21 research outputs found
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Setting-specific Transmission Rates: A Systematic Review and Meta-analysis.
BACKGROUND: Understanding the drivers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is crucial for control policies, but evidence of transmission rates in different settings remains limited. METHODS: We conducted a systematic review to estimate secondary attack rates (SARs) and observed reproduction numbers (Robs) in different settings exploring differences by age, symptom status, and duration of exposure. To account for additional study heterogeneity, we employed a beta-binomial model to pool SARs across studies and a negative-binomial model to estimate Robs. RESULTS: Households showed the highest transmission rates, with a pooled SAR of 21.1% (95% confidence interval [CI]:17.4-24.8). SARs were significantly higher where the duration of household exposure exceeded 5 days compared with exposure of тЙд5 days. SARs related to contacts at social events with family and friends were higher than those for low-risk casual contacts (5.9% vs 1.2%). Estimates of SARs and Robs for asymptomatic index cases were approximately one-seventh, and for presymptomatic two-thirds of those for symptomatic index cases. We found some evidence for reduced transmission potential both from and to individuals younger than 20 years of age in the household context, which is more limited when examining all settings. CONCLUSIONS: Our results suggest that exposure in settings with familiar contacts increases SARS-CoV-2 transmission potential. Additionally, the differences observed in transmissibility by index case symptom status and duration of exposure have important implications for control strategies, such as contact tracing, testing, and rapid isolation of cases. There were limited data to explore transmission patterns in workplaces, schools, and care homes, highlighting the need for further research in such settings
Concrete sewer pipe corrosion induced by sulphuric acid environment
Corrosion of concrete sewer pipes induced by sulphuric acid attack is a recognised problem worldwide, which is not only an attribute of countries with hot climate conditions as thought before. The significance of this problem is by far only realised when the pipe collapses causing surface flooding and other severe consequences. To change the existing post-reactive attitude of managing companies, easy to use and robust models are required to be developed which currently lack reliable data to be correctly calibrated. This paper focuses on laboratory experiments of establishing concrete pipe corrosion rate by submerging samples in to 0.5 pH sulphuric acid solution for 56 days under 10┬║C, 20┬║C and 30┬║C temperature regimes. The result showed that at very early stage of the corrosion process the samples gained overall mass, at 30┬║C the corrosion progressed quicker than for other temperature regimes, however with time the corrosion level for 10┬║C and 20┬║C regimes tended towards those at 30┬║C. Overall, at these conditions the corrosion rates of 10 mm/year, 13,5 mm/year and 17 mm/year were observed
Long-term exposure to outdoor and household air pollution and blood pressure in the prospective urban and rural epidemiological (pure) study
Exposure to air pollution has been linked to elevated blood pressure (BP) and hypertension, but most research has focused on short-term (hours, days, or months) exposures at relatively low concentrations. We examined the associations between long-term (3-year average) concentrations of outdoor PM2.5 and household air pollution (HAP) from cooking with solid fuels with BP and hypertension in the Prospective Urban and Rural Epidemiology (PURE) study. Outdoor PM2.5 exposures were estimated at year of enrollment for 137,809 adults aged 35тАУ70 years from 640 urban and rural communities in 21 countries using satellite and ground-based methods. Primary use of solid fuel for cooking was used as an indicator of HAP exposure, with analyses restricted to rural participants (n = 43,313) in 27 study centers in 10 countries. BP was measured following a standardized procedure and associations with air pollution examined with mixed-effect regression models, after adjustment for a comprehensive set of potential confounding factors. Baseline outdoor PM2.5 exposure ranged from 3 to 97 ╬╝g/m3 across study communities and was associated with an increased odds ratio (OR) of 1.04 (95% CI: 1.01, 1.07) for hypertension, per 10 ╬╝g/m3 increase in concentration
Prevalence of noncommunicable disease risk factors among the Kani tribe in Thiruvananthapuram district, Kerala
Background & objective: Noncommunicable Disease (NCD) risk factors are on the rise and often linked to the adoption of modern lifestyles. This study explores NCD risk factors in a rapidly modernising indigenous population in Kerala, the Kani tribe. Methods: A representative sample of 298 adults of the Kani tribe in Thiruvananthapuram district was studied using the WHO stepwise framework for surveillance of NCD risk factors. Descriptive, bivariate and multivariable analysis were done using the R statistical package. Results: Prevalence of hypertension (48.3%), use of tobacco (81.5%) and alcohol consumption (36.2%) were found to be higher in the Kani tribe compared to the general population in Kerala. Abdominal obesity (22.1%) is found to be higher in Kani tribes compared to other tribal groups in India. The physical inactivity level (9.7%) was similar to urban Kerala and higher than many other tribes in India. Hypertension was scientifically associated (p┬а<┬а0.05) with higher age, male sex, low education levels, and tobacco intake among them. On multivariable analysis, age and alcohol consumption were found to be the prominent risk factors for hypertension and high education level was found to be a protective factor. Conclusion: The major modifiable NCD risk factors were found to be higher among the people of the Kani tribe compared to the general population in Kerala. Physical inactivity level was comparable to urban Kerala, and obesity rates were higher than many other tribal communities in India. The findings warrants targeted action in these vulnerable communities for effective control of the noncommunicable epidemic
Spatiotemporal clustering of dengue cases in Thiruvananthapuram district, Kerala
Background: Dengue cases are increasing in Kerala since 2010. Information on clustering of cases across locations and time periods is vital for disease surveillance and timely control. Objectives: The objective is to study spatiotemporal clustering of dengue cases and their climatic and physioenvironmental correlates in Thiruvananthapuram district during 2010тАУ2014. Methods: Health department data on reported cases of dengue were obtained from January 2011 to June 2014. Cases were individually geocoded, using Google Earth. Moran's I index was estimated to analyze spatial autocorrelation using GeoDa software. SpaceтАУtime clustering across 178 geo-divisions within the district was analyzed using SaTScan software. Correlation analysis was done for spaceтАУtime clustering with climatic variables. Results: Definite spatial and temporal trends were found on analysis of a total of 8279 dengue cases. Significant spatial autocorrelation (Moran's I = 0.32, P< 0.01) and spaceтАУtime clusters with very high log-likelihood ratios (P < 0.01) were found across geo-divisions. Pallichal panchayat was the most likely cluster in every year. The monthly incidence of dengue cases showed a significant positive association (P < 0.05) with a 2-month lag of mean minimum temperature (╧Б = 0.39), 1-month lag of rainfall (╧Б = 0.33), and 1-month lag of humidity (╧Б = 0.38). Dengue occurrences showed an inverse association (P < 0.01) with mean maximum temperatures of the respective months (╧Б= -0.48). Conclusion: Spatial analysis using epidemiological tools reveals spatial and temporal clustering of dengue cases within the district and their association with climatic parameters. This information can be used in controlling outbreaks in the future. This work upholds scope and feasibility of geospatial research in public health in India
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Maternal and neonatal outcomes of gestational diabetes: A retrospective cohort study from Southern India
Background: The prevalence of gestational diabetes is on the rise. Understanding the various outcomes of it is necessary to face this challenge. Objectives: To study the frequency of occurrence of various maternal and fetal outcomes among gestational diabetes patients. Methods: This is a retrospective cohort study conducted in rural Kerala, a southern state of India. The study participants were followed up for a period of 4 years, from 2007 to 2011. The participants included 60 women with gestational diabetes and 120 women without gestational diabetes. Gestational diabetes was the major exposure variable. The frequencies of various outcomes were computed. Multivariable logistic regression was done to compute the risk for various outcomes in gestational diabetes. Results: The major outcomes included termination of pregnancy by caesarean section, long-term progression to type 2 diabetes, in-born nursery (IBN) admissions and increased neonatal birth weight. The maximum adjusted RR [13.2 (1.5-116.03)] was for the development of type 2 DM later. Conclusion: Gestational diabetes can result in significant feto-maternal outcomes; so better facilities are needed to manage gestational diabetes
Rate and Risk of all cause mortality among people with known hypertension in a rural community of southern Kerala, India: The results from the prolife cohort
Background: Hypertension is one of the most important determinants of death due to vascular damage and is fast emerging as a high burden disease in India. However, its documentation is poor in the country. This study aims to estimate the rate and the causal pattern of mortality in a cohort of people with high blood pressure as compared to normotensives.
Methods: The study setting is Varkkala, a rural village in southern Kerala, India, and the study design was that of a prospective cohort. A total of 77,881 participants of age 20 years and above were considered for analysis. The rate and risk of all cause mortality (death due to any cause) among hypertensives were quantified and compared against the normotensives. The causes of death were also analyzedin both the groups. Cox proportional hazard models were created to estimate the hazard ratios of death among hypertensives adjusted for sociodemographic factors, behaviors, and comorbidities.
Results: The incidence proportion of deaths in the study was 4.28% during the follow-up period of 6 years. The relative risk of mortality was 3.13 (CI: 2.91-3.37) in the high BP group. The age-adjusted hazard ratio of all cause mortality for the high BP group was 2.96 (2.56-3.42). Coronary artery disease was the major cause of death among the subjects with high BP.
Conclusions: The study revealed high prevalence of hypertension in the study population. A person with hypertension is at three times higher risk of death due to any cause compared to a normotensive individual even after adjustment for age