Objectives: To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China.
BackgroundAccurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can result in misleading conclusions about the validity of an instrument. The Bland-Altman method is the most popular method judging by the many citations of the article proposing this method. However, the number of citations does not necessarily mean that this method has been applied in agreement research. No previous study has been conducted to look into this. This is the first systematic review to identify statistical methods used to test for agreement of medical instruments. The proportion of various statistical methods found in this review will also reflect the proportion of medical instruments that have been validated using those particular methods in current clinical practice.Methodology/FindingsFive electronic databases were searched between 2007 and 2009 to look for agreement studies. A total of 3,260 titles were initially identified. Only 412 titles were potentially related, and finally 210 fitted the inclusion criteria. The Bland-Altman method is the most popular method with 178 (85%) studies having used this method, followed by the correlation coefficient (27%) and means comparison (18%). Some of the inappropriate methods highlighted by Altman and Bland since the 1980s are still in use.ConclusionsThis study finds that the Bland-Altman method is the most popular method used in agreement research. There are still inappropriate applications of statistical methods in some studies. It is important for a clinician or medical researcher to be aware of this issue because misleading conclusions from inappropriate analyses will jeopardize the quality of the evidence, which in turn will influence quality of care given to patients in the future.
BackgroundHIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria.MethodsThe data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15–49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS.ResultsA total of 56 307 men and women aged 15–49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education.ConclusionThere is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.
Globalization has altered the way we live our lives and earn a livelihood. Consequently, trade and travel have been recognized as significant determinants of the spread of disease. Additionally, rise in urbanization and the closer integration of the world economy has facilitated global interconnectedness. Therefore, globalization has emerged as an essential mechanism of disease transmission . This paper aims to examine the potential impacts of COVID-19 on globalization and global health in terms of mobility, trade, travel, and countries most impacted. The effect of globalization was operationalized in terms of mobility, economy, and healthcare systems. The mobility of individuals and its magnitude was assessed using airline and seaport trade data and travel information. The economic impact was measured based on the workforce, event cancellations, food and agriculture, academic institutions, and supply chain. The healthcare capacity was assessed by consideration of healthcare systems indicators and preparedness of countries. Utilizing a technique for order of preference by similarity to ideal solution (TOPSIS) we calculated a pandemic vulnerability index (PVI) creating a quantitative measure of the potential global health. The pandemic has placed an unprecedented burden on the world's economy, healthcare, and globalization through the travel, events cancellation, employment workforce, food chain, academia, and healthcare capacity. Based on PVI results, certain countries are more vulnerable than others. In Africa, more vulnerable countries include South Africa and Egypt; in Europe, they are Russia, Germany, and Italy; in Asia and Oceania, they are India, Iran, Pakistan, Saudi Arabia, and Turkey; and for the Americas, they are Brazil, USA, Chile, Mexico, and Peru. The impact on mobility, economy, and healthcare systems has only started to manifest. The findings of this study may help in the planning and implementation of strategies at the country level to help ease this emerging burden.
Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAp), as well as the association with dengue igM and igG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings. Five hundred individuals (aged 18 years and above) were approached for pre-tested KAp and seroprevalences assessment. the study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAp levels (p < 0.05). In conclusion, proactive and sustainable efforts are needed to bring a behavioural change among communities in order to fight dengue outbreaks in endemic areas. Dengue fever is a mosquito-borne viral disease caused by a flavivirus. There are four distinct serotypes of dengue virus, namely DEN-1, 2, 3 and 4. Female Aedes aegypti and Aedes albopictus mosquitoes are the primary and secondary vectors in Malaysia, respectively. Evidently, dengue is the most rapidly spreading arboviral disease in the world. The Global Burden of Disease reported that dengue incidence has multiplied to six-folds from 1990 to 2013, with Southeast Asia region contributing 52% of the disease burden 1. World Health Organisation (WHO) estimates that 50 million to 100 million cases occur annually 2 .The disease is currently endemic in more than 100 countries, with SouthEast Asia being among the worst affected region. Dengue fever was established in Malaysia ever since the first reported case of dengue in 1902. From then on, the numbers of cases continued to rise despite numerous initiatives undertaken by the Ministry of Health to curb the disease 3,4. According to WHO, the recent cumulative case count in Malaysia from 1 Jan to 2 Mac 2019 was 157% higher than that of the same period in 2018 5. In addition, a total of 79,151 dengue cases have been reported until end of July 2019 nationwide, with Selangor state contributing more than 50% of the cases (n = 40,849, 51.6%) 6. Vector control and surveillance is still the mainstay of dengue prevention strategies since there is no specific treatment for disease and vaccination remains a non-viable option 7. Local programs like Communications for Behavorial Changes (COMBI) in Malaysia have proved their potential effect in reducing dengue morbidity 8 but it requires understanding from community as well 9. Besides, vector control measures ...
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