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Hatteberg SJ, Kollath-Cattano C. Applying the health belief model to examine college students' early stage adoption of non-pharmaceutical interventions in response to COVID-19. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:340-345. [PMID: 35271433 DOI: 10.1080/07448481.2022.2047698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/14/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Amidst the COVID-19 pandemic, colleges worked to minimize transmission through non-pharmaceutical interventions (NPIs). The objective of this study was to apply the Health Belief Model to assess correlates of US college students' early stage NPI uptake. PARTICIPANTS Sample includes 1,223 students from a medium-sized university who participated in an anonymous health survey. METHODS Logistic regression assessed associations between HBM factors and consistent adoption of five individual NPI strategies. Multivariate linear regression assessed HBM correlates of NPI adoption overall. RESULTS Correlates of NPI uptake varied by strategy. Only perceived NPI benefits were significantly associated with NPI adoption individually and overall. Perceived susceptibility was associated with use of hand sanitizer, facemasks, and general NPI adoption. Perceived severity was associated with avoidance of large social gatherings only. CONCLUSION The HBM appears valuable for understanding students' NPI adoption. Results suggest university health initiatives should prioritize education on the efficacy of particular preventive behaviors.
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Sun Y, Wang P, Tang J. Impact of mental health, job insecurity, and COVID-19 symptoms on protective behavior changes among White, Black, and other minorities in the US. Front Psychol 2022; 13:1040413. [PMID: 36478929 PMCID: PMC9720273 DOI: 10.3389/fpsyg.2022.1040413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION Job insecurity such as loss of jobs or reduced wages has become a serious social problem in the US since COVID-19 started. Combined with psychological distress and experience of COVID-19 symptoms, the changes of people's protective behaviors vary across states in the US. METHODS This research investigated racial differences in the COVID-19 related factors among White, Black, and other minorities in the US, and examined how mental health mediated the impact of job insecurity on protective behaviors, and how the COVID-19 symptoms moderated the mediation effect of mental health. The 731 valid responses in a cross-sectional survey from May 23 to 27, 2020, in the US were analyzed with independent sample t-tests, Pearson's chi-square tests, and path analysis. RESULTS The findings showed that there were significant differences in job insecurity and Nonpharmaceutical Interventions (NPIs) practice among White, Black, and other minorities. Job insecurity was significantly negatively associated with NPIs practice and was significantly positively associated with mental health. Mental health significantly partially mediated the effect of job insecurity on NPIs practice, in that job insecurity is a better predictor of NPIs practice for individuals with worse mental health than that for individuals with better mental health. Experience of COVID-19 symptoms moderates the mediation effect of mental health on the relationship between job insecurity and NPIs practice, in that mental health is a better predictor of NPIs practice for individuals with a higher experience of COVID-19 symptoms than for individuals with a lower experience of COVID-19 symptoms. DISCUSSION The findings in this study shed lights on psychological and behavioral studies of people's behavior changes during a pandemic. The study indicates the importance of treating mental health to promote protective behaviors during a pandemic, as well as advocating for employees by identifying the needs for those whose jobs were negatively impacted the most.
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Affiliation(s)
- Yingying Sun
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Ping Wang
- College of Business, James Madison University, Harrisonburg, VA, United States
| | - Jun Tang
- School of Public Administration and Policy, Renmin University of China, Beijing, China
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Ae R, Shibata Y, Furuno T, Sasahara T, Nakamura Y, Hamada H. Human Mobility and Droplet-Transmissible Pediatric Infectious Diseases during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116941. [PMID: 35682525 PMCID: PMC9180602 DOI: 10.3390/ijerph19116941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 12/23/2022]
Abstract
The study tested the hypothesis that human mobility may be a potential factor affecting reductions in droplet-transmissible pediatric infectious diseases (PIDs) during the coronavirus disease-2019 (COVID-19) pandemic mitigation period in 2020. An ecological study was conducted using two publicly available datasets: surveillance on infectious diseases collected by the Japanese government and COVID-19 community mobility reports presented by Google. The COVID-19 community mobility reports demonstrated percentage reductions in the movement of people over time in groceries and pharmacies, parks, and transit stations. We compared the weekly trends in the number of patients with droplet-transmissible PIDs identified in 2020 with those identified in the previous years (2015–2019) and assessed the correlations between the numbers of patients and percentage decreases in human mobility during 2020. Despite experiencing their peak seasons, dramatic reductions were found in the numbers of patients with pharyngoconjunctival fever (PCF) and group A streptococcal (GAS) pharyngitis after the tenth week of 2020. Beyond the 20th week, no seasonal peaks were observed in the number of patients with all PIDs identified in 2020. Significant correlations were found between the percentage decreases in human mobility in transit stations and the number of patients with hand-foot-and-mouth disease (Pearson correlation coefficient [95% confidence interval]: 0.65 [0.44–0.79]), PCF (0.47 [0.21–0.67]), respiratory syncytial virus infection (0.45 [0.19–0.66]), and GAS pharyngitis (0.34 [0.06–0.58]). The highest correlations were found in places underlying potential human-to-human contacts among adults. These findings suggest that reductions in human mobility for adults might contribute to decreases in the number of children with droplet-transmissible PIDs by the potential prevention of adult-to-child transmission.
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Affiliation(s)
- Ryusuke Ae
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Yoshihide Shibata
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
- Department of Electrical and Computer Engineering, National Institute of Technology, Gifu College, 2236-2 Kamimakuwa, Motosu 501-0495, Gifu, Japan
| | - Toshiki Furuno
- Advanced Course for Interdisciplinary Technology Development, National Institute of Technology, Gifu College, 2236-2 Kamimakuwa, Motosu 501-0495, Gifu, Japan;
| | - Teppei Sasahara
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Yosikazu Nakamura
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (R.A.); (Y.S.); (T.S.); (Y.N.)
| | - Hiromichi Hamada
- Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, 477-96 Owada-Shinden, Yachiyo 276-0046, Chiba, Japan
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8670, Chiba, Japan
- Correspondence: ; Tel.: +81-474-50-6000
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Effects of Population Knowledge, Perceptions, Attitudes, and Practices on COVID-19 Infection Prevention and Control in NUST. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105918. [PMID: 35627455 PMCID: PMC9141020 DOI: 10.3390/ijerph19105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
The global COVID-19 pandemic has had a major impact on the education sector of most countries. One of the basic CDC prevention guidelines is the implementation of non-pharmaceutical interventions (NPIs) to protect the health of students and staff members to curve the spread of COVID-19. The current study aimed to examine the knowledge, perceptions, attitudes, and practices of students at the Namibia University of Technology toward the COVID-19 pandemic. A cross-sectional descriptive survey was conducted using a closed-ended questionnaire. Data were collected from full-time students who were on campus during the COVID-19 pandemic between 29 January to 14 February 2021. The average knowledge about the modes of transmission, protective measures, and clinical symptoms ranged from 78% to 96%. About 31% of student respondents believed the virus was created in a laboratory, and 47% believed the vaccine has negative side effects and therefore, refused to take it. The three main sources of information about COVID-19 were social media (75%), television (63%), and friends and family (50%). The students had an overall positive attitude towards the implementation of NPIs. However, the importance of vaccine safety must be emphasized. Lockdowns should be lifted gradually to reduce the amount of time students are spending on online content. Reopening of classrooms for face-to-face study will bring unquestionable benefits to students and the wider economy.
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Choi JH. Effects of nonpharmaceutical interventions for coronavirus disease 2019. Clin Exp Pediatr 2022; 65:250-251. [PMID: 35344981 PMCID: PMC9082245 DOI: 10.3345/cep.2021.01830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/10/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Jae Hong Choi
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
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Ho PI, Liu W, Li TZR, Chan TC, Ku CC, Lien YH, Shen YHD, Chen JR, Yen MY, Tu YK, Lin WY, Compans R, Lee PI, King CC. Taiwan's Response to Influenza: A Seroepidemiological Evaluation of Policies and Implications for Pandemic Preparedness. Int J Infect Dis 2022; 121:226-237. [PMID: 35235824 DOI: 10.1016/j.ijid.2022.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate class suspension and mass vaccination implemented among Taipei schoolchildren during the 2009 influenza pandemic and investigate factors affecting antibody responses. METHODS We conducted 2 cohort studies on: (1) 972 schoolchildren from November 2009-March 2010 to evaluate pandemic policies and (2) 935 schoolchildren from November 2011-March 2012 to verify factors in antibody waning. Anti-influenza H1N1pdm09 hemagglutination inhibition antibodies (HI-Ab) were measured from serum samples collected before vaccination, and at 1 and 4 months after vaccination. Factors affecting HI-Ab responses were investigated through logistic regression and generalized estimating equation. RESULTS Seroprevalence of H1N1pdm09 before vaccination was significantly higher among schoolchildren who experienced class suspensions than those who did not (59.6% vs 47.5%, p<0.05). Participating in after-school activities (adjusted odds ratio [aOR]=2.47, p=0.047) and having ≥3 hours per week of exercise (aOR=2.86, p=0.019) were significantly correlated with H1N1pdm09 infection. Two doses of the H1N1pdm09 vaccine demonstrated significantly better antibody persistence than 1 dose (HI-Ab geometric mean titer: 132.5 vs 88.6, p=0.047). Vaccine effectiveness after controlling for preexisting immunity was 86% (32%-97%). Exercise ≥3 hours per week and preexisting immunity were significantly associated with antibody waning/maintenance. CONCLUSIONS This study is the first to show that exercise and preexisting immunity may affect antibody waning. Further investigation is needed to identify immune correlates of protection.
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Affiliation(s)
- Pui-I Ho
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Wei Liu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Tiger Zheng-Rong Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities & Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Chia-Chi Ku
- Institute of Immunology, College of Medicine, NTU, Taipei, Taiwan
| | - Yu-Hui Lien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Ya-Hui Daphne Shen
- Department of Infection, Yuan's General Hospital, Kaohsiung City, Taiwan; StatPlus, Inc., Taipei, Taiwan
| | | | | | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Wan-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan
| | - Richard Compans
- Department of Microbiology and Immunology and Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, United States of America (U.S.A.)
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chwan-Chuen King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan.
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Geng MJ, Zhang HY, Yu LJ, Lv CL, Wang T, Che TL, Xu Q, Jiang BG, Chen JJ, Hay SI, Li ZJ, Gao GF, Wang LP, Yang Y, Fang LQ, Liu W. Changes in notifiable infectious disease incidence in China during the COVID-19 pandemic. Nat Commun 2021; 12:6923. [PMID: 34836947 PMCID: PMC8626444 DOI: 10.1038/s41467-021-27292-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022] Open
Abstract
Nationwide nonpharmaceutical interventions (NPIs) have been effective at mitigating the spread of the novel coronavirus disease (COVID-19), but their broad impact on other diseases remains under-investigated. Here we report an ecological analysis comparing the incidence of 31 major notifiable infectious diseases in China in 2020 to the average level during 2014-2019, controlling for temporal phases defined by NPI intensity levels. Respiratory diseases and gastrointestinal or enteroviral diseases declined more than sexually transmitted or bloodborne diseases and vector-borne or zoonotic diseases. Early pandemic phases with more stringent NPIs were associated with greater reductions in disease incidence. Non-respiratory diseases, such as hand, foot and mouth disease, rebounded substantially towards the end of the year 2020 as the NPIs were relaxed. Statistical modeling analyses confirm that strong NPIs were associated with a broad mitigation effect on communicable diseases, but resurgence of non-respiratory diseases should be expected when the NPIs, especially restrictions of human movement and gathering, become less stringent.
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Affiliation(s)
- Meng-Jie Geng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.,Center for Disease Control and Prevention of Central Theater Command, Shijingshan District, Beijing, China
| | - Lin-Jie Yu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Tian-Le Che
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Simon I Hay
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - George F Gao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
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Hanratty J, Bradley DT, Miller SJ, Dempster M. Determinants of health behaviours intended to prevent spread of respiratory pathogens that have pandemic potential: A rapid review. Acta Psychol (Amst) 2021; 220:103423. [PMID: 34624664 PMCID: PMC8492069 DOI: 10.1016/j.actpsy.2021.103423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
Effective public health messages to encourage behaviours to reduce the spread of COVID-19 should be informed by existing research that identifies the factors that are associated with these preventive behaviours. This rapid review summarises the existing research on the determinants of behaviours that aim to prevent the spread of COVID-19. The review focuses on the body of research (excluding research conducted with health care workers) that was produced in the context of viruses other than SARS CoV-2 that cause severe respiratory illness and are transmitted in a similar way. A total of 58 published peer-reviewed studies included in the review were identified through searches of Medline, Embase, PsychInfo and CINAHL. Most were conducted in the context of the influenza A (H1N1) pandemic in 2009. Most studies examined the determinants of wearing a face covering, handwashing and social or physical distancing. The findings suggest that public health messages to encourage preventive behaviours should emphasise the potential seriousness of COVID-19 to elicit appropriate concern, strengthen perceptions of risk or threat from COVID-19, enhance self-efficacy about preventive behaviours, and improve knowledge about SARS-CoV-2, how it is transmitted, and how preventive behaviours can reduce the risk of transmission.
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Affiliation(s)
- Jennifer Hanratty
- School of Psychology, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
| | - Declan T Bradley
- Centre for Public Health, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
| | - Sarah J Miller
- School of Social Sciences, Education and Social Work, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, University Road, Belfast BT7 1NN, UK.
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Cipriano LE, Haddara WMR, Zaric GS, Enns EA. Impact of university re-opening on total community COVID-19 burden. PLoS One 2021; 16:e0255782. [PMID: 34383796 PMCID: PMC8360395 DOI: 10.1371/journal.pone.0255782] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 07/25/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND University students have higher average number of contacts than the general population. Students returning to university campuses may exacerbate COVID-19 dynamics in the surrounding community. METHODS We developed a dynamic transmission model of COVID-19 in a mid-sized city currently experiencing a low infection rate. We evaluated the impact of 20,000 university students arriving on September 1 in terms of cumulative COVID-19 infections, time to peak infections, and the timing and peak level of critical care occupancy. We also considered how these impacts might be mitigated through screening interventions targeted to students. RESULTS If arriving students reduce their contacts by 40% compared to pre-COVID levels, the total number of infections in the community increases by 115% (from 3,515 to 7,551), with 70% of the incremental infections occurring in the general population, and an incremental 19 COVID-19 deaths. Screening students every 5 days reduces the number of infections attributable to the student population by 42% and the total COVID-19 deaths by 8. One-time mass screening of students prevents fewer infections than 5-day screening, but is more efficient, requiring 196 tests needed to avert one infection instead of 237. INTERPRETATION University students are highly inter-connected with the surrounding off-campus community. Screening targeted at this population provides significant public health benefits to the community through averted infections, critical care admissions, and COVID-19 deaths.
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Affiliation(s)
- Lauren E. Cipriano
- Ivey Business School, Western University, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Wael M. R. Haddara
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Canada
- Division of Critical Care, London Health Sciences Centre, London, Canada
| | - Gregory S. Zaric
- Ivey Business School, Western University, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Eva A. Enns
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States of America
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Norton JO, Evans KC, Semchenko AY, Al-Shawaf L, Lewis DMG. Why Do People (Not) Engage in Social Distancing? Proximate and Ultimate Analyses of Norm-Following During the COVID-19 Pandemic. Front Psychol 2021; 12:648206. [PMID: 34276471 PMCID: PMC8279748 DOI: 10.3389/fpsyg.2021.648206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/28/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has had a profound negative effect on many aspects of human life. While pharmacological solutions are being developed and implemented, the onus of mitigating the impact of the virus falls, in part, on individual citizens and their adherence to public health guidelines. However, promoting adherence to these guidelines has proven challenging. There is a pressing need to understand the factors that influence people's adherence to these guidelines in order to improve public compliance. To this end, the current study investigated whether people's perceptions of others' adherence predict their own adherence. We also investigated whether any influence of perceived social norms was mediated by perceptions of the moral wrongness of non-adherence, anticipated shame for non-adherence, or perceptions of disease severity. One hundred fifty-two Australians participated in our study between June 6, 2020 and August 21, 2020. Findings from this preliminary investigation suggest that (1) people match their behavior to perceived social norms, and (2) this is driven, at least in part, by people using others' behavior as a cue to the severity of disease threat. Such findings provide insight into the proximate and ultimate bases of norm-following behavior, and shed preliminary light on public health-related behavior in the context of a pandemic. Although further research is needed, the results of this study-which suggest that people use others' behavior as a cue to how serious the pandemic is and as a guide for their own behavior-could have important implications for public health organizations, social movements, and political leaders and the role they play in the fight against epidemics and pandemics.
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Affiliation(s)
- James O. Norton
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Kortnee C. Evans
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | | | - Laith Al-Shawaf
- Department of Psychology, University of Colorado, Colorado Springs, Colorado Springs, CO, United States
- Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, Colorado Springs, CO, United States
| | - David M. G. Lewis
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
- Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, WA, Australia
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11
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Barriers Associated with the Uptake Ratio of Seasonal Flu Vaccine and Ways to Improve Influenza Vaccination Coverage among Young Health Care Workers in Poland. Vaccines (Basel) 2021; 9:vaccines9050530. [PMID: 34065371 PMCID: PMC8161323 DOI: 10.3390/vaccines9050530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 01/27/2023] Open
Abstract
Despite not being full-time health care workers, annual flu vaccination is nevertheless an important consideration for medical students. This study examined the reasons for refusing flu vaccination among medical students, a group characterized by low vaccination coverage, despite the fact that the flu vaccine is arguably the most effective way of preventing serious flu complications. A cross-sectional survey was performed of 1313 students at the Medical University of Lodz. The findings indicate that the main sites of vaccination were primary care centers, and main source of information about influenza vaccination (about 90% of cases) was the general practitioner (GP). The most common motivations for vaccination were a recommendation by the family doctor or the belief that it was an important factor for protection against influenza. Most students reported various adverse effects after vaccination, usually mild pain at the site of vaccination, malaise, or fever. The main reasons for rejecting influenza vaccination were the apparent low risk of disease, the need for annual vaccination, the need to pay for it, lack of time or opportunity, lack of vaccination promotion, negative attitudes toward the flu vaccine, or the belief that there are other methods of preventing flu. To increase long-term vaccine acceptance and increase the vaccination rate among medical students and qualified health care workers, there is a need to adapt the health system and to initiate ongoing promotion programs at university to raise consciousness, promote vaccinations, and develop clinical skills for immunization.
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12
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Shen D, Liu D, Cai M, Chen P, Wang Z, Zhang Y, Li Z, Zhang X, Wu X, Yang X, Mao C. Association between supportive attitude and adoptive practice of control strategy against COVID-19 amosng college students in China: a cross-sectional study. BMC Public Health 2021; 21:796. [PMID: 33902517 PMCID: PMC8072096 DOI: 10.1186/s12889-021-10752-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 04/04/2021] [Indexed: 01/22/2023] Open
Abstract
Background We investigated college students’ attitude and compliance towards a prevention strategy involving use of non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19). Methods We conducted a cross-sectional online survey in four universities in Guangdong Province (China) based on purposive sampling. A self-administered questionnaire was given to College students (CSs) to measure the supportive attitude towards an outbreak control strategy and adoption of NPIs in respondents. Results A total of 44,446 CSs participated between 31 January and 10 February 2020; 92.7% of respondents supported the outbreak control strategy. The proportion of respondents who avoided public places, wore a facemask, avoid gatherings, and washed hands more frequently than usual was 94.8, 92.8, 91.2 and 86.9%. respectively. A total of 76.5% respondents adopted all four measures. A supportive attitude was associated with NPI adoption. Students who were female, postgraduate, anxious, and not depressed tended to have a higher supportive attitude and higher chance of NPI adoption. Conclusions Higher supportiveness towards the disease control strategy for the Chinese public may lead to higher adoption rate of NPIs. Psychosocial factors were related to a supportive attitude and adoption of the NPI. We believe that our findings could aid policymakers to create NPIs to prevent and control emerging infectious diseases such as COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10752-6.
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Affiliation(s)
- Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Miaochun Cai
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Peiliang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Zhenghe Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yujie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Zhihao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Xiru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Xingfen Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
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Barrett C, Cheung KL. Knowledge, socio-cognitive perceptions and the practice of hand hygiene and social distancing during the COVID-19 pandemic: a cross-sectional study of UK university students. BMC Public Health 2021; 21:426. [PMID: 33648486 PMCID: PMC7919985 DOI: 10.1186/s12889-021-10461-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic, social distancing and hand hygiene have been the primary means of reducing transmission in the absence of effective treatments or vaccines, but understanding of their determinants is limited. This study aimed to investigate knowledge and socio-cognitive perceptions, and their associations with such protective behaviours, in UK university students. METHODS A cross-sectional online survey of 293 students was undertaken on 13 May 2020. Survey questions addressed demographics, knowledge of the disease and effectiveness of the protective measures, risk perception, socio-cognitive perceptions (e.g. attitude, social support, and self-efficacy), habit, time factors and trust, as well as the hand hygiene and social distancing behaviours. Multiple linear regression was used to identify the strongest associations of potential determinants with behaviour. RESULTS Participants reported high levels of social distancing with 88.9% answering "Mostly" or "Always" for every activity, but only 42.0% reporting the same for all hand hygiene activities. Knowledge of the effectiveness of each activity in preventing transmission was high, with 90.7% and 93.5% respectively identifying at least 7 of 8 hand hygiene or 9 of 10 social distancing activities correctly. Habit (β = 0.39, p = 0.001) and time factors (β = 0.28, p = 0.001) were the greatest contributors to unique variance in hand hygiene behaviour, followed by ethnicity (β = - 0.13, p = 0.014) and risk perception (β = 0.13, p = 0.016). For social distancing behaviour, the determinants were self-efficacy (β = 0.25, p < 0.001), perceived advantages (β = 0.15, p = 0.022), trust in policy (β = 0.14, p = 0.026) and gender (β = - 0.14, p = 0.016). Regression models explained 40% hand hygiene and 25% social distancing variance. CONCLUSIONS This study indicated that communications about effectiveness of hand hygiene and social distancing behaviours had been effective in terms of knowledge acquisition. However, in the light of likely second waves of COVID-19, attention to maintaining social distancing behaviour and improving hand hygiene behaviour may need to address more difficult areas of changing habits, overcoming time factors and building trust, as well as interventions to increase self-efficacy and address risk perception concerns.
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Affiliation(s)
- Christine Barrett
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - Kei Long Cheung
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
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Shamsir MS, Krauss SE, Ismail IA, Ab Jalil H, Johar MA, Abdul Rahman I. Development of a Haddon Matrix Framework for Higher Education Pandemic Preparedness: Scoping Review and Experiences of Malaysian Universities During the COVID-19 Pandemic. HIGHER EDUCATION POLICY 2021; 35:439-478. [PMID: 34594092 PMCID: PMC7808121 DOI: 10.1057/s41307-020-00221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Managing education and research during pandemics has increased in importance since the onset of epidemics such as avian flu, SARS and now CoViD-19. Successful management in times of crisis ensures business continuity and institutional survival, making preparedness preceding an impending pandemic essential. Institutions of higher education (IHEs) must maintain balance between academic continuity and preventing morbidity during a pandemic crisis. To date, however, no general pandemic preparedness frameworks exist for IHEs. The aim of this paper is to report on the development of a Haddon matrix framework for IHE pandemic preparedness based on a scoping literature review of past IHE responses including pre-, during and post-pandemic phases. First, a review of previous global responses by IHEs during past pandemics was carried out. The review findings were then collated into a new IHE-centric Haddon matrix for pandemic preparedness. The content of the matrix is then illustrated through the documented responses of Malaysian universities during the early stages of the COVID-19 pandemic. The resulting IHE Haddon matrix can be used by universities as a general guide to identify preparedness gaps and intervention opportunities for business continuity during pandemics.
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Affiliation(s)
- Mohd Shahir Shamsir
- Faculty of Applied Sciences and Technology, Universiti Tun Hussein Onn Malaysia, Pagoh Higher Education Hub, 84600 Muar, Johor Malaysia
| | - Steven Eric Krauss
- Innovative Learning Sciences Research Centre of Excellence (INNOVATE), Faculty of Educational Studies, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Ismi Arif Ismail
- Innovative Learning Sciences Research Centre of Excellence (INNOVATE), Faculty of Educational Studies, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Habibah Ab Jalil
- Innovative Learning Sciences Research Centre of Excellence (INNOVATE), Faculty of Educational Studies, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Muhammad Akmal Johar
- Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia, 86400 Batu Pahat, Johor Malaysia
| | - Ismail Abdul Rahman
- Faculty of Civil Engineering and Built Environment, Universiti Tun Hussein Onn Malaysia, 86400 Batu Pahat, Johor Malaysia
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Abstract
Previous research on respiratory infection transmission among university students has primarily focused on influenza. In this study, we explore potential transmission events for multiple respiratory pathogens in a social contact network of university students. University students residing in on-campus housing (n = 590) were followed for the development of influenza-like illness for 10-weeks during the 2012-13 influenza season. A contact network was built using weekly self-reported contacts, class schedules, and housing information. We considered a transmission event to have occurred if students were positive for the same pathogen and had a network connection within a 14-day period. Transmitters were individuals who had onset date prior to their infected social contact. Throat and nasal samples were analysed for multiple viruses by RT-PCR. Five viruses were involved in 18 transmission events (influenza A, parainfluenza virus 3, rhinovirus, coronavirus NL63, respiratory syncytial virus). Transmitters had higher numbers of co-infections (67%). Identified transmission events had contacts reported in small classes (33%), dormitory common areas (22%) and dormitory rooms (17%). These results suggest that targeting person-to-person interactions, through measures such as isolation and quarantine, could reduce transmission of respiratory infections on campus.
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Williams SN, Armitage CJ, Tampe T, Dienes K. Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK-based focus group study. BMJ Open 2020; 10:e039334. [PMID: 32690752 PMCID: PMC7387310 DOI: 10.1136/bmjopen-2020-039334] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE This study explored UK public perceptions and experiences of social distancing and social isolation related to the COVID-19 pandemic. DESIGN This qualitative study comprised five focus groups, carried out online during the early stages of the UK's stay at home order ('lockdown'), and analysed using a thematic approach. SETTING Focus groups took place via online videoconferencing. PARTICIPANTS Participants (n=27) were all UK residents aged 18 years and older, representing a range of gender, ethnic, age and occupational backgrounds. RESULTS Qualitative analysis revealed four main themes: (1) loss-participants' loss of (in-person) social interaction, loss of income and loss of structure and routine led to psychological and emotional 'losses' such as loss of motivation, loss of meaning and loss of self-worth; (2) criticisms of government communication-participants reported a lack of trust in government and a lack of clarity in the guidelines around social distancing and isolation; (3) adherence-participants reported high self-adherence to social distancing guidelines but reported seeing or hearing of non-adherence in others; (4) uncertainty around social reintegration and the future-some participants felt they would have lingering concerns over social contact while others were eager to return to high levels of social activity.Most participants, and particularly those in low-paid or precarious employment, reported feeling that the social distancing and isolation associated with COVID-19 policy has had negative impacts on their mental health and well-being during the early stages of the UK's 'lockdown'. CONCLUSIONS A rapid response is necessary in terms of public health programming to mitigate the mental health impacts of COVID-19 social distancing and isolation. Social distancing and isolation 'exit strategies' must account for the fact that, although some individuals will voluntarily or habitually continue to socially distance, others will seek high levels of social engagement as soon as possible.
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Affiliation(s)
- Simon N Williams
- Centre for People and Organisation, School of Management, Swansea University, Swansea, UK
| | | | - Tova Tampe
- World Health Organization, Genève, Switzerland
| | - Kimberly Dienes
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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17
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Gudi SK, Chhabra M, Undela K, Venkataraman R, Mateti UV, Tiwari KK, Nyamagoud S. Knowledge and beliefs towards universal safety precautions during the coronavirus disease (COVID-19) pandemic among the Indian public: a web-based cross-sectional survey. DRUGS & THERAPY PERSPECTIVES 2020; 36:413-420. [PMID: 32837191 PMCID: PMC7334629 DOI: 10.1007/s40267-020-00752-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background The novel coronavirus disease 2019 (COVID-19) is considered the most serious global health threat in recent times. As there is a current lack of approved treatments and vaccines, universal safety precautions (USPs) must be taken to deal with this emergency. Objective The aim of this study was to assess the knowledge and beliefs of the Indian public with regard to USPs during the COVID-19 pandemic. Methods A cross-sectional, web-based survey was conducted during March 2020. A 20-item self-administered questionnaire was developed, validated and distributed using Google Forms through social media networks. Binary logistic regression analysis was used to identify the factors influencing knowledge regarding COVID-19 USPs. Results Of the 1117 individuals who participated in the survey, the mean age was 28.8 ± 10.9 years, 32.9% had a post-graduate education, 45% had a professional job, and 40% belonged to the upper-middle economic class. Overall, the mean correct response scores were 63% for USP knowledge and 83% for USP beliefs. All the sociodemographic variables were significantly (p < 0.001) associated with the USP knowledge levels. Importantly, students were less likely to have a lower level of USP knowledge compared with the other occupations (odds ratio 0.35, 95% CI 0.23-0.53; p < 0.001). Conclusion Although the knowledge and beliefs of the Indian public towards USPs are encouraging, there is a need for long-term educational interventions as the dynamics and severity of COVID-19 rapidly change. These findings could guide public health authorities to make and implement precautionary measures to combat this pandemic.
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Affiliation(s)
- Sai Krishna Gudi
- grid.21613.370000 0004 1936 9609College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, 228 Notre Dame Avenue, Winnipeg, MB R3B 1N7 Canada
| | - Manik Chhabra
- grid.418006.b0000 0004 1800 4675Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga, Punjab India
| | - Krishna Undela
- grid.411962.90000 0004 1761 157XDepartment of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education AND Research, Mysore, Karnataka India
| | - Rajesh Venkataraman
- Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G. Nagara, Karnataka India
| | - Uday Venkat Mateti
- Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Mangalore, Karnataka India
| | - Komal Krishna Tiwari
- grid.418280.70000 0004 1794 3160JSS College of Physiotherapy, Rajiv Gandhi University of Health Sciences, Mysore, Karnataka India
| | - Sanath Nyamagoud
- grid.411053.20000 0001 1889 7360Department of Pharmacy Practice, KLE University, Hubli, Karnataka India
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18
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Uncertainty and Immunity in Public Communications on Pandemics. PANDEMICS, PUBLICS, AND POLITICS 2019. [PMCID: PMC7122379 DOI: 10.1007/978-981-13-2802-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This chapter examines uncertainty in the expert advice on pandemics given to members of the general public. The chapter draws on research conducted in Australia and Scotland on public engagements with the 2009 influenza (swine flu) pandemic and discusses implications for communications on more recent infectious disease outbreaks, including Ebola and Zika. It shows how public health messages aim to achieve a workable balance of warning and reassurance and deflect problems of trust in experts and science. The chapter considers how uncertainties which prevail in pandemics reinforce the personalization of responses to pandemic risk, in ways that undermine the cooperation and collective action which are also needed to respond effectively to pandemics.
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19
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Hashmi S, D'Ambrosio L, Diamond DV, Jalali MS, Finkelstein SN, Larson RC. Preventive behaviors and perceptions of influenza vaccination among a university student population. J Public Health (Oxf) 2018; 38:739-745. [PMID: 28158761 DOI: 10.1093/pubmed/fdv189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Lisa D'Ambrosio
- Institute for Data, Systems and Society, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - David V Diamond
- MIT Medical, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mohammad S Jalali
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Stan N Finkelstein
- Institute for Data, Systems and Society, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Richard C Larson
- Institute for Data, Systems and Society, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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20
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Peak CM, Wesolowski A, zu Erbach-Schoenberg E, Tatem AJ, Wetter E, Lu X, Power D, Weidman-Grunewald E, Ramos S, Moritz S, Buckee CO, Bengtsson L. Population mobility reductions associated with travel restrictions during the Ebola epidemic in Sierra Leone: use of mobile phone data. Int J Epidemiol 2018; 47:1562-1570. [PMID: 29947788 PMCID: PMC6208277 DOI: 10.1093/ije/dyy095] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2018] [Indexed: 11/12/2022] Open
Abstract
Background Travel restrictions were implemented on an unprecedented scale in 2015 in Sierra Leone to contain and eliminate Ebola virus disease. However, the impact of epidemic travel restrictions on mobility itself remains difficult to measure with traditional methods. New 'big data' approaches using mobile phone data can provide, in near real-time, the type of information needed to guide and evaluate control measures. Methods We analysed anonymous mobile phone call detail records (CDRs) from a leading operator in Sierra Leone between 20 March and 1 July in 2015. We used an anomaly detection algorithm to assess changes in travel during a national 'stay at home' lockdown from 27 to 29 March. To measure the magnitude of these changes and to assess effect modification by region and historical Ebola burden, we performed a time series analysis and a crossover analysis. Results Routinely collected mobile phone data revealed a dramatic reduction in human mobility during a 3-day lockdown in Sierra Leone. The number of individuals relocating between chiefdoms decreased by 31% within 15 km, by 46% for 15-30 km and by 76% for distances greater than 30 km. This effect was highly heterogeneous in space, with higher impact in regions with higher Ebola incidence. Travel quickly returned to normal patterns after the restrictions were lifted. Conclusions The effects of travel restrictions on mobility can be large, targeted and measurable in near real-time. With appropriate anonymization protocols, mobile phone data should play a central role in guiding and monitoring interventions for epidemic containment.
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Affiliation(s)
- Corey M Peak
- Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Flowminder Foundation, Stockholm, Sweden
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elisabeth zu Erbach-Schoenberg
- Flowminder Foundation, Stockholm, Sweden
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, UK
| | - Andrew J Tatem
- Flowminder Foundation, Stockholm, Sweden
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, UK
| | - Erik Wetter
- Flowminder Foundation, Stockholm, Sweden
- Misum, Stockholm School of Economics, Stockholm, Sweden
- Asian Institute of Management, University in Makati, Metro Manila, Philippines
| | - Xin Lu
- Flowminder Foundation, Stockholm, Sweden
- School of Business, Central South University, Changsha, China
- College of Information System and Management, National University of Defense Technology, Changsha, China
| | | | | | - Sergio Ramos
- Erisson Technology and Emerging Business, Ericsson, Stockholm, Sweden
| | - Simon Moritz
- Erisson Technology and Emerging Business, Ericsson, Stockholm, Sweden
| | - Caroline O Buckee
- Department of Epidemiology, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linus Bengtsson
- Flowminder Foundation, Stockholm, Sweden
- Department of Epidemiology and Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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21
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Chen J, Marathe A, Marathe M. Feedback Between Behavioral Adaptations and Disease Dynamics. Sci Rep 2018; 8:12452. [PMID: 30127447 PMCID: PMC6102227 DOI: 10.1038/s41598-018-30471-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/27/2018] [Indexed: 11/26/2022] Open
Abstract
We study the feedback processes between individual behavior, disease prevalence, interventions and social networks during an influenza pandemic when a limited stockpile of antivirals is shared between the private and the public sectors. An economic model that uses prevalence-elastic demand for interventions is combined with a detailed social network and a disease propagation model to understand the feedback mechanism between epidemic dynamics, market behavior, individual perceptions, and the social network. An urban and a rural region are simulated to assess the robustness of results. Results show that an optimal split between the private and public sectors can be reached to contain the disease but the accessibility of antivirals from the private sector is skewed towards the richest income quartile. Also, larger allocations to the private sector result in wastage where individuals who do not need it are able to purchase it but who need it cannot afford it. Disease prevalence increases with household size and total contact time but not by degree in the social network, whereas wastage of antivirals decreases with degree and contact time. The best utilization of drugs is achieved when individuals with high contact time use them, who tend to be the school-aged children of large families.
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Affiliation(s)
- Jiangzhuo Chen
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA.
| | - Achla Marathe
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Madhav Marathe
- Network Dynamics and Simulation Science Laboratory, Virginia Tech, Blacksburg, VA, 24061, USA
- Department of Computer Science, Virginia Tech, Blacksburg, VA, 24061, USA
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22
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Pérez A, Rodríguez T, López MJ, Continente X, Nebot M. Adoption of Preventive Measures and Attitudes Toward the H1N1 Influenza Pandemic in Schools. THE JOURNAL OF SCHOOL HEALTH 2016; 86:534-542. [PMID: 27246678 DOI: 10.1111/josh.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 11/16/2015] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND This study describes the perceived impact of H1N1 influenza and the adoption of the recommended measures to address the pandemic in schools. METHODS A cross-sectional self-reported survey was conducted in 433 schools in Barcelona addressed to the school principal or the H1N1 influenza designated person. A descriptive analysis was performed, stratifying by educational level and type of school. A logistic regression analysis also was conducted. RESULTS Around 70% of the respondents reported that there had been H1N1 influenza cases among students, being this percentage significantly higher among those schools offering primary education (74.4%) (p < .05). The main measures (single-use paper towels, availability of sanitizer solutions and 15 minutes ventilation per day of enclosed spaces) were implemented in most of the centers. However, the correct adoption of the main measures took place in around 30% of the schools, being the percentage lower in those offering only secondary education (Odds ratio [OR]: 0.518; 95% confidence interval [CI]:0.272-0.986) and those located in medium (OR: 0.438, 95% CI: 0.234-0.811) or low socioeconomic status (SES) districts (OR: 0.321, 95% CI: 0.159-0.649). CONCLUSIONS Despite the climate of social alarm, the perceived impact of H1N1 influenza in most schools was moderate. In future potential threats, the educational level and the SES of the school should be considered, especially when measures requiring purchasing any product are recommended but not provided.
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Affiliation(s)
- Anna Pérez
- Agència de Salut Pública de Barcelona, Spain (Public Health Agency, Barcelona, Spain).
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health, Spain).
- Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research, Spain).
| | - Tània Rodríguez
- Agència de Salut Pública de Barcelona, Spain (Public Health Agency, Barcelona, Spain).
| | - Maria José López
- Agència de Salut Pública de Barcelona, Spain (Public Health Agency, Barcelona, Spain).
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health, Spain).
- Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research, Spain).
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF) (Experimental and Health Sciences Department, Pompeu Fabra University, Barcelona, Spain).
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Spain (Public Health Agency, Barcelona, Spain).
- Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research, Spain).
| | - Manel Nebot
- Agència de Salut Pública de Barcelona, Spain (Public Health Agency, Barcelona, Spain).
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health, Spain).
- Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research, Spain).
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra (UPF) (Experimental and Health Sciences Department, Pompeu Fabra University, Barcelona, Spain).
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Andrews MA, Bauch CT. Disease Interventions Can Interfere with One Another through Disease-Behaviour Interactions. PLoS Comput Biol 2015; 11:e1004291. [PMID: 26047028 PMCID: PMC4457811 DOI: 10.1371/journal.pcbi.1004291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 04/17/2015] [Indexed: 11/19/2022] Open
Abstract
Theoretical models of disease dynamics on networks can aid our understanding of how infectious diseases spread through a population. Models that incorporate decision-making mechanisms can furthermore capture how behaviour-driven aspects of transmission such as vaccination choices and the use of non-pharmaceutical interventions (NPIs) interact with disease dynamics. However, these two interventions are usually modelled separately. Here, we construct a simulation model of influenza transmission through a contact network, where individuals can choose whether to become vaccinated and/or practice NPIs. These decisions are based on previous experience with the disease, the current state of infection amongst one's contacts, and the personal and social impacts of the choices they make. We find that the interventions interfere with one another: because of negative feedback between intervention uptake and infection prevalence, it is difficult to simultaneously increase uptake of all interventions by changing utilities or perceived risks. However, on account of vaccine efficacy being higher than NPI efficacy, measures to expand NPI practice have only a small net impact on influenza incidence due to strongly mitigating feedback from vaccinating behaviour, whereas expanding vaccine uptake causes a significant net reduction in influenza incidence, despite the reduction of NPI practice in response. As a result, measures that support expansion of only vaccination (such as reducing vaccine cost), or measures that simultaneously support vaccination and NPIs (such as emphasizing harms of influenza infection, or satisfaction from preventing infection in others through both interventions) can significantly reduce influenza incidence, whereas measures that only support expansion of NPI practice (such as making hand sanitizers more available) have little net impact on influenza incidence. (However, measures that improve NPI efficacy may fare better.) We conclude that the impact of interference on programs relying on multiple interventions should be more carefully studied, for both influenza and other infectious diseases.
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Affiliation(s)
- Michael A. Andrews
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
| | - Chris T. Bauch
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
- Department of Applied Mathematics, University of Waterloo, Waterloo, Ontario, Canada
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24
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Belfroid E, Hautvast JLA, Hilbink M, Timen A, Hulscher MEJL. Selection of key recommendations for quality indicators describing good quality outbreak response. BMC Infect Dis 2015; 15:166. [PMID: 25888491 PMCID: PMC4397715 DOI: 10.1186/s12879-015-0896-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 09/30/2014] [Accepted: 03/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The performance of recommended control measures is necessary for quick and uniform infectious disease outbreak control. To assess whether these procedures are performed, a valid set of quality indicators (QIs) is required. The goal of this study was to select a set of key recommendations that can be systematically translated into QIs to measure the quality of infectious disease outbreak response from the perspective of disaster emergency responders and infectious disease control professionals. METHODS Applying the Rand modified Delphi procedure, the following steps were taken to systematically select a set of key recommendations: extraction of recommendations from relevant literature; appraisal of the recommendations in terms of relevance through questionnaires to experts; expert meeting to discuss recommendations; prioritization of recommendations through a second questionnaire; and final expert meeting to approve the selected set. Infectious disease physicians and nurses, policymakers and communication experts participated in the expert group (n=48). RESULTS In total, 54 national and international publications were systematically searched for recommendations, yielding over 200 recommendations. The Rand modified Delphi procedure resulted in a set of 65 key recommendations. The key recommendations were categorized into 10 domains describing the whole response pathway from outbreak recognition to aftercare. CONCLUSION This study provides a set of key recommendations that represents 'good quality of response to an infectious disease outbreak'. These key recommendations can be systematically translated into QIs. Organizations and professionals involved in outbreak control can use these QIs to monitor the quality of response to infectious disease outbreaks and to assess in which domains improvement is needed.
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Affiliation(s)
- Evelien Belfroid
- Radboud university medical center, Radboud Institute for Health Sciences, Academic Collaborative Centre AMPHI, Department of Primary and Community Care, PO box 9101, 6500 HB, Nijmegen, The Netherlands. .,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, PO box 9101, 6500 HB, Nijmegen, The Netherlands. .,National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
| | - Jeannine L A Hautvast
- Radboud university medical center, Radboud Institute for Health Sciences, Academic Collaborative Centre AMPHI, Department of Primary and Community Care, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Mirrian Hilbink
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands.
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, PO box 9101, 6500 HB, Nijmegen, The Netherlands.
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Rashid H, Ridda I, King C, Begun M, Tekin H, Wood JG, Booy R. Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic. Paediatr Respir Rev 2015; 16:119-26. [PMID: 24630149 DOI: 10.1016/j.prrv.2014.01.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 01/22/2014] [Accepted: 01/26/2014] [Indexed: 02/01/2023]
Abstract
The role of social distancing measures in mitigating pandemic influenza is not precisely understood. To this end, we have conducted a systematised review, particularly in light of the 2009 pandemic influenza, to better inform the role of social distancing measures against pandemic influenza. Articles were identified from relevant databases and the data were synthesised to provide evidence on the role of school or work place-based interventions, case-based distancing (self-isolation, quarantine), and restriction of mobility and mass gatherings. School closure, whether proactive or reactive, appears to be moderately effective and acceptable in reducing the transmission of influenza and in delaying the peak of an epidemic but is associated with very high secondary costs. Voluntary home isolation and quarantine are also effective and acceptable measures but there is an increased risk of intra-household transmission from index cases to contacts. Work place-related interventions like work closure and home working are also modestly effective and are acceptable, but likely to be economically disruptive. Internal mobility restriction is effective only if prohibitively high (50% of travel) restrictions are applied and mass gatherings occurring within 10 days before the epidemic peak are likely to increase the risk of transmission of influenza.
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Affiliation(s)
- Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, NSW 2145, Australia.
| | - Iman Ridda
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, NSW 2145, Australia; School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Townsville, Australia
| | - Catherine King
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, NSW 2145, Australia
| | - Matthew Begun
- School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Hatice Tekin
- School of Mathematics and Statistics, The University of Sydney, Australia
| | - James G Wood
- School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Australia
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Amour S, Djhehiche K, Zamora A, Bergeret A, Vanhems P. Perception of the A/H1N1 influenza pandemic and acceptance of influenza vaccination by Université Claude Bernard Lyon 1 staff: A descriptive study. Hum Vaccin Immunother 2015; 11:727-31. [PMID: 25715115 DOI: 10.1080/21645515.2015.1008887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.
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Affiliation(s)
- Sélilah Amour
- a Observatoire de la Santé des Personnels de Lyon 1; Université de Lyon; Université Claude Bernard Lyon 1 ; Lyon , France
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Beyhun NE, Kosan Z, Aras A, Guraksin A, Ezmeci T. Willingness to Receive the Influenza A(H1N1) Vaccine and its Determinants among University Students during the 2009 Outbreak in Turkey. Eurasian J Med 2015; 46:8-14. [PMID: 25610287 DOI: 10.5152/eajm.2014.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 07/22/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The study aimed to determine the willingness to receive the Influenza A(H1N1) vaccine and its determinants in a large group of university students. MATERIALS AND METHODS This is a self-administered questionnairre based cross-sectional study. Students being educated at health and non-health faculties were invited to participate in this attitude survey. RESULTS A total of 974 students were included in the study, of whom 51.3% (n=500) were in health related faculties. The rate of willingness to receive the Influenza A(H1N1) vaccine was 11.9 and 7.5% for health and non-health groups, respectively (p<0.05). For the health group, having been vaccined with seasonal influenza was a significant determinant of being willingness to receive the Influenza A(H1N1) vaccine (O.R [95% C.I.]), (O.R: 2.9 [1.5-5.6]) and to believe that the Influenza A(H1N1) vaccine prevents swine flu (O.R: 1.7 [1.09-2.8]). For the non-health group, the only determinant was to believe that Influenza A(H1N1) vaccine prevents from swine flu (O.R: 19.1 [5.7-64.1]) which found to be affected by confusing news in media. CONCLUSION The public health professionals who will organize the efforts to improve the acceptability of Influenza A vaccines during influenza outbreaks should try to increase the vaccination rates of seasonal influenza. Information provided by the media should be organized in order not to cause fear and confusion, which was shown to decrease willingness and belief in the Influenza A(H1N1) vaccine.
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Affiliation(s)
- Nazim Ercument Beyhun
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Zahide Kosan
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Aysun Aras
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Asuman Guraksin
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Talat Ezmeci
- Department of Public Health, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Transmission characteristics of different students during a school outbreak of (H1N1) pdm09 influenza in China, 2009. Sci Rep 2014; 4:5982. [PMID: 25102240 PMCID: PMC4124738 DOI: 10.1038/srep05982] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/17/2014] [Indexed: 11/25/2022] Open
Abstract
Many outbreaks of A(H1N1)pdm09 influenza have occurred in schools with a high population density. Containment of school outbreaks is predicted to help mitigate pandemic influenza. Understanding disease transmission characteristics within the school setting is critical to implementing effective control measures. Based on a school outbreak survey, we found almost all (93.7%) disease transmission occurred within a single grade, only 6.3% crossed grades. Transmissions originating from freshmen exhibited a star-shaped network; other grades exhibited branch- or line-shaped networks, indicating freshmen have higher activity and are more likely to cause infection. R0 for freshmen, calculated as 2.04, estimated as 2.76, was greater than for other grades (P < 0.01). Without intervention, the estimated number of cases was much greater when the outbreak was initiated by freshmen than by other grades. Furthermore, the estimated number of cases required to be under quarantine and isolation for freshmen was less than that of equivalent other grades. So we concluded that different grades have different transmission mode. Freshmen were the main facilitators of the spread of A(H1N1)pdm09 influenza during this school outbreak, so control measures (e.g. close contact isolation) priority used for freshmen would likely have effectively reduced spread of influenza in school settings.
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Evaluation of the spread of pandemic influenza A/H1N1 2009 among Japanese university students. Environ Health Prev Med 2014; 19:315-21. [PMID: 24993386 DOI: 10.1007/s12199-014-0396-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/11/2014] [Indexed: 10/25/2022] Open
Abstract
The pandemic influenza A/H1N1 2009 virus is commonly known to affect younger individuals. Several epidemiological studies have clarified the epidemic features of university students in Japan. In this study, we reviewed these studies in Japan in comparison with reports from other countries. The average cumulative incidence rate among university students was 9.6 %, with the major symptoms being cough, sore throat, and rhinorrhea. These epidemiological features were similar between Japan and other countries. Attitudes and behaviors toward pandemic influenza control measures were different before and improved during and after the epidemic. These features were also similar to those in other countries. On the other hand, the epidemic spread through club activities or social events, and transmission was attenuated after temporary closure of such groups in Japan. This transmission pattern was inconsistent among countries, which may have been due to differences in lifestyle and cultural habits. Based on these results, infection control measures of pandemic influenza for university organizations in Japan should be considered.
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Hand hygiene and risk of influenza virus infections in the community: a systematic review and meta-analysis. Epidemiol Infect 2014; 142:922-32. [PMID: 24572643 DOI: 10.1017/s095026881400003x] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Community-based prevention strategies for seasonal and pandemic influenza are essential to minimize their potential threat to public health. Our aim was to evaluate the efficacy of hand hygiene interventions in reducing influenza transmission in the community and to investigate the possible modifying effects of latitude, temperature and humidity on hand hygiene efficacy. We identified 979 articles in the initial search and 10 randomized controlled trials met our inclusion criteria. The combination of hand hygiene with facemasks was found to have statistically significant efficacy against laboratory-confirmed influenza while hand hygiene alone did not. Our meta-regression model did not identify statistically significant effects of latitude, temperature or humidity on the efficacy of hand hygiene. Our findings highlight the potential importance of interventions that protect against multiple modes of influenza transmission, and the modest efficacy of hand hygiene suggests that additional measures besides hand hygiene may also be important to control influenza.
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Masuet‐Aumatell C, Toovey S, Zuckerman JN. Prevention of influenza among travellers attending at a UK travel clinic: beliefs and perceptions. A cross-sectional study. Influenza Other Respir Viruses 2013; 7:574-83. [PMID: 22998606 PMCID: PMC5781004 DOI: 10.1111/irv.12010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Travellers' compliance with measures to prevent influenza through the use of antivirals and influenza vaccine remains very poor despite influenza being one of the commonest travel and vaccine-preventable diseases. A study was undertaken to assess travellers' beliefs, perceptions and intentions to take antivirals for the treatment and prevention of influenza during the H1N1 pandemic. METHODS A cross-sectional survey (n = 96) of travellers who attended the Royal Free Travel Health Centre, London, UK was undertaken in September 2009. A self-administered questionnaire was completed by a traveller in advance of their pre-travel health consultation. Logistic regression identified variables independently associated with compliance. RESULTS Influenza vaccination uptake for the 5 years preceding the study was found to be 20·8%. This was statistically significantly higher for older travellers and those with underlying health conditions (P < 0·005). Mean intention to comply with antiviral drugs on a preventive and therapeutic basis was 58% and 72%, respectively, and this varied markedly with age and with dispensed antimalarial chemoprophylaxis. CONCLUSION This study identifies some beliefs and perceptions travellers consider with regard to the therapeutic and preventive influenza use of antivirals during the H1N1 pandemic; it underscores the importance of travellers receiving hemisphere appropriate influenza vaccination. The external validity of these study findings requires further corroboration involving other travel clinics and different cohorts of travellers during seasonal activity or outbreaks of influenza. These findings could guide the development of future strategies for the prevention of influenza in travellers.
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Affiliation(s)
- Cristina Masuet‐Aumatell
- Bellvitge Biomedical Research Institute (IDIBELL), International Health Centre and Travel Medicine Clinic, Department of Preventive Medicine, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Stephen Toovey
- Academic Centre for Travel Medicine & Vaccines, WHO Collaborating Centre for Reference, Research and Training in Travel Medicine University College London Medical School, London, UK
| | - Jane N. Zuckerman
- Academic Centre for Travel Medicine & Vaccines, WHO Collaborating Centre for Reference, Research and Training in Travel Medicine University College London Medical School, London, UK
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Rebmann T, Elliott MB, Swick Z, Reddick D. US school morbidity and mortality, mandatory vaccination, institution closure, and interventions implemented during the 2009 influenza A H1N1 pandemic. Biosecur Bioterror 2013; 11:41-8. [PMID: 23472749 DOI: 10.1089/bsp.2012.0050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The 2009 H1N1 pandemic disproportionately affected school-aged children, but only school-based outbreak case studies have been conducted. The purposes of this study were to evaluate US academic institutions' experiences during the 2009 H1N1 pandemic in terms of infection prevention interventions implemented and to examine factors associated with school closure during the pandemic. An online survey was sent to school nurses in May through July 2011. Hierarchical logistic regressions were used to determine predictive models for having a mandatory H1N1 vaccination policy for school nurses and school closure. In all, 1,997 nurses from 26 states participated. Very few nurses (3.3%, n=65) reported having a mandatory H1N1 influenza vaccination policy; nurses were more likely than all other school employees (p<.001) to be mandated to receive vaccine. Determinants of having a mandatory H1N1 vaccination policy were being employed by a hospital or public health agency, and the school being located in a western or northeastern state. Factors related to school closure included being in a western or northeastern state, having higher H1N1-related morbidity/mortality, being a school nurse employed by a public health agency or hospital, and being a private school. The most commonly implemented interventions included encouraging staff and students to exercise hand hygiene and increasing classroom cleaning; least commonly implemented interventions included discouraging face-to-face meetings, training staff on H1N1 influenza and/or respiratory hygiene, and discouraging handshaking. Schools should develop and continue to improve their pandemic plans, including collaborating with community response agencies.
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Affiliation(s)
- Terri Rebmann
- Institute for Biosecurity, Department of Environmental and Occupational Health, Saint Louis University, School of Public Health, St. Louis, MO 63104, USA.
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Agolory SG, Barbot O, Averhoff F, Weiss D, Wilson E, Egger J, Miller J, Ogbuanu I, Walton S, Kahn E. Implementation of non-pharmaceutical interventions by New York City public schools to prevent 2009 influenza A. PLoS One 2013; 8:e50916. [PMID: 23341877 PMCID: PMC3546112 DOI: 10.1371/journal.pone.0050916] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/26/2012] [Indexed: 11/18/2022] Open
Abstract
Introduction Children are important transmitters of influenza in the community and a number of non-pharmaceutical interventions (NPIs), including hand washing and use of hand sanitizer, have been recommended to mitigate the transmission of influenza, but limited information is available regarding schools' ability to implement these NPIs during an influenza outbreak. We evaluated implementation of NPIs during fall 2009 in response to H1N1 pandemic influenza (pH1N1) by New York City (NYC) public schools. Methods From January 25 through February 9, 2010, an online survey was sent to all the 1,632 NYC public schools and principals were asked to participate in the survey or to designate a school nurse or other school official with knowledge of school policies and characteristics to do so. Results Of 1,633 schools, 376(23%) accessed and completed the survey. Nearly all respondents (99%) implemented at least two NPIs. Schools that had a Flu Response Team (FRT) as a part of school emergency preparedness plan were more likely to implement the NPI guidelines recommended by NYC public health officials than schools that did not have a FRT. Designation of a room for isolating ill students, for example, was more common in schools with a FRT (72%) than those without (53%) (p<0.001). Conclusions Implementing an NPI program in a large school system to mitigate the effects of an influenza outbreak is feasible, but there is potential need for additional resources in some schools to increase capacity and adherence to all recommendations. Public health influenza-preparedness plans should include school preparedness planning and FRTs.
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Affiliation(s)
- Simon G Agolory
- Epidemic Intelligence Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Gerald LB, Gerald JK, Zhang B, McClure LA, Bailey WC, Harrington KF. Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children? J Allergy Clin Immunol 2012; 130:1317-24. [PMID: 23069487 PMCID: PMC3511646 DOI: 10.1016/j.jaci.2012.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 08/16/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Viral upper respiratory tract infections have been implicated as a major cause of asthma exacerbations among school-aged children. Regular hand washing is the most effective method to prevent the spread of viral respiratory tract infections, but effective hand-washing practices are difficult to establish in schools. OBJECTIVES This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools' usual hand hygiene practices. METHODS This was a 2-year, community-based, randomized controlled crossover trial. Schools were randomized to usual care and then intervention (sequence 1) or intervention and then usual care (sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school. RESULTS Five hundred twenty-seven students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations compared with the schools' usual hand hygiene practices (P = .132). There was a strong temporal trend because both sequences experienced fewer exacerbations during year 2 compared with year 1 (P < .001). CONCLUSIONS Although the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual-care schools. Therefore these results should be viewed cautiously.
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Affiliation(s)
- Lynn B. Gerald
- Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, Arizona Respiratory Center, University of Arizona, 1295 N Martin Avenue, PO Box 245163, Tucson, AZ 85724-5163, (520)626-3243, (520)626-6093 FAX
| | - Joe K. Gerald
- Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona
| | - Bin Zhang
- Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center
| | | | - William C. Bailey
- Lung Health Center School Of Medicine, University of Alabama at Birmingham
| | - Kathy F. Harrington
- Lung Health Center, Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham
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Pollock SL, Sagan M, Oakley L, Fontaine J, Poffenroth L. Investigation of a pandemic H1N1 influenza outbreak in a remote First Nations community in northern Manitoba, 2009. Canadian Journal of Public Health 2012. [PMID: 22530528 DOI: 10.1007/bf03404209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES First Nations communities in Manitoba were significantly affected by the pandemic H1N1 influenza virus (pH1N1) in 2009. Our objective was to conduct an epidemiologic investigation of a pH1N1 outbreak in one remote First Nations community (population 3,300) in northern Manitoba to inform a timely public health response and provide recommendations for preventing future outbreaks. METHODS Chart reviews were conducted at the nursing station for patients meeting the influenza-like illness (ILI) case definition during the study period (April 20 to June 11, 2009). Descriptive analyses examined age, gender, clinical presentation, management, outcomes and risk factors. Comparisons were made for hospitalized versus non-hospitalized cases and laboratory-confirmed versus possible cases using Pearson's chi-square test for gender and symptoms and using a t-test for age. RESULTS There were 180 ILI cases, including 23 laboratory-confirmed cases of pH1N1. Forty percent of children < 1 year old in the community and 9.4% of pregnant women presented to the nursing station with ILI. Most ILI cases were managed through the community nursing station, although 18.3% of cases (n = 33) were medically evacuated and 16.1% (n = 29) were hospitalized. There were no differences between hospitalized versus non-hospitalized or laboratory-confirmed versus possible cases. Risk factors identified in a subset of cases included exposure to an individual with ILI prior to illness onset, overcrowding and inadequate access to household water. CONCLUSIONS Early arrival and rapid transmission of pH1N1 rendered usual non-pharmacological control measures largely ineffective. Recommendations for prevention of future outbreaks include an effective communications strategy and daily surveillance for disease detection and monitoring. Key determinants of health should be addressed in remote First Nations communities to prevent disease and protect the health of these populations.
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Affiliation(s)
- Sue L Pollock
- Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, ON
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Seale H, Mak JPI, Razee H, MacIntyre CR. Examining the knowledge, attitudes and practices of domestic and international university students towards seasonal and pandemic influenza. BMC Public Health 2012; 12:307. [PMID: 22537252 PMCID: PMC3447694 DOI: 10.1186/1471-2458-12-307] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 04/26/2012] [Indexed: 11/29/2022] Open
Abstract
Background Prior to the availability of the specific pandemic vaccine, strategies to mitigate the impact of the disease typically involved antiviral treatment and “non-pharmaceutical” community interventions. However, compliance with these strategies is linked to risk perceptions, perceived severity and perceived effectiveness of the strategies. In 2010, we undertook a study to examine the knowledge, attitudes, risk perceptions, practices and barriers towards influenza and infection control strategies amongst domestic and international university students. Methods A study using qualitative methods that incorporated 20 semi-structured interviews was undertaken with domestic and international undergraduate and postgraduate university students based at one university in Sydney, Australia. Participants were invited to discuss their perceptions of influenza (seasonal vs. pandemic) in terms of perceived severity and impact, and attitudes towards infection control measures including hand-washing and the use of social distancing, isolation or cough etiquette. Results While participants were generally knowledgeable about influenza transmission, they were unable to accurately define what ‘pandemic influenza’ meant. While avian flu or SARS were mistaken as examples of past pandemics, almost all participants were able to associate the recent “swine flu” situation as an example of a pandemic event. Not surprisingly, it was uncommon for participants to identify university students as being at risk of catching pandemic influenza. Amongst those interviewed, it was felt that ‘students’ were capable of fighting off any illness. The participant’s nominated hand washing as the most feasible and acceptable compared with social distancing and mask use. Conclusions Given the high levels of interaction that occurs in a university setting, it is really important that students are informed about disease transmission and about risk of infection. It may be necessary to emphasize that pandemic influenza could pose a real threat to them, that it is important to protect oneself from infection and that infection control measures can be effective.
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Affiliation(s)
- Holly Seale
- School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, South Wales, Australia.
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Kao CL, Chan TC, Tsai CH, Chu KY, Chuang SF, Lee CC, Li ZRT, Wu KW, Chang LY, Shen YH, Huang LM, Lee PI, Yang C, Compans R, Rouse BT, King CC. Emerged HA and NA mutants of the pandemic influenza H1N1 viruses with increasing epidemiological significance in Taipei and Kaohsiung, Taiwan, 2009-10. PLoS One 2012; 7:e31162. [PMID: 22328930 PMCID: PMC3273476 DOI: 10.1371/journal.pone.0031162] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 01/03/2012] [Indexed: 11/22/2022] Open
Abstract
The 2009 influenza pandemic provided an opportunity to observe dynamic changes of the hemagglutinin (HA) and neuraminidase (NA) of pH1N1 strains that spread in two metropolitan areas -Taipei and Kaohsiung. We observed cumulative increases of amino acid substitutions of both HA and NA that were higher in the post–peak than in the pre-peak period of the epidemic. About 14.94% and 3.44% of 174 isolates had one and two amino acids changes, respective, in the four antigenic sites. One unique adaptive mutation of HA2 (E374K) was first detected three weeks before the epidemic peak. This mutation evolved through the epidemic, and finally emerged as the major circulated strain, with significantly higher frequency in the post-peak period than in the pre-peak (64.65% vs 9.28%, p<0.0001). E374K persisted until ten months post-nationwide vaccination without further antigenic changes (e.g. prior to the highest selective pressure). In public health measures, the epidemic peaked at seven weeks after oseltamivir treatment was initiated. The emerging E374K mutants spread before the first peak of school class suspension, extended their survival in high-density population areas before vaccination, dominated in the second wave of class suspension, and were fixed as herd immunity developed. The tempo-spatial spreading of E374K mutants was more concentrated during the post–peak (p = 0.000004) in seven districts with higher spatial clusters (p<0.001). This is the first study examining viral changes during the naïve phase of a pandemic of influenza through integrated virological/serological/clinical surveillance, tempo-spatial analysis, and intervention policies. The vaccination increased the percentage of E374K mutants (22.86% vs 72.34%, p<0.001) and significantly elevated the frequency of mutations in Sa antigenic site (2.36% vs 23.40%, p<0.001). Future pre-vaccination public health efforts should monitor amino acids of HA and NA of pandemic influenza viruses isolated at exponential and peak phases in areas with high cluster cases.
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Affiliation(s)
- Chuan-Liang Kao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
- Department of Clinical Laboratory Sciences & Medical Biotechnology, College of Medicine, NTU, Taipei, Taiwan, Republic of China (ROC)
- Department of Laboratory Medicine, NTU Hospital, Taipei, Taiwan, Republic of China (ROC)
| | - Ta-Chien Chan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
| | - Chu-Han Tsai
- Department of Clinical Laboratory Sciences & Medical Biotechnology, College of Medicine, NTU, Taipei, Taiwan, Republic of China (ROC)
| | - Kuan-Ying Chu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
| | - Shu-Fang Chuang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
- Department of Clinical Laboratory Sciences & Medical Biotechnology, College of Medicine, NTU, Taipei, Taiwan, Republic of China (ROC)
| | - Chang-Chun Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
| | - Zheng-Rong Tiger Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
| | - Ko-Wen Wu
- Institute of Biomedical Informatics, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan, Republic of China (ROC)
| | - Luan-Yin Chang
- Department of Pediatrics, NTU Hospital, Taipei, Taiwan, Republic of China (ROC)
| | - Yea-Huei Shen
- Department of Internal Medicine, Yuan's General Hospital, Kaohsiung, Taiwan, Republic of China (ROC)
| | - Li-Min Huang
- Department of Pediatrics, NTU Hospital, Taipei, Taiwan, Republic of China (ROC)
| | - Ping-Ing Lee
- Department of Pediatrics, NTU Hospital, Taipei, Taiwan, Republic of China (ROC)
| | - ChingLai Yang
- Department of Microbiology and Immunology and Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Richard Compans
- Department of Microbiology and Immunology and Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Barry T. Rouse
- Department of Pathobiology, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Chwan-Chuen King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan, Republic of China (ROC)
- * E-mail:
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38
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Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS. Facemasks, hand hygiene, and influenza among young adults: a randomized intervention trial. PLoS One 2012; 7:e29744. [PMID: 22295066 PMCID: PMC3266257 DOI: 10.1371/journal.pone.0029744] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 12/02/2011] [Indexed: 11/19/2022] Open
Abstract
Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007–2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio [RR] = 0.25, [95% CI, 0.07 to 0.87]). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic.
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Affiliation(s)
- Allison E Aiello
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, Michigan, United States of America.
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Iuliano AD, Dawood FS, Silk BJ, Bhattarai A, Copeland D, Doshi S, France AM, Jackson ML, Kennedy E, Loustalot F, Marchbanks T, Mitchell T, Averhoff F, Olsen SJ, Swerdlow DL, Finelli L. Investigating 2009 pandemic influenza A (H1N1) in US schools: what have we learned? Clin Infect Dis 2011; 52 Suppl 1:S161-7. [PMID: 21342889 DOI: 10.1093/cid/ciq032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
US investigations of school-based outbreaks of 2009 pandemic influenza A (H1N1) virus infection characterized influenza-like illness (ILI) attack rates, transmission risk factors, and adherence to nonpharmaceutical interventions. We summarize seven school-based investigations conducted during April-June 2009 to determine what questions might be answered by future investigations. Surveys were administered 5-28 days after identification of the outbreaks, and participation rates varied among households (39-86%) and individuals (24-49%). Compared with adults (4%-10%) and children aged <4 years (2%-7%), elementary through university students had higher ILI attack rates (4%-32%). Large gatherings or close contact with sick persons were identified as transmission risk factors. More participants reported adherence to hygiene measures, but fewer reported adherence to isolation measures. Challenges included low participation and delays in survey initiation that potentially introduced bias. Although school-based investigations can increase our understanding of epidemiology and prevention strategy effectiveness, investigators should decide which objectives are most feasible, given timing and design constraints.
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Affiliation(s)
- A Danielle Iuliano
- Division of HIV AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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