Variation In Incidence Of Disease Research Articles

Cardiovascular Disease Prevalence in Asians Versus Americans: A Review of Genetics, Diet, and the Call for Enhanced Prevention and Screening.

Cardiovascular disease (CVD) continues to pose a global health challenge, demonstrating significant disparities in occurrence among various populations. A wide number of research studies have indicated a higher prevalence of cardiovascular disease in South Asian immigrants compared to the local American population. The demand to improve the cardiovascular benefits of immigrants is increasing, which calls for further research with larger and more diverse population samples. This study will investigate the major causes of this variation, which include genetically diverse characteristics and changes in nutritional status among the study population groups. To assess the increase in the prevalence of cardiovascular disease among South Asian populations compared to the US population, a narrative review of accessible data is carried out. The data in support of the present document are from the Centre for Disease Prevention and Control, Statistics for Heart Diseases and Stroke 2023, a trend analysis about incidences of cardiac diseases and global burden in 2017, all dating back to the last two decades. Relevant articles from PubMed and Google Scholar have also been included, as appropriate, and their references are provided wherever necessary. Graphs for the geographical variations in disease incidence are produced using Microsoft Excel (Microsoft® Corp., Redmond, WA). The review shows that there is a significant decline in the prevalence of CVD among American citizens when compared to the steady increase in the number of cases among South Asians, which is attributed to the unique genetic predisposition of South Asians to be more prone to CVDs. The changing dietary habits also play an important role in the fall in HDL levels in South Asians when compared to Americans. This is driven by genetic disparities, including the APOA1 and APOA2 genes, and nutritional disparities, including variance in quality and quantity of dietary consumption. Addressing the escalating cases of CVDamong South Asians necessitates additional research to enhance proactive preventive measures and implement screening programs specifically tailored to address prevalent risk factors within the population.

Dermatological Manifestation of SLE Patients, Living in Aseer Region

ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects both men and women differently and has a variety of multisystemic symptoms. One of the diseases most often affected target organs is the skin. Different ethnic and racial groupings may display variations in disease incidence, clinical heterogeneity, and severity depending on environmental, cultural, or genetic factors. This study is conducted to determine the prevalence of SLE’s cutaneous symptoms and their relationship to organ involvement. Materials and Methods: Data were gathered for this study from the patient chart, the study design was the retrospective chart review after the consent of the patients and obtaining an ethical approval, The study was carried out in Aseer Central Hospital, Abha Saudi Arabia Results: Out of a total of 100 patients 92% were females while 8% were males. The mean (SD) of the age of the respondent was 38.3 (8.5). 89.2 of the respondents had skin manifestations Conclusion: A thorough understanding of SLE skin lesions will aid in the accurate identification of the condition and in the effective therapy of lupus patients. In order to more accurately diagnose cutaneous lesions in SLE patients, we need more dermatology and rheumatology clinics that combine expertise together.

Increasing Awareness Of Sustainable Oral Health In The Elderly With The Peer Group Methods At Klinic Pratama 'Aisyiyah Moyudan Sleman Yogyakarta 2023

Introduction - The link between disease and age is extremely complicated. Age explains more variation in disease incidence than any other known factor, including oral diseases. Periodontal infections and dental caries are the most frequent human diseases and the leading causes of tooth loss. Both disorders can impair nutrition and have a detrimental impact on self-esteem and quality of life. The aim of this study is to maximize self-efficacy and health literacy through health empowerment, elderly adults with Diabetes Mellitus (DM), hypertension, or other systemic disorders require dental health promotion by creating dental and oral health cadres, the goal is to raise elderly's awareness of dental and oral health through peer groups.
 Method - Forming and educating cadres in oral health was one of the tasks done. Two men and two women who were patients at the Klinic Pratama ‘Aisyiyah Moyudan Sleman Yogyakarta Indonesia and also members of chronic disease management Program (PROLANIS), were chosen as cadres. The cadres were given tooth brushing aids and dental and oral health posters, which were then used to train 30 elderly participants on how to brush their teeth properly and correctly. The training participants worked on pre-test and post-test questions before and after the training.
 Result – Oral health cadres have been selected and trained to provide education to fellow elderly and participants. The education conducted by the cadres for 30 other participants generated very good results, where the average post-test score experienced a high increase (90) compared to the pre-test average score (60). In the second and third month after the program's execution, cadres' activities were independently monitored. Dental and oral health cadres could teach the people how to brush their teeth effectively.
 Implications – Promotive and preventive efforts carried out by cadres who were fellow elders employing peer group methods get excellent results, whereas education carried out from and by the internal community was more targeted and achieved excellent results.

Stromal heterogeneity may explain increased incidence of metaplastic breast cancer in women of African descent

The biologic basis of genetic ancestry-dependent variability in disease incidence and outcome is just beginning to be explored. We recently reported enrichment of a population of ZEB1-expressing cells located adjacent to ductal epithelial cells in normal breasts of women of African ancestry compared to those of European ancestry. In this study, we demonstrate that these cells have properties of fibroadipogenic/mesenchymal stromal cells that express PROCR and PDGFRα and transdifferentiate into adipogenic and osteogenic lineages. PROCR + /ZEB1 + /PDGFRα+ (PZP) cells are enriched in normal breast tissues of women of African compared to European ancestry. PZP: epithelial cell communication results in luminal epithelial cells acquiring basal cell characteristics and IL-6-dependent increase in STAT3 phosphorylation. Furthermore, level of phospho-STAT3 is higher in normal and cancerous breast tissues of women of African ancestry. PZP cells transformed with HRasG12V ± SV40-T/t antigens generate metaplastic carcinoma suggesting that these cells are one of the cells-of-origin of metaplastic breast cancers.

Gender and racial disparities in the incidence and mortality of pancreatic cancer in Mississippi State from 2003 to 2019.

In the United States, the incidence and prevalence of pancreatic cancer are well-established relative to the factors of gender and race. These rates can be seen to be dictated by biological, behavioral, socio-environmental, socioeconomic, and structural factors. This paper focused on the context of Mississippi, with a particular emphasis on racial and gender-linked mortality and incidence from 2003 to 2019. Data were obtained from the Mississippi Cancer Registry. Specific parameters that were focused upon included the data source in the form of all cancer incidents and cancer mortality, geography in terms of cancer coalition regions, cancer sites in the form of the digestive system as a category to which pancreatic cancer belongs, and the year, ranging from 2003 to 2019. From the findings, the rates were more dominant in blacks than their white counterparts, suggesting racial disparity. Additionally, regardless of race, females exhibited lower rates compared to males. In the state, there were also marked geographical variations in disease incidence and mortality rates, with the Delta cancer coalition region faring the worst in terms of incidence rates for both races and genders. It was concluded that in Mississippi, being a black male poses the highest risk. In the future, certain additional factors that will need to be investigated as per their probable moderating role to inform the coining of health care interventions at the state level. They include lifestyle and behavioral factors, comorbidities, stage of disease, and geographical variations or remoteness.

EE102 Fluctuation in Treatment Initiation: Increasing the Accuracy of Modeling Patient Entry in Budget Impact Analyses

Seasonal variation in disease incidence, screening, and diagnosis has been extensively reported and impacts treatment initiation. However, budget impact analyses typically assume that patients initiate treatment at the start of each year. We explored whether accounting for fluctuations in patient entry timing affects budget impact projections.

Incidence of white mould of bean and characterization of its causal pathogen, Sclerotinia sclerotiorum in Kashmir valley, India

White mould caused by Sclerotinia sclerotiorum affects the quality and quantity of bean crop. The aims of this study were to evaluate the incidence and severity of white mould disease in four districts of Kashmir valley and to characterize the morphological variability of 60 Sclerotinia sclerotiorum isolates from bean plants. Three bean fields per village and five villages per district were chosen randomly for sampling. The highest incidence among surveyed areas was found in Ganderbal (37.94%) and lowest in Shupiyan (19.98%). The disease severity was highest in district Ganderbal (15.54%) and lowest in district Shupiyan (7.94%). Single spore method was used to isolate the fungus. Sixty isolates of the causal organism were isolated from bean plants collected from the surveyed areas and pathogenecity test was carried out following Koch’s postulates. Morphological characters of the different isolates, like number of sclerotia per Petri plate, time required for formation of the first sclerotium and average weight and shape of the sclerotia were studied. Among sixty isolates of S. sclerotiorum isolated from bean, it was observed that 25% of the isolates had abundant mycelium, 25% had irregular mycelium, half of the isolates had thin mycelium. 75% of the isolates had white colour and 25% had beige coloration. 25% of the isolates had a round shape, and 75% had a diverse shape. Sclerotia were detected in 50% of the cases in a regular pattern along the colony edge, 25% spread throughout the colony, and 25% in concentric circles. The mean number of sclerotia per colony ranged from 11.68 (SS55) to 32.32 (SS26). The mean number of days for formation of the first sclerotium ranged from 9.3 (SS30) to 17.7 (SS60). The average weight of sclerotia ranged from 0.0918 (SS58) to 0.2475 (SS21). The variation in disease incidence across different sites and the morphological variation of the isolates can be due to differences in genetic constitution as well as environmental conditions.

Abstract P2-26-08: Influence of genetic ancestry on breast stromal cells provides biologic basis for increased incidence of metaplastic breast cancer in women of African descent

Abstract The biologic basis of genetic ancestry-dependent variability in disease incidence and outcome is just beginning to be explored. We recently reported enrichment of a population of ZEB1-expressing cells located adjacent to the ductal epithelial cells in the normal breast of women of African Ancestry (AA) compared to European Ancestry (EA). By establishing and characterizing cell lines corresponding to these cells and validating in vitro findings with tissue microarrays of healthy breast tissue from AA, EA and Latina Ancestry (LA) women, we demonstrate that these cells have the properties of fibroadipogenic/mesenchymal stromal cells that express PROCR and PDGFR. PROCR+/ZEB1+/PDGFR+ cells, hence renamed as PZP cells, are enriched in the normal breast tissues of AA compared to EA or LA women. In vitro, PZP cells trans-differentiated into adipocytes or osteocytes. In co-culture conditions, PZP:epithelial cell communication resulted in luminal epithelial cells acquiring basal/stem cell characteristics and increased expression of IL-6 suggesting the impact of this communication on the microenvironment and breast epithelial hierarchy. Consistent with this possibility, the level of phospho-STAT3, which is a downstream target of IL-6, was higher in the normal and cancerous breast tissues of AA compared to EA women. PZP cells transformed with HRasG12V ± SV40-T/t antigens generated metaplastic carcinoma in NSG mice suggesting that these cells could be the cell-of-origin of metaplastic breast cancers. Collectively, these results identify a stromal cell component that could influence the biology of breast cancer in AA women. Citation Format: Brijesh Kumar, Katie Batic, Poornima Bhat-Nakshatri, Maggie Granatir, Rebekah Addison, Megan Szymanski, Lee Ann Baldridge, Constance Temm, George Sandusky, Sandra Althouse, Anna Maria Storniolo, Harikrishna Nakshatri. Influence of genetic ancestry on breast stromal cells provides biologic basis for increased incidence of metaplastic breast cancer in women of African descent [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-26-08.

Confirmation of physiological race of Bipolaris maydis causing maydis leaf blight of maize in India

Maydis leaf blight (MLB) incited by Bipolaris maydis occurs in most of the maize growing regions. Present study revealed morphological divergence among 74 isolates of B. maydis collected from geographically distant places of India. Based on morpho-cultural features clustered by R software, 25 representative isolates of B. maydis were used for race identification. The internal transcribed spacer (ITS) sequence further confirmed the isolates as B. maydis. In recent concept, variation in disease incidence and infectivity denotes genetic shift in the pathogen or introduction of new pathogenic race(s) through germplasm exchange. For unveiling Indian race(s) of B. maydis, present exploration was made. Four genetically divergent maize genotypes with cytoplasmic male sterility (CMS), viz. -C (MGU- 161QPV-C), -T (MGU- 345PV-T), -S (MGU-150Q-S) and CM-119 (fertile cytoplasm) were assessed using 25 isolates of B. maydis during kharif 2018-19 at ICAR-IARI, New Delhi. The genotype MGU-161QPV-C associated with CMS-C was highly resistant followed by MGU-345PV-T (CMS-T) and MGU-150Q-S (CMS-S), whereas CM-119 showed high susceptibility. Present outcome confirmed prevalence of race 'O' of B. maydis in India and eliminated uncertainty about occurrence of other races, i.e. T and C.

Changes in Otorhinolaryngologic Disease Incidences before and during the COVID-19 Pandemic in Korea.

This study aimed to investigate the change in the incidence and variance of otorhinolaryngologic diseases during the coronavirus disease 19 (COVID-19) pandemic. The entire Korean population (~50 million) was evaluated for the monthly incidence of 11 common otorhinolaryngologic diseases of upper respiratory infection (URI), influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, stomatitis and related lesions, acute sinusitis, rhinitis, otitis media, and dizziness from January 2018 through March 2021 using the International Classification of Disease (ICD)-10 codes with the data of the Korea National Health Insurance Service. The differences in the mean incidence of 11 common otorhinolaryngologic diseases before and during COVID-19 were compared using the Mann—Whitney U test. The differences in the variance of incidence before and during COVID-19 were compared using Levene’s test. The incidence of all 11 otorhinolaryngologic diseases was lower during COVID-19 than before COVID-19 (all p < 0.05). The variations in disease incidence by season were lower during COVID-19 than before COVID-19 for infectious diseases, including URI, influenza, acute tonsillitis, peritonsillar abscess, retropharyngeal and parapharyngeal abscess, acute laryngitis and bronchitis, acute sinusitis, and otitis media (all p < 0.05), while it was not in noninfectious diseases, including stomatitis, rhinitis, and dizziness. As expected, the incidences of all otorhinolalryngolgic diseases were decreased. Additionally, we found that seasonal variations in infectious diseases disappeared during the COVID-19 pandemic, while noninfectious diseases did not.

What Bioethicists Need to Know About the Social Determinants of Health-and Why.

What more can be said about COVID-19 and the social determinants of health? This article describes neglected perspectives that derive from the history of social epidemiology, a field that identifies the social etiology of disease and variations in disease incidence among people differentially located in the social structure. The "discovery" of social determinants of diseases like COVID-19 is nothing new for epidemiology: debate over how to analyze structural determinants versus individual-level risk factors persisted throughout the 19th and 20th centuries. By the late 20th century, research had highlighted fundamental causes of health disparities, such as social conditions and structural racism; these are structural factors, embedded in the social fabric of life. Measurement of structured inequalities within systems faces complex and challenging problems, as research aims to better account for these lived realities at different levels of analysis and as multiple factors merge to influence outcomes (revealed in intersectionality theory). At each of these intersections, there are opportunities for bioethicists to consider their ethical implications. It is imperative to understand the social and ethical roots of our present conversations about health inequalities, in order to partner intelligently with researchers on the forefront of advocating for change.

Effect of fungicides and spray regimes against Phytophthora leaf blight disease of taro cultivars in Nsukka, Southeastern Nigeria

Effects of fungicide types and spray regimes were assessed on Phytophthora leaf blight disease during the early and late cropping seasons in Nsukka, southeastern Nigeria. The field experiment was laid out in 3 × 3 × 5 factorial in randomized complete block design with three replications in early and late cropping seasons of taro, respectively. The factors consisted of three Colocasia esculenta cultivars (Nachi (purple taro/Nce003), Odogolo (green taro/Nce002) and Ugwuta (Coco-India/Nce001); two fungicides (Ridomil Gold 66 WP plus, Ridomil Gold + Champ Drill Prill 50.00%:50.00% mixture and control); and five spray regimes (no spray, 1, 2, 3, and 4 weeks spray). Results showed that there were significant variations in disease incidence among the fungicides, spray regimes, cultivars and between seasons at 90, 120 and 150 days after planting. Disease incidences and severity varied among the fungicides, spray regimes, cultivars and between the seasons. The results on establishment percentage significantly differed among the cultivars and cropping seasons. Ugwuta cultivar significant had the highest establishment percentage in both cropping seasons at 15 and 30 days after planting. The growth attributes on plant height (cm) and number of leaves significantly varied among the fungicides, spray regimes, cultivars and between cropping seasons. Ridomil Gold 66 WP at weekly spray regime performed best compared to other fungicides and spray regimes. There were significant variations among the cultivars and cropping seasons at the sampling periods. Tuber yield significantly differed among the fungicides, spray regimes, cultivars and cropping seasons at harvest. Ridomil Gold 66 WP at weekly spray regimes, Odogolo cultivar and early cropping season performed best in all yield traits at harvest.

Conditional power in vaccine trials with seasonal variations

ABSTRACT Conditional power (CP) is widely used in clinical trial monitoring to quantify the evidence for futility stopping or sample size adaptation during the trial. When planning an interim analysis in vaccine trials for seasonal infectious diseases, CPs calculated under the hypothesized or currently estimated effect sizes may not truly reflect future data due to seasonal variations in disease incidence and/or vaccine efficacy (VE). Relying on these estimates alone could lead to erroneous decisions. Therefore, we carried out simulation studies to investigate the use of seven different choices for the drift parameter in computing CP or predictive power (PP) in end-of-season interim analysis. Our simulations showed that, when used to inform futility stopping, CP under the hypothesized effect and a weighted PP under a normal prior distribution appear to outperform others in terms of the overall type II error rate. All CPs and PPs considered in this study resulted in comparable powers and expected sample sizes when used to inform sample size adaptation. The performance of either CP or PP largely depends on the extent to which the chosen drift parameter or the prior distribution of the drift parameter matches the remainder of the trial. Weighted CP/PP tends to be less sensitive to settings where observed data and emerging data in future seasons differ substantially as they incorporate both current estimate and future variations. Therefore, weighted strategies deserve further exploration and perhaps increased usage in guiding trial operations because they are more robust to inaccuracies in prediction. In summary, for vaccine trials with seasonal variations, a decision on trial operations should be guided by a careful consideration of plausible CPs and PPs calculated under reasonable assumptions leveraging the data, prior hypotheses, and new evidence on clinical relevance.

A Tale of Four Danish Cities: Legionella pneumophila Diversity in Domestic Hot Water and Spatial Variations in Disease Incidence.

Denmark has one of the highest Legionnaires’ disease notification rates within Europe, averaging 4.7 cases per 100,000 population annually (2017 to 2020). The relatively high incidence of disease is not uniform across the country, and approximately 70% of all domestically acquired cases in Denmark are caused by Legionella pneumophila (LP) strains that are considered less virulent. The aim of this study was to investigate if colonization rates, levels of colonization, and/or types of LP present in hot water systems were associated with geographic differences in Legionnaires’ disease incidence. Domestic water systems from four cities in Denmark were analyzed via culture and qPCR. Serogrouping and sequence typing was performed on randomly selected isolates. Single nucleotide polymorphism was used to identify clonal relationship among isolates from the four cities. The results revealed a high LP colonization rate from 68% to 87.5% among systems, composed primarily of non-serogroup 1. LP serogroup 1 reacting with the monoclonal antibody (MAb) 3/1 was not identified in any of the systems tested, while MAb 3/1 negative serogroup 1 strains were isolated from 10 systems (9.6%). We hypothesize that a combination of factors influences the incidence rate of LD in each city, including sequence type and serogroup distribution, colonization rate, concentration of Legionella in Pre-flush and Flush samples, and potentially building characteristics such as water temperature measured at the point of use.

Analyzing the demographic, spatial, and temporal factors influencing social contact patterns in U.S. and implications for infectious disease spread

BackgroundDiseases such as COVID-19 are spread through social contact. Reducing social contacts is required to stop disease spread in pandemics for which vaccines have not yet been developed. However, existing data on social contact patterns in the United States (U.S.) is limited.MethodWe use American Time Use Survey data from 2003–2018 to describe and quantify the age-pattern of disease-relevant social contacts. For within-household contacts, we construct age-structured contact duration matrices (who spends time with whom, by age). For both within-household and non-household contacts, we also estimate the mean number and duration of contact by location. We estimate and test for differences in the age-pattern of social contacts based on demographic, temporal, and spatial characteristics.ResultsThe mean number and duration of social contacts vary by age. The biggest gender differences in the age-pattern of social contacts are at home and at work; the former appears to be driven by caretaking responsibilities.Non-Hispanic Blacks have a shorter duration of contact and fewer social contacts than non-Hispanic Whites. This difference is largely driven by fewer and shorter contacts at home. Pre-pandemic, non-Hispanic Blacks have shorter durations of work contacts. Their jobs are more likely to require close physical proximity, so their contacts are riskier than those of non-Hispanic Whites. Hispanics have the highest number of household contacts and are also more likely to work in jobs requiring close physical proximity than non-Hispanic Whites.With the exceptions of work and school contacts, the duration of social contact is higher on weekends than on weekdays. Seasonal differences in the total duration of social contacts are driven by school-aged respondents who have significantly shorter contacts during the summer months. Contact patterns did not differ by metro status. Age patterns of social contacts were similar across regions.ConclusionSocial contact patterns differ by age, race and ethnicity, and gender. Other factors besides contact patterns may be driving seasonal variation in disease incidence if school-aged individuals are not an important source of transmission. Pre-pandemic, there were no spatial differences in social contacts, but this finding has likely changed during the pandemic.

Evaluation and genome-wide association study of resistance to bacterial blight race 18 in U.S. Upland cotton germplasm.

Bacterial blight (BB), caused by Xanthomonas citripv.malvacearum (Xcm), is a destructive disease to cotton production in many countries. In the U.S., Xcm race 18 is the most virulent and widespread race and can cause serious yield losses. Planting BB-resistant cotton cultivars is the most effective method of controlling this disease. In this study, 335 U.S. Upland cotton accessions were evaluated for resistance to race 18 using artificial inoculations by scratching cotyledons on an individual plant basis in a greenhouse. The analysis of variance detected significant genotypic variation in disease incidence, and 50 accessions were resistant including 38 lines with no symptoms on either cotyledons or true leaves. Many of the resistant lines were developed in the MAR (multi-adversity resistance) breeding program at Texas A&M University, whereas others were developed before race 18 was first reported in the U.S. in 1973, suggesting a broad base of resistance to race 18. A genome-wide association study (GWAS) based on 26,301 single nucleotide polymorphic (SNP) markers detected 11 quantitative trait loci (QTL) anchored by 79 SNPs, including three QTL on each of the three chromosomes A01, A05 and D02, and one QTL on each of D08 and D10. This study has identified a set of obsolete Upland germplasm with resistance to race 18 and specific chromosomal regions delineated by SNPs for resistance. The results will assist in breeding cotton for BB resistance and facilitate furthergenomic studies in fine mapping resistance genes to enhance the understanding of the genetic basis of BB resistance in cotton.

Effect of microclimate modification on Karnal bunt of wheat under ludhiana conditions

A field experiment was conducted to study the effect of microclimate on Karnal Bunt (KB) in wheat under Ludhiana district, Punjab. The microclimate effect was studied using three dates of sowing (20th October, 05th November and 20th November), two methods of cultivation (recommended cultivation and additional leaf wetness) and three wheat varieties (Unnat PBW 343, PBW 725 and HD 2967). The maximum disease incidence (22.15%) was observed in crop sown on 5th November followed by 20th November (19.64%) and 20th October (16.03%). Maximum KB incidence was observed in variety PBW 725 (26.52%) followed by HD 2967(19.77%) and Unnat PBW 343(11.54%). Additional leaf wetness resulted in higher disease incidence (26.99%) as compared to recommended cultivation (11.56%). Relative humidity inside the crop canopy and canopy temperature showed 71 and 65 per cent variability in disease incidence, respectively. The study indicated an important role of microclimatic parameters viz. canopy temperature and relative humidity within canopy in KB development.

Economic Impact of FMD in cattle and buffaloes in India

In India, among various diseases that limit livestock production, Foot and Mouth Disease (FMD) stands first and affects thousands of animals every year. The estimation of loss due to FMD is of paramount importance for designing appropriate control plans. The economic impact studies on various livestock diseases including FMD are very minimal and hence this study assessed the economic loss due to FMD in cattle and buffaloes in few states and overall loss in the country. The total loss estimated comprise of milk yield reduction, unavailability of draught power, distress sale, treatment cost, mortality and opportunity cost of labour based on primary survey undertaken in 10 states and one Union territory. The results revealed that there was variation in loss levels between species and among the study states due to variation in disease incidence and severity levels, productive capacity of the animals, animal health infrastructure in the respective states, etc. The total estimated loss due to FMD in cattle and buffalo was INR 20,897 crore during 2013-14 with wide variation in magnitude across the states studied. The study provided empirical evidence of loss due to FMD in cattle and buffaloes in few states and overall loss in the country.

The interplay of spatial spread of COVID-19 and human mobility in the urban system of China during the Chinese New Year

The rapid spread of infectious diseases is devastating to the healthcare systems of all countries. The dynamics of the spatial spread of epidemic have received considerable scientific attention. However, the understanding of the spatial variation of epidemic severity in the urban system is lagging. Using synchronized epidemic data and human mobility data, integrated with other multiple-sourced data, this study examines the interplay between disease spread of coronavirus disease (COVID-19) and inter-city and intra-city mobility among 319 Chinese cities. The results show a disease spreading process consisting of a major transfer (inter-city) diffusion before the Chinese New Year and a subsequent local (intra-city) diffusion after the Chinese New Year in the urban system of China. The variations in disease incidence between cities are mainly driven by inter-city mobility from Wuhan, the epidemic center of COVID-19. Cities that are closer to the epidemic center and with more population in the urban area will face higher risks of disease incidence. Warm and humid weather could help mitigate the spread of COVID-19. The extensive inter-city and intra-city travel interventions in China have reduced approximately 70% and 40% inter-city and intra-city mobility, respectively, and effectively slowed down the spread of the disease by minimizing human to human transmission together with other disease monitoring, control, and preventive measures. These findings could provide valuable insights into understanding the dynamics of disease spread in the urban system and help to respond to another new wave of pandemic in China and other parts of the world.

Risk-based Vaccines and the Need for Risk-based Subnational Vaccination Strategies for Introduction.

BackgroundMost vaccines in the Expanded Program on Immunization are universal childhood vaccines (eg, measles and rotavirus vaccines). Other vaccines such as typhoid conjugate (TCV) and Japanese encephalitis vaccines are risk based and only used in countries where populations are at risk of these diseases. However, strategies to introduce risk-based vaccines are becoming complex due to increasing intracountry variability in disease incidence. There is a need to assess whether subnational vaccine strategies are appropriate.Criteria, challenges, and benefitsSubnational strategies consider intracountry heterogeneous risk and prioritize vaccination only in those areas that are at risk; there is no intent to introduce the vaccine nationally. The following variables should be considered to determine appropriateness of subnational strategies: disease burden, outbreak potential, treatment availability and costs, cost-effectiveness, and availability of other preventive interventions. We propose criteria for each variable and use a hypothetical country considering TCV introduction to show how criteria are applied to determine if a subnational strategy is appropriate. Challenges include granularity of disease-burden data, political challenges of vaccinating only a portion of a population, and potentially higher costs of introduction. Benefits include targeted reduction of disease burden, increased equity for marginalized populations, and progress on development goals.ConclusionsIn the absence of perfect information at the national level, adopting a subnational vaccine strategy can provide country decision makers with an alternative to national vaccine introduction. Given the changing nature of communicable disease burden, subnational vaccination may be a tool to effectively avert mortality and morbidity while maximizing the use of available health and financial resources.