for COVID‐19 diagnosis and treatment but more messages for other reasons related to COVID‐19‐related health care (eg, isolation and anxiety). The frequent senders of COVID‐19‐related messages among rural patients were 40+ years old, women, married, and White.ConclusionsIn this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID‐19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.

Shift work disorder and the prevalence of help seeking behaviors for sleep concerns in Australia: A descriptive study

ABSTRACT Shift work disorder (SWD) is a circadian rhythm sleep-wake disorder, defined by symptoms of insomnia and excessive levels of sleepiness resulting from work that occurs during non-standard hours. Sleep problems are common in shift workers, yet our understanding of help seeking behaviours for sleep in shift workers is limited. The primary aim of this study was to examine the help seeking behaviours of Australian workers who meet criteria for SWD. Of the 448 (46% of sample, n = 964 total) Australian workers reporting non-standard work hours, 10.5% (n = 41) met the criteria for probable shift work disorder (pSWD). Non-standard workers with pSWD did not seek help for sleep problems at higher rates than workers without SWD. Of the small proportion of workers with pSWD who sought help, general practitioners were the most common healthcare professionals for sleep problems. Self-management was common in workers with pSWD, with a high self-reported prevalence of alcohol use (31.7%) as a sleep management strategy, and caffeine consumption (76.9%) as a sleepiness management strategy. The majority of individuals with pSWD reported the mentality of ‘accept it and keep going’ as a sleepiness management strategy, highlighting a potential barrier to help seeking behaviour in workers with pSWD. These findings provide novel insight into the help seeking behaviours of those with pSWD. There is a need for further research to understand why individuals at risk for SWD are not actively seeking help, and to develop health promotion and intervention strategies to improve help seeking when needed.

Context-dependent host dispersal and habitat fragmentation determine heterogeneity in infected tick burdens: an agent-based modelling study.

As the incidence of tick-borne diseases has sharply increased over the past decade, with serious consequences for human and animal health, there is a need to identify ecological drivers contributing to heterogeneity in tick-borne disease risk. In particular, the relative importance of animal host dispersal behaviour in its three context-dependent phases of emigration, transfer and settlement is relatively unexplored. We built a spatially explicit agent-based model to investigate how the host dispersal process, in concert with the tick and host demographic processes, habitat fragmentation and the pathogen transmission process, affects infected tick distributions among hosts. A sensitivity analysis explored the impacts of different input parameters on infected tick burdens on hosts and infected tick distributions among hosts. Our simulations indicate that ecological predictors of infected tick burdens differed among the post-egg life stages of ticks, with tick attachment and detachment, tick questing activity and pathogen transmission dynamics identified as key processes, in a coherent way. We also found that the type of host settlement strategy and the proportion of habitat suitable for hosts determined super-spreading of infected ticks. We developed a theoretical mechanistic framework that can serve as a first step towards applied studies of on-the-ground public health intervention strategies.

Impact of maternal morbidities on the longitudinal health-related quality of life trajectories among women who gave childbirth in four hospitals of Northwest Ethiopia: a group-based trajectory modelling study

ObjectivesTo identify distinct trajectories of health-related quality of life and its predictors among postpartum women in Northwest Ethiopia.DesignHealth facility-linked community-based prospective follow-up study.SettingSouth Gondar zone, Northwest Ethiopia.ParticipantsWe recruited 775 mothers...

Contributing effects of individual characteristics, behavioural and job-related factors on occurrence of mining-related injuries: A systematic review.

Occupational health and safety (OHS) is a complex system due to its three components, namely human, technological and organizational factors. The interplay between the three systems causes workplace accidents and, subsequently, injuries. The body of research currently available demonstrates a disparity in the focus on contributors that cause mining-related injuries beyond the presence of hazards. The aim of this paper was to systematically review and synthesise peer-reviewed published studies that have investigated whether certain individual characteristics, behavioural factors and job-related factors predict mining-related injuries. Databases were searched and peer-reviewed publications from 2004 to 2020 were retrieved and analysed. Only 24 from 3073 identified articles were retained for review and synthesis following careful screening. Most identified studies were either cross-sectional or case-control studies, and they were rated as moderate-to-good quality. The review results showed that there is a diverging view in relation to risk factors that cause mining-related injuries. Some publications suggested that old age, male miners, married miners, less educated miners, less experienced miners, alcohol and drug usage, poor working conditions, poor management or supervision, job dissatisfaction and job stress predict injury events while other studies found contradictory relationships or insignificant statistical associations. Despite the fact that studied risk factors have been well-established in other industries, there is a significant gap in mining that needs further examination. It is imperative that health and safety intervention strategies are devised and implemented for vulnerable groups.

Fatores de risco à infecção pelo HIV entre adolescentes e jovens: revisão sistemática

Abstract Objective: to identify and analyze HIV infection risk factors among adolescents and the youth. Method: this is a systematic review whose guide question is: what are the risk factors for HIV infection among adolescents and the youth?” In total, five databases and Google Scholar were searched in December 2021 and the found publications between 2012-2022 were filtered without language restriction. Studies were selected by two independent reviewers. The included materials were subjected to methodological quality evaluation and narrative synthesis. Results: overall, we included seven studies out of the 26,191 retrieved. All studies were conducted in Africa. We found that the female gender, older age, low schooling, Black ethnicity, multiple sexual partners, inconsistent use of condoms, alcohol consumption, and early sexual onset constituted risk factors for HIV infection in adolescents and the youth. Conclusion: understanding risk factors underscores the provision of health policies and intervention strategies to strengthen the responsiveness of health services and nursing teams’ care to reduce HIV transmission among adolescents and the youth.

Investigating seasonal patterns in enteric infections: a systematic review of time series methods.

Foodborne and waterborne gastrointestinal infections and their associated outbreaks are preventable, yet still result in significant morbidity, mortality and revenue loss. Many enteric infections demonstrate seasonality, or annual systematic periodic fluctuations in incidence, associated with climatic and environmental factors. Public health professionals use statistical methods and time series models to describe, compare, explain and predict seasonal patterns. However, descriptions and estimates of seasonal features, such as peak timing, depend on how researchers define seasonality for research purposes and how they apply time series methods. In this review, we outline the advantages and limitations of common methods for estimating seasonal peak timing. We provide recommendations improving reporting requirements for disease surveillance systems. Greater attention to how seasonality is defined, modelled, interpreted and reported is necessary to promote reproducible research and strengthen proactive and targeted public health policies, intervention strategies and preparedness plans to dampen the intensity and impacts of seasonal illnesses.

Comprehensive Humoral and Cellular Immune Responses to SARS-CoV-2 Variants in Diverse Chinese Population.

The SARS-CoV-2 variants have been emerging and have made great challenges to current vaccine and pandemic control strategies. It is urgent to understand the current immune status of various Chinese populations given that the preexisting immunity has been established by national vaccination or exposure to past variants. Using sera from 85 individuals (including 21 convalescents of natural infection, 15 cases which suffered a breakthrough infection after being fully vaccinated, and 49 healthy vaccinees), we showed significantly enhanced neutralizing activities against SRAS-CoV-2 variants in convalescent sera, especially those who had been fully vaccinated. The neutralizing antibodies against Omicron were detectable in 75% of convalescents and 44.9% of healthy vaccinees (p = 0.006), with a GMT of 289.5, 180.9-463.3, and 42.6, 31.3-59, respectively. However, the neutralizing activities were weaker in young convalescents (aged < 18 y), with a detectable rate of 50% and a GMT of 46.4 against Omicron. We also examined and found no pan-sarbecovirus neutralizing activities in vaccinated SARS-CoV-1 survivors. A booster dose could further increase the breadth and magnitude of neutralization against WT and variants of concern (VOCs) to different degrees. In addition, we showed that COVID-19-inactivated vaccines can elicit Omicron-specific T-cell responses. The positive rates of ELISpot reactions were 26.7% (4/15) and 43.8% (7/16) in the full vaccination group and the booster vaccination group, respectively, although without statistically significant difference. The neutralizing antibody titers declined while T-cell responses remain consistent over 6 months. These findings will inform the optimization of public health vaccination and intervention strategies to protect diverse populations against SARS-CoV-2 variants. Advances. Breakthrough infection significantly boosted neutralizing activities against SARS-CoV-2 variants as compared to booster immunization with inactivated vaccine. Vaccine-induced virus-specific T-cell immunity, on the other hand, may compensate for the shortfall. Furthermore, the public health system should target the most vulnerable group due to a poorer protective serological response in both infected and vaccinated adolescents.

Risk factors for HIV infection among adolescents and the youth: a systematic review.

to identify and analyze HIV infection risk factors among adolescents and the youth. this is a systematic review whose guide question is: what are the risk factors for HIV infection among adolescents and the youth?" In total, five databases and Google Scholar were searched in December 2021 and the found publications between 2012-2022 were filtered without language restriction. Studies were selected by two independent reviewers. The included materials were subjected to methodological quality evaluation and narrative synthesis. overall, we included seven studies out of the 26,191 retrieved. All studies were conducted in Africa. We found that the female gender, older age, low schooling, Black ethnicity, multiple sexual partners, inconsistent use of condoms, alcohol consumption, and early sexual onset constituted risk factors for HIV infection in adolescents and the youth. understanding risk factors underscores the provision of health policies and intervention strategies to strengthen the responsiveness of health services and nursing teams' care to reduce HIV transmission among adolescents and the youth.