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Huang X, Kong QY, Wan X, Huang Y, Wang R, Wang X, Li Y, Wu Y, Guan C, Wang J, Zhang Y. From the Public Health Perspective: a Scalable Model for Improving Epidemiological Testing Efficacy in Low- and Middle-Income Areas. JMIR Public Health Surveill 2024; 10:e55194. [PMID: 38857063 DOI: 10.2196/55194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024] Open
Abstract
The globe is an organically linked whole, and in the pandemic era, COVID-19 has brought heavy public safety threats and economic costs to humanity as almost all countries began to pay more attention to taking steps to minimize the risk of harm to society from sudden-onset diseases. It is worth noting that in some low- and middle-income areas, where the environment for epidemic detection is complex, the causative and comorbid factors are numerous, and where public health resources are scarce. It is often more difficult than in other areas to obtain timely and effective detection and control in the event of widespread virus transmission, which, in turn, is a constant threat to local and global public health security. Pandemics are preventable through effective disease surveillance systems, with nonpharmacological interventions (NPIs) as the mainstay of the control system, effectively controlling the spread of epidemics and preventing larger outbreaks. However, current state-of-the-art NPIs are not applicable in low- and middle-income areas and tend to be decentralized and costly. Based on a 3-year case study of SARS-CoV-2 preventive detection in low-income areas in south-central China, we explored a strategic model for enhancing disease detection efficacy in low- and middle-income areas. For the first time, we propose an integrated and comprehensive approach that covers structural, social, and personal strategies to optimize the epidemic surveillance system in low- and middle-income areas. This model can improve the local epidemic detection efficiency, ensure the health care needs of more people, reduce the public health costs in low- and middle-income areas in a coordinated manner, and ensure and strengthen local public health security sustainably.
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Affiliation(s)
- Xuefeng Huang
- School of Public Health, Dalian Medical University, Dalian, China
| | - Qian-Yi Kong
- School of Economics and Management, University of Science and Technology Beijing, Peking, China
| | - Xiaowen Wan
- School of Economics and Management, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yating Huang
- School of Public Health, Dalian Medical University, Dalian, China
| | - Rongrong Wang
- School of Public Health, Dalian Medical University, Dalian, China
| | - Xiaoxue Wang
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yingying Li
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yuqing Wu
- School of Public Health, Dalian Medical University, Dalian, China
| | - Chongyuan Guan
- School of Public Health, Dalian Medical University, Dalian, China
| | - Junyang Wang
- School of Public Health, Dalian Medical University, Dalian, China
| | - Yuanyuan Zhang
- School of Public Health, Dalian Medical University, Dalian, China
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Meriggi NF, Voors M, Levine M, Ramakrishna V, Kangbai DM, Rozelle M, Tyler E, Kallon S, Nabieu J, Cundy S, Mobarak AM. Last-mile delivery increases vaccine uptake in Sierra Leone. Nature 2024; 627:612-619. [PMID: 38480877 PMCID: PMC10954551 DOI: 10.1038/s41586-024-07158-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2024] [Indexed: 03/20/2024]
Abstract
Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development1. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties2, we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48-72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services3.
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Affiliation(s)
- Niccolò F Meriggi
- International Growth Centre, Freetown, Sierra Leone.
- Wageningen University and Research, Wageningen, The Netherlands.
- Centre for the Study of African Economies, Department of Economics, University of Oxford, Oxford, UK.
| | - Maarten Voors
- Wageningen University and Research, Wageningen, The Netherlands
| | | | | | | | - Michael Rozelle
- Wageningen University and Research, Wageningen, The Netherlands
| | - Ella Tyler
- Wageningen University and Research, Wageningen, The Netherlands
| | - Sellu Kallon
- Wageningen University and Research, Wageningen, The Netherlands
- University of Sierra Leone, Freetown, Sierra Leone
| | - Junisa Nabieu
- Wageningen University and Research, Wageningen, The Netherlands
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3
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Fanny SA, Tam RP, Rule A, Barnes A, Haq H. Transforming Pediatric Global Health Education Through Antiracist and Anticolonial Principles. Pediatrics 2024; 153:e2023062612. [PMID: 38173415 DOI: 10.1542/peds.2023-062612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
| | | | - Amy Rule
- Emory School of Medicine, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Adelaide Barnes
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Heather Haq
- Baylor College of Medicine, Houston, Texas
- Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, Texas
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4
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Nomura S, Ghaznavi C, Shimizu K, Cao A, Sassa M, Uchibori M, Santosh Kumar R, Yamasaki L, Tomoi H, Sakamoto H. Insights from the COVID-19 pandemic: trends in development assistance committee countries' aid allocation, 2011-2021. Glob Health Action 2023; 16:2258707. [PMID: 37733029 PMCID: PMC10515657 DOI: 10.1080/16549716.2023.2258707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Official Development Assistance (ODA) significantly aids sustainable development in low- and middle-income countries (LMICs). However, the COVID-19 pandemic has impacted aid allocation, posing challenges for attaining the Sustainable Development Goals (SDGs). OBJECTIVE This study explores and underscores the profound implications of shifts in ODA allocation by Development Assistance Committee (DAC) member countries, resulting from the COVID-19 pandemic, offering a unique perspective on the evolving landscape of international aid. METHODS Drawing from the gross ODA disbursement data for LMICs by DAC member countries from 2011 to 2021, a linear regression analysis assessed the changes in ODA amount, ODA-to-gross national income (GNI) ratio, sectoral aid allocation, and the balance between bilateral and multilateral aid, primarily focusing on the differences pre- and post-COVID-19. For non-specialised multilateral agencies' core funding, the OECD's methodology for calculating imputed multilateral ODA was employed to estimate ODA flows. RESULTS The study found an increasing trend in the total ODA provided by DAC member countries from 2011 to 2021. However, the average ODA/GNI ratio showed a slight but significant decrease before the pandemic, followed by an increase after the COVID-19 pandemic. The health sector received the highest percentage of aid after the pandemic, with a marked increase in both bilateral and multilateral aid. However, other sectors such as humanitarian aid, water and sanitation, and energy experienced a significant decrease in sectoral aid share. CONCLUSIONS Emerging from this analysis is a strong recommendation for DAC members to re-evaluate aid objectives and escalate their financial commitments to reinforce SDGs and sustainable development efforts. While the rise in health aid is essential, other sectors also require equal focus to offset the ramifications of the COVID-19 pandemic. Understanding the intricacies of aid allocation can improve aid efficacy, culminating in greater, transformative results for recipient countries.
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Affiliation(s)
- Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Better Co-Being, Tokyo, Japan
| | - Cyrus Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Medicine, University of California San Francisco, San Francisco, USA
| | - Kazuki Shimizu
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of International Medical Education, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Alton Cao
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miho Sassa
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manae Uchibori
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Rauniyar Santosh Kumar
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Ocean Policy Research Institute, Sasakawa Peace Foundation, Tokyo, Japan
| | - Lisa Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Hana Tomoi
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Haruka Sakamoto
- Tokyo Foundation for Policy Research, Tokyo, Japan
- Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo, Japan
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5
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Liang Y, Sun Y. Awareness of and attitude toward COVID-19 vaccination among individuals with COPD and the strategies to overcome vaccine hesitation: A mini review. Hum Vaccin Immunother 2023; 19:2286686. [PMID: 38059434 PMCID: PMC10732662 DOI: 10.1080/21645515.2023.2286686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) vaccines have a protective effect on individuals with chronic obstructive pulmonary disease (COPD), preventing them from developing severe illnesses and reducing the risk of hospitalization and mortality. However, the coverage rate of COVID-19 vaccination among this population is not satisfactory, which is associated with their lack of awareness of and negative attitudes toward COVID-19 vaccination, that is, vaccine hesitancy. We reviewed recent literatures on the vaccination status of COPD patients and vaccine hesitancy, described the factors related to vaccine hesitancy among COPD patients, and proposed strategies to improve the vaccine coverage, such as providing accurate and consistent vaccine information to the public, patient health education program, improving self-management capabilities, easy access to vaccination service, etc., which can hopefully help to improve patients' ability to cope with SARS-CoV-2 infection and reduce the COVID-19 related mortality.
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Affiliation(s)
- Ying Liang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China
- Research Center for Chronic Airway Diseases, Peking University Health Science Center, Beijing, People’s Republic of China
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Grieve R, Yang Y, Abbott S, Babu GR, Bhattacharyya M, Dean N, Evans S, Jewell N, Langan SM, Lee W, Molenberghs G, Smeeth L, Williamson E, Mukherjee B. The importance of investing in data, models, experiments, team science, and public trust to help policymakers prepare for the next pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002601. [PMID: 38032861 PMCID: PMC10688710 DOI: 10.1371/journal.pgph.0002601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
The COVID-19 pandemic has brought about valuable insights regarding models, data, and experiments. In this narrative review, we summarised the existing literature on these three themes, exploring the challenges of providing forecasts, the requirement for real-time linkage of health-related datasets, and the role of 'experimentation' in evaluating interventions. This literature review encourages us to broaden our perspective for the future, acknowledging the significance of investing in models, data, and experimentation, but also to invest in areas that are conceptually more abstract: the value of 'team science', the need for public trust in science, and in establishing processes for using science in policy. Policy-makers rely on model forecasts early in a pandemic when there is little data, and it is vital to communicate the assumptions, limitations, and uncertainties (theme 1). Linked routine data can provide critical information, for example, in establishing risk factors for adverse outcomes but are often not available quickly enough to make a real-time impact. The interoperability of data resources internationally is required to facilitate sharing across jurisdictions (theme 2). Randomised controlled trials (RCTs) provided timely evidence on the efficacy and safety of vaccinations and pharmaceuticals but were largely conducted in higher income countries, restricting generalisability to low- and middle-income countries (LMIC). Trials for non-pharmaceutical interventions (NPIs) were almost non-existent which was a missed opportunity (theme 3). Building on these themes from the narrative review, we underscore the importance of three other areas that need investment for effective evidence-driven policy-making. The COVID-19 response relied on strong multidisciplinary research infrastructures, but funders and academic institutions need to do more to incentivise team science (4). To enhance public trust in the use of scientific evidence for policy, researchers and policy-makers must work together to clearly communicate uncertainties in current evidence and any need to change policy as evidence evolves (5). Timely policy decisions require an established two-way process between scientists and policy makers to make the best use of evidence (6). For effective preparedness against future pandemics, it is essential to establish models, data, and experiments as fundamental pillars, complemented by efforts in planning and investment towards team science, public trust, and evidence-based policy-making across international communities. The paper concludes with a 'call to actions' for both policy-makers and researchers.
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Affiliation(s)
- Richard Grieve
- Centre for Data and Statistical Science for Health (DASH), London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Youqi Yang
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sam Abbott
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Giridhara R. Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, India
| | | | - Natalie Dean
- Department of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Stephen Evans
- Centre for Data and Statistical Science for Health (DASH), London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nicholas Jewell
- Centre for Data and Statistical Science for Health (DASH), London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sinéad M. Langan
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Woojoo Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Geert Molenberghs
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Universiteit Hasselt & KU Leuven, Hasselt, Belgium
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth Williamson
- Centre for Data and Statistical Science for Health (DASH), London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America
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7
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De Gaetano A, Bajardi P, Gozzi N, Perra N, Perrotta D, Paolotti D. Behavioral Changes Associated With COVID-19 Vaccination: Cross-National Online Survey. J Med Internet Res 2023; 25:e47563. [PMID: 37906219 PMCID: PMC10646669 DOI: 10.2196/47563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/05/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND During the initial phases of the vaccination campaign worldwide, nonpharmaceutical interventions (NPIs) remained pivotal in the fight against the COVID-19 pandemic. In this context, it is important to understand how the arrival of vaccines affected the adoption of NPIs. Indeed, some individuals might have seen the start of mass vaccination campaigns as the end of the emergency and, as a result, relaxed their COVID-safe behaviors, facilitating the spread of the virus in a delicate epidemic phase such as the initial rollout. OBJECTIVE The aim of this study was to collect information about the possible relaxation of protective behaviors following key events of the vaccination campaign in four countries and to analyze possible associations of these behavioral tendencies with the sociodemographic characteristics of participants. METHODS We developed an online survey named "COVID-19 Prevention and Behavior Survey" that was conducted between November 26 and December 22, 2021. Participants were recruited using targeted ads on Facebook in four different countries: Brazil, Italy, South Africa, and the United Kingdom. We measured the onset of relaxation of protective measures in response to key events of the vaccination campaign, namely personal vaccination and vaccination of the most vulnerable population. Through calculation of odds ratios (ORs) and regression analysis, we assessed the strength of association between compliance with NPIs and sociodemographic characteristics of participants. RESULTS We received 2263 questionnaires from the four countries. Participants reported the most significant changes in social activities such as going to a restaurant or the cinema and visiting relatives and friends. This is in good agreement with validated psychological models of health-related behavioral change such as the Health Belief Model, according to which activities with higher costs and perceived barriers (eg, social activities) are more prone to early relaxation. Multivariate analysis using a generalized linear model showed that the two main determinants of the drop of social NPIs were (1) having previously tested positive for COVID-19 (after the second vaccine dose: OR 2.46, 95% CI 1.73-3.49) and (2) living with people at risk (after the second vaccine dose: OR 1.57, 95% CI 1.22-2.03). CONCLUSIONS This work shows that particular caution has to be taken during vaccination campaigns. Indeed, people might relax their safe behaviors regardless of the dynamics of the epidemic. For this reason, it is crucial to maintain high compliance with NPIs to avoid hindering the beneficial effects of the vaccine.
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Affiliation(s)
- Alessandro De Gaetano
- ISI Foundation, Turin, Italy
- Aix Marseille Univ, Université de Toulon, CNRS, CPT, Marseille, France
| | - Paolo Bajardi
- ISI Foundation, Turin, Italy
- CENTAI Institute, Turin, Italy
| | - Nicolò Gozzi
- ISI Foundation, Turin, Italy
- Networks and Urban Systems Centre, University of Greenwich, London, United Kingdom
| | - Nicola Perra
- Networks and Urban Systems Centre, University of Greenwich, London, United Kingdom
- School of Mathematical Sciences, Queen Mary University of London, London, United Kingdom
| | - Daniela Perrotta
- Laboratory of Digital and Computational Demography, Max Planck Institute for Demographic Research, Rostock, Germany
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8
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Wollburg P, Markhof Y, Kanyanda S, Zezza A. Assessing COVID-19 vaccine hesitancy and barriers to uptake in Sub-Saharan Africa. COMMUNICATIONS MEDICINE 2023; 3:121. [PMID: 37696937 PMCID: PMC10495410 DOI: 10.1038/s43856-023-00330-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/29/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Despite improved availability of COVID-19 vaccines in Sub-Saharan Africa, vaccination campaigns in the region have struggled to pick up pace and trail the rest of the world. Yet, a successful vaccination campaign in Sub-Saharan Africa will be critical to containing COVID-19 globally. METHODS Here, we present new descriptive evidence on vaccine hesitancy, uptake, last-mile delivery barriers, and potential strategies to reach those who remain unvaccinated. Our data comes from national high frequency phone surveys in six countries in East and West Africa with a total population of 415 million people. Samples were drawn from nationally representative samples of households interviewed in recent in-person surveys. Our estimates are based on a survey module harmonized across countries and are re-weighted to mitigate potential sample selection biases. RESULTS We show that vaccine acceptance remains generally high among respondents in Sub-Saharan Africa (between 95.1% and 63.3%) even though hesitancy is non-negligible among those pending vaccination. Many who are willing to get vaccinated are deterred by a lack of easy access to vaccines at the local level. Furthermore, social ties and perceptions as well as intra-household power relations matter for vaccine take-up. Among the unvaccinated population, radio broadcasts have widespread reach and medical professionals are highly trusted. CONCLUSIONS Our findings highlight that creating a positive social norm around COVID-19 vaccination, messaging that leverages trusted and accessible information sources and channels, and more easily accessible vaccination sites at the community level are promising policy options to boost vaccination campaigns in the region and end the pandemic everywhere.
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Affiliation(s)
| | - Yannick Markhof
- Development Data Group, World Bank, Washington, DC, USA
- UNU-MERIT, United Nations University, Maastricht, Netherlands
| | | | - Alberto Zezza
- Development Data Group, World Bank, Washington, DC, USA
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9
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Wollburg P, Markhof Y, Kanyanda S, Zezza A. The evolution of COVID-19 vaccine hesitancy in Sub-Saharan Africa: evidence from panel survey data. BMC Proc 2023; 17:8. [PMID: 37415169 DOI: 10.1186/s12919-023-00266-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND COVID-19 vaccination efforts are lagging in Sub-Saharan Africa, as just over 20 percent of the population has been fully vaccinated. COVID-19 vaccine hesitancy is considered important as a prerequisite for widespread vaccine take-up. Here, we study the dynamics of vaccine acceptance, its correlates, and reasons for hesitancy over time, drawing on two years of panel survey data. METHODS In this observational study, we use multiple rounds of data from national High Frequency Phone Surveys (HFPS) in five countries in East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering a period between 2020 and 2022. The surveys are cross-country comparable and draw their samples from nationally representative sampling frames. Based on this data source, the study presents population-weighted means and performs multivariate regression analysis. RESULTS COVID-19 vaccine acceptance was high throughout the study period (68% to 98%). However, acceptance levels were lower in 2022 than in 2020 in three countries (Burkina Faso, Malawi, Nigeria), and higher in one country (Uganda). Moreover, individuals are observed to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries (Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, Uganda). Vaccine hesitancy is higher in richer households, and those residing in urban areas; among women and those better educated. Hesitancy is lower in larger households and among heads of the household. The main reasons for hesitancy are concerns about side effects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, though these reasons fluctuate over time. CONCLUSIONS Reported COVID-19 vaccine acceptance levels remain far above vaccination rates in the study countries, suggesting that vaccine hesitancy is not the primary obstacle to reaching greater vaccine coverage, which may instead be related to access and delivery barriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts are needed to retain high levels of vaccine acceptance.
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Affiliation(s)
- Philip Wollburg
- World Bank, Development Economics Data Group, Washington, DC, USA.
| | - Yannick Markhof
- World Bank, Development Economics Data Group, Washington, DC, USA
- UNU-MERIT, United Nations University, Maastricht, Netherlands
| | | | - Alberto Zezza
- World Bank, Development Economics Data Group, Washington, DC, USA
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10
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Privor-Dumm L, Excler JL, Gilbert S, Abdool Karim SS, Hotez PJ, Thompson D, Kim JH. Vaccine access, equity and justice: COVID-19 vaccines and vaccination. BMJ Glob Health 2023; 8:e011881. [PMID: 37290896 PMCID: PMC10254992 DOI: 10.1136/bmjgh-2023-011881] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/16/2023] [Indexed: 06/10/2023] Open
Abstract
Although significant progress has been made in achieving goals for COVID-19 vaccine access, the quest for equity and justice remains an unfinished agenda. Vaccine nationalism has prompted calls for new approaches to achieve equitable access and justice not only for vaccines but also for vaccination. This includes ensuring country and community participation in global discussions and that local needs to strengthen health systems, address issues related to social determinants of health, build trust and leverage acceptance to vaccines, are addressed. Regional vaccine technology and manufacturing hubs are promising approaches to address access challenges and must be integrated with efforts to ensure demand. The current situation underlines the need for access, demand and system strengthening to be addressed along with local priorities for justice to be achieved. Innovations to improve accountability and leverage existing platforms are also needed. Sustained political will and investment is required to ensure ongoing production of non-pandemic vaccines and sustained demand, particularly when perceived threat of disease appears to be waning. Several recommendations are made to govern towards justice including codesigning the path forward with low-income and middle-income countries; establishing stronger accountability measures; establishing dedicated groups to engage with countries and manufacturing hubs to ensure that the affordable supply and predictable demand are in balance; addressing country needs for health system strengthening through leveraging existing health and development platforms and delivering on product presentations informed by country needs. Even if difficult, we must converge on a definition of justice well in advance of the next pandemic.
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Affiliation(s)
- Lois Privor-Dumm
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health International Vaccine Access Center, Baltimore, Maryland, USA
| | - Jean-Louis Excler
- Director General's Office, International Vaccine Institute, Seoul, Republic of Korea
| | - Sarah Gilbert
- Pandemic Sciences Institute, Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - Salim S Abdool Karim
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York, USA
- Centre for the Aids Programme of Research in South Africa, Durban, South Africa
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | - Jerome H Kim
- Director General's Office, International Vaccine Institute, Seoul, Republic of Korea
- Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Kutz JM, Rausche P, Gheit T, Puradiredja DI, Fusco D. Barriers and facilitators of HPV vaccination in sub-saharan Africa: a systematic review. BMC Public Health 2023; 23:974. [PMID: 37237329 PMCID: PMC10214362 DOI: 10.1186/s12889-023-15842-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Human Papilloma Virus (HPV) is the most common sexually transmitted infection worldwide. Globally, both men and women have a 50% risk of being infected at least once in their life. HPV prevalence is among the highest in sub-Saharan Africa (SSA), at an average of 24%. HPV causes different types of cancers, including cervical cancer (CC), which is the leading cause of cancer deaths among women in SSA. HPV-vaccination has been proven to be effective in reducing HPV induced cancers. SSA countries are delayed in reaching the WHO's target of fully vaccinating 90% of girls within the age of 15 by 2030. Our systematic review aims to identify barriers and facilitators of HPV-vaccination in SSA to inform national implementation strategies in the region. METHODS This is a mixed method systematic review based on the PRISMA statement and The Joanna Briggs Institute Reviewers' Manual. Search strategies were adapted to each selected database: PubMed/MEDLINE, Livivo, Google Scholar, Science Direct, and African Journals Online for papers published in English, Italian, German, French and Spanish between 1 December 2011 and 31 December 2021. Zotero and Rayyan were the software used for data management. The appraisal was conducted by three independent reviewers. RESULTS A total of 20 articles were selected for appraisal from an initial 536 articles. Barriers included: limited health system capacities, socio-economic status, stigma, fear and costs of vaccines, negative experience with vaccinations, COVID-19 pandemic, lack of correct information, health education (HE) and consent. Additionally, we found that boys are scarcely considered for HPV-vaccination by parents and stakeholders. Facilitators included: information and knowledge, policy implementation, positive experience with vaccinations, HE, stakeholders' engagement, women's empowerment, community engagement, seasonality, and target-oriented vaccination campaigns. CONCLUSIONS This review synthesizes barriers and facilitators of HPV-vaccinations in SSA. Addressing these can contribute to the implementation of more effective HPV immunization programs targeted at eliminating CC in line with the WHO 90/70/90 strategy. REGISTRATION AND FUNDING Protocol ID: CRD42022338609 registered in the International Prospective Register of Systematic Reviews (PROSPERO). Partial funds: German Centre for Infection research (DZIF) project NAMASTE: 8,008,803,819.
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Affiliation(s)
- Jean-Marc Kutz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Pia Rausche
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Tarik Gheit
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Dewi Ismajani Puradiredja
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany.
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany.
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12
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Ashour L, Schoumann-Alkhatib A, Alshawabkeh A, Alsouri M, Sawalmeh M, Hatamleh H, Sawahreh H. Highlighting the Need for MD-PhD Programs in Developing Countries. Avicenna J Med 2023; 13:65-67. [PMID: 37435555 PMCID: PMC10332939 DOI: 10.1055/s-0043-1768445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Affiliation(s)
- Laith Ashour
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | | | | | - Mohammad Alsouri
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | | | - Hamzeh Hatamleh
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Hamza Sawahreh
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
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13
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Cost effectiveness of fractional doses of COVID-19 vaccine boosters in India. MED 2023; 4:182-190.e3. [PMID: 36827972 PMCID: PMC9922587 DOI: 10.1016/j.medj.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/10/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) continues to be a major global public health crisis that exacts significant human and economic costs. Booster vaccination of individuals can improve waning immunity and reduce the impact of community epidemics. METHODS Using an epidemiological model that incorporates population-level severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and waning of vaccine-derived immunity, we identify the hypothetical potential of mass vaccination with fractionated vaccine doses specific to ChAdOx1 nCoV-19 (AZD1222 [Covishield]; AstraZeneca) as an optimal and cost-effective strategy in India's Omicron outbreak. FINDINGS We find that the optimal strategy is 1/8 fractional dosing under mild (Re ∼ 1.2) and rapid (Re ∼ 5) transmission scenarios, leading to an estimated $6 (95% confidence interval [CI]: -13, 26) billion and $2 (95% CI: -26, 30) billion in health-related net monetary benefit over 200 days, respectively. Rapid and broad use of fractional dosing for boosters, together with delivery costs divided by fractionation, could substantially gain more net monetary benefit by $11 (95% CI: -10, 33) and $2 (95% CI: -23, 28) billion, respectively, under the mild and rapid transmission scenarios. CONCLUSIONS Mass vaccination with fractional doses of COVID-19 vaccines to boost immunity in a vaccinated population could be a cost-effective strategy for mitigating the public health costs of resurgences caused by vaccine-evasive variants, and fractional dosing deserves further clinical and regulatory evaluation. FUNDING Financial support was provided by the AIR@InnoHK Program from Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region.
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14
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Kandeel A, Eldeyahy I, Abu ElSood H, Fahim M, Afifi S, Abu Kamar S, BahaaEldin H, Ahmed E, Mohsen A, Abdelghaffar K. COVID-19 vaccination coverage in Egypt: a large-scale national survey - to help achieving vaccination target, March-May, 2022. BMC Public Health 2023; 23:397. [PMID: 36849954 PMCID: PMC9969364 DOI: 10.1186/s12889-023-15283-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Only 57 countries have vaccinated 70% of their population against COVID-19, most of them in high-income countries, whereas almost one billion people in low-income countries remained unvaccinated. In March-May 2022, Egypt's Ministry of Health and Population (MoHP) conducted a nationwide community-based survey to determine COVID-19 vaccine coverage and people's perceptions of vaccination in order to improve COVID-19 vaccination uptake and confidence among Egyptians, as well as to prioritize interventions. METHODS A cross-sectional population-based household survey among Egyptians ≥ 18 years of age was implemented in two phases using a multistage random sampling technique in all of Egypt's 27 governorates. A sample of 18,000 subjects divided into 450 clusters of 20 households each was calculated in proportion to each governorate and the main occupation of the population. Participants were interviewed using a semistructured questionnaire that included demographics, vaccination information from the vaccination card, history of COVID-19 infection, reasons for vaccine refusal among the unvaccinated, and vaccination experience among vaccinated subjects. Vaccination coverage rates were calculated by dividing numbers by the total number of participants. Bivariate and multivariate analyses were performed by comparing the vaccinated and unvaccinated to identify the risk factors for low vaccine uptake. RESULTS Overall 18,107 were interviewed, their mean age was 42 ± 16 years and 58.8% were females. Of them, 8,742 (48.3%) had COVID-19 vaccine and 8,020 (44.3%) were fully vaccinated. Factors associated with low vaccination uptake by multivariate analysis included: age groups (18-29 and 30-39) (ORs 2.0 (95% C.I. 1.8-2.2) and 1.3 (95% C.I.1.2-1.4), respectively), residences in urban or frontier governorates (ORs 1.6 (95% C.I. 1.5-1.8) and 1.2 (95% C.I. 1.1-1.4), respectively), housewives and self-employed people (ORs 1.3 (95% C.I. 1.2-1.4) and 1.2 (95% C.I. 1.1-1.4), respectively), married people (ORs 1.3 (95% C.I. 1.2-1.4), and primary and secondary educated (ORs 1.1 (95% C.I. 1.01-1.2) and 1.1(1.04-1.2) respectively). Vaccine hesitancy was due to fear of adverse events (17.5%), mistrust of vaccine (10.2%), concern over safety during pregnancy and lactation (6.9%), and chronic diseases (5.0%). CONCLUSIONS Survey identified lower vaccination coverage in Egypt compared to the WHO 70% target. Communication programs targeting the groups with low vaccine uptake are needed to eliminate barriers related to vaccination convenience, side effects, and safety to effectively promote vaccine uptake. Findings from the survey could contribute significantly to vaccination promotion by guiding decision-making efforts on the risky groups and preventing vaccine hesitancy.
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Affiliation(s)
- Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Ibrahim Eldeyahy
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Hanaa Abu ElSood
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Public Health Consultant, Cairo, Egypt
| | | | - Hala BahaaEldin
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
| | - ElSabbah Ahmed
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Amira Mohsen
- Community Medicine Department, National Research Centre, Cairo, Egypt
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15
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Duroseau B, Kipshidze N, Limaye RJ. The impact of delayed access to COVID-19 vaccines in low- and lower-middle-income countries. Front Public Health 2023; 10:1087138. [PMID: 36711400 PMCID: PMC9878283 DOI: 10.3389/fpubh.2022.1087138] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction A majority of low-income (LIC) and lower-middle-income countries (LMIC) were unable to achieve at least 10% population coverage during initial vaccine rollouts, despite the rapid development of the coronavirus disease 2019 (COVID-19) vaccines. Nearly three years into this pandemic, evaluating the impact of inequities in vaccine access, uptake, and availability is long overdue. We hypothesized that a delay in receiving COVID-19 vaccines was associated with an increased toll on cumulative cases and mortality. Furthermore, this relationship was modified by the size of a country's economy. Methods We performed an ecological study assessing these relationships, in which a country's economic standing was assessed by world bank income classification, gross domestic product based on the purchasing power parity (GDP PPP) per capita category, and crude GDP PPP. Results Countries with the smallest economies reported first vaccination much later than larger economies on all three rankings, as much as 100 days longer. Among low-income countries, a one-day increase until the first vaccination was associated with a 1.92% (95% CI: 0.100, 3.87) increase in cumulative cases when compared to high-income countries (p = 0.0395) when adjusting for population size, median age, and testing data availability. Similarly, among the lowest GDP PPP countries a one-day increase until the first vaccination was associated with a 2.73% (95% CI: 0.100, 5.44) increase in cumulative cases when compared to the highest GDP PPP countries (p = 0.0415). When modeling cumulative mortality, effects in the same direction and magnitude were observed, albeit statistically non-significant. Conclusion Economic standing modified the effects of delayed access to COVID-19 vaccination on cumulative cases and mortality, in which LMICs tended to fare worse in outcomes than high-income countries despite the eventual rollout of vaccines. These findings highlight the importance of prioritizing equitable and timely access to COVID-19 vaccines across all countries, irrespective of economic size. Future studies should examine the impacts that vaccine inequities had on local transmission dynamics.
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Affiliation(s)
- Brenice Duroseau
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, Baltimore, MD, United States,*Correspondence: Brenice Duroseau ✉
| | - Nodar Kipshidze
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States,Nodar Kipshidze ✉
| | - Rupali Jayant Limaye
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States,International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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16
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Conducting CNS trials during a public health emergency – Lessons learned from the COVID-19 pandemic: A joint ISCTM/ECNP working group consensus paper. NEUROSCIENCE APPLIED 2023; 2:101129. [PMCID: PMC10275769 DOI: 10.1016/j.nsa.2023.101129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/27/2023] [Accepted: 06/09/2023] [Indexed: 12/11/2023]
Abstract
A joint working group between the International Society of CNS Clinical Trials and Methodology (ISCTM) and the European College of Neuropsychopharmacology (ECNP) was formed in the latter part of 2020 to explore possible ways to mitigate the impact of Coronavirus disease-19 (COVID-19) in clinical trials while attempting to advance approaches and capabilities to bring new therapeutics to patients. The working group was tasked with developing guidelines for trial design modifications to assist sponsor companies in minimizing risks to data integrity, with a focus on regulatory, technological, operational, and methodological issues related to COVID-19. To facilitate focused and transferable recommendations, three disease categories were selected as examples to demonstrate the breadth of solutions implemented across CNS clinical trials, as well as ongoing challenges. The categories studied reflected the interests and expertise of the working group, and included neurodegenerative diseases and dementia, mental health disorders, and rare/pediatric diseases. Herein, we describe interim recommendations from the working group as well as priorities for future public health emergencies, to inform permanent adoption in CNS clinical trial development and conduct.
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17
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Tong C, Shi Z, Shi W, Zhang A. How to control the spatiotemporal spread of Omicron in the region with low vaccination rates. Front Public Health 2022; 10:959076. [PMID: 36620235 PMCID: PMC9815609 DOI: 10.3389/fpubh.2022.959076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Currently, finding ways to effectively control the spread of Omicron in regions with low vaccination rates is an urgent issue. In this study, we use a district-level model for predicting the COVID-19 symptom onset risk to explore and control the whole process of spread of Omicron in South Africa at a finer spatial scale. We found that in the early stage of the accelerated spread, Omicron spreads rapidly from the districts at the center of human mobility to other important districts of the human mobility network and its peripheral districts. In the subsequent diffusion-contraction stage, Omicron rapidly spreads to districts with low human mobility and then mainly contracts to districts with the highest human mobility. We found that increasing daily vaccination rates 10 times mainly reduced the symptom onset risk in remote areas with low human mobility. Implementing Alert Level 5 in the three districts at the epicenter, and Alert Level 1 in the remaining 49 districts, the spatial spread related to human mobility was effectively restricted, and the daily onset risk in districts with high human mobility also decreased by 20-80%.
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Affiliation(s)
- Chengzhuo Tong
- The Department of Land Surveying and Geo-Informatics and Otto Poon Charitable Foundation Smart Cities Research Institute, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhicheng Shi
- School of Architecture and Urban Planning, Research Institute for Smart Cities, Shenzhen University, Shenzhen, China,*Correspondence: Zhicheng Shi
| | - Wenzhong Shi
- The Department of Land Surveying and Geo-Informatics and Otto Poon Charitable Foundation Smart Cities Research Institute, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Anshu Zhang
- The Department of Land Surveying and Geo-Informatics and Otto Poon Charitable Foundation Smart Cities Research Institute, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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18
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Kim J, Kim D, Baek K, Kim M, Kang BM, Maharjan S, Park S, Choi JK, Kim S, Kim YK, Park MS, Lee Y, Kwon HJ. Production of a Monoclonal Antibody to the Nucleocapsid Protein of SARS-CoV-2 and Its Application to ELISA-Based Detection Methods with Broad Specificity by Combined Use of Detector Antibodies. Viruses 2022; 15:28. [PMID: 36680068 PMCID: PMC9866944 DOI: 10.3390/v15010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
The coronavirus disease 2019 pandemic, elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is ongoing. Currently accessible antigen-detecting rapid diagnostic tests are limited by their low sensitivity and detection efficacy due to evolution of SARS-CoV-2 variants. Here, we produced and characterized an anti-SARS-CoV-2 nucleocapsid (N) protein-specific monoclonal antibody (mAb), 2A7H9. Monoclonal antibody 2A7H9 and a previously developed mAb, 1G10C4, have different specificities. The 2A7H9 mAb detected the N protein of S clade, delta, iota, and mu but not omicron, whereas the 1G10C4 antibody recognized the N protein of all variants under study. In a sandwich enzyme-linked immunosorbent assay, recombinant N protein bound to the 1G10C4 mAb could be detected by both 1G10C4 and 2A7H9 mAbs. Similarly, N protein bound to the 2A7H9 mAb was detected by both mAbs, confirming the existence of dimeric N protein. While the 1G10C4 mAb detected omicron and mu with higher efficiency than S clade, delta, and iota, the 2A7H9 mAb efficiently detected all the strains except omicron, with higher affinity to S clade and mu than others. Combined use of 1G10C4 and 2A7H9 mAb resulted in the detection of all the strains with considerable sensitivity, suggesting that antibody combinations can improve the simultaneous detection of virus variants. Therefore, our findings provide insights into the development and improvement of diagnostic tools with broader specificity and higher sensitivity to detect rapidly evolving SARS-CoV-2 variants.
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Affiliation(s)
- Jinsoo Kim
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Dongbum Kim
- Institute of Medical Science, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Kyeongbin Baek
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Minyoung Kim
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Bo Min Kang
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sony Maharjan
- Institute of Medical Science, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Sangkyu Park
- Department of Biochemistry, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Jun-Kyu Choi
- Department of Biochemistry, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Suyeon Kim
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
| | - Yong Kyun Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Man-Seong Park
- Department of Microbiology, College of Medicine, and the Institute for Viral Diseases, Korea University, Seoul 02841, Republic of Korea
| | - Younghee Lee
- Department of Biochemistry, College of Natural Sciences, Chungbuk National University, Cheongju 28644, Republic of Korea
| | - Hyung-Joo Kwon
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Institute of Medical Science, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
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Takasaki Y, Abizaid C, Coomes OT. COVID-19 contagion across remote communities in tropical forests. Sci Rep 2022; 12:20727. [PMID: 36456613 PMCID: PMC9713114 DOI: 10.1038/s41598-022-25238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Understanding COVID-19 contagion among poor populations is hampered by a paucity of data, and especially so in remote rural communities with limited access to transportation, communication, and health services. We report on the first study on COVID-19 contagion across rural communities without road access. We conducted telephone surveys with over 400 riverine communities in the Peruvian Amazon in the early phase of the pandemic. During the first wave (April-June, 2020), COVID-19 spread from cities to most communities through public and private river transportation according to their remoteness. The initial spread was delayed by transportation restrictions but at the same time was driven in unintended ways by government social assistance. During the second wave (August, 2020), although people's self-protective behaviors (promoted through communication access) helped to suppress the contagion, people responded to transportation restrictions and social assistance in distinct ways, leading to greater contagion among Indigenous communities than mestizo communities. As such, the spatial contagion during the early phase of the pandemic in tropical forests was shaped by river transportation and social behaviors. These novel findings have important implications for research and policies on pandemics in rural areas.
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Affiliation(s)
- Yoshito Takasaki
- grid.26999.3d0000 0001 2151 536XGraduate School of Economics, University of Tokyo, Tokyo, Japan
| | - Christian Abizaid
- grid.17063.330000 0001 2157 2938Department of Geography and Planning and School of the Environment, University of Toronto, Toronto, ON Canada
| | - Oliver T. Coomes
- grid.14709.3b0000 0004 1936 8649Department of Geography, McGill University, Montreal, QC Canada
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Makram AM, Phu Tran V, Elsheikh R, Hau NTH, Abd Gani SM, Huy NT. Is it still suitable to depend on AstraZeneca for COVID-19 vaccine donations to developing countries? Curr Med Res Opin 2022; 38:2127-2130. [PMID: 36164756 DOI: 10.1080/03007995.2022.2129233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Abdelrahman M Makram
- School of Public Health, Imperial College London, London, UK
- Faculty of Medicine, October 6 University, Giza, Egypt
- Online Research Club, Nagasaki, Japan
| | - Van Phu Tran
- Online Research Club, Nagasaki, Japan
- Department of Medicine, Tra Vinh University, Tra Vinh City, Vietnam
| | - Randa Elsheikh
- Faculty of Medicine, October 6 University, Giza, Egypt
- Online Research Club, Nagasaki, Japan
| | - Nguyen Thi Hien Hau
- Online Research Club, Nagasaki, Japan
- Faculty of Medicine, College of Medicine and Pharmacy, Duy Tan University, Da Nang City, Vietnam
- Institute for Research and Training in Medicine, Biology and Pharmacy, Duy Tan University, Da Nang City, Vietnam
| | - Siti Mariam Abd Gani
- Online Research Club, Nagasaki, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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21
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Gozzi N, Chinazzi M, Dean NE, Longini IM, Halloran ME, Perra N, Vespignani A. Estimating the impact of COVID-19 vaccine allocation inequities: a modeling study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.11.18.22282514. [PMID: 36415459 PMCID: PMC9681050 DOI: 10.1101/2022.11.18.22282514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Access to COVID-19 vaccines on the global scale has been drastically impacted by structural socio-economic inequities. Here, we develop a data-driven, age-stratified epidemic model to evaluate the effects of COVID-19 vaccine inequities in twenty lower middle and low income countries (LMIC) sampled from all WHO regions. We focus on the first critical months of vaccine distribution and administration, exploring counterfactual scenarios where we assume the same per capita daily vaccination rate reported in selected high income countries. We estimate that, in this high vaccine availability scenario, more than 50% of deaths (min-max range: [56% - 99%]) that occurred in the analyzed countries could have been averted. We further consider a scenario where LMIC had similarly early access to vaccine doses as high income countries; even without increasing the number of doses, we estimate an important fraction of deaths (min-max range: [7% - 73%]) could have been averted. In the absence of equitable allocation, the model suggests that considerable additional non-pharmaceutical interventions would have been required to offset the lack of vaccines (min-max range: [15% - 75%]). Overall, our results quantify the negative impacts of vaccines inequities and call for amplified global efforts to provide better access to vaccine programs in low and lower middle income countries.
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22
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Chavda VP, Vihol DR, Solanki HK, Apostolopoulos V. The Vaccine World of COVID-19: India’s Contribution. Vaccines (Basel) 2022; 10:vaccines10111943. [PMID: 36423038 PMCID: PMC9695423 DOI: 10.3390/vaccines10111943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) eruption has left not only illness and mortality in its wake, but also an overwhelming threat to health policy, human regality, food security, and struggle worldwide. The accessibility and potential distribution of a protective and successful vaccination to communities throughout the world are being considered now not just, as a potential of overcoming these hurdles, but also as an example of human perseverance in the face of catastrophe. A vaccine is the only tool that can efficaciously deal with the COVID-19 catastrophe. Currently, more than 47 vaccines are permitted for emergency use in distinct parts of the world. India will play a significant role in the development of the high-priced Moderna shots and Pfizer Inc, therefore assisting in the immunization of a large portion of the world. Moreover, many of the internationally researched and developed vaccine laboratories seek manufacturing in Indian firms and companies for efficient and low-cost production of vaccines intending to provide to the world, hence, making India, a major role player during these pandemic times. This review highlights the Indian contribution to the globe for COVID-19 management.
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Affiliation(s)
- Vivek P. Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad 380008, Gujarat, India
- Correspondence: (V.P.C.); (V.A.)
| | - Disha R. Vihol
- Pharmacy Section, Griffith University, Gold Coast, QLD 4215, Australia
| | - Hetvi K. Solanki
- Department of Pharmaceutics and Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad 380008, Gujarat, India
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3021, Australia
- Immunology Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
- Correspondence: (V.P.C.); (V.A.)
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Brito AF, Semenova E, Dudas G, Hassler GW, Kalinich CC, Kraemer MUG, Ho J, Tegally H, Githinji G, Agoti CN, Matkin LE, Whittaker C, Howden BP, Sintchenko V, Zuckerman NS, Mor O, Blankenship HM, de Oliveira T, Lin RTP, Siqueira MM, Resende PC, Vasconcelos ATR, Spilki FR, Aguiar RS, Alexiev I, Ivanov IN, Philipova I, Carrington CVF, Sahadeo NSD, Branda B, Gurry C, Maurer-Stroh S, Naidoo D, von Eije KJ, Perkins MD, van Kerkhove M, Hill SC, Sabino EC, Pybus OG, Dye C, Bhatt S, Flaxman S, Suchard MA, Grubaugh ND, Baele G, Faria NR. Global disparities in SARS-CoV-2 genomic surveillance. Nat Commun 2022; 13:7003. [PMID: 36385137 PMCID: PMC9667854 DOI: 10.1038/s41467-022-33713-y] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
Genomic sequencing is essential to track the evolution and spread of SARS-CoV-2, optimize molecular tests, treatments, vaccines, and guide public health responses. To investigate the global SARS-CoV-2 genomic surveillance, we used sequences shared via GISAID to estimate the impact of sequencing intensity and turnaround times on variant detection in 189 countries. In the first two years of the pandemic, 78% of high-income countries sequenced >0.5% of their COVID-19 cases, while 42% of low- and middle-income countries reached that mark. Around 25% of the genomes from high income countries were submitted within 21 days, a pattern observed in 5% of the genomes from low- and middle-income countries. We found that sequencing around 0.5% of the cases, with a turnaround time <21 days, could provide a benchmark for SARS-CoV-2 genomic surveillance. Socioeconomic inequalities undermine the global pandemic preparedness, and efforts must be made to support low- and middle-income countries improve their local sequencing capacity.
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Affiliation(s)
- Anderson F Brito
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
- Instituto Todos pela Saúde, São Paulo, SP, Brazil.
| | | | - Gytis Dudas
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Gabriel W Hassler
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Chaney C Kalinich
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | | | - Joses Ho
- GISAID Global Data Science Initiative, Munich, Germany
- Bioinformatics Institute & ID Labs, Agency for Science Technology and Research, Singapore, Singapore
| | - Houriiyah Tegally
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
| | - George Githinji
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Biochemistry and Biotechnology, Pwani University, Kilifi, Kenya
| | - Charles N Agoti
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Health and Human Sciences, Pwani University, Kilifi, Kenya
| | - Lucy E Matkin
- Department of Biology, University of Oxford, Oxford, UK
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK
| | | | | | | | | | | | | | | | | | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Vitali Sintchenko
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, NSW, Australia
- Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead, NSW, Australia
| | - Neta S Zuckerman
- Central Virology Laboratory, Israel Ministry of Health, Sheba Medical Center, Ramat Gan, Israel
| | - Orna Mor
- Central Virology Laboratory, Israel Ministry of Health, Sheba Medical Center, Ramat Gan, Israel
| | - Heather M Blankenship
- Michigan Department of Health and Human Services, Bureau of Laboratories, Lansing, MI, USA
| | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Raymond T P Lin
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Marilda Mendonça Siqueira
- Laboratory of Respiratory Viruses and Measles, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Paola Cristina Resende
- Laboratory of Respiratory Viruses and Measles, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Ana Tereza R Vasconcelos
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Fernando R Spilki
- Feevale University, Institute of Health Sciences, Novo Hamburgo, RS, Brazil
| | - Renato Santana Aguiar
- Laboratório de Biologia Integrativa, Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivan N Ivanov
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivva Philipova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Christine V F Carrington
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Nikita S D Sahadeo
- Department of Preclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Ben Branda
- GISAID Global Data Science Initiative, Munich, Germany
| | - Céline Gurry
- GISAID Global Data Science Initiative, Munich, Germany
| | - Sebastian Maurer-Stroh
- GISAID Global Data Science Initiative, Munich, Germany
- Bioinformatics Institute & ID Labs, Agency for Science Technology and Research, Singapore, Singapore
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Dhamari Naidoo
- Health Emergencies Programme, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Karin J von Eije
- Department of Medical Microbiology and Infection Prevention, Division of Clinical Virology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Emerging Diseases and Zoonoses Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Mark D Perkins
- Emerging Diseases and Zoonoses Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Maria van Kerkhove
- Emerging Diseases and Zoonoses Unit, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Ester C Sabino
- Instituto Todos pela Saúde, São Paulo, SP, Brazil
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Oliver G Pybus
- Department of Biology, University of Oxford, Oxford, UK
- Royal Veterinary College, Hawkshead, UK
| | | | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Seth Flaxman
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Marc A Suchard
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Nuno R Faria
- Department of Biology, University of Oxford, Oxford, UK.
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK.
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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ABO rs657152 and Blood Groups Are as Predictor Factors of COVID-19 Mortality in the Iranian Population. DISEASE MARKERS 2022; 2022:5988976. [PMID: 36419842 PMCID: PMC9678483 DOI: 10.1155/2022/5988976] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/07/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
Several studies have discovered a relationship between specific blood types, genetic variations of the ABO gene, and coronavirus disease 2019 (COVID-19). Therefore, the aim of this study was to evaluate the association between ABO rs657152 polymorphisms and ABO blood groups with COVID-19 mortality. The tetraprimer amplification refractory mutation system, polymerase chain reaction method, was used for ABO rs657152 polymorphism genotyping in 1,211 dead and 1,442 improved patients. In the current study, the frequency of ABO rs657152 AA than CC genotypes was significantly higher in dead patients than in improved patients. Our findings indicated that blood type A was associated with the highest risk of COVID-19 mortality compared to other blood groups, and patients with blood type O have a lower risk of infection, suggesting that blood type O may be a protective factor against COVID-19 mortality. Multivariate logistic regression test indicated that higher COVID-19 mortality rates were linked with alkaline phosphatase, alanine aminotransferase, high density lipoprotein, low-density lipoprotein, fasting blood glucose, uric acid, creatinine, erythrocyte sedimentation rate, C-reactive protein, 25-hydroxyvitamin D, real-time PCR Ct values, ABO blood groups, and ABO rs657152 AA genotype. In conclusion, the AA genotype of ABO rs657152 and blood type A were associated with a considerably increased frequency of COVID-19 mortality. Further research is necessary to validate the obtained results.
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Sanghvi HA, Patel RH, Agarwal A, Gupta S, Sawhney V, Pandya AS. A deep learning approach for classification of COVID and pneumonia using DenseNet-201. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2022; 33:IMA22812. [PMID: 36249091 PMCID: PMC9537800 DOI: 10.1002/ima.22812] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/24/2022] [Accepted: 09/09/2022] [Indexed: 05/27/2023]
Abstract
In the present paper, our model consists of deep learning approach: DenseNet201 for detection of COVID and Pneumonia using the Chest X-ray Images. The model is a framework consisting of the modeling software which assists in Health Insurance Portability and Accountability Act Compliance which protects and secures the Protected Health Information . The need of the proposed framework in medical facilities shall give the feedback to the radiologist for detecting COVID and pneumonia though the transfer learning methods. A Graphical User Interface tool allows the technician to upload the chest X-ray Image. The software then uploads chest X-ray radiograph (CXR) to the developed detection model for the detection. Once the radiographs are processed, the radiologist shall receive the Classification of the disease which further aids them to verify the similar CXR Images and draw the conclusion. Our model consists of the dataset from Kaggle and if we observe the results, we get an accuracy of 99.1%, sensitivity of 98.5%, and specificity of 98.95%. The proposed Bio-Medical Innovation is a user-ready framework which assists the medical providers in providing the patients with the best-suited medication regimen by looking into the previous CXR Images and confirming the results. There is a motivation to design more such applications for Medical Image Analysis in the future to serve the community and improve the patient care.
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Affiliation(s)
| | - Riki H. Patel
- Department of CEECSFlorida Atlantic UniversityBoca RatonFloridaUSA
| | - Ankur Agarwal
- Department of CEECSFlorida Atlantic UniversityBoca RatonFloridaUSA
| | - Shailesh Gupta
- Department of Clinical Trials and ResearchSpecialty Retina CenterCoral SpringsFloridaUSA
| | - Vivek Sawhney
- Department of Clinical Trials and ResearchSpecialty Retina CenterCoral SpringsFloridaUSA
| | - Abhijit S. Pandya
- Department of CEECSFlorida Atlantic UniversityBoca RatonFloridaUSA
- Department of Clinical Trials and ResearchSpecialty Retina CenterCoral SpringsFloridaUSA
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26
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Wang T, Xu J, Wang B, Wang Y, Zhao W, Xiang B, Xue Y, Yuan Q, Wang Y. Receptor-binding domain-anchored peptides block binding of severe acute respiratory syndrome coronavirus 2 spike proteins with cell surface angiotensin-converting enzyme 2. Front Microbiol 2022; 13:910343. [PMID: 36177466 PMCID: PMC9513850 DOI: 10.3389/fmicb.2022.910343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background The COVID-19 pandemic has killed over 6 million people worldwide. Despite the accumulation of knowledge about the causative pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pathogenesis of this disease, cures remain to be discovered. We searched for certain peptides that might interfere with spike protein (S protein)-angiotensin-converting enzyme 2 (ACE2) interactions. Methods Phage display (PhD)-12 peptide library was screened against recombinant spike trimer (S-trimer) or receptor-binding domain (S-RBD) proteins. The resulting enriched peptide sequences were obtained, and their potential binding sites on S-trimer and S-RBD 3D structure models were searched. Synthetic peptides corresponding to these and other reference sequences were tested for their efficacy in blocking the binding of S-trimer protein onto recombinant ACE2 proteins or ACE2-overexpressing cells. Results After three rounds of phage selections, two peptide sequences (C2, DHAQRYGAGHSG; C6, HWKAVNWLKPWT) were enriched by S-RBD, but only C2 was present in S-trimer selected phages. When the 3D structures of static monomeric S-RBD (6M17) and S-trimer (6ZGE, 6ZGG, 7CAI, and 7CAK, each with different status of S-RBDs in the three monomer S proteins) were scanned for potential binding sites of C2 and C6 peptides, C6 opt to bind the saddle of S-RBD in both 6M17 and erected S-RBD in S-trimers, but C2 failed to cluster there in the S-trimers. In the competitive S-trimer-ACE2-binding experiments, synthetic C2 and C6 peptides inhibited S-trimer binding onto 293T-ACE2hR cells at high concentrations (50 μM) but not at lower concentrations (10 μM and below), neither for the settings of S-trimer binding onto recombinant ACE2 proteins. Conclusion Using PhD methodology, two peptides were generated bearing potentials to interfere with S protein-ACE2 interaction, which might be further exploited to produce peptidomimetics that block the attachment of SARS-CoV-2 virus onto host cells, hence diminishing the pathogenesis of COVID-19.
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Affiliation(s)
- Ting Wang
- Oncology Department of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jie Xu
- Central Laboratory, Xiang’an Hospital of Xiamen University, Xiang’an University Medical Center, Xiamen University, Xiamen, Fujian, China
- Eye Institute of Xiamen University, Medical College, Xiamen University, Xiamen, Fujian, China
| | - Beibei Wang
- Center for Advanced Materials Research, Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai, Guangdong, China
| | - Yulian Wang
- Eye Institute of Xiamen University, Medical College, Xiamen University, Xiamen, Fujian, China
| | - Wei Zhao
- Eye Institute of Xiamen University, Medical College, Xiamen University, Xiamen, Fujian, China
| | - Bin Xiang
- Ministry of Education (MOE) Key Laboratory of Protein Sciences, Department of Basic Medical Sciences, School of Medicine, Tsinghua University, Beijing, China
| | - Yuhua Xue
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, China
| | - Quan Yuan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Yiqiang Wang
- Central Laboratory, Xiang’an Hospital of Xiamen University, Xiang’an University Medical Center, Xiamen University, Xiamen, Fujian, China
- Wisdom Lake Academy of Pharmacy, Xi’an Jiaotong-Liverpool University, Suzhou, Jiangsu, China
- *Correspondence: Yiqiang Wang,
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T-Cell Responses Induced by an Intradermal BNT162b2 mRNA Vaccine Booster Following Primary Vaccination with Inactivated SARS-CoV-2 Vaccine. Vaccines (Basel) 2022; 10:vaccines10091494. [PMID: 36146571 PMCID: PMC9501140 DOI: 10.3390/vaccines10091494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
A practical booster vaccine is urgently needed to control the coronavirus disease (COVID-19) pandemic. We have previously reported the safety and immunogenicity of a fractional intradermal booster, using the BNT162b2 mRNA vaccine in healthy volunteers who had completed two doses of inactivated SARS-CoV-2 vaccine. In this study, an intramuscular booster at full dosage was used as a control, and a half-dose vaccination was included for reciprocal comparison. Detailed T-cell studies are essential to understand cellular responses to vaccination. T-cell immunity was examined using S1 peptide restimulation and flow cytometry. The fractional dose (1:5) of the BNT162b2 mRNA vaccine enhanced antigen-specific effector T-cells, but the responses were less remarkable compared to the intramuscular booster at full dosage. However, the intradermal regimen was not inferior to the intramuscular booster a month after boosting. An intradermal booster using only one-fifth of the standard dosage could provide comparable T-cell responses with the fractional intramuscular booster. This work confirms the efficacy of intradermal and fractional vaccination in terms of T-cell immunogenicity in previously immunised populations.
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Ameratunga R, Leung E, Woon ST, Chan L, Steele R, Lehnert K, Longhurst H. SARS-CoV-2 Omicron: Light at the End of the Long Pandemic Tunnel or Another False Dawn for Immunodeficient Patients? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2267-2273. [PMID: 35752434 PMCID: PMC9220855 DOI: 10.1016/j.jaip.2022.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022]
Abstract
COVID-19 has had a disastrous impact on the world. Apart from at least 6 million deaths, countless COVID-19 survivors are suffering long-term physical and psychiatric morbidity. Hundreds of millions have been plunged into poverty caused by economic misery, particularly in developing nations. Early in the pandemic, it became apparent certain groups of individuals such as the elderly and those with comorbidities were more likely to suffer severe disease. In addition, patients with some forms of immunodeficiency, including those with T-cell and innate immune defects, were at risk of poor outcomes. Patients with immunodeficiencies are also disadvantaged as they may not respond optimally to COVID-19 vaccines and often have pre-existing lung damage. SARS-CoV-2 Omicron (B.1.529) and its subvariants (BA.1, BA.2, etc) have emerged recently and are dominating COVID-19 infections globally. Omicron is associated with a reduced risk of hospitalization and appears to have a lower case fatality rate compared with previous SARS-CoV-2 variants. Omicron has offered hope the pandemic may finally be coming to an end, particularly for vaccinated, healthy individuals. The situation is less clear for individuals with vulnerabilities, particularly immunodeficient patients. This perspective offers insight into potential implications of the SARS-CoV-2 Omicron variant for patients with immunodeficiencies.
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Affiliation(s)
- Rohan Ameratunga
- Department of Clinical immunology, Auckland Hospital, Auckland, New Zealand; Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand; Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. E%
| | - Euphemia Leung
- Maurice Wilkins Centre, School of Biological Sciences, University of Auckland, Auckland, New Zealand; Auckland Cancer Society Research Centre, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - See-Tarn Woon
- Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand; Department of Molecular Medicine and Pathology, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lydia Chan
- Department of Clinical immunology, Auckland Hospital, Auckland, New Zealand
| | - Richard Steele
- Department of Virology and Immunology, Auckland Hospital, Auckland, New Zealand; Department of Respiratory Medicine, Wellington Hospital, Wellington, New Zealand
| | - Klaus Lehnert
- Maurice Wilkins Centre, School of Biological Sciences, University of Auckland, Auckland, New Zealand; School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Hilary Longhurst
- Department of Clinical immunology, Auckland Hospital, Auckland, New Zealand; Department of Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Takasaki Y, Coomes OT, Abizaid C. COVID-19 information and self-protective behaviors among rural communities in tropical forests. BMC Public Health 2022; 22:1394. [PMID: 35858862 PMCID: PMC9299405 DOI: 10.1186/s12889-022-13772-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background Health risk communication plays a key role in promoting self-protective measures, which are critical in suppressing COVID-19 contagion. Relatively little is known about the communication channels used by rural poor populations to learn novel measures and their effectiveness in promoting self-protective behaviors. Behavioral change can be shaped by people’s trust in government institutions which may be differentiated by social identity, including indigeneity. Methods During an early phase of the pandemic, we conducted two telephone surveys with over 460 communities – both Indigenous and mestizo – without road access and limited communication access in the Peruvian Amazon. This is the first report on the association of information sources about self-protective measures against COVID-19 with the adoption of self-protective behaviors in remote rural areas in developing countries. Results People mainly relied on mass media (radio, television, newspapers) and interpersonal sources (local authorities, health workers, neighbors/relatives) for information and adopted handwashing, mask-wearing, social distancing, and social restrictions to varying degrees. Overall, self-protective behaviors were largely positively and negatively associated with mass media and interpersonal sources, respectively, depending on the source-measure combination. Mistrust of the government seems to have shaped how Indigenous and mestizo peoples distinctively responded to interpersonal information sources and relied on mass media. Conclusions Our findings call for improved media access to better manage pandemics in rural areas, especially among remote Indigenous communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13772-y.
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Affiliation(s)
- Yoshito Takasaki
- Graduate School of Economics, University of Tokyo, Tokyo, Japan.
| | - Oliver T Coomes
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Christian Abizaid
- Department of Geography & Planning and School of the Environment, University of Toronto, Toronto, ON, Canada
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30
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Sethy G, Chisema M, Sharma L, Joshi K, Singhal S, Omar Nicks P, Macheso S, Damte T, Eleonore Ba A, Mitambo C, Thomas M, Laher B, Phuka J. COVID-19 vaccine express strategy in Malawi: An effort to reach the un-reach. Vaccine 2022; 40:5089-5094. [PMID: 35871867 PMCID: PMC9291406 DOI: 10.1016/j.vaccine.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
Objectives To establish the impact of “Covid-19 Vaccination express” (CVE) on vaccine uptake in Malawi Design Retrospective cross-sectional study to compare the daily vaccine administration rate in CVE and routine covid vaccination (RCV). RCV data was collected from March 2021 to October 2021. The data regarding CVE was collected from 5 November 2021 to 31 December 2021. Data was collected regarding (1) the total number and type of vaccine doses administered and (2) Demographic details like age, gender, occupation, presence of comorbidities, the first dose, or the second dose of the people who received a vaccine. Results From March-December 2021, a total of 1,866,623 COVID-19 vaccine doses were administered, out of which 1,290,145 doses were administered at a mean daily vaccination rate of 1854 (95% CI: 1292-2415) doses as a part of RCV, and 576,478 doses were administered at a mean daily vaccination rate of 3312 (95% CI: 2377-4248) doses as a part of CVE. Comparing the mean daily doses (Astra Zeneca, AZ doses 1 & 2) administered in the CVE and RCV showed that the mean daily doses of AZ vaccine administered were significantly higher in the CVE (p<0.05). Conclusion CVE successfully increased the uptake of the Covid-19 vaccine.
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Affiliation(s)
| | | | | | - Krupal Joshi
- Department of Community and Family Medicine, All India Institute of Medical Science -Rajkot, Gujarat, India.
| | - Sanjay Singhal
- Department of Pulmonary Medicine, All India Institute of Medical Science -Rajkot, Gujarat, India
| | | | | | - Tedla Damte
- UNICEF Country Office, Malawi; LIKA UFPE, Brazil
| | | | | | - Mavuto Thomas
- Health Education Services, Ministry of Health, Malawi
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31
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Reza HM, Agarwal V, Sultana F, Bari R, Mobarak AM. Why are vaccination rates lower in low and middle income countries, and what can we do about it? BMJ 2022; 378:e069506. [PMID: 35830982 DOI: 10.1136/bmj-2021-069506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Hasan Mahmud Reza
- Department of Pharmaceutical Sciences, North South University, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Vaishnavi Agarwal
- Yale Research Initiative on Innovation and Scale (Y-RISE), New Haven, USA
| | - Farhana Sultana
- Department of Political Science and Sociology, North South University, Bashundhara R/A, Dhaka 1229, Bangladesh
| | - Razmin Bari
- College of Arts and Sciences, University of North Carolina at Chapel Hill, North Carolina, USA
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Liu Z, Gao L, Xue C, Zhao C, Liu T, Tia A, Wang L, Sun J, Li Z, Harding D. Epidemiological Trends of Coronavirus Disease 2019 in Sierra Leone From March 2020 to October 2021. Front Public Health 2022; 10:949425. [PMID: 35844842 PMCID: PMC9276960 DOI: 10.3389/fpubh.2022.949425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), a serious public health challenge the world over, has led to significant health concerns in Sierra Leone. In the present study, epidemic indices, such as the number of cases, positivity rate, reproduction rate (R0), case fatality rate (CFR), age, and sex, were used to characterize the epidemiological trends of COVID-19. As of October 31, 2021, a total of 6,398 cases and 121 related deaths had been confirmed. The total number of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests conducted to October 31, 2021, was 249,534, and the average positivity rate was 2.56%. Three waves of COVID-19 were recorded, occurring during weeks 15–46 in 2020 (2,369 cases), week 47 in 2020 to week 16 in 2021 (1,665 cases), and weeks 17–43 in 2021 (2,364 cases), respectively. Remarkably, there was no increase in the numbers of confirmed COVID-19 cases despite rising test numbers throughout the three waves. Moreover, three high R0 values were observed before each wave. The number of positive cases significantly correlated with positive numbers of international arrivals (P < 0.01), deaths (P < 0.01), and the positivity rate of tested samples (P < 0.01). Moreover, all of the deaths occurred during the peak of the three waves. Our results indicate that there was a low level of COVID-19 epidemic in Sierra Leone and that COVID-19's introduction led to local transmission. It is vital to fight against the spread of SARS-CoV-2 from the source of origin by strengthening testing and management of people entering the country. Our findings will provide important clues for expanding sample screening and will contribute to the reasonable allocation of medical resources.
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Affiliation(s)
- Zhiguo Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Liping Gao
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chuizhao Xue
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Chunchun Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Tiezhu Liu
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alie Tia
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Lili Wang
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junling Sun
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Junling Sun
| | - Zhenjun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Zhenjun Li
| | - Doris Harding
- Central Public Health Reference Laboratories, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Doris Harding
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