Low Disease Transmission Research Articles

Utilizing disease transmission and response capacities to optimize covid-19 control in Malaysia

ObjectivesPublic Health Social Measures (PHSM) such as movement restriction movement needed to be adjusted accordingly during the COVID-19 pandemic to ensure low disease transmission alongside adequate health system capacities based on the COVID-19 situational matrix proposed by the World Health Organization (WHO). This paper aims to develop a mechanism to determine the COVID-19 situational matrix to adjust movement restriction intensity for the control of COVID-19 in Malaysia.MethodsSeveral epidemiological indicators were selected based on the WHO PHSM interim guidance report and validated individually and in several combinations to estimate the community transmission level (CT) and health system response capacity (RC) variables. Correlation analysis between CT and RC with COVID-19 cases was performed to determine the most appropriate CT and RC variables. Subsequently, the CT and RC variables were combined to form a composite COVID-19 situational matrix (SL). The SL matrix was validated using correlation analysis with COVID-19 case trends. Subsequently, an automated web-based system that generated daily CT, RC, and SL was developed.ResultsCT and RC variables were estimated using case incidence and hospitalization rate; Hospital bed capacity and COVID-19 ICU occupancy respectively. The estimated CT and RC were strongly correlated [ρ = 0.806 (95% CI 0.752, 0.848); and ρ = 0.814 (95% CI 0.778, 0.839), p < 0.001] with the COVID-19 cases. The estimated SL was strongly correlated with COVID-19 cases (ρ = 0.845, p < 0.001) and responded well to the various COVID-19 case trends during the pandemic. SL changes occurred earlier during the increase of cases but slower during the decrease, indicating a conservative response. The automated web-based system developed produced daily real-time CT, RC, and SL for the COVID-19 pandemic.ConclusionsThe indicators selected and combinations formed were able to generate validated daily CT and RC levels for Malaysia. Subsequently, the CT and RC levels were able to provide accurate and sensitive information for the estimation of SL which provided valuable evidence on the progression of the pandemic and movement restriction adjustment for the control of Malaysia.

ISLAMIC BOARDING SCHOOL BUILDING DESIGN WITH A COVID-19 PROTECTION PROTOCOL

Islamic Boarding School building functions as a place of education for prospective ulama who are expected to be the disseminators of Islamic religious knowledge to the wider community. Coronavirus transmission was very fast in 2019-2022, so Islamic boarding schools must appeal to the government’s way of learning, one of which is to comply with the Covid-19 protection protocol. This study aims to get Islamic boarding school design with Covid-19 protection protocol. The method we did was survey and observation to initial research data, then made floor plans for the first and the second floors with AutoCAD according to a related party and expert ideas. Finally, with SketchUp Pro, a standard building design for the COVID-19 health protocol was obtained, such as the design of the top, 3D, side, and inside view. The design consisted of a bedroom in 8x8 meters with a height of 4 meters for 18 students with adequate ventilation and lighting. In every room and terrace, there is Covid-19 health protocol message. The area for hand washing with soap is located in the right and left wings of the bedroom. The stairs and doors for entry and exit are different. The rooms are arranged with one-way circulation of human movement. The corridor to come through the main stairs or the area near the bathroom goes down through the stairs near the ablution place. With this arrangement of beds, students' movement in the bedroom leads to another corridor from the direction of arrival. The students sitting on the bed can see the green view. They can move without colliding with each other, so it feels more relieved. They are targeted for activities in good health and lower disease transmission. As a result, students get more breathing space and behave more responsibly for personal health. For teachers and management, it is easier to carry out transmission tracing.

Associations between COVID-19 lockdown and post-lockdown on the mental health of pregnant women, postpartum women and their partners from the Queensland family cohort prospective study

BackgroundThere are very few developed countries where physical isolation and low community transmission has been reported for COVID-19 but this has been the experience of Australia. The impact of physical isolation combined with low disease transmission on the mental health of pregnant women is currently unknown and there have been no studies examining the psychological experience for partners of pregnant women during lockdown. The aim of the current study was to examine the impact of the first COVID-19 lockdown in March 2020 and post lockdown from August 2020 on the mental health of pregnant women or postpartum women and their partners.MethodsPregnant women and their partners were prospectively recruited to the study before 24 weeks gestation and completed various questionnaires related to mental health and general wellbeing at 24 weeks gestation and then again at 6 weeks postpartum. The Depression, Anxiety and Stress Scale (DASS-21) and the Edinburgh Postnatal Depression Scale (EPDS) were used as outcome measures for the assessment of mental health in women and DASS-21 was administered to their partners. This analysis encompasses 3 time points where families were recruited; before the pandemic (Aug 2018-Feb 2020), during lockdown (Mar-Aug 2020) and after the first lockdown was over (Sept-Dec 2020).ResultsThere was no significant effect of COVID-19 lockdown and post lockdown on depression or postnatal depression in women when compared to a pre-COVID-19 subgroup. The odds of pregnant women or postpartum women experiencing severe anxiety was more than halved in women during lockdown relative to women in the pre-COVID-19 period (OR = 0.47; 95%CI: 0.27–0.81; P = 0.006). Following lockdown severe anxiety was comparable to the pre-COVID-19 women. Lockdown did not have any substantial effects on stress scores for pregnant and postpartum women. However, a substantial decrease of over 70% in the odds of severe stress was observed post-lockdown relative to pre-COVID-19 levels. Partner’s depression, anxiety and stress did not change significantly with lockdown or post lockdown.ConclusionA reproductive age population appear to be able to manage the impact of lockdown and the pandemic with some benefits related to reduced anxiety.

Communicating with patients and the public about COVID-19 vaccine safety: recommendations from the Collaboration on Social Science and Immunisation.

Communicating with patients and the public about COVID-19 vaccine safety: recommendations from the Collaboration on Social Science and Immunisation.

Epidemic progression and vaccination in a heterogeneous population. Application to the Covid-19 epidemic

The paper is devoted to a compartmental epidemiological model of infection progression in a heterogeneous population which consists of two groups with high disease transmission (HT) and low disease transmission (LT) potentials. Final size and duration of epidemic, the total and current maximal number of infected individuals are estimated depending on the structure of the population. It is shown that with the same basic reproduction number R0 in the beginning of epidemic, its further progression depends on the ratio between the two groups. Therefore, fitting the data in the beginning of epidemic and the determination of R0 are not sufficient to predict its long time behaviour. Available data on the Covid-19 epidemic allows the estimation of the proportion of the HT and LT groups. Estimated structure of the population is used for the investigation of the influence of vaccination on further epidemic development. The result of vaccination strongly depends on the proportion of vaccinated individuals between the two groups. Vaccination of the HT group acts to stop the epidemic and essentially decreases the total number of infected individuals at the end of epidemic and the current maximal number of infected individuals while vaccination of the LT group only acts to protect vaccinated individuals from further infection.

Accidental and late parasitological diagnosis of Leishmania sp. in a dog from a low disease transmission area of Brazil: A case report

Canine Leishmaniasis diagnosis must be fast and accurate since dogs are urban reservoirs of the disease and earlier therapeutic intervention is more clinically effective. However, this still represents a challenge, particularly in low transmission areas. The present report describes the difficulties of clinical suspicion and the late diagnosis of a dog infected with Leishmania sp.

Locals get travellers' diarrhoea too: risk factors for diarrhoeal illness and pathogenic Escherichia coli infection across an urban-rural gradient in Ecuador.

Diarrhoea is a common and well-studied cause of illness afflicting international travellers. However, traveller's diarrhoea can also result from travel between high and low disease transmission regions within a country, which is the focus of this study. We recruited participants for a case-control study of diarrhoea at four sites along an urban-rural gradient in Northern Ecuador: Quito, Esmeraldas, Borbón and rural communities outside of Borbón. At each of these sites, approximately 100 subjects with diarrhoea (cases) were recruited from Ministry of Health clinics and were age-matched with subjects visiting the same clinics for other complaints (controls). Travellers to urban destinations had higher risk of diarrhoea and diarrhoeagenic Escherichia coli (DEC) infections. Travel to Quito was associated with diarrhoea (aOR=2.01, 95% CI=1.10-3.68) and travel to Guayaquil (another urban centre in Ecuador) was associated with Diffuse Adherent E.coli infection (OR=2.09, 95% CI=1.01-4.33). Compared to those not travelling, urban origins were also associated with greater risk of diarrhoea in Esmeraldas (aOR=2.28, 95% CI=1.20-4.41), and with higher risk of diarrhoeagenic E.coli infections in Quito (aOR=2.61, 95% CI=1.16-5.86), with >50% of travel from Quito and Esmeraldas specified to another urban destination. This study suggests that individuals travelling from lower-transmission regions (rural areas) to higher transmission regions (urban centres) within a single country are at a greater risk of acquiring a diarrhoea-related illness. Investments to improve water, sanitation and hygiene conditions in urban areas could have impacts on outlying rural areas within a given country.

Modelling the large-scale yellow fever outbreak in Luanda, Angola, and the impact of vaccination.

BackgroundYellow fever (YF), transmitted via bites of infected mosquitoes, is a life-threatening viral disease endemic to tropical and subtropical regions of Africa and South America. YF has largely been controlled by widespread national vaccination campaigns. Nevertheless, between December 2015 and August 2016, YF resurged in Angola, quickly spread and became the largest YF outbreak for the last 30 years. Recently, YF resurged again in Brazil (December 2016). Thus, there is an urgent need to gain better understanding of the transmission pattern of YF.ModelThe present study provides a refined mathematical model, combined with modern likelihood-based statistical inference techniques, to assess and reconstruct important epidemiological processes underlying Angola’s YF outbreak. This includes the outbreak’s attack rate, the reproduction number (), the role of the mosquito vector, the influence of climatic factors, and the unusual but noticeable appearance of two-waves in the YF outbreak. The model explores actual and hypothetical vaccination strategies, and the impacts of possible human reactive behaviors (e.g., response to media precautions).FindingsWhile there were 73 deaths reported over the study period, the model indicates that the vaccination campaign saved 5.1-fold more people from death and saved from illness 5.6-fold of the observed 941 cases. Delaying the availability of the vaccines further would have greatly worsened the epidemic in terms of increased cases and deaths. The analysis estimated a mean and an attack rate of 0.09-0.15% (proportion of population infected) over the whole period from December 2015 to August 2016. Our estimated lower and upper bounds of are in line with previous studies. Unusually, oscillated in a manner that was “delayed” with the reported deaths. High recent number of deaths were associated (followed) with periods of relatively low disease transmission and low , and vice-versa. The time-series of Luanda’s YF cases suggest the outbreak occurred in two waves, a feature that would have become far more prominent had there been no mass vaccination. The waves could possibly be due to protective reactive behavioral changes of the population affecting the mosquito population. The second wave could well be an outcome of the March-April rainfall patterns in the 2016 El Niño year by creating ideal conditions for the breeding of the mosquito vectors. The modelling framework is a powerful tool for studying future YF epidemic outbreaks, and provides a basis for future vaccination campaign evaluations.

Serological Measures of Trachoma Transmission Intensity.

Ocular infection with Chlamydia trachomatis can lead to trachoma, a leading infectious cause of blindness. Trachoma is targeted for elimination by 2020. Clinical grading for ocular disease is currently used for evaluating trachoma elimination programs, but serological surveillance can be a sensitive measure of disease transmission and provide a more objective testing strategy than clinical grading. We calculated the basic reproduction number from serological data in settings with high, medium, and low disease transmission based on clinical disease. The data showed a striking relationship between age seroprevalence and clinical data, demonstrating the proof-of-principle that age seroprevalence predicts transmission rates and therefore could be used as an indicator of decreased transmission of ocular trachoma.

The effect of Calcium Sulfate on the periodontal healing of 2-wall intrabony defects in dogs

There have been numerous bone graft materials used in periodontics, in an attempt to reach the main goal of periodontal therapy, i.e. the regeneration of periodontal tissue lost due to destructive periodontal diseases. Autogenous bone grafts, with their ability to retain cell viability and a high potential of revascularization as well as low disease transmission, have been widely favored1). However, autogenous bone grafts generally require secondary surgical sites, and have limitations in the amount of grafts that can be procured. A search for the allografts and synthetic bone substitutes that can match the clinical success of autogenous bone grafts without the limitations inherent in the autogenous grafts has been going on for decades. Some of the materials studied include plaster of Paris2, 3), hydroxyapatite4, 5), calcium carbonate6), and decalcified freezedried bone7), to name a few. The hemihydrate of calcium sulfate, also known as plaster of Paris, is prepared by heating gypsum8). When the dry powder is mixed with water, calcium sulfate hardens to form a solid mass of crystals. Initially, medical use of calcium sulfate was limited to a cast which immobilize the injured limb or incorporation in bandages and splints. However, there was a report in 1892 by Dressman as described by Peltier2), where bone cavities were filled with plaster of Paris and later found to be filled with solid bone. Since then, the use of calcium sulfate in animals and in human orthopedic and dental bone defects has been reported in numerous publications. These reports generally agree that the plaster of Paris does not induce inflammatory reaction more than what is present before the grafting8), and the grafted area is histologically normal. A number of animal studies using calcium sulfate suggest that calcium sulfate does not inhibit the osteoblast activities, and may provide conducting matrix for ingrowth of blood vessels and osteogenic cells. However, Shaffer & App3) in 1971 reported that no new bone formation was found in the intrabony defects 대한치주과학회지 : Vol. 27, No. 2, 1997