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Dahal S, Delgado I, Sattenspiel L, Mamelund SE, Chowell G. Comparative analysis of COVID-19 diagnoses and mortality among hospitalized indigenous and non-indigenous populations in Chile: 2020-2021. BMC Public Health 2024; 24:2337. [PMID: 39198791 PMCID: PMC11351375 DOI: 10.1186/s12889-024-19756-4] [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: 11/03/2023] [Accepted: 08/12/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Current literature presents mixed effects of the COVID-19 pandemic on Indigenous communities. We aim to highlight potential disparities and temporal shifts in both the impact of COVID-19 and vaccine uptake among hospitalized Indigenous populations in Chile. METHODS We conducted an observational analysis utilizing 1,598,492 hospitalization records from 2020 to 2021 based on publicly accessible hospital discharge data spanning 65 healthcare facilities of medium and high complexity funded through the Diagnosis-Related Groups (DRG) mechanism in Chile, representing roughly 70% of the country's total hospitalizations. This was supplemented with publicly available municipal data on COVID-19 vaccinations and socio-demographic variables. We performed logistic regression analysis at 0.05 level of significance to assess the bivariate and multivariable association of Indigenous status with COVID-19 diagnosis and COVID-19 deaths among hospitalized populations. We also performed univariate and multiple linear regression to assess the association of COVID-19 vaccination rate and Indigenous status at the municipality level. In addition, we report the distribution of top 10 secondary diagnoses among hospitalized COVID-19 cases and deaths separately for Indigenous and non-Indigenous populations. RESULTS Indigenous populations displayed lower adjusted odds for both COVID-19 diagnosis (OR: 0.76, 95% CI: 0.74, 0.77) and death (OR: 0.91, 95% CI: 0.85, 0.97) when compared to non-Indigenous groups. Notably, the adjusted odds ratio for COVID-19 diagnosis in Indigenous populations rose from 0.59 (95% CI: 0.57, 0.61) in 2020 to 1.17 (95% CI: 1.13, 1.21) in 2021. Factors such as the significantly higher median age and greater number of comorbidities in the non-Indigenous hospitalized groups could account for their increased odds of COVID-19 diagnosis and mortality. Additionally, our data indicates a significantly negative adjusted association between COVID-19 vaccination rates and the proportion of Indigenous individuals. CONCLUSION Although Indigenous populations initially showed lower odds of COVID-19 diagnosis and mortality, a marked rise in diagnosis odds among these groups in 2021 underscores the urgency of targeted interventions. The observed negative association between the proportion of Indigenous populations and vaccination rates further underscores the necessity to tackle vaccine access barriers and work towards equitable distribution.
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Affiliation(s)
- Sushma Dahal
- School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - Iris Delgado
- Center for Epidemiology and Health Policies, Faculty of Medicine, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society (PANSOC), Oslo Metropolitan University, Oslo, Norway.
| | - Gerardo Chowell
- School of Public Health, Georgia State University, Atlanta, GA, USA
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2
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Nygaard IH, Dahal S, Chowell G, Sattenspiel L, Sommerseth HL, Mamelund SE. Age-specific mortality and the role of living remotely: The 1918-20 influenza pandemic in Kautokeino and Karasjok, Norway. Int J Circumpolar Health 2023; 82:2179452. [PMID: 36876885 PMCID: PMC9970246 DOI: 10.1080/22423982.2023.2179452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
The 1918-20 pandemic influenza killed 50-100 million people worldwide, but mortality varied by ethnicity and geography. In Norway, areas dominated by Sámi experienced 3-5 times higher mortality than the country's average. We here use data from burial registers and censuses to calculate all-cause excess mortality by age and wave in two remote Sámi areas of Norway 1918-20. We hypothesise that geographic isolation, less prior exposure to seasonal influenza, and thus less immunity led to higher Indigenous mortality and a different age distribution of mortality (higher mortality for all) than was typical for this pandemic in non-isolated majority populations (higher young adult mortality & sparing of the elderly). Our results show that in the fall of 1918 (Karasjok), winter of 1919 (Kautokeino), and winter of 1920 (Karasjok), young adults had the highest excess mortality, followed by also high excess mortality among the elderly and children. Children did not exhibit excess mortality in the second wave in Karasjok in 1920. It was not the young adults alone who produced the excess mortality in Kautokeino and Karasjok. We conclude that geographic isolation caused higher mortality among the elderly in the first and second waves, and among children in the first wave.
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Affiliation(s)
- Ingrid Hellem Nygaard
- Department of Archaeology, History, Religious Studies and Theology, University of Tromsø - the Arctic University of Norway, Norway
| | - Sushma Dahal
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Gerardo Chowell
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Lisa Sattenspiel
- College of Arts and Science, University of Missouri, Columbia, MO, USA
| | - Hilde Leikny Sommerseth
- Department of Archaeology, History, Religious Studies and Theology, University of Tromsø - the Arctic University of Norway, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society (PANSOC), Oslo Metropolitan University, Norway
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3
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Lee NR, King A, Vigil D, Mullaney D, Sanderson PR, Ametepee T, Hammitt LL. Infectious diseases in Indigenous populations in North America: learning from the past to create a more equitable future. THE LANCET. INFECTIOUS DISEASES 2023; 23:e431-e444. [PMID: 37148904 PMCID: PMC10156139 DOI: 10.1016/s1473-3099(23)00190-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 05/08/2023]
Abstract
The COVID-19 pandemic, although a profound reminder of endured injustices by and the disparate impact of infectious diseases on Indigenous populations, has also served as an example of Indigenous strength and the ability to thrive anew. Many infectious diseases share common risk factors that are directly tied to the ongoing effects of colonisation. We provide historical context and case studies that illustrate both challenges and successes related to infectious disease mitigation in Indigenous populations in the USA and Canada. Infectious disease disparities, driven by persistent inequities in socioeconomic determinants of health, underscore the urgent need for action. We call on governments, public health leaders, industry representatives, and researchers to reject harmful research practices and to adopt a framework for achieving sustainable improvements in the health of Indigenous people that is both adequately resourced and grounded in respect for tribal sovereignty and Indigenous knowledge.
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Affiliation(s)
- Naomi R Lee
- Department of Chemistry and Biochemistry, Northern Arizona University, Flagstaff, AZ, USA
| | - Alexandra King
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Deionna Vigil
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dustin Mullaney
- Department of Biology, Northern Arizona University, Flagstaff, AZ, USA
| | - Priscilla R Sanderson
- Department of Health Sciences, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, USA
| | - Taiwo Ametepee
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Laura L Hammitt
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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4
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Alves DE, Rogeberg O, Sattenspiel L, Mamelund S. Indigenous communities and influenza: protocol for a systematic review and meta-analysis. Syst Rev 2023; 12:151. [PMID: 37644574 PMCID: PMC10466723 DOI: 10.1186/s13643-023-02319-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/11/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Several studies have documented that specific Indigenous groups have been disproportionately affected by previous pandemics. The objective of this paper is to describe the protocol to be used in a review and meta-analysis of the literature on Indigenous groups and influenza. Using this protocol as a guide, a future study will provide a comprehensive historical overview of pre-COVID impact of influenza on Indigenous groups by combining data from the last five influenza pandemics and seasonal influenza up to date. METHODS/PRINCIPLE FINDINGS The review will include peer-reviewed original studies published in English, Spanish, Portuguese, Swedish, Danish, and Norwegian. Records will be identified through systematic literature search in eight databases: Embase, MEDLINE, CINAHL, Web of Science, Academic Search Ultimate, SocINDEX, ASSIA, and Google Scholar. Results will be summarized narratively and using meta-analytic strategies. DISCUSSION To our knowledge, there is no systematic review combining historical data on the impact of both seasonal and pandemic influenza on Indigenous populations. By summarizing results within and across Indigenous groups, different countries, and historical periods, as well as research in six different languages, we aim to provide information on how strong the risk for influenza is among Indigenous groups and how consistent this risk is across groups, regions, time, and seasonal versus the specific pandemic influenza strains. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021246391.
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Affiliation(s)
- D E Alves
- Work Research Institute and Centre for Research on Pandemics and Society, OsloMet - Oslo Metropolitan University, Oslo, Norway.
| | - O Rogeberg
- Frisch Center, University of Oslo, Oslo, Norway
| | - L Sattenspiel
- Department of Anthropology, University of Missouri, Columbia, MO, USA
| | - S Mamelund
- Centre for Research on Pandemics and Society, OsloMet - Oslo Metropolitan University, Oslo, Norway
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5
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Crooks K, Law C, Taylor K, Brett K, Murray P, Kohlhagen J, Hope K, Durrheim DN. Embedding Aboriginal cultural governance, capacity, perspectives and leadership into a local Public Health Unit Incident Command System during COVID-19 in New South Wales, Australia. BMJ Glob Health 2023; 8:e012709. [PMID: 37460245 PMCID: PMC10357298 DOI: 10.1136/bmjgh-2023-012709] [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: 04/28/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
This case study describes the development and implementation of a governance structure that prioritised First Nations peoples in a local public health Incident Command System activated for the COVID-19 pandemic response in New South Wales, Australia. Using lessons learnt from past pandemics and planning exercises, public health leaders embedded an approach whereby First Nations peoples determined and led community and culturally informed pandemic control strategies and actions.In March 2020, First Nations governance was embedded into the local public health emergency response to COVID-19 in the Hunter New England region of New South Wales, Australia, enabling First Nations staff and community members to actively participate in strategic and operational decision-making with the objective of minimising COVID-19-related risks to First Nations peoples and communities. The model provided cultural insight and oversight to the local COVID-19 response; strengthened and advanced First Nations leadership; increased the First Nations public health workforce; led the development of First Nations disease surveillance strategies; and supported working groups to appropriately respond to local needs and priorities. This model demonstrates the feasibility of reframing a standard Incident Command System to embed and value First Nations principles of self-determination and empowerment to appropriately plan and respond to public health emergencies.
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Affiliation(s)
- Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Charlee Law
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Kylie Taylor
- Population Health, Hunter New England Local Health District, Tamworth, New South Wales, Australia
| | - Katie Brett
- Population Health, Hunter New England Local Health District, Tamworth, New South Wales, Australia
| | - Peter Murray
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Julie Kohlhagen
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Kirsty Hope
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - David N Durrheim
- Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
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Pickering K, Galappaththi EK, Ford JD, Singh C, Zavaleta-Cortijo C, Hyams K, Miranda JJ, Arotoma-Rojas I, Togarepi C, Kaur H, Arvind J, Scanlon H, Namanya DB, Anza-Ramirez C. Indigenous peoples and the COVID-19 pandemic: a systematic scoping review. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2023; 18:033001. [PMID: 36798651 PMCID: PMC9923364 DOI: 10.1088/1748-9326/acb804] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 02/01/2023] [Indexed: 05/06/2023]
Abstract
Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few (<2%) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To 'build back better' we must address these knowledge gaps.
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Affiliation(s)
- Kerrie Pickering
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Eranga K Galappaththi
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Chandni Singh
- School of Environment and Development, Indian Institute for Human Settlements, Bangalore, India
| | - Carol Zavaleta-Cortijo
- Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Keith Hyams
- Department of Politics and International Studies, University of Warwick, Coventry, United Kingdom
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ingrid Arotoma-Rojas
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Cecil Togarepi
- Department of Animal Production, Agribusiness and Economics, School of Agriculture and Fisheries Sciences, University of Namibia, Windhoek, Namibia
| | - Harpreet Kaur
- Indian Institute for Human Settlements, Bangalore, India
| | | | - Halena Scanlon
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Didacus B Namanya
- Ministry of Health, Uganda National Health Research Organisation, Entebbe, Uganda
| | - Cecilia Anza-Ramirez
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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7
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Risk perception, adaptation, and resilience during the COVID-19 pandemic in Southeast Alaska Natives. Soc Sci Med 2023; 317:115609. [PMID: 36525784 PMCID: PMC9734070 DOI: 10.1016/j.socscimed.2022.115609] [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: 08/03/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Indigenous communities worldwide are at higher risk of negative pandemic outcomes, and communities Indigenous to the Arctic are disproportionately affected compared to national majorities. Despite this, their experiences have scarcely been investigated qualitatively and from their own perspectives. We collected and analyzed 22 structured interviews in three Southeast Alaska island communities (Sitka, Hoonah, and Kake) to learn about their perceptions of and experiences with the COVID-19 pandemic. Interviews were analyzed with thematic qualitative analysis in Dedoose. Four primary categories were identified within which to discuss risk and resilience in Southeast Alaska: (1) risk perception, (2) socioeconomic impacts, (3) reactions to public health guidelines, and (4) coping. Primary findings indicate that Southeast Alaska Native communities display considerable resilience and adaptive flexibility despite the significant adversity imposed by the COVID-19 pandemic. Southeast Alaska Native people use historical and traditional knowledge to culturally ground adaptive behaviors to cope with the threat of COVID-19. Interviewees expressed that adaptive, community-centered, and non-individualistic behaviors strongly tied to Native culture minimized the negative epidemiological impacts of the pandemic. Future research can more deeply explore the root causes of the need for adaptiveness and resilience, such as histories of colonialism and marginalization, to emergency situations in Indigenous communities.
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Gonzalez M, Zeidan J, Lai J, Yusuf A, Wright N, Steiman M, Karpur A, Shih A, Elsabbagh M, Shikako K. Socio-demographic disparities in receipt of clinical health care services during the COVID-19 pandemic for Canadian children with disability. BMC Health Serv Res 2022; 22:1434. [PMID: 36443767 PMCID: PMC9706900 DOI: 10.1186/s12913-022-08672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Little is known about the experience of receiving in-person and virtual clinical health care services during the COVID-19 pandemic for Canadian children with developmental disabilities and delays facing multiple layers of vulnerability (e.g., low income, low educational attainment families). We examined the relationship between socio-demographic factors and the receipt of these services (physical and mental health services) during COVID-19 for Canadian children with these conditions. METHODS Data collected in Canada for the Global Report on Developmental Delays, Disorders and Disabilities were used. The survey: (1) was developed and disseminated in collaboration with caregivers of children with disabilities, (2) included topics such as response to the pandemic and receipt of services and supports, and (3) documented the experiences of a non-random convenience sample of caregivers of children (any age) with these conditions during and prior to the pandemic. We used four logistic regression models to assess the association between socio-demographic factors and receipt of services. RESULTS Being a single parent, having low educational attainment (high school or less), having low income (making less than $40,000 per year), working less than full time (working part-time, working reduced hours due to COVID, retired, stay home parent or student), as well as male gender and older age of the child with disability were factors associated with decreased likelihood of receiving services. CONCLUSION Our findings point to the need for tailoring services for families of children with disabilities, particularly low socioeconomic status families, to ensure continuity of care during public health emergencies.
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Affiliation(s)
- Miriam Gonzalez
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada. .,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada.
| | - Jinan Zeidan
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada
| | - Jonathan Lai
- Autism Alliance of Canada, 1111-23 Sheppard Ave E, M2N OC8, Toronto, ON, Canada
| | - Afiqah Yusuf
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Nicola Wright
- Department of Biostatistics and Health Informatics, King's College London, WC2R 2LS, London, UK
| | - Mandy Steiman
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Arun Karpur
- Autism Speaks, 1060 State Rd #1446, 08540, Princeton, Princeton, NJ, NJ, USA
| | - Andy Shih
- Autism Speaks, New York 1 E 33rd St, 10016, New York, NY, USA
| | - Mayada Elsabbagh
- Faculty of Medicine, Montreal Neurological Institute-Hospital, McGill University, Rue University, 3775, H3A 2B4, Montréal, Canada.,Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada
| | - Keiko Shikako
- Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, H4A 3J1, Montréal, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal, Canada
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9
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Alves DE, Mamelund SE, Dimka J, Simonsen L, Mølbak M, Ørskov S, Sattenspiel L, Tripp L, Noymer A, Chowell-Puente G, Dahal S, Van Doren TP, Wissler A, Heffernan C, Renfree Short K, Battles H, Baker MG. Indigenous peoples and pandemics. Scand J Public Health 2022; 50:662-667. [PMID: 35546099 PMCID: PMC9361406 DOI: 10.1177/14034948221087095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Daniele E. Alves
- Centre for Research on Pandemics &
Society, Oslo Metropolitan University, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics &
Society, Oslo Metropolitan University, Norway
| | - Jessica Dimka
- Centre for Research on Pandemics &
Society, Oslo Metropolitan University, Norway
| | | | | | | | | | - Lianne Tripp
- Department of Anthropology, University
of Northern British Columbia, Canada
| | - Andrew Noymer
- Program in Public Health, University of
California, Irvine, USA
| | | | - Sushma Dahal
- Department of Population Health
Sciences, Georgia State University, USA
| | | | - Amanda Wissler
- School of Human Evolution and Social
Change, Arizona State University, USA
| | - Courtney Heffernan
- Tuberculosis Program Evaluation and
Research Unit, University of Alberta, Canada
| | - Kirsty Renfree Short
- School of Chemistry and Molecular
Biosciences, University of Queensland, Australia
| | - Heather Battles
- Department of Anthropology,
University of Auckland, New Zealand
| | - Michael G. Baker
- Health Environment Infection Research
Unit, University of Otago, New Zealand
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10
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Hernández-Vásquez A, Chavez-Ecos F, Barrenechea-Pulache A, Comandé D, Bendezu-Quispe G. Seroprevalence and lethality by SARS-CoV-2 in indigenous populations of Latin America and the Caribbean: a systematic review. PeerJ 2022; 9:e12552. [PMID: 35003919 PMCID: PMC8684739 DOI: 10.7717/peerj.12552] [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: 07/26/2021] [Accepted: 11/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background Latin America and the Caribbean (LAC) has presented some of the highest numbers of cases and deaths due to COVID-19 in the world. Even though indigenous communities represent 8% of the total population in this region, the impact of COVID-19 on this historically vulnerable population has only been briefly explored. Thus, this study aimed to estimate the seroprevalence and lethality attributable to SARS-CoV-2 in the indigenous population of LAC. Methods A systematic review was conducted utilizing multiple databases (registry PROSPERO: CRD42020207862). Studies published in English, Spanish or Portuguese were selected between December 1st, 2019, and April 14th, 2021. The evaluation of the quality of the study was carried out utilizing the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A qualitative synthesis of the data analyzed was conducted following the MOOSE and PRISMA declarations. Results Fifteen studies met the inclusion criteria. Eleven studies were carried out in a Brazilian population, three in a Mexican population, and one in a Colombian population. Four studies reported data about the seroprevalence of SARS-CoV-2 in indigenous populations of Brazil (range: 4.2–81.65%). Twelve studies reported lethality in indigenous people (eight in Brazil, three in Mexico, and one in Colombia). In Brazil, a lethality of 53.30% was described in a hospital setting and between 1.83% and 4.03% in community studies. In Mexico, the lethality of COVID-19 ranged between 16.5% and 19.9%. Meanwhile, in Colombia, a lethality of 3.41% was reported. Most studies were deemed to be of good quality. Conclusions Despite COVID-19 affecting indigenous populations of LAC, there is limited evidence of the seroprevalence and lethality of the infection by SARS-CoV-2 in this population. Future investigations should ensure standardized methods that allow comparability among studies and ensure the precision of the results obtained.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Fabian Chavez-Ecos
- Sociedad Científica de Estudiantes de Medicina de Ica, Universidad Nacional "San Luis Gonzaga", Ica, Peru
| | | | - Daniel Comandé
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Guido Bendezu-Quispe
- Centro de Investigación Epidemiológica en Salud Global, Universidad Privada Norbert Wiener, Lima, Peru
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11
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COVID-19 pandemic evolution in the Brazilian Indigenous population. J Racial Ethn Health Disparities 2022; 9:921-937. [PMID: 33782907 PMCID: PMC8006870 DOI: 10.1007/s40615-021-01031-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected several neglected populations such as the Indigenous peoples, which have suffered a high impact from the pandemic. OBJECTIVES To analyze the impact on the health and disease process according to the COVID-19 evolution in the Brazilian Indigenous population. METHODS Data was collected from press releases by the Health Ministry and a descriptive analysis of the numbers of Indigenous individuals infected with the SARS-CoV-2 in Brazil was carried out. RESULTS In February 2021, there were 41,855 confirmed cases of Indigenous individuals infected by the SARS-CoV-2, including 4,387 active cases, 36,809 recovered cases, and 549 deaths. The Brazilian Indigenous population is distributed in over 300 ethnic groups and, due to the high number of deaths by the COVID-19, many of these groups are endangered. The elderly are the most affected age group, and they play a fundamental role among the Indigenous population for transmitting their customs mainly orally. Indigenous populations do not have proper access to transport to specialized health centers, since many areas are inaccessible and other cases require air or river transportation, which many times results in late assistance. When managing the COVID-19, it is important to emphasize the need for social isolation to prevent the virus from spreading among the Indigenous groups, mainly due to their contact with other ethnic groups represented by missionaries, hunters, and wood explorers, among others. CONCLUSION The adoption of practices that can reduce the virus transmission among the Indigenous population and provide them with better access to treatment, mainly for the elderly, must be prioritized in Brazil.
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12
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Mamelund SE, Dimka J. Not the great equalizers: Covid-19, 1918-20 influenza, and the need for a paradigm shift in pandemic preparedness. Population Studies 2021; 75:179-199. [PMID: 34902275 DOI: 10.1080/00324728.2021.1959630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Despite common perceptions to the contrary, pandemic diseases do not affect populations indiscriminately. In this paper, we review literature produced by demographers, historians, epidemiologists, and other researchers on disparities during the 1918-20 influenza pandemic and the Covid-19 pandemic. Evidence from these studies demonstrates that lower socio-economic status and minority/stigmatized race or ethnicity are associated with higher morbidity and mortality. However, such research often lacks theoretical frameworks or appropriate data to explain the mechanisms underlying these disparities fully. We suggest using a framework that considers proximal and distal factors contributing to differential exposure, susceptibility, and consequences as one way to move this research forward. Further, current pandemic preparedness plans emphasize medically defined risk groups and epidemiological approaches. Therefore, we conclude by arguing in favour of a transdisciplinary paradigm that recognizes socially defined risk groups, includes input from the social sciences and humanities and other diverse perspectives, and contributes to the reduction of health disparities before a pandemic hits.
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13
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Buheji M, AlDerazi A, Ahmed D, Bragazzi NL, Jahrami H, Hamadeh RR, BaHammam AS. The association between the initial outcomes of COVID-19 and the human development index: An ecological study. HUMAN SYSTEMS MANAGEMENT 2021. [DOI: 10.3233/hsm-210005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND & OBJECTIVE: Outcomes of the pandemic COVID-19 varied from one country to another. We aimed to describe the association between the global recovery and mortality rates of COVID-19 cases in different countries and the Human Development Index (HDI) as a socioeconomic indicator. METHODS: A correlational (ecological) study design is used. The analysis used data from 173 countries. Poisson regression models were applied to study the relationship between HDI and pandemic recovery and mortality rates, adjusting for country median age and country male to female sex ratio. RESULTS: During the first three months, the global pooled recovery rate was 32.4%(95%CI 32.3%–32.5%), and the pooled mortality rate was 6.95%(95%CI 6.94%–6.99%). Regression models revealed that HDI was positively associated with recovery β= 1.37, p = 0.016. HDI was also positively associated with the mortality outcome β= 1.79, p = 0.016. CONCLUSIONS: Our findings imply that the positive association between the HDI and recovery rates is reflective of the pandemics’ preparedness. The positive association between the HDI and mortality rates points to vulnerabilities in approaches to tackle health crises. It is critical to better understand the connection between nations’ socioeconomic factors and their readiness for future pandemics in order to strengthen public health policies.
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Affiliation(s)
| | | | - Dunya Ahmed
- International Institute of Inspiration Economy, Bahrain
- Social Science Department, University of Bahrain, Zallaq, Bahrain
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Department of Health Sciences, School of Public Health, University of Genoa, Genoa, Italy
| | - Haitham Jahrami
- Ministry of Health, Bahrain
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Randah R. Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed S. BaHammam
- Department of Medicine, College of Medicine, University Respiratory and Sleep Disorders Centre, King Saud University, Riyadh, Saudi Arabia
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
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14
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Abstract
This study aimed to analyse the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 2020 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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15
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Holuka C, Snoeck CJ, Mériaux SB, Ollert M, Krüger R, Turner JD. Adverse Life Trajectories Are a Risk Factor for SARS-CoV-2 IgA Seropositivity. J Clin Med 2021; 10:jcm10102159. [PMID: 34067606 PMCID: PMC8157140 DOI: 10.3390/jcm10102159] [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: 04/13/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 01/08/2023] Open
Abstract
Asymptomatic individuals, called “silent spreaders” spread SARS-CoV-2 efficiently and have complicated control of the ongoing COVID-19 pandemic. As seen in previous influenza pandemics, socioeconomic and life-trajectory factors are important in disease progression and outcome. The demographics of the asymptomatic SARS-CoV-2 carriers are unknown. We used the CON-VINCE cohort of healthy, asymptomatic, and oligosymptomatic individuals that is statistically representative of the overall population of Luxembourg for age, gender, and residency to characterise this population. Gender (male), not smoking, and exposure to early-life or adult traumatic experiences increased the risk of IgA seropositivity, and the risk associated with early-life exposure was a dose-dependent metric, while some other known comorbidities of active COVID-19 do not impact it. As prior exposure to adversity is associated with negative psychobiological reactions to external stressors, we recorded psychological wellbeing during the study period. Exposure to traumatic events or concurrent autoimmune or rheumatic disease were associated with a worse evolution of anxiety and depressive symptoms throughout the lockdown period. The unique demographic profile of the “silent spreaders” highlights the role that the early-life period plays in determining our lifelong health trajectory and provides evidence that the developmental origins of health and disease is applicable to infectious diseases.
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Affiliation(s)
- Cyrielle Holuka
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4354 Esch-sur-Alzette, Luxembourg; (C.H.); (S.B.M.)
- Faculty of Science, University of Luxembourg, L-4365 Belval, Luxembourg
| | - Chantal J. Snoeck
- Clinical and Applied Virology Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4354 Esch-sur-Alzette, Luxembourg;
| | - Sophie B. Mériaux
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4354 Esch-sur-Alzette, Luxembourg; (C.H.); (S.B.M.)
| | - Markus Ollert
- Allergy and Clinical Immunology, Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354 Esch-sur-Alzette, Luxembourg;
- Odense Research Center for Anaphylaxis, Department of Dermatology and Allergy Center, University of Southern Denmark, 5000 Odense, Denmark
| | - Rejko Krüger
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), L-1445 Strassen, Luxembourg;
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, L-4362 Esch-Sur-Alzette, Luxembourg
| | - Jonathan D. Turner
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4354 Esch-sur-Alzette, Luxembourg; (C.H.); (S.B.M.)
- Correspondence: ; Tel.: +352-2697-0629
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16
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Moodie N, Ward J, Dudgeon P, Adams K, Altman J, Casey D, Cripps K, Davis M, Derry K, Eades S, Faulkner S, Hunt J, Klein E, McDonnell S, Ring I, Sutherland S, Yap M. Roadmap to recovery: Reporting on a research taskforce supporting Indigenous responses to COVID-19 in Australia. THE AUSTRALIAN JOURNAL OF SOCIAL ISSUES 2021; 56:4-16. [PMID: 33041398 PMCID: PMC7537170 DOI: 10.1002/ajs4.133] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 05/07/2023]
Abstract
In April 2020 a Group of Eight Taskforce was convened, consisting of over 100 researchers, to provide independent, research-based recommendations to the Commonwealth Government on a "Roadmap to Recovery" from COVID-19. The report covered issues ranging from pandemic control and relaxation of social distancing measures, to well-being and special considerations for vulnerable populations. Our work focused on the critical needs of Aboriginal and Torres Strait Islander communities; this paper presents an overview of our recommendations to the Roadmap report. In addressing the global challenges posed by pandemics for citizens around the world, Indigenous people are recognised as highly vulnerable. At the time of writing Australia's First Nations Peoples have been largely spared from COVID-19 in comparison to other Indigenous populations globally. Our recommendations emphasise self-determination and equitable needs-based funding to support Indigenous communities to recover from COVID-19, addressing persistent overcrowded housing, and a focus on workforce, especially for regional and remote communities. These latter two issues have been highlighted as major issues of risk for Indigenous communities in Australia It remains to be seen how governments across Australia take up these recommendations to support Indigenous peoples' health and healing journey through yet another, potentially catastrophic, health crisis.
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Affiliation(s)
- Nikki Moodie
- Faculty of ArtsThe University of MelbourneMelbourneVic.Australia
| | - James Ward
- School of Public HealthThe University of QueenslandHerstonQldAustralia
| | | | - Karen Adams
- Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonVic.Australia
| | - Jon Altman
- Australian National UniversityCanberraACTAustralia
| | - Dawn Casey
- National Aboriginal Community Controlled Health OrganisationBraddonACTAustralia
| | | | - Megan Davis
- University of New South WalesSydneyNSWAustralia
| | - Kate Derry
- The University of Western AustraliaPerthWAAustralia
| | - Sandra Eades
- Curtin Medical SchoolCurtin UniversityBentleyWAAustralia
| | | | - Janet Hunt
- Centre for Aboriginal Economic Policy ResearchThe Australian National UniversityCanberraACTAustralia
| | - Elise Klein
- Australian National UniversityCanberraACTAustralia
| | | | - Ian Ring
- James Cook UniversityTownsvilleQldAustralia
| | | | - Mandy Yap
- Centre for Aboriginal Economic Policy ResearchThe Australian National UniversityCanberraACTAustralia
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17
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Mallard A, Pesantes MA, Zavaleta-Cortijo C, Ward J. An urgent call to collect data related to COVID-19 and Indigenous populations globally. BMJ Glob Health 2021; 6:e004655. [PMID: 33653731 PMCID: PMC7929635 DOI: 10.1136/bmjgh-2020-004655] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/19/2022] Open
Affiliation(s)
- Alistair Mallard
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Maria Amalia Pesantes
- Department of Anthropology and Archaeology, Dickinson College, Carlisle, Pennsylvania, USA
| | | | - James Ward
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
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18
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Ortiz-Prado E, Simbaña-Rivera K, Barreno LG, Diaz AM, Barreto A, Moyano C, Arcos V, Vásconez-González E, Paz C, Simbaña-Guaycha F, Molestina-Luzuriaga M, Fernández-Naranjo R, Feijoo J, Henriquez-Trujillo AR, Adana L, López-Cortés A, Fletcher I, Lowe R. Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador. PLoS Negl Trop Dis 2021; 15:e0008958. [PMID: 33395425 PMCID: PMC7817051 DOI: 10.1371/journal.pntd.0008958] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 01/20/2021] [Accepted: 11/05/2020] [Indexed: 01/15/2023] Open
Abstract
The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities. A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). We present an analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador's response to the outbreak.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Lenin Gómez Barreno
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Ana Maria Diaz
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Alejandra Barreto
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Carla Moyano
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Vannesa Arcos
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | | | - Clara Paz
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | | | | | - Raúl Fernández-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Javier Feijoo
- Instituto de Física La Plata, Universidad Nacional de la Plata, La Plata, Argentina
| | | | - Lila Adana
- School of psychology, Universidad de Las Americas, Quito, Ecuador
| | - Andrés López-Cortés
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
- Red Latinoamericana de Implementación y Validación de Guías Clínicas Farmacogenómicas (RELIVAF-CYTED), Quito, Ecuador
| | - Isabel Fletcher
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
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19
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Chand SJ, Thomas LB. ‘Toshao’ as Strategic Link for Cultural Continuity and Resiliency among Amerindians During the COVID-19 Pandemic in Guyana. ETHNOLOGIES 2021. [DOI: 10.7202/1088196ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Fallon B, Lefebvre R, Collin-Vézina D, Houston E, Joh-Carnella N, Malti T, Filippelli J, Schumaker K, Manel W, Kartusch M, Cash S. Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response. CHILD ABUSE & NEGLECT 2020; 110:104706. [PMID: 32919762 PMCID: PMC7472971 DOI: 10.1016/j.chiabu.2020.104706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Pandemics have a wide range of economic, health and social consequences related to both the spread of a disease and efforts made by government leaders to contain it which may be particularly detrimental for the child welfare-involved population. This is because child welfare agencies serve some of the highest needs children and families. A significant proportion of these families face economic hardship, and as a result of containment measures for COVID-19, more families inevitably will. OBJECTIVE Given the range of negative consequences related to the pandemic and the evolving supports available to families, child protection workers needed a clinical tool to guide and support work with families informed by an understanding of economic hardship. The objective of this paper is to report on the development and implementation strategy of a tool to be used for practice intervention during the pandemic. METHODS Action research methodology was utilized in the creation of the clinical tool. The tool's development and implementation occurred through an academic/child welfare sector partnership involving child welfare agencies representing diverse regions and populations in Ontario, Canada. Factor analysis of representative child welfare data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) on economic hardship was used to inform the development of questions on the clinical tool. RESULTS The development and implementation strategy of the clinical tool are described, including the results from analyses of the OIS-2018. CONCLUSIONS Future directions for the project are discussed, including considerations for using this tool beyond the pandemic.
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Affiliation(s)
- Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada.
| | - Rachael Lefebvre
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Emmaline Houston
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Tina Malti
- Department of Psychology, University of Toronto, Canada
| | - Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Wendy Manel
- Catholic Children's Aid Society of Toronto, Canada
| | | | - Scottye Cash
- College of Social Work, The Ohio State University, USA
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21
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Palamim CVC, Ortega MM, Marson FAL. COVID-19 in the Indigenous Population of Brazil. J Racial Ethn Health Disparities 2020; 7:1053-1058. [PMID: 33025421 PMCID: PMC7537979 DOI: 10.1007/s40615-020-00885-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
Brazil has 896,917 Indigenous individuals distributed among 505 Indigenous lands. There are 274 different Indigenous languages within 305 Indigenous ethnic groups. The Indigenous population is susceptible to pandemics, especially to the current pandemic of COVID-19, which has spread rapidly. In Brazil, after the first COVID-19-confirmed Indigenous case on 05th June 2020, more 420 suspected cases, 1727 confirmed cases being 934 active cases, 715 cases with clinical cure, and 70 cases of death were accounted through the first week of June. The number of cases is underestimated, according to the Special Secretariat for Indigenous Health (SESAI) database, since the deaths are due to respiratory failure, possibly caused by COVID-19, but not confirmed. The first COVID-19-caused death was a 15-year-old Indigenous Yanomami teenage from Roraima State without known previous diseases history and/or comorbidities. In the present study, the importance of social isolation, especially for Indigenous people who are more vulnerable to the COVID-19, was highlighted by the identification of the infection community. An Indigenous of the Kokama ethnicity was infected after coming in contact with a Medical Doctor who was infected with the disease. Later, it was noticed that both, Indigenous and doctor, were responsible for COVID-19’s transmission to 43 other Indigenous individuals (30 in Alto Rio Solimões and 13 in Parintis), causing possibly other confirmed deaths. The impact of COVID-19 for Indigenous population might be an unprecedented tragedy, and the government in Brazil must take emergency measures as the social isolation.
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Affiliation(s)
- Camila Vantini Capasso Palamim
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil
| | - Manoela Marques Ortega
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil.,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil
| | - Fernando Augusto Lima Marson
- Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, 12916-000, São Paulo, Brazil. .,Laboratory of Human and Medical Genetics, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, São Paulo, 12916-900, Brazil.
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22
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Whittle RS, Diaz-Artiles A. An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York City. BMC Med 2020; 18:271. [PMID: 32883276 PMCID: PMC7471585 DOI: 10.1186/s12916-020-01731-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/04/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND New York City was the first major urban center of the COVID-19 pandemic in the USA. Cases are clustered in the city, with certain neighborhoods experiencing more cases than others. We investigate whether potential socioeconomic factors can explain between-neighborhood variation in the COVID-19 test positivity rate. METHODS Data were collected from 177 Zip Code Tabulation Areas (ZCTA) in New York City (99.9% of the population). We fit multiple Bayesian Besag-York-Mollié (BYM) mixed models using positive COVID-19 tests as the outcome, a set of 11 representative demographic, economic, and health-care associated ZCTA-level parameters as potential predictors, and the total number of COVID-19 tests as the exposure. The BYM model includes both spatial and nonspatial random effects to account for clustering and overdispersion. RESULTS Multiple regression approaches indicated a consistent, statistically significant association between detected COVID-19 cases and dependent children (under 18 years old), population density, median household income, and race. In the final model, we found that an increase of only 5% in young population is associated with a 2.3% increase in COVID-19 positivity rate (95% confidence interval (CI) 0.4 to 4.2%, p=0.021). An increase of 10,000 people per km2 is associated with a 2.4% (95% CI 0.6 to 4.2%, p=0.011) increase in positivity rate. A decrease of $10,000 median household income is associated with a 1.6% (95% CI 0.7 to 2.4%, p<0.001) increase in COVID-19 positivity rate. With respect to race, a decrease of 10% in White population is associated with a 1.8% (95% CI 0.8 to 2.8%, p<0.001) increase in positivity rate, while an increase of 10% in Black population is associated with a 1.1% (95% CI 0.3 to 1.8%, p<0.001) increase in positivity rate. The percentage of Hispanic (p=0.718), Asian (p=0.966), or Other (p=0.588) populations were not statistically significant factors. CONCLUSIONS Our findings indicate associations between neighborhoods with a large dependent youth population, densely populated, low-income, and predominantly black neighborhoods and COVID-19 test positivity rate. The study highlights the importance of public health management during and after the current COVID-19 pandemic. Further work is warranted to fully understand the mechanisms by which these factors may have affected the positivity rate, either in terms of the true number of cases or access to testing.
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Affiliation(s)
- Richard S. Whittle
- Department of Aerospace Engineering, Texas A&M University, College Station, TX USA
- International Space University, Illkirch-Graffenstaden, France
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, TX USA
- International Space University, Illkirch-Graffenstaden, France
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23
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Whittle RS, Diaz-Artiles A. An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York City. BMC Med 2020; 18:271. [PMID: 32883276 DOI: 10.1101/2020.04.17.20069823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/04/2020] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND New York City was the first major urban center of the COVID-19 pandemic in the USA. Cases are clustered in the city, with certain neighborhoods experiencing more cases than others. We investigate whether potential socioeconomic factors can explain between-neighborhood variation in the COVID-19 test positivity rate. METHODS Data were collected from 177 Zip Code Tabulation Areas (ZCTA) in New York City (99.9% of the population). We fit multiple Bayesian Besag-York-Mollié (BYM) mixed models using positive COVID-19 tests as the outcome, a set of 11 representative demographic, economic, and health-care associated ZCTA-level parameters as potential predictors, and the total number of COVID-19 tests as the exposure. The BYM model includes both spatial and nonspatial random effects to account for clustering and overdispersion. RESULTS Multiple regression approaches indicated a consistent, statistically significant association between detected COVID-19 cases and dependent children (under 18 years old), population density, median household income, and race. In the final model, we found that an increase of only 5% in young population is associated with a 2.3% increase in COVID-19 positivity rate (95% confidence interval (CI) 0.4 to 4.2%, p=0.021). An increase of 10,000 people per km2 is associated with a 2.4% (95% CI 0.6 to 4.2%, p=0.011) increase in positivity rate. A decrease of $10,000 median household income is associated with a 1.6% (95% CI 0.7 to 2.4%, p<0.001) increase in COVID-19 positivity rate. With respect to race, a decrease of 10% in White population is associated with a 1.8% (95% CI 0.8 to 2.8%, p<0.001) increase in positivity rate, while an increase of 10% in Black population is associated with a 1.1% (95% CI 0.3 to 1.8%, p<0.001) increase in positivity rate. The percentage of Hispanic (p=0.718), Asian (p=0.966), or Other (p=0.588) populations were not statistically significant factors. CONCLUSIONS Our findings indicate associations between neighborhoods with a large dependent youth population, densely populated, low-income, and predominantly black neighborhoods and COVID-19 test positivity rate. The study highlights the importance of public health management during and after the current COVID-19 pandemic. Further work is warranted to fully understand the mechanisms by which these factors may have affected the positivity rate, either in terms of the true number of cases or access to testing.
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Affiliation(s)
- Richard S Whittle
- Department of Aerospace Engineering, Texas A&M University, College Station, TX, USA.
- International Space University, Illkirch-Graffenstaden, France.
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, TX, USA
- International Space University, Illkirch-Graffenstaden, France
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Weinman AL, Sullivan SG, Vijaykrishna D, Markey P, Levy A, Miller A, Tong SYC. Epidemiological trends in notified influenza cases in Australia's Northern Territory, 2007-2016. Influenza Other Respir Viruses 2020; 14:541-550. [PMID: 32445270 PMCID: PMC7431647 DOI: 10.1111/irv.12757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The Northern Territory (NT) of Australia has a mix of climates, sparsely distributed population and a large proportion of the populace are Indigenous Australians, and influenza is known to have a disproportionate impact upon this group. Understanding the epidemiology of influenza in this region would inform public health strategies. OBJECTIVES To assess if there are consistent patterns in characteristics of influenza outbreaks in the NT. METHODS Laboratory confirmed influenza cases in the NT are notified to the NT Centre for Disease Control. We conducted analyses on notified cases from 2007-2016 to determine incidence rates (by age group, Indigenous status and area), seasonality of cases and spatial distribution of influenza types. Notified cases were linked to laboratory datasets to update information on influenza type or subtype RESULTS: The disparity in Indigenous and non-Indigenous notification rates varied by age group, with rate ratios for Indigenous versus non-Indigenous ranging from 1.58 (95% CI:1.39, 1.80) for ages 15-24 to 5.56 (95% CI: 4.71, 6.57) for ages 55-64. The disparity between Indigenous and non-Indigenous notification rates appeared higher in the Central Australia region. Indigenous versus non-Indigenous hospitalisation and mortality rate ratios were 6.51 (95% CI: 5.91, 7.18) and 5.46 (95% CI: 2.40, 12.71) respectively. Inter-seasonal peaks during February and March occurred in 2011, 2013 and 2014, and were due to influenza activity in the tropical north of the NT. CONCLUSIONS Our results highlight the importance of influenza vaccination across all age groups for Indigenous Australians. An early vaccination campaign targeted against outbreaks in February-March would be best focused on the tropical north.
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Affiliation(s)
- Aaron L. Weinman
- Doherty DepartmentPeter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVictoriaAustralia
| | - Sheena G. Sullivan
- Doherty DepartmentWHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne HospitalPeter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVictoriaAustralia
| | - Dhanasekaran Vijaykrishna
- Department of MicrobiologyBiomedicine Discovery InstituteMonash UniversityClaytonVictoriaAustralia
- WHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne HospitalPeter Doherty Institute for Infection and ImmunityMelbourneVictoriaAustralia
| | - Peter Markey
- Northern Territory Centre for Disease ControlCasuarinaNorthern TerritoryAustralia
| | - Avram Levy
- PathWest Laboratory MedicineNedlandsWestern AustraliaAustralia
| | - Adrian Miller
- Centre for Indigenous Health and Equity ResearchCQUniversityTownsvilleQueenslandAustralia
| | - Steven Y. C. Tong
- Doherty DepartmentVictorian Infectious Diseases ServiceThe Royal Melbourne HospitalPeter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVictoriaAustralia
- Menzies School of Health ResearchDarwinNorthern TerritoryAustralia
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Trienekens SCM, Shepherd W, Pebody RG, Mangtani P, Cleary P. Overrepresentation of South Asian ethnic groups among cases of influenza A(H1N1)pdm09 during the first phase of the 2009 pandemic in England. Influenza Other Respir Viruses 2020; 15:270-277. [PMID: 32875701 PMCID: PMC7902259 DOI: 10.1111/irv.12801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND During the first wave of the influenza A(H1N1)pdm09 pandemic in England in 2009, morbidity and mortality were higher in patients of South Asian (Indian, Pakistani or Bangladeshi) ethnic minority groups. OBJECTIVES This study aims to provide insights in the representation of this group among reported cases, indicating susceptibility and exposure. METHODS All laboratory-confirmed cases including basic demographic and limited clinical information that were reported to the FluZone surveillance system between April and October 2009 were retrieved. Missing ethnicity data were imputed using the previously developed and validated South Asian Names and Group Recognition Algorithm (SANGRA). Differences between ethnic groups were calculated using chi-square, log-rank and t tests and rate ratios. Geographic clustering was compared using Ripley's K functions. RESULTS SANGRA identified 2447 (28%) of the total of 8748 reported cases as South Asian. South Asian cases were younger (P < .001), more often male (P = .002) and more often from deprived areas (P < .001) than cases of other ethnic groups. Time between onset of symptoms and laboratory sampling was longer in this group (P < .001), and they were less often advised antiviral treatment (P < .001), however, declined treatment less. The highest cumulative incidence was seen in the West Midlands region (32.7/10 000), London (7.0/10 000) and East of England region (5.7/10 000). CONCLUSIONS People of South Asian ethnic groups were disproportionally affected by the first wave of the influenza pandemic in England in 2009. The findings presented contribute to further understanding of demographic, socioeconomic and ethnic factors of the outbreak and inform future influenza preparedness to ensure appropriate prevention and care.
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Affiliation(s)
- Suzan C M Trienekens
- Field Epidemiology Training Programme, Public Health England, UK.,Field Service North West, National Infection Service, Public Health England, UK
| | - Wendi Shepherd
- North West Health Protection Team, Public Health England, UK.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Punam Mangtani
- Department of Infectious Disease Epidemiology, London School of Tropical Medicine and Hygiene, London, UK
| | - Paul Cleary
- Field Service North West, National Infection Service, Public Health England, UK
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Cupertino GA, Cupertino MDC, Gomes AP, Braga LM, Siqueira-Batista R. COVID-19 and Brazilian Indigenous Populations. Am J Trop Med Hyg 2020; 103:609-612. [PMID: 32524964 PMCID: PMC7410482 DOI: 10.4269/ajtmh.20-0563] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/24/2022] Open
Abstract
The newly discovered SARS-CoV-2 is the cause of COVID-19, including severe respiratory symptoms with an important lethality rate and high dissemination capacity. Considering the indigenous people of Brazil, it is feared that COVID-19 will spread to these communities, causing another stage of decimation. Despite advances in indigenous health care in the country, there are still many challenges due to the social vulnerability of this population, whose lands continue to be illegally exploited. Based on these considerations, this article discusses challenges in caring for the indigenous population in the context of the COVID-19 pandemic in Brazil.
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Affiliation(s)
| | - Marli do Carmo Cupertino
- School of Medicine, Faculdade Dinâmica do Vale do Piranga, Ponte Nova, Minas Gerais, Brazil
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Andréia Patrícia Gomes
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Luciene Muniz Braga
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Rodrigo Siqueira-Batista
- School of Medicine, Faculdade Dinâmica do Vale do Piranga, Ponte Nova, Minas Gerais, Brazil
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Holuka C, Merz MP, Fernandes SB, Charalambous EG, Seal SV, Grova N, Turner JD. The COVID-19 Pandemic: Does Our Early Life Environment, Life Trajectory and Socioeconomic Status Determine Disease Susceptibility and Severity? Int J Mol Sci 2020; 21:E5094. [PMID: 32707661 PMCID: PMC7404093 DOI: 10.3390/ijms21145094] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 01/08/2023] Open
Abstract
A poor socioeconomic environment and social adversity are fundamental determinants of human life span, well-being and health. Previous influenza pandemics showed that socioeconomic factors may determine both disease detection rates and overall outcomes, and preliminary data from the ongoing coronavirus disease (COVID-19) pandemic suggests that this is still true. Over the past years it has become clear that early-life adversity (ELA) plays a critical role biasing the immune system towards a pro-inflammatory and senescent phenotype many years later. Cytotoxic T-lymphocytes (CTL) appear to be particularly sensitive to the early life social environment. As we understand more about the immune response to SARS-CoV-2 it appears that a functional CTL (CD8+) response is required to clear the infection and COVID-19 severity is increased as the CD8+ response becomes somehow diminished or exhausted. This raises the hypothesis that the ELA-induced pro-inflammatory and senescent phenotype may play a role in determining the clinical course of COVID-19, and the convergence of ELA-induced senescence and COVID-19 induced exhaustion represents the worst-case scenario with the least effective T-cell response. If the correct data is collected, it may be possible to separate the early life elements that have made people particularly vulnerable to COVID-19 many years later. This will, naturally, then help us identify those that are most at risk from developing the severest forms of COVID-19. In order to do this, we need to recognize socioeconomic and early-life factors as genuine medically and clinically relevant data that urgently need to be collected. Finally, many biological samples have been collected in the ongoing studies. The mechanisms linking the early life environment with a defined later-life phenotype are starting to be elucidated, and perhaps hold the key to understanding inequalities and differences in the severity of COVID-19.
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Affiliation(s)
- Cyrielle Holuka
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
| | - Myriam P. Merz
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
| | - Sara B. Fernandes
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
| | - Eleftheria G. Charalambous
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
| | - Snehaa V. Seal
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
| | - Nathalie Grova
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
- Calbinotox, Faculty of Science and Technology, Lorraine University, 54506 Nancy, France
| | - Jonathan D. Turner
- Immune Endocrine Epigenetics Research Group, Department of Infection and Immunity, Luxembourg Institute of Health, L-4345 Esch-sur-Alzette, Luxembourg; (C.H.); (M.P.M.); (S.B.F.); (E.G.C.); (S.V.S.); (N.G.)
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Vazquez-Pagan A, Honce R, Schultz-Cherry S. Impact of influenza virus during pregnancy: from disease severity to vaccine efficacy. Future Virol 2020. [DOI: 10.2217/fvl-2020-0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pregnant women are among the individuals at the highest risk for severe influenza virus infection. Infection of the mother during pregnancy increases the probability of adverse fetal outcomes such as small for gestational age, preterm birth and fetal death. Animal models of syngeneic and allogeneic mating can recapitulate the increased disease severity observed in pregnant women and are used to define the mechanism(s) of that increased severity. This review focuses on influenza A virus pathogenesis, the unique immunological landscape during pregnancy, the impact of maternal influenza virus infection on the fetus and the immune responses at the maternal–fetal interface. Finally, we summarize the importance of immunization and antiviral treatment in this population and highlight issues that warrant further investigation.
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Affiliation(s)
- Ana Vazquez-Pagan
- Graduate School of Biomedical Sciences, St Jude Children’s Research Hospital, Memphis, TN, USA
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Rebekah Honce
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
- Integrated Program in Biomedical Sciences, Department of Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Stacey Schultz-Cherry
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
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Kaplan HS, Trumble BC, Stieglitz J, Mamany RM, Cayuba MG, Moye LM, Alami S, Kraft T, Gutierrez RQ, Adrian JC, Thompson RC, Thomas GS, Michalik DE, Rodriguez DE, Gurven MD. Voluntary collective isolation as a best response to COVID-19 for indigenous populations? A case study and protocol from the Bolivian Amazon. Lancet 2020; 395:1727-1734. [PMID: 32422124 PMCID: PMC7228721 DOI: 10.1016/s0140-6736(20)31104-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 01/08/2023]
Abstract
Indigenous communities worldwide share common features that make them especially vulnerable to the complications of and mortality from COVID-19. They also possess resilient attributes that can be leveraged to promote prevention efforts. How can indigenous communities best mitigate potential devastating effects of COVID-19? In Bolivia, where nearly half of all citizens claim indigenous origins, no specific guidelines have been outlined for indigenous communities inhabiting native communal territories. In this Public Health article, we describe collaborative efforts, as anthropologists, physicians, tribal leaders, and local officials, to develop and implement a multiphase COVID-19 prevention and containment plan focused on voluntary collective isolation and contact-tracing among Tsimane forager-horticulturalists in the Bolivian Amazon. Phase 1 involves education, outreach, and preparation, and phase 2 focuses on containment, patient management, and quarantine. Features of this plan might be exported and adapted to local circumstances elsewhere to prevent widespread mortality in indigenous communities.
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Affiliation(s)
- Hillard S Kaplan
- Economic Science Institute, Chapman University, Orange, CA, USA; Tsimane Health and Life History Project, San Borja, Bolivia.
| | - Benjamin C Trumble
- Tsimane Health and Life History Project, San Borja, Bolivia; School of Human Evolution and Social Change, Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | - Jonathan Stieglitz
- Tsimane Health and Life History Project, San Borja, Bolivia; Institute for Advanced Study in Toulouse, Toulouse, France
| | - Roberta Mendez Mamany
- Economic Science Institute, Chapman University, Orange, CA, USA; Tsimane Health and Life History Project, San Borja, Bolivia
| | | | | | - Sarah Alami
- Tsimane Health and Life History Project, San Borja, Bolivia; Department of Anthropology, University of California, Santa Barbara CA, USA
| | - Thomas Kraft
- Tsimane Health and Life History Project, San Borja, Bolivia; Institute for Advanced Study in Toulouse, Toulouse, France
| | | | | | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA; University of Missouri-Kansas City, Kansas City, MO, USA
| | - Gregory S Thomas
- MemorialCare, Southern California, USA; Division of Cardiology, University of California, Irvine, CA, USA
| | - David E Michalik
- Miller Children's and Women's Hospital Long Beach, CA, USA; Division of Pediatric Infectious Diseases, University of California, Irvine, CA, USA
| | - Daniel Eid Rodriguez
- Tsimane Health and Life History Project, San Borja, Bolivia; Institute of Biomedical Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia
| | - Michael D Gurven
- Tsimane Health and Life History Project, San Borja, Bolivia; Department of Anthropology, University of California, Santa Barbara CA, USA.
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30
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Cupertino M, Cupertino G, Gomes A, Mayers N, Siqueira-Batista R. COVID-19 in Brazil: Epidemiological update and perspectives. ASIAN PAC J TROP MED 2020. [DOI: 10.4103/1995-7645.282215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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31
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Horwood PF, Tarantola A, Goarant C, Matsui M, Klement E, Umezaki M, Navarro S, Greenhill AR. Health Challenges of the Pacific Region: Insights From History, Geography, Social Determinants, Genetics, and the Microbiome. Front Immunol 2019; 10:2184. [PMID: 31572391 PMCID: PMC6753857 DOI: 10.3389/fimmu.2019.02184] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/29/2019] [Indexed: 02/06/2023] Open
Abstract
The Pacific region, also referred to as Oceania, is a geographically widespread region populated by people of diverse cultures and ethnicities. Indigenous people in the region (Melanesians, Polynesians, Micronesians, Papuans, and Indigenous Australians) are over-represented on national, regional, and global scales for the burden of infectious and non-communicable diseases. Although social and environmental factors such as poverty, education, and access to health-care are assumed to be major drivers of this disease burden, there is also developing evidence that genetic and microbiotic factors should also be considered. To date, studies investigating genetic and/or microbiotic links with vulnerabilities to infectious and non-communicable diseases have mostly focused on populations in Europe, Asia, and USA, with uncertain associations for other populations such as indigenous communities in Oceania. Recent developments in personalized medicine have shown that identifying ethnicity-linked genetic vulnerabilities can be important for medical management. Although our understanding of the impacts of the gut microbiome on health is still in the early stages, it is likely that equivalent vulnerabilities will also be identified through the interaction between gut microbiome composition and function with pathogens and the host immune system. As rapid economic, dietary, and cultural changes occur throughout Oceania it becomes increasingly important that further research is conducted within indigenous populations to address the double burden of high rates of infectious diseases and rapidly rising non-communicable diseases so that comprehensive development goals can be planned. In this article, we review the current knowledge on the impact of nutrition, genetics, and the gut microbiome on infectious diseases in indigenous people of the Pacific region.
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Affiliation(s)
- Paul F. Horwood
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | | | - Cyrille Goarant
- Institut Pasteur de Nouvelle-Calédonie, Noumea, New Caledonia
| | - Mariko Matsui
- Institut Pasteur de Nouvelle-Calédonie, Noumea, New Caledonia
| | - Elise Klement
- Institut Pasteur de Nouvelle-Calédonie, Noumea, New Caledonia
- Internal Medicine and Infectious Diseases Department, Centre Hospitalier Territorial, Noumea, New Caledonia
| | - Masahiro Umezaki
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Severine Navarro
- Immunology Department, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Andrew R. Greenhill
- School of Health and Life Sciences, Federation University Australia, Churchill, VIC, Australia
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Choi WS, Choi MJ, Noh JY, Song JY, Kim WJ, Park DW, Lee J, Seo YB, Baek JH, Choi S, Cheong HJ. Clinical and economic analysis of the 2009 H1N1 influenza pandemic among pregnant Korean women. Korean J Intern Med 2019; 34:1136-1144. [PMID: 29232939 PMCID: PMC6718764 DOI: 10.3904/kjim.2017.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/29/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Unlike Western countries, the 2009 pandemic influenza infection among pregnant women was reported as mild in a previous interim study in South Korea. However, several mortalities were reported thereafter, suggesting that nationwide data were lacking. METHODS This case-control study covers the entire 2009 pandemic inf luenza period, from May 2009 to February 2010. The clinical and economic data of pregnant (case) and age-matched non-pregnant (control) women with influenza A (H1N1) pdm09 virus (H1N1pdm09) infection were retrospectively collected from nine hospitals in South Korea. RESULTS A total of 130 pregnant women with H1N1pdm09 infection were identified. The mean age of the pregnant women was 31.1 years (range, 19 to 41) and mean gestational age was 18.4 weeks (range, 3 to 40). Both case and control groups were similar in terms of age (p = 0.43) and comorbidities (p = 0.18). The overall rate of complications was comparable between the two groups (p = 0.648). However, mortality was reported only among the cases, so mean economic per capita burden is estimated to be higher for pregnant women compared to the control (4,821,992 Korean won [KRW] vs. 351,233 KRW, p = 0.31). Obstetric complications were observed in 12 cases, including preterm labor (n = 7), low birth-weight (n = 3), miscarriage (n = 1), stillbirth (n = 1), and cleft lip (n = 1). CONCLUSION Although statistically insignificant, the detrimental impact of influenza A H1N1pdm09 on pregnancy can be serious in some complicated cases in South Korea. Thus, the strong recommendation of influenza vaccination should be maintained for pregnant women as a high priority.
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Affiliation(s)
- Won Suk Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Min Joo Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Yoon Noh
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dae Won Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yu Bin Seo
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Ji Hyeon Baek
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sooran Choi
- Department of Obstetrics and Gynecology, Inha University College of Medicine, Incheon, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Correspondence to Hee Jin Cheong, M.D. Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea Tel: +82-2-2626-3050 Fax: +82-2-2626-1105 E-mail:
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McHugh L, Binks MJ, Gao Y, Andrews RM, Ware RS, Snelling T, Kildea S. Influenza vaccination in pregnancy among a group of remote dwelling Aboriginal and Torres Strait Islander mothers in the Northern Territory: The 1+1 Healthy Start to Life study. ACTA ACUST UNITED AC 2019; 43. [PMID: 31426733 DOI: 10.33321/cdi.2019.43.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Remote-living Aboriginal and Torres Strait Islander women experience a higher burden of influenza infection during pregnancy than any other Australian women. Despite recommendations of inactivated influenza vaccination (IIV) in pregnancy, uptake and safety data are scarce for this population. We examined uptake of IIV in pregnancy and report adverse birth outcomes amongst a predominantly unvaccinated group of remote-living Aboriginal and Torres Strait Islander women from the Northern Territory (NT), using data from the 1+1 Healthy Start to Life study. Data were deterministically linked with the NT Immunisation Register to ascertain IIV exposure in pregnant women during 2003-2006 and 2009-2011 inclusive. Overall, IIV uptake in pregnancy was 3% (n=20/697 pregnancies); 0% (0/414) pre-influenza A(H1N1)pdm09 and 7% (20/293) post-influenza A(H1N1)pdm09 (2009-2011). Vaccine uptake was poor in this cohort and it is unclear at what stage this policy failure occurred. Women with known comorbidities and/or high risk factors were not targeted for vaccination. Much larger study participant numbers are required to validate between group comparisons but there was no clinically nor statistically significant difference in median gestational ages (38 weeks for both groups), mean infant birthweights (3,001 g unvaccinated vs 3,175 g IIV vaccinated), nor birth outcomes between the few women who received IIV in pregnancy and those who did not. There were no stillbirths in women who received an IIV in pregnancy.
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Affiliation(s)
- Lisa McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Michael J Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Yu Gao
- Mater Midwifery Research Unit - University of Queensland, Women's Health and Newborn Services (Maternity) Mater Health Service; School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia; Applied Epidemiology Program, National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tom Snelling
- Infectious Disease Implementation Research, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; Perth Children's Hospital, Perth, Western Australia, Australia; Curtin University, School of Public Health, Perth, Western Australia, Australia
| | - Sue Kildea
- Mater Research Institute - University of Queensland, Women's Health and Newborn Services (Maternity) Mater Health Service; School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
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Counting Oceanians of Non-European, Non-Asian Descent (ONENA) in the South Pacific to Make Them Count in Global Health. Trop Med Infect Dis 2019; 4:tropicalmed4030114. [PMID: 31405081 PMCID: PMC6789437 DOI: 10.3390/tropicalmed4030114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 01/07/2023] Open
Abstract
Several diseases and vulnerabilities associated with genetic or microbial factors are more frequent among populations of Oceanian, Non-European, Non-Asian descent (ONENA). ONENA are specific and have long been isolated geographically. To our knowledge, there are no published official, quantitative, aggregated data on the populations impacted by these excess vulnerabilities in Oceania. We searched official census reports for updated estimates of the total population for each of the Pacific Island Countries and Territories (including Australia) and the US State of Hawaii, privileging local official statistical or censual sources. We multiplied the most recent total population estimate by the cumulative percentage of the ONENA population as determined in official reports. Including Australia and the US State of Hawaii, Oceania counts 27 countries and territories, populated in 2016 by approximately 41 M inhabitants (17 M not counting Australia) among which approximately 12.5 M (11.6 M not counting Australia) consider themselves of entire or partial ONENA ancestry. Specific genetic and microbiome traits of ONENA may be unique and need further investigation to adjust risk estimates, risk prevention, diagnostic and therapeutic strategies, to the benefit of populations in the Pacific and beyond.
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McHugh L, Crooks K, Creighton A, Binks M, Andrews RM. Safety, equity and monitoring: a review of the gaps in maternal vaccination strategies for Aboriginal and Torres Strait Islander women. Hum Vaccin Immunother 2019; 16:371-376. [PMID: 31368832 DOI: 10.1080/21645515.2019.1649552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Influenza and pertussis infections are disproportionately higher among Aboriginal and Torres Strait Islander women and their infants compared to other Australians. These infections are potentially preventable through vaccination in pregnancy; however, there is a lack of systematic monitoring and therefore knowledge of vaccine uptake, safety and effectiveness in Australia, and specifically among Aboriginal and Torres Strait Islander women. The limited data available suggest there is a lower uptake of maternal vaccination among Aboriginal and Torres Strait Islander women compared to non-Aboriginal and Torres Strait Islander women, and this review seeks to explore potential reasons and the knowledge gaps in this regard. Other key gaps include the equitable access to quality antenatal care for Aboriginal and Torres Strait Islander women; and pregnancy loss <20 weeks gestation. Furthermore, our review highlights the importance of addressing these gaps in maternal vaccination strategies in partnership with Aboriginal and Torres Strait Islander peoples.
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Affiliation(s)
- Lisa McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Amy Creighton
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Michael Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Department of Population Health, National Centre for Epidemiology, Australian National University, Canberra, Australian Capital Territory, Australia
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Cardoso AM, Resende PC, Paixao ES, Tavares FG, Farias YN, Barreto CTG, Pantoja LN, Ferreira FL, Martins AL, Lima ÂB, Fernandes DA, Sanches PM, Almeida WAF, Rodrigues LC, Siqueira MM. Investigation of an outbreak of acute respiratory disease in an indigenous village in Brazil: Contribution of Influenza A(H1N1)pdm09 and human respiratory syncytial viruses. PLoS One 2019; 14:e0218925. [PMID: 31283762 PMCID: PMC6613774 DOI: 10.1371/journal.pone.0218925] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 06/13/2019] [Indexed: 11/18/2022] Open
Abstract
Analyses of the 2009 H1N1 influenza pandemic and post-pandemic years showed high attack rates and severity among indigenous populations. This study presents the characteristics of the first documented influenza outbreak in indigenous peoples in Brazil, that occurred from 30th March to 14th April 2016 in a Guarani village in Southeast Region. Acute respiratory infections were prospectively investigated. The majority of the 73 cases were influenza-like illness (ILI) (63.0%) or severe acute respiratory infection (SARI) (20.5%). The ILI+SARI attack rate (35.9%) decreased with increasing age. There was a high influenza vaccination rate (86.3%), but no statistically significant difference in vaccination rates between severe and non-severe cases was seen (p = 0.334). Molecular analyses of 19.2% of the cases showed 100% positivity for influenza A(H1N1)pdm09 and/or hRSV. Influenza A(H1N1)pdm09 was included in the 6B.1 genetic group, a distinct cluster with 13 amino acid substitutions of A/California/07/2009-like. The hRSV were clustered in the BA-like genetic group. The early arrival of the influenza season overlapping usual hRSV season, the circulation of a drifted influenza virus not covered by vaccine and the high prevalence of risk factors for infection and severity in the village jointly can explain the high attack rate of ARI, even with a high rate of influenza vaccination. The results reinforce the importance of surveillance of respiratory viruses, timely vaccination and controlling risk factors for infection and severity of in the indigenous populations in order to preventing disease and related deaths, particularly in children.
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Affiliation(s)
- Andrey Moreira Cardoso
- Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Enny S. Paixao
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Ao T, McCracken JP, Lopez MR, Bernart C, Chacon R, Moscoso F, Paredes A, Castillo L, Azziz-Baumgartner E, Arvelo W, Lindblade KA, Peruski LF, Bryan JP. Hospitalization and death among patients with influenza, Guatemala, 2008-2012. BMC Public Health 2019; 19:463. [PMID: 32326933 PMCID: PMC6696630 DOI: 10.1186/s12889-019-6781-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Influenza is a major cause of respiratory illness resulting in 3–5 million severe cases and 291,243-645,832 deaths annually. Substantial health and financial burden may be averted by annual influenza vaccine application, especially for high risk groups. Methods We used an active facility-based surveillance platform for acute respiratory diseases in three hospitals in Guatemala, Central America, to estimate the incidence of laboratory-confirmed hospitalized influenza cases and identify risk factors associated with severe disease (defined as admission to the intensive care unit (ICU) or death). We enrolled patients presenting with signs and symptoms of acute respiratory infection (ARI) and obtained naso- and oropharyngeal samples for real-time reverse transcriptase polymerase chain reaction (RT-PCR). We used multivariable logistic regression to identify risk factors for ICU admission or death, adjusted for age and sex. Results From May 2008 to July 2012, among 6326 hospitalized ARI cases, 446 (7%) were positive for influenza: of those, 362 (81%) had influenza A and 84 (18%) had influenza B. Fifty nine percent of patients were aged ≤ 5 years, and 10% were aged ≥ 65 years. The median length of hospitalization was 5 days (interquartile range: 5). Eighty of 446 (18%) were admitted to the ICU and 28 (6%) died. Among the 28 deaths, 7% were aged ≤ 6 months, 39% 7–60 months, 21% 5–50 years, and 32% ≥ 50 years. Children aged ≤ 6 months comprised 19% of cases and 22% of ICU admissions. Women of child-bearing age comprised 6% of cases (2 admitted to ICU; 1 death). In multivariable analyses, Santa Rosa site (adjusted odds ratio [aOR] = 10, 95% confidence interval [CI] = 2–50), indigenous ethnicity (aOR = 4, 95% CI = 2–13, and radiologically-confirmed pneumonia (aOR = 5, 95% CI = 3–11) were independently associated with severe disease. Adjusted for hospital utilization rate, annual incidence of hospitalized laboratory-confirmed influenza was 24/100,000 overall, 93/100,000 for children aged < 5 years and 50/100,000 for those ≥ 65 years. Conclusions Influenza is a major contributor of hospitalization and death due to respiratory diseases in Guatemala. Further application of proven influenza prevention and treatment strategies is warranted.
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Affiliation(s)
- Trong Ao
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS E-04, Atlanta, GA, 30329, USA.
| | - John P McCracken
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala.,Global Disease Detection Program, CDC Central America Regional Office, Guatemala City, Guatemala
| | - Maria Rene Lopez
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Chris Bernart
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Rafael Chacon
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Fabiola Moscoso
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Antonio Paredes
- Ministry of Public Health and Social Welfare, Guatemala City, Guatemala
| | - Leticia Castillo
- Ministry of Public Health and Social Welfare, Guatemala City, Guatemala
| | | | - Wences Arvelo
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS E-04, Atlanta, GA, 30329, USA.,Global Disease Detection Program, CDC Central America Regional Office, Guatemala City, Guatemala
| | - Kim A Lindblade
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS E-04, Atlanta, GA, 30329, USA.,Global Disease Detection Program, CDC Central America Regional Office, Guatemala City, Guatemala
| | - Leonard F Peruski
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS E-04, Atlanta, GA, 30329, USA.,Global Disease Detection Program, CDC Central America Regional Office, Guatemala City, Guatemala
| | - Joe P Bryan
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS E-04, Atlanta, GA, 30329, USA.,Global Disease Detection Program, CDC Central America Regional Office, Guatemala City, Guatemala
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Wellington D, Laurenson-Schafer H, Abdel-Haq A, Dong T. IFITM3: How genetics influence influenza infection demographically. Biomed J 2019; 42:19-26. [PMID: 30987701 PMCID: PMC6468115 DOI: 10.1016/j.bj.2019.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/06/2018] [Accepted: 01/07/2019] [Indexed: 12/18/2022] Open
Abstract
The role of host genetics in influenza infection is unclear despite decades of interest. Confounding factors such as age, sex, ethnicity and environmental factors have made it difficult to assess the role of genetics without influence. In recent years a single nucleotide polymorphism, interferon-induced transmembrane protein 3 (IFITM3) rs12252, has been shown to alter the severity of influenza infection in Asian populations. In this review we investigate this polymorphism as well as several others suggested to alter the host's defence against influenza infection. In addition, we highlight the open questions surrounding the viral restriction protein IFITM3 with the hope that by answering some of these questions we can elucidate the mechanism of IFITM3 viral restriction and therefore how this restriction is altered due to the rs12252 polymorphism.
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Affiliation(s)
- Dannielle Wellington
- MRC Human Immunology Unit, WIMM, University of Oxford, OX3 9DS, UK; CAMS Oxford Institute, Nuffield Department of Medicine, Oxford University, OX3 9FZ, UK.
| | - Henry Laurenson-Schafer
- MRC Human Immunology Unit, WIMM, University of Oxford, OX3 9DS, UK; CAMS Oxford Institute, Nuffield Department of Medicine, Oxford University, OX3 9FZ, UK
| | - Adi Abdel-Haq
- MRC Human Immunology Unit, WIMM, University of Oxford, OX3 9DS, UK; Martin-Luther-University, Halle-Wittenberg, Germany
| | - Tao Dong
- MRC Human Immunology Unit, WIMM, University of Oxford, OX3 9DS, UK; CAMS Oxford Institute, Nuffield Department of Medicine, Oxford University, OX3 9FZ, UK.
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McHugh L, Andrews R, Leckning B, Snelling T, Binks M. Baseline incidence of adverse birth outcomes and infant influenza and pertussis hospitalisations prior to the introduction of influenza and pertussis vaccination in pregnancy: a data linkage study of 78 382 mother-infant pairs, Northern Territory, Australia, 1994-2015. Epidemiol Infect 2019; 147:e233. [PMID: 31364572 PMCID: PMC6627012 DOI: 10.1017/s0950268819001171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 11/18/2022] Open
Abstract
We conducted probabilistic data linkage of three population datasets for the Northern Territory (NT), Australia, to describe the incidence of preterm births, stillbirths, low birthweight and small for gestational age (SGA) per 1000 NT births; and influenza and pertussis hospitalisations per 1 00 000 NT births in infants <7 months of age, in a pre-maternal vaccination era. The Perinatal Trends dataset (1994-2014) formed the cohort of 78 382 births. Aboriginal mother-infant pairs (37%) had disproportionately higher average annual rates (AR) for all adverse birth outcomes compared to their non-Aboriginal counterparts; rate ratios: preterm births 2.2 (AR 142.4 vs. 64.7); stillbirths 2.3 (AR 10.8 vs. 4.6); low birthweight 2.9 (AR 54 vs. 19); and SGA 1.7 (AR 187 vs. 111). Hospitalisation (2000-2015) and Immunisation Register datasets (1994-2015), showed that influenza hospitalisations (n = 53) and rates were 42.3 times higher in Aboriginal infants (AR 254 vs. 6); and that pertussis hospitalisations (n = 37) were 7.1 times higher in Aboriginal infants (AR 142.5 vs. 20.2) compared to non-Aboriginal infants. These baseline data are essential to assess the safety and effectiveness of influenza and pertussis vaccinations in pregnant women from the NT. Remote living Aboriginal women and infants stand to benefit the most from these vaccines.
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Affiliation(s)
- L. McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - R.M. Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
- National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - B. Leckning
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - T. Snelling
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
- Curtin University, School of Public Health, Perth, Western Australia
- University of Western Australia Perth, Western Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia
| | - M.J. Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
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40
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Planning for and responding to pandemic influenza emergencies: it's time to listen to, prioritize and privilege Aboriginal perspectives. Western Pac Surveill Response J 2018; 9:5-7. [PMID: 31832246 PMCID: PMC6902653 DOI: 10.5365/wpsar.2018.9.5.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Short KR, Kedzierska K, van de Sandt CE. Back to the Future: Lessons Learned From the 1918 Influenza Pandemic. Front Cell Infect Microbiol 2018; 8:343. [PMID: 30349811 PMCID: PMC6187080 DOI: 10.3389/fcimb.2018.00343] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 01/02/2023] Open
Abstract
2018 marks the 100-year anniversary of the 1918 influenza pandemic, which killed ~50 million people worldwide. The severity of this pandemic resulted from a complex interplay between viral, host, and societal factors. Here, we review the viral, genetic and immune factors that contributed to the severity of the 1918 pandemic and discuss the implications for modern pandemic preparedness. We address unresolved questions of why the 1918 influenza H1N1 virus was more virulent than other influenza pandemics and why some people survived the 1918 pandemic and others succumbed to the infection. While current studies suggest that viral factors such as haemagglutinin and polymerase gene segments most likely contributed to a potent, dysregulated pro-inflammatory cytokine storm in victims of the pandemic, a shift in case-fatality for the 1918 pandemic toward young adults was most likely associated with the host's immune status. Lack of pre-existing virus-specific and/or cross-reactive antibodies and cellular immunity in children and young adults likely contributed to the high attack rate and rapid spread of the 1918 H1N1 virus. In contrast, lower mortality rate in in the older (>30 years) adult population points toward the beneficial effects of pre-existing cross-reactive immunity. In addition to the role of humoral and cellular immunity, there is a growing body of evidence to suggest that individual genetic differences, especially involving single-nucleotide polymorphisms (SNPs), contribute to differences in the severity of influenza virus infections. Co-infections with bacterial pathogens, and possibly measles and malaria, co-morbidities, malnutrition or obesity are also known to affect the severity of influenza disease, and likely influenced 1918 H1N1 disease severity and outcomes. Additionally, we also discuss the new challenges, such as changing population demographics, antibiotic resistance and climate change, which we will face in the context of any future influenza virus pandemic. In the last decade there has been a dramatic increase in the number of severe influenza virus strains entering the human population from animal reservoirs (including highly pathogenic H7N9 and H5N1 viruses). An understanding of past influenza virus pandemics and the lessons that we have learnt from them has therefore never been more pertinent.
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Affiliation(s)
- Kirsty R. Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Carolien E. van de Sandt
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
- Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
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42
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The extensive networks of frequent population mobility in the Samoan Islands and their implications for infectious disease transmission. Sci Rep 2018; 8:10136. [PMID: 29973612 PMCID: PMC6031642 DOI: 10.1038/s41598-018-28081-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/15/2018] [Indexed: 11/09/2022] Open
Abstract
Population mobility has been demonstrated to contribute to the persistent transmission and global diffusion of epidemics. In the Pacific Islands, population mobility is particularly important for emerging infectious diseases, disease elimination programs, and diseases spread by close contact. The extent of population mobility between American Samoa villages, Samoa districts and other countries was investigated based on travel data collected during community surveys in American Samoa in 2010 and 2014. Within American Samoa, workers commuted daily across the whole of the main island of Tutuila, with work hubs drawing from villages across the island. Of the 670 adult workers surveyed, 37% had traveled overseas in the past year, with 68% of trips to Samoa. Of children aged 8–13 years (n = 337), 57% had traveled overseas, with 55% of trips to Samoa. An extensive network of connections between American Samoa villages and Samoa districts was demonstrated, with most trips lasting one week to one month. Our study showed that populations in the Samoan islands are highly mobile, and quantified the extent and destinations of their travels. Our findings offer insight into the impact of population mobility on the transmission of infectious diseases and data to refine existing models of disease transmission in the Pacific islands.
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Clemens EB, van de Sandt C, Wong SS, Wakim LM, Valkenburg SA. Harnessing the Power of T Cells: The Promising Hope for a Universal Influenza Vaccine. Vaccines (Basel) 2018; 6:vaccines6020018. [PMID: 29587436 PMCID: PMC6027237 DOI: 10.3390/vaccines6020018] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 02/07/2023] Open
Abstract
Next-generation vaccines that utilize T cells could potentially overcome the limitations of current influenza vaccines that rely on antibodies to provide narrow subtype-specific protection and are prone to antigenic mismatch with circulating strains. Evidence from animal models shows that T cells can provide heterosubtypic protection and are crucial for immune control of influenza virus infections. This has provided hope for the design of a universal vaccine able to prime against diverse influenza virus strains and subtypes. However, multiple hurdles exist for the realisation of a universal T cell vaccine. Overall primary concerns are: extrapolating human clinical studies, seeding durable effective T cell resident memory (Trm), population human leucocyte antigen (HLA) coverage, and the potential for T cell-mediated immune escape. Further comprehensive human clinical data is needed during natural infection to validate the protective role T cells play during infection in the absence of antibodies. Furthermore, fundamental questions still exist regarding the site, longevity and duration, quantity, and phenotype of T cells needed for optimal protection. Standardised experimental methods, and eventually simplified commercial assays, to assess peripheral influenza-specific T cell responses are needed for larger-scale clinical studies of T cells as a correlate of protection against influenza infection. The design and implementation of a T cell-inducing vaccine will require a consensus on the level of protection acceptable in the community, which may not provide sterilizing immunity but could protect the individual from severe disease, reduce the length of infection, and potentially reduce transmission in the community. Therefore, increasing the standard of care potentially offered by T cell vaccines should be considered in the context of pandemic preparedness and zoonotic infections, and in combination with improved antibody vaccine targeting methods. Current pandemic vaccine preparedness measures and ongoing clinical trials under-utilise T cell-inducing vaccines, reflecting the myriad questions that remain about how, when, where, and which T cells are needed to fight influenza virus infection. This review aims to bring together basic fundamentals of T cell biology with human clinical data, which need to be considered for the implementation of a universal vaccine against influenza that harnesses the power of T cells.
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Affiliation(s)
- E Bridie Clemens
- Department of Microbiology and Immunology, The University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia.
| | - Carolien van de Sandt
- Department of Microbiology and Immunology, The University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia.
| | - Sook San Wong
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
| | - Linda M Wakim
- Department of Microbiology and Immunology, The University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia.
| | - Sophie A Valkenburg
- HKU Pasteur Research Pole, School of Public Health, University of Hong Kong, Hong Kong 999077, China.
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Sambaturu N, Mukherjee S, López-García M, Molina-París C, Menon GI, Chandra N. Role of genetic heterogeneity in determining the epidemiological severity of H1N1 influenza. PLoS Comput Biol 2018; 14:e1006069. [PMID: 29561846 PMCID: PMC5880410 DOI: 10.1371/journal.pcbi.1006069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 04/02/2018] [Accepted: 02/26/2018] [Indexed: 12/31/2022] Open
Abstract
Genetic differences contribute to variations in the immune response mounted by different individuals to a pathogen. Such differential response can influence the spread of infectious disease, indicating why such diseases impact some populations more than others. Here, we study the impact of population-level genetic heterogeneity on the epidemic spread of different strains of H1N1 influenza. For a population with known HLA class-I allele frequency and for a given H1N1 viral strain, we classify individuals into sub-populations according to their level of susceptibility to infection. Our core hypothesis is that the susceptibility of a given individual to a disease such as H1N1 influenza is inversely proportional to the number of high affinity viral epitopes the individual can present. This number can be extracted from the HLA genetic profile of the individual. We use ethnicity-specific HLA class-I allele frequency data, together with genome sequences of various H1N1 viral strains, to obtain susceptibility sub-populations for 61 ethnicities and 81 viral strains isolated in 2009, as well as 85 strains isolated in other years. We incorporate these data into a multi-compartment SIR model to analyse the epidemic dynamics for these (ethnicity, viral strain) epidemic pairs. Our results show that HLA allele profiles which lead to a large spread in individual susceptibility values can act as a protective barrier against the spread of influenza. We predict that populations skewed such that a small number of highly susceptible individuals coexist with a large number of less susceptible ones, should exhibit smaller outbreaks than populations with the same average susceptibility but distributed more uniformly across individuals. Our model tracks some well-known qualitative trends of influenza spread worldwide, suggesting that HLA genetic diversity plays a crucial role in determining the spreading potential of different influenza viral strains across populations. Levels of immunity to strains of H1N1 influenza can vary, depending on the individual. This strongly influences how the disease spreads in a population. Accounting for such variations is a major challenge for the epidemiology of infectious diseases. We study the effect of population-level genetic heterogeneity on the epidemic spread of different strains of H1N1 influenza. We model the immune response of specific ethnicities to a number of H1N1 viral strains, using this information to study disease spread for these (ethnicity, viral strain) epidemic pairs. Our results show that larger genetic diversity at the level of immune response, leading to the presence of susceptibility sub-populations with a broad distribution of susceptibilities, protects against the spread of influenza in a population. We also show that populations with a small number of highly susceptible individuals, but with a large number of less susceptible ones, should exhibit smaller outbreaks than populations with the same average susceptibility but where it is more uniformly distributed. Our work captures some qualitative trends of influenza spread worldwide, providing a first attempt at understanding how susceptibility heterogeneities arising from variations in immune response determine disease spread in populations.
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Affiliation(s)
- Narmada Sambaturu
- IISc Mathematics Initiative, Indian Institute of Science, Bangalore, Karnataka, India
| | - Sumanta Mukherjee
- IISc Mathematics Initiative, Indian Institute of Science, Bangalore, Karnataka, India
| | - Martín López-García
- Department of Applied Mathematics, University of Leeds, Leeds, United Kingdom
| | - Carmen Molina-París
- Department of Applied Mathematics, University of Leeds, Leeds, United Kingdom
| | - Gautam I. Menon
- Computational Biology and Theoretical Physics groups, The Institute of Mathematical Sciences, Chennai, Tamil Nadu, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, Maharashtra, India
- * E-mail: (NC); (GIM)
| | - Nagasuma Chandra
- IISc Mathematics Initiative, Indian Institute of Science, Bangalore, Karnataka, India
- Department of Biochemistry, Indian Institute of Science, Bangalore, Karnataka, India
- * E-mail: (NC); (GIM)
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45
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Jung JJ, Pinto R, Zarychanski R, Cook DJ, Jouvet P, Marshall JC, Kumar A, Long J, Rodin R, Fowler RA. 2009-2010 Influenza A(H1N1)-related critical illness among Aboriginal and non-Aboriginal Canadians. PLoS One 2017; 12:e0184013. [PMID: 29049285 PMCID: PMC5648104 DOI: 10.1371/journal.pone.0184013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 11/24/2022] Open
Abstract
Background Preliminary studies suggested that Aboriginal Canadians had disproportionately higher rates of infection, hospitalization, and critical illness due to pandemic Influenza A(H1N1)pdm09. Methods We used a prospective cohort study of critically ill patients with laboratory confirmed or probable H1N1 infection in Canada between April 16 2009 and April 12 2010. Baseline characteristics, medical interventions, clinical course and outcomes were compared between Aboriginal and non-Aboriginal patients. The primary outcome was hospital mortality. Results Of 647 critically ill adult patients with known ethnicity, 81 (12.5%) were Aboriginal, 566 (87.5%) were non-Aboriginal. Aboriginal patients were younger (mean [SD] age 40.7[13.7] v. 49.0[14.9] years, p < 0.001) and more frequently female (64.2% v. 51.1%, p = 0.027). Rates of any co-morbid illnesses (Aboriginal v. non-Aboriginal, 92.6% v. 91.0%, p = 0.63), time from symptom onset to hospital admission (median [interquartile range] 4 [2–7] v. 4 [2–7] days, p = 0.84), time to ICU admission (5 [3–8] v.5 [3–8] days, p = 0.91), and severity of illness (mean APACHE II score (19.9 [9.6] v. 21.1 [9.9], p = 0.33) were similar. A similar proportion of Aboriginal patients received antiviral medication before ICU admission than non-Aboriginal patients (91.4% v. 93.8%, p = 0.40). Among Aboriginal versus non-Aboriginal patients, the need for mechanical ventilation (93.8% v. 88.6%, p = 0.15), ventilator-free days (14 [3–23] v. 17 [0–24], p = 0.62), durations of stay in ICU (13[7-19.5] v. 11 [5–8] days, p = 0.05), hospital (19 [12.5-33.5] v. 18 [11-35] days, p = 0.63), and hospital mortality were similar (19.8% v. 22.6%, p = 0.56). In multiple logistic regression analyses, higher APACHE II score (1.06; 1.04-1.09, p<0.001) was independently associated with an increased risk of death; antiviral treatment with a lower risk of death (0.34; 0.15 – 0.78, p = 0.01). Ethnicity was not associated with mortality. Interpretation During the 2009-2010 Influenza A (H1N1) pandemic, Aboriginal and non-Aboriginal Canadians with H1N1-related critical illness had a similar risk of death, after adjusting for potential confounding factors.
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Affiliation(s)
- James J. Jung
- University of Toronto, Faculty of Medicine. Department of Critical Care Medicine; Sunnybrook Hospital; Toronto, Ontario, Canada
| | - Ruxandra Pinto
- Department of Critical Care Medicine; Sunnybrook Hospital; Toronto, Ontario, Canada
| | | | - Deborah J. Cook
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Philippe Jouvet
- Le Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | | | - Anand Kumar
- University of Manitoba Health Sciences Centre, Section of Critical Care Medicine, Winnipeg MB, Canada
| | - Jennifer Long
- Department of Critical Care Medicine; Sunnybrook Hospital; Toronto, Ontario, Canada
| | | | - Robert A. Fowler
- University of Toronto Departments of Medicine and Critical Care Medicine; Sunnybrook Hospital Toronto, Ontario, Canada
- * E-mail:
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Influenza A (H1N1pdm09)-Related Critical Illness and Mortality in Mexico and Canada, 2014. Crit Care Med 2017; 44:1861-70. [PMID: 27359085 DOI: 10.1097/ccm.0000000000001830] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The 2009-2010 influenza A (H1N1pdm09) pandemic caused substantial morbidity and mortality among young patients; however, mortality estimates have been confounded by regional differences in eligibility criteria and inclusion of selected populations. In 2013-2014, H1N1pdm09 became North America's dominant seasonal influenza strain. Our objective was to compare the baseline characteristics, resources, and treatments with outcomes among critically ill patients with influenza A (H1N1pdm09) in Mexican and Canadian hospitals in 2014 using consistent eligibility criteria. DESIGN Observational study and a survey of available healthcare setting resources. SETTING Twenty-one hospitals, 13 in Mexico and eight in Canada. PATIENTS Critically ill patients with confirmed H1N1pdm09 during 2013-2014 influenza season. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The main outcome measures were 90-day mortality and independent predictors of mortality. Among 165 adult patients with H1N1pdm09-related critical illness between September 2013 and March 2014, mean age was 48.3 years, 64% were males, and nearly all influenza was community acquired. Patients were severely hypoxic (median PaO2-to-FIO2 ratio, 83 mm Hg), 97% received mechanical ventilation, with mean positive end-expiratory pressure of 14 cm H2O at the onset of critical illness and 26.7% received rescue oxygenation therapy with prone ventilation, extracorporeal life support, high-frequency oscillatory ventilation, or inhaled nitric oxide. At 90 days, mortality was 34.6% (13.9% in Canada vs 50.5% in Mexico, p < 0.0001). Independent predictors of mortality included lower presenting PaO2-to-FIO2 ratio (odds ratio, 0.89 per 10-point increase [95% CI, 0.80-0.99]), age (odds ratio, 1.49 per 10 yr increment [95% CI, 1.10-2.02]), and requiring critical care in Mexico (odds ratio, 7.76 [95% CI, 2.02-27.35]). ICUs in Canada generally had more beds, ventilators, healthcare personnel, and rescue oxygenation therapies. CONCLUSIONS Influenza A (H1N1pdm09)-related critical illness still predominantly affects relatively young to middle-aged patients and is associated with severe hypoxemic respiratory failure. The local critical care system and available resources may be influential determinants of patient outcome.
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Grohskopf LA, Sokolow LZ, Broder KR, Olsen SJ, Karron RA, Jernigan DB, Bresee JS. Prevention and Control of Seasonal Influenza with Vaccines. MMWR Recomm Rep 2016; 65:1-54. [PMID: 27560619 DOI: 10.15585/mmwr.rr6505a1] [Citation(s) in RCA: 295] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This report updates the 2015-16 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines (Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 influenza season. MMWR Morb Mortal Wkly Rep 2015;64:818-25). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For the 2016-17 influenza season, inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will be available in a trivalent formulation (RIV3). In light of concerns regarding low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, for the 2016-17 season, ACIP makes the interim recommendation that live attenuated influenza vaccine (LAIV4) should not be used. Vaccine virus strains included in the 2016-17 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines will include an additional influenza B virus strain, a B/Phuket/3073/2013-like virus (Yamagata lineage).Recommendations for use of different vaccine types and specific populations are discussed. A licensed, age-appropriate vaccine should be used. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended product is otherwise appropriate. This information is intended for vaccination providers, immunization program personnel, and public health personnel. Information in this report reflects discussions during public meetings of ACIP held on October 21, 2015; February 24, 2016; and June 22, 2016. These recommendations apply to all licensed influenza vaccines used within Food and Drug Administration-licensed indications, including those licensed after the publication date of this report. Updates and other information are available at CDC's influenza website (http://www.cdc.gov/flu). Vaccination and health care providers should check CDC's influenza website periodically for additional information.
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Affiliation(s)
- Lisa A Grohskopf
- Influenza Division, National Center for Immunization and Respiratory Diseases, CDC
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Culqui DR, Ayuso-Alvarez A, Munayco CV, Quispe-Huaman C, Mayta-Tristán P, Campos JDMD. Demographic and health attributes of the Nahua, initial contact population of the Peruvian Amazon. CIENCIA & SAUDE COLETIVA 2016; 21:273-84. [PMID: 26816184 DOI: 10.1590/1413-81232015211.20502014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 05/21/2015] [Indexed: 11/21/2022] Open
Abstract
We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's population, considered of initial contact. This population consists of human groups that for a long time decided to live in isolation, but lately have begun living a more sedentary lifestyle and in contact with Western populations. There are two fully identified initial contact groups in Peru: the Nahua and the Nanti. The health statistics of the Nahua are scarce. This study offers an interpretation of demographic and epidemiological indicators of the Nahua people, trying to identify if a certain degree of health vulnerability exists. We performed a cross sectional study, and after analyzing their health indicators, as well as the supplemental qualitative analysis of the population, brought us to conclude that in 2006, the Nahua, remained in a state of health vulnerability.
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Affiliation(s)
- Dante R Culqui
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España,
| | - Ana Ayuso-Alvarez
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España,
| | - Cesar V Munayco
- Department of Preventive Medicine and Biometrics Uniformed Services, University of Health Sciences, USA
| | - Carlos Quispe-Huaman
- Instituto Nacional de Desarrollo de Pueblos Andinos, Amazónicos y Afroperuanos, España
| | | | - Juan de Mata Donado Campos
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, España
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49
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Clemens EB, Grant EJ, Wang Z, Gras S, Tipping P, Rossjohn J, Miller A, Tong SYC, Kedzierska K. Towards identification of immune and genetic correlates of severe influenza disease in Indigenous Australians. Immunol Cell Biol 2015; 94:367-77. [PMID: 26493179 PMCID: PMC4840236 DOI: 10.1038/icb.2015.93] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 01/11/2023]
Abstract
Indigenous populations, including Indigenous Australians, are highly susceptible to severe influenza disease and the underlying mechanisms are unknown. We studied immune and genetic factors that could predicate severe influenza disease in Indigenous Australians enrolled in the LIFT study: looking into influenza T-cell immunity. To examine CD8+ T-cell immunity, we characterised human leukocyte antigen (HLA) profiles. HLA typing confirmed previous studies showing predominant usage of HLA-A*02:01, 11:01, 24:02, 34:01 and HLA-B*13:01, 15:21, 40:01/02, 56:01/02 in Indigenous Australians. We identified two new HLA alleles (HLA-A*02:new and HLA-B*56:new). Modelling suggests that variations within HLA-A*02:new (but not HLA-B56:new) could affect peptide binding. There is a relative lack of known influenza epitopes for the majority of these HLAs, with the exception of a universal HLA-A*02:01-M158 epitope and proposed epitopes presented by HLA-A*11:01/HLA-A*24:02. To dissect universal CD8+ T-cell responses, we analysed the magnitude, function and T-cell receptor (TCR) clonality of HLA-A*02:01-M158+CD8+ T cells. We found comparable IFN-γ, TNF and CD107a and TCRαβ characteristics in Indigenous and non-Indigenous Australians, suggesting that the ~15% of Indigenous people that express HLA-A*02:01 have universal influenza-specific CD8+ T-cell immunity. Furthermore, the frequency of an influenza host risk factor, IFITM3-C/C, was comparable between Indigenous Australians and Europeans, suggesting that expression of this allele does not explain increased disease severity at a population level. Our study indicates a need to identify novel influenza-specific CD8+ T-cell epitopes restricted by HLA-A and HLA-B alleles prevalent in Indigenous populations for the rational design of universal T-cell vaccines.
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Affiliation(s)
- E Bridie Clemens
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Emma J Grant
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Zhongfang Wang
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Stephanie Gras
- Infection and Immunity Program, Biomedicine Discovery Institute and The Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Clayton, Victoria, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia
| | - Peta Tipping
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Jamie Rossjohn
- Infection and Immunity Program, Biomedicine Discovery Institute and The Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Clayton, Victoria, Australia.,Australian Research Council Centre of Excellence for Advanced Molecular Imaging, Monash University, Clayton, Victoria, Australia.,Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - Adrian Miller
- Indigenous Research Network, Griffith University, Brisbane, Queensland, Australia
| | - Steven Y C Tong
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Khieu TQ, Pierse N, Telfar-Barnard LF, Huang QS, Baker MG. Estimating the contribution of influenza to hospitalisations in New Zealand from 1994 to 2008. Vaccine 2015; 33:4087-92. [DOI: 10.1016/j.vaccine.2015.06.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/08/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
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