COVID-19: A Syndemic Requiring an Integrated Approach for Marginalized Populations

The novel coronavirus, SARS-CoV-2, responsible for the COVID-19 pandemic, has challenged healthcare systems globally. The health inequities experienced by immigrants, refugees, and racial/ethnic minorities have been aggravated during the COVID-19 pandemic. The socioeconomic, political, and demographic profile of these vulnerable populations places them at increased risk of contracting COVID-19 and experiencing significant morbidity and mortality. Thus, the burden of the COVID-19 pandemic is disproportionally higher among these at-risk groups. The purpose of this perspective is to: (1) highlight the interactions among the social determinants of health (SDoH) and their bi-directional relationship with the COVID-19 pandemic which results in the current syndemic and; (2) offer recommendations that consider an integrated approach to mitigate COVID-19 risk for marginalized populations in general. For these at-risk populations, we discuss how individual, structural, sociocultural, and socioeconomic factors interact with each other to result in a disparate risk to contracting and transmitting COVID-19. Marginalized populations are the world\u27s collective responsibility. We recommend implementing the Essential Public Health Services (EPHS) framework to promote those systems and policies that enable optimal health for all while removing systemic and structural barriers that have created health inequities. The pledge of “Health for All” is often well-accepted in theory, but the intricacy of its practical execution is not sufficiently recognized during this COVID-19 syndemic and beyond. “Where there is life, there is hope.” -R.I. Kelly, Irish Immigrant

Re-activation of a Small Hydropower(SHP)Plant: Oyan SHP Station,Nigeria

Electricity production in small hydropower (SHP) plants can be increased without the need for the construction of new SHP scheme, but by upgrading and optimizing different aspects of existing plant's operations. An assessment of the electromechanical equipment that suites the existing heads, discharge or flow rates and other electromechanical parameters at the Oyan SHP plant, using Retscreen Clean Energy Project Analysis Software and hydraulic turbine specific speed equation ( ) to evaluate plant performances was carried out in this work. Two cases involving upgrading of the electromechanical equipment to yield 10 and 12 MW of installed capacities respectively were considered, while at the same time maintaining the existing structures such as the weir, powerhouse and penstocks. The two cases were analysed and compared with a reference case (the existing installed capacity generation of 9 MW). Findings in terms of the financial and economic analysis for optimum installation and operation, favoured the 10 MW installation. Energy gain by installing the 10 MW is 33.37% relative to the reference case while the 12 MW is 5% compared with the reference. The simple payback for the 10 and 12 MW capacities is 11 and 13 months respectively. Hence, upgrade and optimization to 10 MW is found to be a more profitable option than the 12 MW capacity

Disparities in risks of malaria associated with climatic variability among women, children and elderly in the Chittagong hill tracts of Bangladesh

Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1–7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8–7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7–27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9–25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar setting

Associations between initial change in physical activity level and subsequent change in regional body fat distributions

Background: Few studies have examined which lifestyle factors relate to the development of fat distribution. Therefore, the identification of the determinants of changes in fat deposition is highly relevant. Methods: The association between the change in physical activity (PA) and the subsequent changes in regional body fat distributions was examined. In total, 1,236 men and 1,201 women were included at baseline and participated in the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study. A questionnaire was used to assess PA at 5 and 11 years after baseline examination, while waist circumference (WC) and hip circumference (HC) were measured at both follow-ups. Results: Among men, WC increased in the constant active group to a lesser extent than in the non-constant active group (3.4 vs. 4.1 cm; p = 0.03) concerning leisure time physical activities (LTPA). A similar pattern was observed for both WC and HC in relation to occupational physical activities (OPA) (p = 0.02). Among women, the results went in the same direction for LTPA, whereas the associations with OPA were in the opposite direction (p = 0.001). Conclusion: LTPA and OPA were associated with reduced subsequent 6-year changes in regional fat distribution for men. For women, no associations were observed in relation to WC; however, OPA seemed to increase HC among women

Changing Ecotypes of Dengue Virus 2 Serotype in Nigeria and the Emergence of Cosmopolitan and Asian I Lineages, 1966–2019

Dengue virus (DENV) is a leading mosquito-borne virus with a wide geographical spread and a major public health concern. DENV serotype 1 (DENV-1) and serotype 2 (DENV-2) were first reported in Africa in 1964 in Ibadan, Nigeria. Although the burden of dengue is unknown in many African countries, DENV-2 is responsible for major epidemics. In this study, we investigated the activities of DENV-2 to determine the circulating strains and to appraise the changing dynamics in the epidemiology of the virus in Nigeria. Nineteen DENV-2 sequences from 1966–2019 in Nigeria were retrieved from the GenBank of the National Center of Biotechnology Information (NCBI). A DENV genotyping tool was used to identify the specific genotypes. The evolutionary history procedure was performed on 54 DENV-2 sequences using MEGA 7. There is a deviation from Sylvatic DENV-2 to other genotypes in Nigeria. In 2019, the Asian I genotype of DENV-2 was predominant in southern Edo State, located in the tropical rainforest region, with the first report of the DENV-2 Cosmopolitan strain. We confirmed the circulation of other non-assigned genotypes of DENV-2 in Nigeria. Collectively, this shows that DENV-2 dynamics have changed from Sylvatic transmission reported in the 1960s with the identification of the Cosmopolitan strain and Asian lineages. Sustained surveillance, including vectorial studies, is required to fully establish the trend and determine the role of these vectors

Social and demographic factors associated with morbidities in young children in Egypt: A Bayesian geo-additive semi-parametric multinomial model.

Globally, the burden of mortality in children, especially in poor developing countries, is alarming and has precipitated concern and calls for concerted efforts in combating such health problems. Examples of diseases that contribute to this burden of mortality include diarrhoea, cough, fever, and the overlap between these illnesses, causing childhood morbidity and mortality. Methods: To gain insight into these health issues, we employed the 2008 Demographic and Health Survey Data of Egypt, which recorded details from 10,872 children under five. This data focused on the demographic and socio-economic characteristics of household members. We applied a Bayesian multinomial model to assess the area-specific spatial effects and risk factors of co-morbidity of fever, diarrhoea and cough for children under the age of five. Results: The results showed that children under 20 months of age were more likely to have the three diseases (OR: 6.8; 95% CI: 4.6-10.2) than children between 20 and 40 months (OR: 2.14; 95% CI: 1.38-3.3). In multivariate Bayesian geo-additive models, the children of mothers who were over 20 years of age were more likely to have only cough (OR: 1.2; 95% 2 CI: 0.9-1.5) and only fever (OR: 1.2; 95% CI: 0.91-1.51) compared with their counterparts. Spatial results showed that the North-eastern region of Egypt has a higher incidence than most of other regions. Conclusions: This study showed geographic patterns of Egyptian governorates in the combined prevalence of morbidity among Egyptian children. It is obvious that the Nile Delta, Upper Egypt, and south-eastern Egypt have high rates of diseases and are more affected. Therefore, more attention is needed in these areas. Funding: The authors have no support or funding to report. Competing Interests: The authors have declared that no competing interests exist

Editorial:The Impact of Migration and Resettlement on Health

Editorial - No Abstract available

Editorial: The Impact of Migration and Resettlement on Health

COVID-19; Healthcare access; Mental healthCOVID-19; Accés a la sanitat; Salut mentalCOVID-19; Acceso a la sanidad; Salud menta

Detection of Crimean-Congo Hemorrhagic Fever Virus Antibodies in Cattle in Plateau State, Nigeria

Crimean-Congo hemorrhagic fever (CCHF) is a vector-borne viral hemorrhagic disease with global clinical significance. Certain species of ticks are vectors of CCHF, which can be transmitted from animals to humans and humans to humans by direct exposure to blood or other body fluids. The zoonotic transmission at the human–animal interface from viremic animal hosts to humans is a public health concern with a paucity of data in Nigeria. Samples from 184 pastoral cattle from three local government areas (LGAs) of Plateau state, Nigeria, were screened for CCHF virus using a commercial enzyme-linked immunosorbent assay (ID Screen® CCHF Double Antigen for Multi-Species). Overall seropositivity of 30.4% (n = 56) (95% CI: 23.88%, 37.63%) was recorded from the study areas in Plateau State, while 48/126 (38.1%, 95% CI: 29.59%, 47.17%) sampled cows tested positive for CCHFV antibodies. Seropositivity was significantly higher (p < 0.001) among older cattle greater than two years, 54.69% (95% CI: 2.88%, 11.24%) compared to cattle younger than two years, 17.5% (95% CI: 11.17%, 25.50%). The location of farms played a significant role in the seropositivity of CCHF with the least risk observed in Wase LGA. CCHF is an important zoonotic disease in different parts of the globe with a high risk of transmission to pastoralists, livestock keepers/slaughterhouse workers, and veterinarians who handle animals. There is a need for a collaborative one-health approach with various stakeholders to unravel the dynamics of CCHFV epidemiology in Nigeria