A statistical assessment of association between meteorological parameters and COVID-19 pandemic in 10 countries

Background Eleven out of 13 published articles reported temperature and humidity as factors that could reduce the daily confirmed COVID-19 cases among many other findings. However, there are significant caveats, related to statistical assumptions and the spatial-temporal nature of the data. Methods Associative and causative analyses of data was conducted for 10 countries representing 6 continents of the world, with data obtained between January 22, 2020 to April 30, 2020. Daily confirmed cases, number of deaths, recovered cases, lockdown stringency index, and several meteorological factors are considered. Also, a Granger-Causality test was performed to check if any COVID-19 outcomes are influenced by itself and not by any or combination of maximum temperature, humidity, wind speed and stringency index. Results Most of the associations reported in the literature, between meteorological parameters and COVID-19 pandemic are weak evidence, need to be interpreted with caution, as most of these articles neglected the temporal spatial nature of the data. Based on our findings, most of the correlations no matter which coefficient is used are mostly and strictly between -0.5 and 0.5, and these are weak correlations. An interesting finding is the correlation between stringency and each of the COVID-19 outcomes, the strongest being between stringency and confirmed cases, 0.80 (0.78, 0.82) P<.0001. Similarly, wind speed is weakly associated with recovery rate, 0.22 (0.16, 0.28) P<.0001. Lastly, the Granger-Causality test of no dependencies was accepted at P=0.1593, suggesting independence among the parameters. Conclusions Although many articles reported association between meteorological parameters and COVID-19, they mainly lack strong evidence and clear interpretation of the statistical results (e.g. underlying assumption, confidence intervals, a clear hypothesis). Our findings showed that, without effective control measures, strong outbreaks are likely in more windy climates and summer weather, humidity or warmer temperature will not substantially limit pandemic growth.Peer reviewedFinal Published versio

A cautionary note on the association between meteorological parameters and COVID-19 pandemic

Will the increasing temperature and humidity stop the spread of coronavirus, like seasonal patterns seen in viruses like influenza? In the authors’ opinion, weather has little or no part to play in bringing an end to the pandemic. As soon as the World Health Organization (WHO) declared the COVID-19 a pandemic, many published articles reported temperature and humidity as potential weather parameter that could wane off the daily confirmed COVID-19 cases [1,2]. COVID-19 pandemic has set the globe on a medical emergency by constituting a threat to human existence. A holistic and non-medically related approach to the reduction in disease burden is urgently required. Most countries have gradually tightened lockdown policies and citizens are recommended to stay at home and preserve the physical distance. On the other hand, this concept demands critical review of the meteorological parameters and its relationship with the disease transmission, morbidity and mortality of COVID-19 which has been a subject of research since its outbreak. Several postulations to the uneven disease burden in various regions were adduced to the climatic variations.Peer reviewedFinal Published versio

Influenza, malaria parasitemia, and typhoid fever coinfection in children: Seroepidemiological investigation in four Health-care Centers in Lagos, Nigeria

Objectives: There are similarities in the presentation of influenza-A infection, malaria, and typhoid fever which include their overlapping clinical symptoms such as fever and myalgia. Coinfection may be easily missed and may lead to more severe associated morbidity. This study, therefore, investigated the prevalence of coinfection of influenza A, malaria, and typhoid fever in children in four locations in Lagos and determined their age, gender, and location-related prevalence.Materials and Methods: A cross-sectional hospital-based study was conducted between March and October 2018. Children less than 15 years attending four health centers in Festac, Amuwo, Ojo, and Shibiri were recruited consecutively. Demographic and epidemiological data were obtained using structured questionnaires, to ascertain children with influenza-like symptoms. Their blood samples were then tested with rapid diagnostic method for malaria and typhoid fever. The children were further screened for influenza-A-specific IgM using ELISA method. Descriptive statistics were reported while p-values were determined for comparable parameters using Chi-square.Results: There were 364 children aged &lt;1–14 years including 207 (56.9%) males. Of the 364 children tested, 76/364 (20.9%) were seropositive for influenza-A virus out of which 47/76 (61.8%) had malaria parasitemia, 42/76 (55.3%) had typhoid fever, and 21/76 (27.6%) were coinfected with both malaria parasites and Salmonella enteric Typhi. Children coinfected with influenza-A and malaria were found with a higher frequency of chest pain and cold/chill symptom respectively compared to children having influenza alone (P = 0.0001). Seropositivity for influenza was recorded in all the months studied with the month of March recording the highest influenza-A seropositivity of 20/76 (26.3%) (P = 0.02).Conclusion: This study detected 27.6% trio coinfection seroprevalence of influenza Type-A, malaria, and typhoid fever among children population. The finding is unique being the first of such report, to the best of our knowledge. Children coinfected with influenza-A and malaria had greater morbidity

ASYMPTOMATIC INTESTINAL PROTOZOA IN SCHOOL AGE CHILDREN IN PATEGI, PATEGI LGA OF KWARA STATE, NIGERIA.

Intestinal protozoan infection is one of the principal diseases contributing to human illness and suffering in tropical countries with significant effect of morbidity and mortality on children. The prevalence of intestinal asymptomatic protozoan infection was assessed (November, 2012 through May, 2013) among school age children in Pategi, Pategi Local Government area of Kwara State, Nigeria. Four public primary schools with nursery, prebasic and basic sections were used for the study. The age range was from 1 to 15 years old. Seven hundred and forty eight (748) stool specimens were collected and examined for protozoan cysts using the direct wet preparation and formol-ether concentration methods. One hundred and ninety seven (26.3%) of the samples were positive for intestinal protozoan parasite. The distribution of the parasites was E. histolytica/dispar (75.1), E. coli (18.8) and G. lamblia (6.1%). Balantidium coli cyst was not detected in the stool samples of the pupils. Highest prevalence of E. histolytica was observed among Gboke primary school (35.0%), closely followed by Nyamkpan (31.7%) and Sudan Interior Mission (SIM) (5.9%). Due males (28.0%) were more infection and female (24.7%), the difference was not statistically significant (P>0.05) except for G. lamblia infection (

Impact of pre-exposure and post-exposure prophylaxes prevention programme on HIV burden and services in a low-resource setting: a simulation modelling approach

Introduction:&nbsp;sub-Saharan African countries contribute substantially to the global HIV disease burden. Despite this burden, and the promises that prevention could deliver, the implementation and uptake of HIV prevention programmes are still low. The study used the decision support system model to explore the potential impacts of prevention implementation on HIV burden (incidence) and service delivery. Methods:&nbsp;an operational research technique known as discrete event simulation model was used to capture an individual patient´s pathways through the HIV care process from diagnosis to treatment and monitoring. The regular monitoring, over a 5-year period, including all the activities and resources utilized at each stage of the pathway were analysed, and the impact of increasing prevention measures for an HIV treatment service in a treatment centre in Nigeria was tested using the simulation model. Results:&nbsp;forty-three patients currently access the Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) annually, with a 20% and 80% split in the number of patients offered PrEP and PEP, respectively. Scenarios-based on increasing the number of people offered PrEP and PEP from 43 to 250 with a 50/50 split were tested. The outputs revealed improved preventive care by averting new HIV cases, reduction in service demand and utilization, but an increase in the required human resource as well as financial burden. In the next 5 years, the cumulative averted HIV cases are expected to increase from 2 and 5 people (baseline) to 24 and 20 people for PrEP and PEP, respectively. The potentially averted 2 cases per infected persons based on the basic reproductive number of HIV. Conclusion:&nbsp;the effective implementation of PrEP/PEP programme offers an additional safety measure to prevent HIV transmission in at-risk individuals and possibility of ending HIV epidemic

SmartHIV Manager: a web-based computer simulation system for better management of HIV services

© Journal of Public Health and Emergency. All rights reserved. This work is licensed under CC-BY-NC_ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/)Background: Life-changing developments enabled people living with HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) to live a relatively normal life like the general population. However, there is not any user-friendly platform that enables key decision-makers to assess scenarios for improvement. Therefore, the objective of this study is to demonstrate the potentials of a web-based simulation system for effective and efficient management of HIV services. Methods: SmartHIV Manager is a web-based interactive planning platform for management of HIV services. Discrete event simulation technique is used to capture real-life HIV patients through HIV care continuum and all the resources needed. Patient flow information from HIV caregivers in three HIV treatment centres in Kenya and Nigeria was tested and validated. A total of 93 input parameters were established in the HIV pathway of care. Dashboards, which are fed by the simulation outcomes, were prepared to assess the impact of several interventions. The dashboard components include graphs and tables on service demand and utilization, preventive strategies, UNAIDS (the joint United Nations programme on HIV/AIDS) 90-90-90 goals, human resource management, budgeting and financial planning. Results: The usefulness and functionalities of the system is demonstrated on capacity planning in prevention programmes and UNAIDS 90-90-90 target. We ran scenarios based on increasing prevention measures and increasing the number of people on treatment to reach UNAIDS 90-90-90 target for a service in Nigeria. More cases are expected to be averted, where naïve patients reduced due to prevention measures. As the service struggled to achieve UNAIDS target, necessary outputs were generated, in the form of required resources to reach the target by 2025 and assessed the overall impact on service outcomes. Conclusions: A novel simulation powered technology is developed for effective HIV/AIDS management and control. This would give a robust patient care which can be properly evaluated and predicted in interventional implementation for appropriate policy directions.Peer reviewe

Modelling length of stay and patient flows : Methodological case studies from the UK neonatal care services

Copyright and all rights therein are retained by the authors. All persons copying this information are expected to adhere to the terms and conditions invoked by each author's copyright. These works may not be re-posted without the explicit permission of the copyright holdersThe number of babies needing neonatal care is increasing due mainly to technological and therapeutic advances. These advances have implied a decreasing neonatal mortality rate for low birth weight infants and also a falling incidence of preterm stillbirth. Given the structural changes in the National Health Service in England, coupled with recession and capacity constraints, the neonatal system is facing some serious challenges, such as nurse shortages and the lack of cots, which could inevitably impact neonates length of stay, and the performance of the system as a whole. These constraints have forced neonatal managers to better understand their organisation and operations in order to optimize their systems. As a result, we have developed three unique methodologies based on length of stay modelling, physical patient pathways, and system dynamics modelling. This paper evaluates these techniques applied to neonatal services in London, and showcases their usefulness and implications in practice, particularly focusing on patient flow to determine major drivers of the system, which could reduce inefficiencies, improve patient experience, and reduce cos

The Analyses of Individual Patient Pathways : Investigating Regional Variation in COPD readmissions

Regional variation for those treated for chronic obstructive pulmonary disease (COPD) has been studied amongst many public health issues. However, for those experiencing frequent readmissions were not considered. The objective is to determine the probability of a patient being in the high risk group in their next readmission, given patient and regional specific previous readmissions, i.e. capturing individual clinical pathways of patient's leading to multiple readmissions. Data on COPD patients were extracted from the national (England) hospital episodes statistics (HES) dataset. Individual patient pathways from initial admission through to more than four readmissions are captured. Here, patients are classified into the low risk of readmission group (LRRG) and the high risk of readmission group (HRRG). This classification is based on the definition of readmission, where we have previously developed a stochastic modelling approach to determine the appropriate width of a time window in defining readmission. Hence, using this classification as a response variable, a marginal continuation-ratio logit model is used to examine regional disparities in progressing through multiple readmissions. Significant regional differences were found in each readmission and classification groups (HRRG or LRRG). For example, COPD patients from the North West of England were found to be 16% more likely to experience multiple readmissions than Yorkshire and The Humber region

HISTORICAL DEVELOPMENT OF THE ORANYAN CULTURAL FESTIVAL IN NEW OYO: A STRATEGIC MEASURE TO PRESERVE YORÙBÁ ANTIQUITIES IN THE 21ST CENTURY

This study investigated the different ways in which Yorùbá cultural indigenous identities are presented to the world in contemporary times through the Oranyan festivals. The Oranyan festival in New Oyo is a traditional celebration of Yorùbá heritage, with roots dating back to the late 14th century. The cultural festivals of Oyo Yorùbá are diverse, but the Oranyan festival is unique in New Oyo because of its global acceptance orchestrated by His Royal Highness, the Alaafin of Oyo, the late Oba Lamidi Adeyemi Olayiwola III. The festival is one of the special annuals that attracts people from different parts of the universe. The event, since its commencement, has uniquely portrayed Yorùbá cultural values, mainly to present Yorùbá cultural values from a historical perspective against Eurocentric views, and characterised by handmade attire, sculptures, liturgical objects and other traditional instruments. This paper gave an in-depth analysis of the historical development of the Oranyan festival among the Yorùbá and its impact on global assessment in the African past. The study used primary and secondary data to elicit information. Primary sources involved archival materials, structured questionnaires, and in-depth interviews with rural and urban dwellers. Secondary sources included texts, articles, and newspapers to complement data from primary sources. The finding shows that the Oranyan festival plays a critical role in the affirmation of African pantheon and preserving Yorùbá antiquities in the 21st century. The paper concludes that the continued practice and celebration of the festival are essential for preserving Yorùbá antiquities and promoting a sense of identity and cultural heritage

HIV-MSS: A user-friendly management support system for better planning of HIV care services

© 2021 John Wiley & Sons Ltd. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1002/hpm.3268The advent of antiretroviral therapy (ART) has transformed HIV infection from a deadly disease to a manageable chronic condition. The life expectancy of people living with HIV has been prolonged dramatically. Therefore, health systems are now confronted with new challenges, with ever-increasing number of newly diagnosed cases, fuelling the pool of existing patients, with many comorbidities and requiring hospital admissions. Are health systems prepared to handle large and increasing numbers of people with HIV? We developed a HIV-Management Support System (MSS) to support service evaluation and management using simulation by capturing individual patient's pathways within HIV services in the United Kingdom. Two scenarios were tested: (1) the impact of increasing the number of diagnosed cases in steps of 5% on human resources and (2) the impact of treating all patients with ART on hospital admissions. A 5% increase in newly diagnosed HIV cases increases human resource requirements between 4% and 8%, whereas the impact of treating all HIV patients with ART on hospital admissions is far greater. HIV services are under intense pressure and managing patient and service needs are far more important than ever, hence the development of our HIV MSS is timely, to support better planning of services. Note that the HIV simulation model presented in this study is the first of its kind.Peer reviewe