Lower Fatality Research Articles

Cost-effectiveness of One Health intervention to reduce risk of human exposure and infection with non-typhoidal salmonellosis (NTS) in Nigeria

BackgroundNon-typhoidal Salmonella infection (NTS) is an important foodborne zoonosis with underappreciated health and economic burdens, and low case fatality. It has global prevalence, with more burdens in under-resourced countries with poor health infrastructures. Using a cohort study, we determined the cost-effectiveness of NTS in humans in Nigeria for the year 2020. MethodsUsing a customized Excel-based cost-effectiveness analysis tool, structured (One Health) and unstructured (episodic intervention against NTS) in Nigeria were evaluated. Input data on the disease burdens, costs surveillance, response and control of NTS were obtained from validated sources and the public health system. ResultsThe non-complicated and complicated cases were 309,444 (95%) and 16,287 (5%) respectively, and the overall programme cost was US$ 31,375,434.38. The current non-systematic episodic intervention costed US$ 14,913,480.36, indicating an additional US$ 16,461,954 to introduce the proposed intervention. The intervention will avert 4036.98 NTS DALYs in a single year. The non-complicated NTS case was US$ 60/person with significant rise in complicated cases. The cumulative costs of NTS with and without complications far outweighed the program cost for One Health intervention with an incremental cost-effectiveness ratio (ICER) of -US$ 221.30). ConclusionsUtilising structured One Health intervention is cost-effective against NTS in Nigeria, it carries additional mitigative benefits for other diseases and is less costly and more effective, indicative of a superior health system approach. Identified limitations must be improved to optimize benefits associated and facilitate policy discussions and resource allocation.

Characteristics and outcomes of a hospitalized cohort with reduced mortality from COVID-19, White Mountain apache tribal lands, April 1 – July 31, 2020

BackgroundWidespread transmission of COVID-19 continues to threaten public health, particularly of rural, American Indian communities. Although COVID-19 risk factors for severe disease and clinical characteristics are well described in the general population, there has been little shared on hospitalized American Indian populations.MethodsIn this observational study, we performed chart extractions on all persons hospitalized with COVID-19 from April 1 through July 31, 2020 among an exclusively American Indian population living on or near Tribal lands in eastern Arizona. We provide descriptive statistics for the cohort stratified by presentation, comparing those who self-presented or were referred by an outreach program. Exploratory analyses were performed to identify risk factors for morbidity and mortality.ResultsDuring the observation period, 2262 persons were diagnosed with COVID-19 and 490 (22%) were hospitalized. Hospitalized persons had a median age of 54 years; 92% had at least one comorbidity, 72% had greater than one comorbidity, and 60% had a BMI of > 30. Most persons required supplemental oxygen (83%), but the majority (62%) only required nasal cannula and only 11% were intubated. The case fatality rates were 1.7% for the population, 7.1% among hospitalizations, and 9.3% among hospitalized patients 50 years and older. All rates that are significantly lower than those reported nationally during the same period.ConclusionsWe observed a cohort of American Indian patients hospitalized secondary to COVID-19 with greater number of comorbidities compared to the general population but with lower mortality rates. We posit that the primary driver of mortality reduction for this population and the hospitalized cohort was a community-based referral program that led to disproportionately lower fatality rates among the oldest persons.

A Review of Mpox Outbreak and Public Health Response in Spain.

In May 2022, an unprecedented Mpox outbreak was reported in several non-endemic countries with unknown epidemiological links. Since May 2022, more than 20,000 cases have been reported in Europe. Spain has been the most affected country in Europe. We aim to describe the Mpox epidemiological profile in Spain, identify its outbreak risks, and describe public health interventions implemented by the Spanish authorities. A literature review was conducted, using specific selection criteria to obtain relevant publications describing Mpox clinical presentation and risk factors and the public health response in Spain to the ongoing outbreak. 63.1% of the cases presented an anogenital rash, considered a specific and early symptom in this outbreak. Low case fatality rate is observed, mainly in risk groups, such as the immunocompromised population. Patients evolution was generally favorable, although 3-8% required hospitalization and two deaths occurred; 40% of patients were previously diagnosed with HIV infection. Most of the cases were seen among young population and concentrated in men who had sex with other men, mainly with multiple sexual partners, who did not practice safe sex such as using condoms, and those attending mass event parties. To date, the Mpox outbreak is not considered a public health emergency of international concern. The epidemiological trend of the virus in Spain shows that public health response interventions (health education, contact tracing, vaccination, etc.) have adequately controlled the epidemic curve in high-risk populations and avoided spreading the virus to other groups within the community.

Study on intentional control strategy of COVID-19

With the ongoing evolution of the novel coronavirus pathogen and continuous improvements in our social environment, the mortality rate of COVID-19 is on a decline. In response to this, we introduce an adaptive control strategy known as intentional control, which offers cost-efficiency and superior control effectiveness. The classical SEIR model faces limitations in accurately representing close contacts and sub-close contacts and fails to distinguish their varying levels of infectivity. To address this, our study modifies the classical model by incorporating close contact (E) and a sub-close contact (E2) while reworking the infectious mechanism. Once the model is formulated, we employ various statistical methods to identify crucial parameters, including R2, adjusted R2, and standard deviation. For disease control, we implement an intentional control program with four distinct grades. We develop and apply a scheme in MATLAB for our proposed model, generating diverse simulation results based on realistic parameter values for discussion. Additionally, we explore a range of strategy combinations to differentiate their effectiveness under various social conditions, aiming to identify an optimal approach. Comparing the intentional control strategy to random control, our findings consistently demonstrate the superiority of intentional control across all scenarios. Furthermore, the results indicate that our approach better aligns with the characteristics of the novel coronavirus, characterized by an “extremely low fatality rate and strong infectivity,” while offering detailed insights into the transmission dynamics among different compartments.

Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis.

Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

Optimal non-pharmaceutical interventions considering limited healthcare system capacity and economic costs in the Republic of Korea

Due to the relatively low severity and fatality rates of the omicron variant of COVID-19, strict non-pharmaceutical interventions (NPIs) with high economic costs may not be necessary. We develop a mathematical model of the COVID-19 outbreak in Korea that considers NPIs, variants, medical capacity, and economic costs. Using optimal control theory, we propose an optimal strategy for the omicron period. To suggest a realistic strategy, we consider limited hospital beds for severe cases and incorporate it as a penalty term in the objective functional using a logistic function. This transforms the constrained problem into an unconstrained one. Given that the solution to the optimal control problem is continuous, we propose the adoption of a sub-optimal control as a more practically implementable alternative. Our study demonstrates how to strategically balance the trade-off between minimizing the economic cost for NPIs and ensuring that the number of severe cases in hospitals is manageable.

Negative effects of high public debt on health systems facing pandemic crisis: Lessons from COVID-19 in Europe to prepare for future emergencies

<p>The investigation goal here was to analyze how the level of public debt affects preparedness of health systems to face emergencies. In particular, this study examined the negative effects of high public debt on health systems of European countries in the presence of the COVID-19 pandemic crisis. Empirical evidence revealed that European countries with a lower level of government debt as a percentage of GDP both in 2009 and 2019 (the period before the arrival of the pandemic) had lower COVID-19 fatality rates compared to countries with higher levels of public debt. The explanation is that high levels of public debt in countries trigger budget constraints that limit their ability to allocate resources to healthcare systems (e.g., health expenditures and investments), weakening health system performance and causing systemic vulnerability and lower preparedness during emergencies, such as with the COVID-19 pandemic. Implications of health policies are suggested to improve strategies of crisis management.</p>

Predicting herd immunity achievement: a time-series analysis of vaccination and fatality rates using 1,075 days of COVID-19 data.

The COVID-19 pandemic, driven by SARS-CoV-2, has made vaccination a critical strategy for global control. However, vaccine hesitancy, particularly among certain age groups, remains a significant barrier to achieving herd immunity. This study uses Poisson regression and ARIMA time-series modeling to identify factors contributing to vaccine hesitancy, understand age-specific vaccination preferences, and assess the impact of bivalent vaccines on reducing hesitancy and fatality rates. It also predicts the time required to achieve herd immunity by analyzing factors such as vaccine dosing intervals, age-specific preferences, and changes in fatality rates. The study finds that individuals recovering from COVID-19 often delay vaccination due to perceived immunity. There is a preference for combining BNT162b2 and CoronaVac vaccines. The BNT162b2 bivalent vaccine has significantly reduced vaccine hesitancy and is linked with lower fatality rates, particularly in those aged 80 and above. However, it tends to induce more severe side effects compared to Sinovac. Vaccine hesitancy is most prevalent among the youngest (0-11) and oldest (80+) age groups, posing a challenge to reaching 90% vaccination coverage. Vaccine hesitancy is a major obstacle to herd immunity. Effective strategies include creating urgency, offering incentives, and prioritizing vulnerable age groups. Despite these challenges, the government should have continued to encourage vaccinations while gradually lifting COVID-19 control measures, balancing public health safety with the return to normal life, as was observed in the transition period during the latter stages of the pandemic.

The effectiveness of regulations preventing alcohol-related road traffic crashes and fatalities in the European Union countries

Introduction: This article addresses the impact of policy measures on the number of alcohol-related crashes and fatalities in European Union countries. In particular, it assesses (1) whether mild or severe penalty measures should be used to reduce the number of crashes and fatalities caused by alcohol; and (2) whether alcoholic beverages should be treated differently or proportionally to their alcohol content. Methods: This study analyzed the number of alcohol-related crashes and fatalities in 24 European Union countries between 2002 and 2014. The methodology involved fixed-effects panel models, models with instrumental variables, the Hausman–Taylor model, and seemingly unrelated regressions (SUR). SUR improve the results of coefficient estimates when the data are not complete. Results: The results of the SUR indicated that vehicle impoundment, community service, and alcolocks correlate with lower crashes, while detention correlates with lower fatalities. Furthermore, a higher alcohol content in beverages is positively associated with fatalities and negatively associated with the number of crashes. Conclusions: Mild and harsh measures for preventing alcohol-related crashes and fatalities differ in effectiveness; therefore, they should be used simultaneously. Blood alcohol concentration limits were found to be an ineffective tool for preventing crashes and fatalities under the influence of alcohol. Practical implications: The regulatory restrictions on different types of alcohol should be stricter for hard alcohol (especially spirits) and lower for low-alcohol beverages, such as beer, if fewer fatalities are preferred to fewer crashes.

Comparative transcriptome analysis of SARS-CoV-2, SARS-CoV, MERS-CoV, and HCoV-229E identifying potential IFN/ISGs targets for inhibiting virus replication.

Since its outbreak in December 2019, SARS-CoV-2 has spread rapidly across the world, posing significant threats and challenges to global public health. SARS-CoV-2, together with SARS-CoV and MERS-CoV, is a highly pathogenic coronavirus that contributes to fatal pneumonia. Understanding the similarities and differences at the transcriptome level between SARS-CoV-2, SARS-CoV, as well as MERS-CoV is critical for developing effective strategies against these viruses. In this article, we comparatively analyzed publicly available transcriptome data of human cell lines infected with highly pathogenic SARS-CoV-2, SARS-CoV, MERS-CoV, and lowly pathogenic HCoV-229E. The host gene expression profiles during human coronavirus (HCoV) infections were generated, and the pathways and biological functions involved in immune responses, antiviral efficacy, and organ damage were intensively elucidated. Our results indicated that SARS-CoV-2 induced a stronger immune response versus the other two highly pathogenic HCoVs. Specifically, SARS-CoV-2 induced robust type I and type III IFN responses, marked by higher upregulation of type I and type III IFNs, as well as numerous interferon-stimulated genes (ISGs). Further Ingenuity Pathway Analysis (IPA) revealed the important role of ISGs for impeding SARS-CoV-2 infection, and the interferon/ISGs could be potential targets for therapeutic interventions. Moreover, our results uncovered that SARS-CoV-2 infection was linked to an enhanced risk of multi-organ toxicity in contrast to the other two highly pathogenic HCoVs. These findings provided valuable insights into the pathogenic mechanism of SARS-CoV-2, which showed a similar pathological feature but a lower fatality rate compared to SARS-CoV and MERS-CoV.

Influence of the human development index, motorcycle growth and policy intervention on road traffic fatalities – A case study of Vietnam

Motorcycle ownership in Vietnam has increased exponentially during the last two decades. As a result, traffic congestion, emissions, and traffic safety have been on the rise. Of particular concern is the significant increase in the number of traffic accidents due to higher traffic volume that is stimulated by economic development and improved households’ economic mobility. During this time frame, many programs, such as traffic safety awareness campaign, have been developed and implemented by transportation agencies to reduce traffic fatalities. This study seeks to understand the long-term effect of policy intervention on traffic fatalities. This is accomplished by developing a log-linear regression model which the response variable is the number of traffic fatalities between 1990 and 2019 and the independent variables include Human Development Index (HDI), motorcycle ownership, and policy interventions. The model estimation results indicate that: (1) a higher degree of economic development (HDI) corresponds to lower traffic fatalities, (2) the motorcycle helmet law has lowered the number of annual traffic fatalities since its enactment, and (3) a higher number of motorcycle trips corresponds to a higher number of traffic fatalities. Based on this study’s findings, it is recommended that transportation agencies in Vietnam develop and promote an alternative transportation mode.

PP27 The Private Healthcare Responses Against COVID-19 Emergencies In Brazil

IntroductionThe Corona Virus Disease 2019 (COVID-19) pandemic is the biggest public health crisis of all time. Private health care plays a major role in health globally. We conducted a study to document the engagement of a Brazilian private health care organization to influence decisions to private and public health emergencies of COVID-19.MethodsThis retrospective study evaluated the outputs of the health technology assessment (HTA) group of Unimed-BH, a private Health Maintenance Organization (HMO) with 1.5 million participants in Belo Horizonte, Minas Gerais state. The study evaluated the impacts on the overview of health local decisions in the municipality and the national supplementary health agency (ANS) during the period from March 2020 to December 2022.ResultsDuring the pandemic, Unimed-BH made all its sanitary decisions based on scientific research, such as the use of masks and appropriate medications. Even though some medicines, such as regdanvimab, were authorized for emergency use by the Brazilian Health Regulatory Agency (ANVISA), Unimed-BH did not recommend their use due to uncertain evidence, and months later, ANVISA withdrew the registration.Unimed-BH also conducted a systematic review of ivermectin for COVID-19 treatment, which showed no effect, and therefore did not recommend its use. Additionally, Unimed-BH provided weekly updates on COVID-19 data, including suspected and confirmed cases, hospitalizations, and deaths in their customer portfolio. The organization also actively supported the decisions made by ANS and municipal managers using evidence and statistics on the pandemic. The Unimed-BH HTA group produced a total of 167 reports from March 2020 to December 2022.ConclusionsBelo Horizonte had the lowest in-hospital mortality rates with COVID-19 in Brazil. Unimed-BH’s HTA reports provided evidence-based assessments for decision-making, proposed partnership with policymakers, fomented information transparency, and strict follow-up on pandemic numbers, which may have contributed to the lower fatality rate in our city. These findings underscore the importance of private healthcare organizations in responding to COVID-19 emergencies, and their potential to support evidence-based decision-making and minimize the impact of the pandemic.

Findings from the first wave of Covid-19 on the different impacts of lockdown on public health and economic growth

This paper examines the impact of different durations of national lockdown measures during the first wave of the COVID-19 pandemic on the public health and economic conditions of nations. Results indicate that a) countries with shorter lockdown periods, approximately 15 days, experience a higher variation of confirmed cases/population (%) compared to countries with longer lockdowns, lasting for over one month; b) countries with shorter lockdown periods experience lower average fatality rates compared to countries with longer lockdown periods, while the variation in fatality rates indicates that countries with longer periods of lockdown achieved a more substantial reduction in fatality rates. Nevertheless, the findings of the study indicate that while longer durations of national lockdowns, implemented as a government response to the COVID-19 pandemic, appear to produce somewhat uncertain outcomes in terms of public health, they exhibit a more substantial adverse effect on a country’s economic growth, resulting in a contraction in gross domestic product growth. Extracting key lessons from this study can prove invaluable in crafting effective public responses for future COVID-19 waves and epidemics that resemble the characteristics of COVID-19.

Lumpy Skin Disease, an Emerging Transboundary Viral Disease in Animal’s: A Review

Lumpy skin disease (LSD) is an arising viral ailment impacting cows and buffaloes in India. Livestock industry suffers enormous financial damages as a result of lumpy skin disease (LSD). Lumpy skin disease virus (LSDV), a part of the Poxviridae family induces it, along with precursor being Neethling variant. Lumpy skin disease virus belongs to Capripox virus genus, it also contains sheep and goat pox viruses. Lumpy skin ailment is a bovine illness that is enzootic, contagious, eruptive, and infrequently lethal. It is characterised by skin lumps. Cows and buffalo are the sole impacted types of animals, with substantial morbidity yet lower fatality levels; although, calves die at a greater rate. Lumpy skin disease lowers milk and meat output, induces female miscarriages, and promotes male impotency. Skin nodules all over the body, fever, lachraimal discharge, nasal discharge, anorexia, decreased milk yield, emaciation, depression, and reluctance to move are all major clinical signs. LSD's origins can be traced back to 1929 in Zambia. Lumpy skin disease is regarded an indigenous illness in the African continent. However, around 1984, this disease spread beyond Africa. It has been reported in Madagascar as well as some Middle Eastern countries and Arabian Peninsula. This sickness has lately been documented in regions where lumpy skin ailment is not available (Syria, Lebanon, Iran, Turkey, and Iraq, Jordan), posing a financial risk to the livestock industry. After the earliest case of lumpy skin ailment was reported in India, it has spread rapidly throughout the country, posing a risk to the cattle and buffalo populations of productivity and mortality.

An assessment of the safety and efficiency of log trucks with increased weight limits on interstate highways in Wisconsin and Minnesota, USA

ABSTRACT Design standards for the Federal Interstate Highway System in the US are generally higher than those on other roads within most states, making it the safest road system in the US. Federal law prevents states from enforcing vehicle weight limits on interstate highways that deviate from established Federal weight limits or state-specific grandfathered weight limits or exceptions. As a result, trucks hauling logs at state-legal limits must travel on other roads, passing through towns/cities and school zones where they may encounter on-coming traffic and intersections. All these encounters increase the risk of an accident. This study compared fatality rates of log trucks to other heavy trucks in the lower 48 states, road damage cost estimates for interstate and non-interstate roads and assessed the impact of relaxing interstate weight limits on various factors for hauling logs along three travel corridors in Wisconsin and Minnesota, USA. On a per-load basis, log trucks have a lower fatality rate than other heavy trucks in 83% of the lower 48 states. Due to the higher design standards, pavement damage costs are lowest on interstate highways as compared to other road types. Allowing state-legal, loaded log trucks access to federal interstate highways would improve the overall safety and efficiency of timber transportation and reduce pavement damage costs and CO2 emissions within the study areas. Overall, the study findings suggest that allowing state-legal, loaded log trucks to operate on interstate highways would improve the safety and efficiency of timber transportation in Wisconsin and Minnesota.

Importance of basic life support training in rural India.

Basic life support (BLS) provided right away can lower fatality rates. Cardiac arrest typically results in death within minutes if it is untreated. Therefore, it is of interest to assess how BLS training affected villagers. The pre-experimental one-group pre-test post-test design was chosen for the investigation. A non-probability volunteer sampling technique was adopted to collect a sample of 220 village residents who met the inclusion requirements. The participants received training in basic life support that is achieved by using a real-life role model, hands-on CPR instruction. Checklist served as a standardized method for assessing the BLS training program. The pre-test and post-test's means were 23.05 and 56.51, respectively, and their respective standard deviations were 11.89 and 8.27. The 'z test' calculation result is 12.36) The results showed that BLS training was more successful for villagers and that they required regular BLS training programs to maintain their BLS skill level.

Phage Therapy, a Salvage Treatment for Multidrug-Resistant Bacteria Causing Infective Endocarditis.

Infective endocarditis (IE) is defined as an infection of the endocardium, or inner surface of the heart, most frequently affecting the heart valves or implanted cardiac devices. Despite its rarity, it has a high rate of morbidity and mortality. IE generally occurs when bacteria, fungi, or other germs from another part of the body, such as the mouth, spread through the bloodstream and attach to damaged areas in the heart. The epidemiology of IE has changed as a consequence of aging and the usage of implantable cardiac devices and heart valves. The right therapeutic routes must be assessed to lower complication and fatality rates, so this requires early clinical suspicion and a fast diagnosis. It is urgently necessary to create new and efficient medicines to combat multidrug-resistant bacterial (MDR) infections because of the increasing threat of antibiotic resistance on a worldwide scale. MDR bacteria that cause IE can be treated using phages rather than antibiotics to combat MDR bacterial strains. This review will illustrate how phage therapy began and how it is considered a powerful potential candidate for the treatment of MDR bacteria that cause IE. Furthermore, it gives a brief about all reported clinical trials that demonstrated the promising effect of phage therapy in combating resistant bacterial strains that cause IE and how it will become a hope in future medicine.

COVID-19 incidence and outcomes among patients with kidney replacement therapy.

We aimed to investigate the incidence, fatality, and associated factors in patients with hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT) hospitalized for coronavirus disease 2019 (COVID-19) infection and reimbursed from the National Health Security Office (NHSO). The retrospective cohort analysis was conducted from an electronic-claimed database, and COVID-19 vaccination status was evaluated in patients with HD, PD, and KT from January 2020 to December 2021. There were 85,305 patients reimbursed for HD, PD, and KT by the NHSO. The rates of COVID-19 infection, COVID-19 vaccination, comorbidities, fatalities, and the cost of treatment were evaluated. COVID-19 infection was observed in 1,799 of 36,982 HD cases (4.9%), 1,531 of 45,453 PD cases (3.4%), and 95 of 2,870 KT cases (3.3%). Patients receiving COVID-19 vaccinations were most common in the KT group, followed by those with HD and PD (76.93% vs. 70.65% vs. 51.34%, respectively). KT patients had a lower fatality rate compared to those with PD and HD (8.42% vs. 18.41% vs. 21.40%, respectively). Advanced age, diabetes, cardiovascular diseases, and COVID-19 vaccination status were associated with fatality. The adjusted odds ratios of fatality after receiving one or two doses of vaccines were 0.7 (95% confidence interval [CI], 0.6-0.9) and 0.3 (95% CI, 0.2-0.4), respectively. The cost of treatment was highest in patients with HD, followed by PD and KT. The incidence of COVID-19 infection was higher in patients with HD than in those with PD or KT. COVID-19 vaccination following the national health policy should be encouraged for these patients to prevent fatality.

A case of Monkeypox in a baby monkey

Despite having a low fatality rate in monkeys, monkeypox remains an important disease because of its zoonotic potential. The aim of this study is to describe the clinical, pathological, ultrastructural and virological findings of the first monkeypox case diagnosed in a baby monkey in Türkiye with unknown transmission. A monkeypox infection was detected in a 1-month-old, female, baby monkey born in Antalya Zoo and died with skin lesions. It was reported that the baby's mother did not care for and caregivers took care of the cub, and skin lesions on the hands of the caregivers and responsible veterinarian were reported. Necropsy, histopathology, electron microscopy and chorioallantoic membrane (CAM) test were performed. Typical cutaneous and pulmonary poxvirus finding in a baby monkey was described in this case. CAM results firstly reported in a monkeypox case. Because of the zoonotic potential of illness, monkey colonies, particularly in zoos, must be controlled with vigilance. This is the first monkeypox report in a baby monkey in Türkiye.

Comparative Analysis of Aviation Occurrence Patterns among Three Northeast Asian Countries: South Korea, China and Japan

This study investigates the commonalities and differences in aviation occurrences among three Northeast Asian countries–South Korea, China and Japan, using the ICAO's Integrated Safety Trend Analysis and Reporting System (iSTARS) dataset. Logistic regression and latent class analysis are employed to identify factors influencing the likelihood of fatalities and to classify occurrences into distinct groups. The findings indicate that operational issues in airspace pose greater risks than runway-related issues in this region. The ground and landing flight phases have lower fatality likelihoods compared to the cruise phase, and winter seasons show reduced odds of fatalities. Latent class analysis identifies five distinct occurrence classes, highlighting specific risks and areas for targeted interventions. Technical and environmental issues are prominent in Japan, while operational issues during the cruise and maneuvering phases are significant in South Korea, associated with a high fatality rate. Light recreational general aviation flights pose a considerable risk of fatalities in China and Japan. The findings of this study highlight the need for comprehensive research to explore the causes and contributing factors of aviation occurrences in different countries to enhance safety practices and mitigate fatality risks.