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Amanya G, Washington ML, Kadobera D, Richard M, Ndyabakiira A, Harris J. Cost effectiveness and decision analysis for national airport screening options to reduce risk of COVID-19 introduction in Uganda, 2020. Cost Eff Resour Alloc 2024; 22:40. [PMID: 38735961 PMCID: PMC11089758 DOI: 10.1186/s12962-024-00548-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
INTRODUCTION Early during the COVID-19 outbreak, various approaches were utilized to prevent COVID-19 introductions from incoming airport travellers. However, the costs and effectiveness of airport-specific interventions have not been evaluated. METHODS We evaluated policy options for COVID-19-specific interventions at Entebbe International Airport for costs and impact on COVID-19 case counts, we took the government payer perspective. Policy options included; (1)no screening, testing, or mandatory quarantine for any incoming traveller; (2)mandatory symptom screening for all incoming travellers with RT-PCR testing only for the symptomatic and isolation of positives; and (3)mandatory 14-day quarantine and one-time testing for all, with 10-day isolation of persons testing positive. We calculated incremental cost-effectiveness ratios (ICERs) in US$ per additional case averted. RESULTS Expected costs per incoming traveller were $0 (Option 1), $19 (Option 2), and $766 (Option 3). ICERs per case averted were $257 for Option 2 (which averted 4,948 cases), and $10,139 for Option 3 (which averted 5,097 cases) compared with Option I. Two-week costs were $0 for Option 1, $1,271,431 Option 2, and $51,684,999 Option 3. The per-case ICER decreased with increase in prevalence. The cost-effectiveness of our interventions was modestly sensitive to the prevalence of COVID-19, diagnostic test sensitivity, and testing costs. CONCLUSION Screening all incoming travellers, testing symptomatic persons, and isolating positives (Option 2) was the most cost-effective option. A higher COVID-19 prevalence among incoming travellers increased cost-effectiveness of airport-specific interventions. This model could be used to evaluate prevention options at the airport for COVID-19 and other infectious diseases with similar requirements for control.
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Affiliation(s)
- Geofrey Amanya
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda.
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Michael L Washington
- Division of Preparedness and Emerging Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Migisha Richard
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Alex Ndyabakiira
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Julie Harris
- Division of Global Health Protection, US Centers for Disease Control and Prevention, Kampala, Uganda
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Ding W, Wang QG, Zhang JX. Analysis and prediction of COVID-19 epidemic in South Africa. ISA Trans 2022; 124:182-190. [PMID: 33551132 PMCID: PMC7842146 DOI: 10.1016/j.isatra.2021.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/01/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
The coronavirus disease-2019 (COVID-19) has been spreading rapidly in South Africa (SA) since its first case on 5 March 2020. In total, 674,339 confirmed cases and 16,734 mortality cases were reported by 30 September 2020, and this pandemic has made severe impacts on economy and life. In this paper, analysis and long-term prediction of the epidemic dynamics of SA are made, which could assist the government and public in assessing the past Infection Prevention and Control Measures and designing the future ones to contain the epidemic more effectively. A Susceptible-Infectious-Recovered model is adopted to analyse epidemic dynamics. The model parameters are estimated over different phases with the SA data. They indicate variations in the transmissibility of COVID-19 under different phases and thus reveal weakness of the past Infection Prevention and Control Measures in SA. The model also shows that transient behaviours of the daily growth rate and the cumulative removal rate exhibit periodic oscillations. Such dynamics indicates that the underlying signals are not stationary and conventional linear and nonlinear models would fail for long-term prediction. Therefore, a large class of mappings with rich functions and operations is chosen as the model class and the evolutionary algorithm is utilized to obtain the optimal model for long term prediction. The resulting models on the daily growth rate, the cumulative removal rate and the cumulative mortality rate predict that the peak and inflection point will occur on November 4, 2020 and October 15, 2020, respectively; the virus shall cease spreading on April 28, 2021; and the ultimate numbers of the COVID-19 cases and mortality cases will be 785,529 and 17,072, respectively. The approach is also benchmarked against other methods and shows better accuracy of long-term prediction.
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Affiliation(s)
- Wei Ding
- Faculty of Electrical Engineering and Automation, Changshu Institute of Technology, Changshu, 215500, PR China; Institute for Intelligent Systems, Faculty of Engineering and the Built Environment, University of Johannesburg, Johannesburg, 2006, South Africa
| | - Qing-Guo Wang
- Institute of Artificial Intelligence and Future Networks, Beijing Normal University at Zhuhai; BNU-HKBU United International College, Zhuhai, 519000, PR China.
| | - Jin-Xi Zhang
- State Key Laboratory of Synthetical Automation for Process Industries, Northeastern University, Shenyang, 110819, PR China
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Gunasekeran D, Chew AMK, Chandrasekar E, Rajendram P, Kandarpa V, Rajendram M, Chia A, Smith H, Leong CK. The impact and applications of social media platforms for public health responses before and during COVID-19. J Med Internet Res 2022; 24:e33680. [PMID: 35129456 PMCID: PMC9004624 DOI: 10.2196/33680] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 01/27/2022] [Accepted: 02/04/2022] [Indexed: 12/21/2022] Open
Abstract
Background Social media platforms have numerous potential benefits and drawbacks on public health, which have been described in the literature. The COVID-19 pandemic has exposed our limited knowledge regarding the potential health impact of these platforms, which have been detrimental to public health responses in many regions. Objective This review aims to highlight a brief history of social media in health care and report its potential negative and positive public health impacts, which have been characterized in the literature. Methods We searched electronic bibliographic databases including PubMed, including Medline and Institute of Electrical and Electronics Engineers Xplore, from December 10, 2015, to December 10, 2020. We screened the title and abstracts and selected relevant reports for review of full text and reference lists. These were analyzed thematically and consolidated into applications of social media platforms for public health. Results The positive and negative impact of social media platforms on public health are catalogued on the basis of recent research in this report. These findings are discussed in the context of improving future public health responses and incorporating other emerging digital technology domains such as artificial intelligence. However, there is a need for more research with pragmatic methodology that evaluates the impact of specific digital interventions to inform future health policy. Conclusions Recent research has highlighted the potential negative impact of social media platforms on population health, as well as potentially useful applications for public health communication, monitoring, and predictions. More research is needed to objectively investigate measures to mitigate against its negative impact while harnessing effective applications for the benefit of public health.
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Affiliation(s)
| | | | | | | | | | - Mallika Rajendram
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG
| | - Audrey Chia
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG
| | - Helen Smith
- Lee Kong Chian School of Medicine (LKCMedicine), Singapore, SG
| | - Choon Kit Leong
- National University of Singapore (NUS), 10 Medical Drive, Singapore, SG.,Mission Medical Clinic, Singapore, SG
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Vandepitte S, Alleman T, Nopens I, Baetens J, Coenen S, De Smedt D. Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review. Value Health 2021; 24:1551-1569. [PMID: 34711355 PMCID: PMC8481648 DOI: 10.1016/j.jval.2021.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/07/2021] [Accepted: 05/23/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has had a major impact on our society, with drastic policy restrictions being implemented to contain the spread of the severe acute respiratory syndrome coronavirus 2. This study aimed to provide an overview of the available evidence on the cost-effectiveness of various coronavirus disease 2019 policy measures. METHODS A systematic literature search was conducted in PubMed, Embase, and Web of Science. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the Consensus Health Economic Criteria checklist. Next, the quality of the epidemiological models was evaluated. RESULTS A total of 3688 articles were identified (March 2021), of which 23 were included. The studies were heterogeneous with regard to methodological quality, contextual factors, strategies' content, adopted perspective, applied models, and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation, and hygienic measures were found to be cost-effective. Furthermore, the most optimal choice and combination of strategies depended on the reproduction number and context. With a rising reproduction number, extending the testing strategy and early implementation of combined multiple restriction measures are most efficient. CONCLUSIONS The quality assessment highlighted numerous flaws and limitations in the study approaches; hence, their results should be interpreted with caution because the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key because this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.
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Affiliation(s)
- Sophie Vandepitte
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Tijs Alleman
- BIOMATH, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Ingmar Nopens
- BIOMATH, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Jan Baetens
- KERMIT, Department of Data Analysis and Mathematical Modeling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Samuel Coenen
- ELIZA, Centre for General Practice, Department of Primary and Interdisciplinary Care and VAXINFECTIO, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Delphine De Smedt
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Alali AS, Alshehri AO, Assiri A, Khan S, Alkathiri MA, Almohammed OA, Badoghaish W, AlQahtani SM, Alshammari MA, Mohany M, Alamri FF, AlRuthia Y, Alqahtani F. Demographics, comorbidities, and outcomes among young and middle-aged COVID-19 patients in Saudi Arabia. Saudi Pharm J 2021; 29:833-842. [PMID: 34177315 PMCID: PMC8213516 DOI: 10.1016/j.jsps.2021.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/13/2021] [Indexed: 01/08/2023] Open
Abstract
The impact of different sociodemographic and clinical characteristics on the COVID-19-related morbidity and mortality rates have been studied extensively around the world; however, there is a dearth of data on the impact of different clinical and sociodemographic variables on the COVID-19-related outcomes in Saudi Arabia. This study aimed to identify those at high risk of worse clinical outcomes, such as hospitalization and longer length of stay (LOS) among young and middle-aged adults (18 to 55 years). In this questionnaire-based cross-sectional study, 706 patients with real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 infection were interviewed. Patients' demographic characteristics, dietary habits, medical history, and lifestyle choices were collected through phone interviews. Patients with chronic health conditions, such as diabetes and hypertension, reported a higher rate of hospitalization, ICU admission, oxygen-support needs, and a longer period of recovery and LOS. Multiple logistic regression showed that diabetes, hypertension, and pulmonary disease (e.g., asthma and chronic obstructive pulmonary disease (COPD)) were associated with a higher risk of hospitalization and longer LOS. Multiple logistic regression showed that symptoms of breathlessness, loss of smell and/or taste, diarrhea, and cough were associated with a longer recovery period. Similarly, breathlessness, vomiting, and diarrhea were associated with higher rates of hospitalization. The findings of this study confirm the similarity of the factors associated with worse clinical outcomes across the world. Future studies should use more robust designs to investigate the impact of different therapies on the COVID-19-related morbidity and mortality in Saudi Arabia.
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Affiliation(s)
- Amer S. Alali
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Abdulaziz O. Alshehri
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahmed Assiri
- General Directorate of Clinical Excellence, Assistant Deputy of Planning and Organizational Excellence, Ministry of Health, Riyadh, Saudi Arabia
| | - Shahd Khan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Munirah A. Alkathiri
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Omar A. Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Waleed Badoghaish
- Department of Internal Medicine, College of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Saeed M. AlQahtani
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - Musaad A. Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohamed Mohany
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Faisal F. Alamri
- Basic Sciences Department, College of Science and Health Professions (KSAU-HS), King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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Losina E, Leifer V, Millham L, Panella C, Hyle EP, Mohareb AM, Neilan AM, Ciaranello AL, Kazemian P, Freedberg KA. College campuses and COVID-19 mitigation: clinical and economic value. medRxiv 2020. [PMID: 32908989 DOI: 10.1101/2020.09.03.20187062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Decisions around US college and university operations will affect millions of students and faculty amidst the COVID-19 pandemic. We examined the clinical and economic value of different COVID-19 mitigation strategies on college campuses. METHODS We used the Clinical and Economic Analysis of COVID-19 interventions (CEACOV) model, a dynamic microsimulation that tracks infections accrued by students and faculty, accounting for community transmissions. Outcomes include infections, $/infection-prevented, and $/quality-adjusted-life-year ($/QALY). Strategies included extensive social distancing (ESD), masks, and routine laboratory tests (RLT). We report results per 5,000 students (1,000 faculty) over one semester (105 days). RESULTS Mitigation strategies reduced COVID-19 cases among students (faculty) from 3,746 (164) with no mitigation to 493 (28) with ESD and masks, and further to 151 (25) adding RLTq3 among asymptomatic students and faculty. ESD with masks cost $168/infection-prevented ($49,200/QALY) compared to masks alone. Adding RLTq3 ($10/test) cost $8,300/infection-prevented ($2,804,600/QALY). If tests cost $1, RLTq3 led to a favorable cost of $275/infection-prevented ($52,200/QALY). No strategies without masks were cost-effective. CONCLUSION Extensive social distancing with mandatory mask-wearing could prevent 87% of COVID-19 cases on college campuses and be very cost-effective. Routine laboratory testing would prevent 96% of infections and require low cost tests to be economically attractive.
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