2 research outputs found

    Potential of prevention strategies for the modifiable risk factor type 2 diabetes with relation to the future number of dementia patients in Germany– a multi-state projection through 2040

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    Background: We assess the impact of prevention strategies regarding type 2 diabetes as a modifiable risk factor for dementia and its consequences for the future number of dementia patients in Germany. Methods: We used a random sample of health claims data (N = 250,000) of insured persons aged 50+ drawn in 2014, and data on population size and death rates in 2015 from the Human Mortality Database. Using exponential hazard models, we calculated age- and sex-specific transition probabilities and death rates between the states (no diabetes/no dementia, diabetes/no dementia, no diabetes/dementia, diabetes/dementia). In multi-state projections, we estimated the future number of dementia cases aged 75+ through 2040 depending on the development of the incidence of diabetes among persons without diabetes and without dementia, and the dementia incidence among persons with and without diabetes. Results: In 2015 there were 1.53 million people with dementia aged 75+ in Germany. A relative annual reduction in death rates of 2.5% and in dementia incidence in persons without diabetes of 1% will increase this number to 3.38 million by 2040. A relative reduction of diabetes incidence by 1% annually would decrease dementia cases by around 30,000, while a reduction of dementia incidence among people with diabetes by 1% would result in 220,000 fewer dementia cases. Both prevention strategies combined would prevent 240,000 dementia cases in 2040. Conclusions: The increase in life expectancy is decisive for the future number of people with dementia. Strategies of better diabetes treatment have the potential to lower the increase in the number of dementia patients in the coming decades.Peer Reviewe

    A SARS-CoV-2 Omicron outbreak among crew members on a cruise ship in Germany in early 2022

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    Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks on cruise shipshave rarely been investigated. In early 2022, we were informed about a SARS-CoV-2 outbreak on a cruiseship calling Port of Hamburg after 10 infections among crew members were detected. We conducted anoutbreak investigation in collaboration between ship owners, the ship physician and Hamburg’s Institutefor Hygiene and Environment, to identify risk factors and to achieve containment. The aim was to identifyrisk factors for SARS-CoV-2 infection and SARS-CoV-2 variants in a cohort of 165 crew members.Materials and methods: For this purpose, we collected data on age, sex, nationality, boarding-time, cabin use(single/shared), work place, and vaccination status of the study participants. Cases were defined as individualswho tested SARS-CoV-2 positive at least once in daily screenings during the outbreak period (10 days)by polymerase chain reaction or antigen test. We investigated risk factors for infection by descriptive, univariableand multivariable analysis. We performed whole genome sequencing to identify SARS-CoV-2 variants.Results: We verified 103 SARS-CoV-2 positive cases (attack rate [AR] 62.4%); 39/41 sequenced sampleswere BA.2.3 Omicron subtype, one BA.1 and one BA.1.1. Among boostered crew members, AR was 38%vs. 65% among those vaccinated once or twice. Among those who stayed < 30 days on board, AR was31% vs. 72% among those staying on board longer. Among Europeans, the AR was 53% vs. 71% in non--Europeans. Adjusting for age and sex, cases were more likely to have received no booster vaccine (oddsratio [OR]: 2.66, 95% confidence interval [CI]: 0.99–7.13), to have spent more time on board (≥ 30 days,OR: 6.36, 95% CI: 2.81–14.40 vs. < 30 days) and to have a non-European nationality (OR: 2.14, 95% CI:1.08–4.27). The outbreak stopped shortly after offboard isolation of cases.Conclusions: This investigation confirms the importance of a booster vaccine against COVID-19. Longerstays onboard could facilitate social mixing. Further studies could investigate the impact of social, cultural/behavioural patterns and public health access on the infection risk. Physical distancing together withscreening and isolation can contain SARS-CoV-2 outbreaks on cruise ships
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