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Fulltext Defending against the Novel Coronavirus (COVID-19) outbreak: How can the Internet of Things (IoT) help to save the world?

Rahman MS, Peeri NC, Shrestha N, Zaki R, Haque U, Hamid SHA

Health Policy Technol, 2020 Jun;9(2):136-138.
PMID: 32322475 DOI: 10.1016/j.hlpt.2020.04.005

•IoT within infectious disease epidemiology is an emerging field of research, however the ubiquitous availability of smart technologies, as well as increased risks of infectious disease spread through the globalization and interconnectedness of the world necessitates its use for predicting, preventing and controlling emerging infectious diseases.•Considering the present situation in China, IoT based smart disease surveillance systems have the potential to be a major breakthrough in efforts to control the current pandemic. With much of the infrastructure itself in place already (i.e. smartphones, wearable technologies, internet access) the role this technology can have in limiting the spread of the pandemic involves only the collection and analysis of data already gathered.•More research must be carried out for the development of automated and effective alert systems to provide early and timely detection of outbreaks of such diseases in order to reduce morbidity mortality and prevent global spread.
Fulltext Assessment of Knowledge, Attitudes, and Practices Regarding Dengue among Physicians: A Web-Based Cross-Sectional Survey

Koonisetty KS, Aghamohammadi N, Urmi T, Yavaşoglu Sİ, Rahman MS, Nandy R, et al.

Behav Sci (Basel), 2021 Jul 21;11(8).
PMID: 34436095 DOI: 10.3390/bs11080105

Dengue fever is one of the most important viral infections transmitted by Aedes mosquitoes and a major cause of morbidity and mortality globally. Accurate identification of cases and treatment of dengue patients at the early stages can reduce medical complications and dengue mortality rate. This survey aims to determine the knowledge, attitude, and practices (KAP) among physicians in dengue diagnosis and treatment. This study was conducted among physicians in Turkey as one nonendemic country and Bangladesh, India, and Malaysia as three dengue-endemic countries. The dosing frequencies, maximum doses, and contraindications in dengue fever were examined. The results found that physicians from Bangladesh, India, and Malaysia have higher KAP scores in dengue diagnosis and treatment compared to physicians in Turkey. This may be due to a lack of physician's exposure to a dengue patient as Turkey is considered a nonendemic country. This assessment may help establish a guideline for intervention strategies among physicians to have successful treatment outcomes and reduce dengue mortality.
Fulltext Appraising the historical and projected spatiotemporal changes in the heat index in Bangladesh

Rahman MB, Salam R, Islam ARMT, Tasnuva A, Haque U, Shahid S, et al.

Theor Appl Climatol, 2021;146(1-2):125-138.
PMID: 34334853 DOI: 10.1007/s00704-021-03705-x

Climate change-derived extreme heat phenomena are one of the major concerns across the globe, including Bangladesh. The appraisal of historical spatiotemporal changes and possible future changes in heat index (HI) is essential for developing heat stress mitigation strategies. However, the climate-health nexus studies in Bangladesh are very limited. This study was intended to appraise the historical and projected changes in HI in Bangladesh. The HI was computed from daily dry bulb temperature and relative humidity. The modified Mann-Kendal (MMK) test and linear regression were used to detect trends in HI for the observed period (1985-2015). The future change in HI was projected for the mid-century (2041-2070) for three Representative Concentration Pathway (RCP) scenarios, RCP 2.6, 4.5, and 8.5 using the Canadian Earth System Model Second Generation (CanESM2). The results revealed a monotonic rise in the HI and extreme caution conditions, especially in the humid summer season for most parts of Bangladesh for the observed period (1985-2015). Future projections revealed a continuous rise in HI in the forthcoming period (2041-2070). A higher and remarkable increase in the HI was projected in the northern, northeastern, and south-central regions. Among the three scenarios, the RCP 8.5 showed a higher projection of HI both in hot and humid summer compared to the other scenarios. Therefore, Bangladesh should take region-specific adaptation strategies to mitigate the impacts of HI.
Supplementary Information: The online version contains supplementary material available at 10.1007/s00704-021-03705-x.
Determining Perceived Self-Efficacy for Preventing Dengue Fever in Two Climatically Diverse Mexican States: A Cross-Sectional Study

Annan E, Angulo-Molina A, Yaacob WFW, Kline N, Lopez-Lemus UA, Haque U

Behav Sci (Basel), 2022 Mar 28;12(4).
PMID: 35447666 DOI: 10.3390/bs12040094

Knowledge of dengue fever and perceived self-efficacy toward dengue prevention does not necessarily translate to the uptake of mosquito control measures. Understanding how these factors (knowledge and self-efficacy) influence mosquito control measures in Mexico is limited. Our study sought to bridge this knowledge gap by assessing individual-level variables that affect the use of mosquito control measures. A cross-sectional survey with 623 participants was administered online in Mexico from April to July 2021. Multiple linear regression and multiple logistic regression models were used to explore factors that predicted mosquito control scale and odds of taking measures to control mosquitoes in the previous year, respectively. Self-efficacy (β = 0.323, p-value = < 0.0001) and knowledge about dengue reduction scale (β = 0.316, p-value =< 0.0001) were the most important predictors of mosquito control scale. The linear regression model explained 24.9% of the mosquito control scale variance. Increasing age (OR = 1.064, p-value =< 0.0001) and self-efficacy (OR = 1.020, p-value = 0.0024) were both associated with an increase in the odds of taking measures against mosquitoes in the previous year. There is a potential to increase mosquito control awareness and practices through the increase in knowledge about mosquito reduction and self-efficacy in Mexico.
Fulltext Prediction of dengue outbreak in Selangor Malaysia using machine learning techniques

Salim NAM, Wah YB, Reeves C, Smith M, Yaacob WFW, Mudin RN, et al.

Sci Rep, 2021 01 13;11(1):939.
PMID: 33441678 DOI: 10.1038/s41598-020-79193-2

Dengue fever is a mosquito-borne disease that affects nearly 3.9 billion people globally. Dengue remains endemic in Malaysia since its outbreak in the 1980's, with its highest concentration of cases in the state of Selangor. Predictors of dengue fever outbreaks could provide timely information for health officials to implement preventative actions. In this study, five districts in Selangor, Malaysia, that demonstrated the highest incidence of dengue fever from 2013 to 2017 were evaluated for the best machine learning model to predict Dengue outbreaks. Climate variables such as temperature, wind speed, humidity and rainfall were used in each model. Based on results, the SVM (linear kernel) exhibited the best prediction performance (Accuracy = 70%, Sensitivity = 14%, Specificity = 95%, Precision = 56%). However, the sensitivity for SVM (linear) for the testing sample increased up to 63.54% compared to 14.4% for imbalanced data (original data). The week-of-the-year was the most important predictor in the SVM model. This study exemplifies that machine learning has respectable potential for the prediction of dengue outbreaks. Future research should consider boosting, or using, nature inspired algorithms to develop a dengue prediction model.
Moderation effects of serotype on dengue severity across pregnancy status in Mexico

Annan E, Nguyen UDT, Treviño J, Wan Yaacob WF, Mangla S, Pathak AK, et al.

BMC Infect Dis, 2023 Mar 10;23(1):147.
PMID: 36899304 DOI: 10.1186/s12879-023-08051-z

BACKGROUND: Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico.
METHOD: Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status.
RESULTS: Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype.
CONCLUSION: The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.
Fulltext The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?

Peeri NC, Shrestha N, Rahman MS, Zaki R, Tan Z, Bibi S, et al.

Int J Epidemiol, 2020 Jun 01;49(3):717-726.
PMID: 32086938 DOI: 10.1093/ije/dyaa033

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.
METHODS: Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made.
RESULTS: Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally.
CONCLUSIONS: We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.
Fulltext The impact of COVID-19 on globalization

Shrestha N, Shad MY, Ulvi O, Khan MH, Karamehic-Muratovic A, Nguyen UDT, et al.

One Health, 2020 Dec 20;11:100180.
PMID: 33072836 DOI: 10.1016/j.onehlt.2020.100180

Globalization has altered the way we live and earn a livelihood. Consequently, trade and travel have been recognized as significant determinants of the spread of disease. Additionally, the rise in urbanization and the closer integration of the world economy have facilitated global interconnectedness. Therefore, globalization has emerged as an essential mechanism of disease transmission. This paper aims to examine the potential impact of COVID-19 on globalization and global health in terms of mobility, trade, travel, and countries most impacted. The effect of globalization were 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 considering healthcare system 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) by creating a quantitative measure of the potential global health. The pandemic has placed an unprecedented burden on the world economy, healthcare, and globalization through travel, events cancellation, employment workforce, food chain, academia, and healthcare capacity. Based on PVI results, certain countries were more vulnerable than others. In Africa, more vulnerable countries included South Africa and Egypt; in Europe, they were Russia, Germany, and Italy; in Asia and Oceania, they were India, Iran, Pakistan, Saudi Arabia, and Turkey; and for the Americas, they were 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.
Fulltext Clinical Symptoms of Arboviruses in Mexico

Ananth S, Shrestha N, Treviño C JA, Nguyen US, Haque U, Angulo-Molina A, et al.

Pathogens, 2020 Nov 19;9(11).
PMID: 33228120 DOI: 10.3390/pathogens9110964

Arboviruses such as Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV) have emerged as a significant public health concern in Mexico. The existing literature lacks evidence regarding the dispersion of arboviruses, thereby limiting public health policy's ability to integrate the diagnosis, management, and prevention. This study seeks to reveal the clinical symptoms of CHIK, DENV, and ZIKV by age group, region, sex, and time across Mexico. The confirmed cases of CHIKV, DENV, and ZIKV were compiled from January 2012 to March 2020. Demographic characteristics analyzed significant clinical symptoms of confirmed cases. Multinomial logistic regression was used to assess the association between clinical symptoms and geographical regions. Females and individuals aged 15 and older had higher rates of reported significant symptoms across all three arboviruses. DENV showed a temporal variation of symptoms by regions 3 and 5, whereas ZIKV presented temporal variables in regions 2 and 4. This study revealed unique and overlapping symptoms between CHIKV, DENV, and ZIKV. However, the differentiation of CHIKV, DENV, and ZIKV is difficult, and diagnostic facilities are not available in rural areas. There is a need for adequately trained healthcare staff alongside well-equipped lab facilities, including hematological tests and imaging facilities.
Fulltext COVID-19 Vaccine Hesitancy and Emerging Variants: Evidence from Six Countries

Mangla S, Zohra Makkia FT, Pathak AK, Robinson R, Sultana N, Koonisetty KS, et al.

Behav Sci (Basel), 2021 Oct 28;11(11).
PMID: 34821609 DOI: 10.3390/bs11110148

As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual's knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23-2.74) and an age range 45-54 years (AOR = 5.81, 95% CI: 2.30-14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04-9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15-11.74) and high school education (AOR = 2.16, 95% CI: 1.07-4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).

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