April 25, 2022
Research urges more comprehensive and transparent reporting of COVID-19 data in India. A study by One Health Trust researchers and other experts systematically analyzed the quality of reporting of COVID-19 data on over 100 government platforms from India. The analysis reveals an inadequate data granularity with regards to COVID-19 surveillance, vaccination, and hospital bed availability. Age and gender distribution were available for less than 22% of cases and deaths as of June 2021, and comorbidity distribution was available for less than 30% of deaths. Furthermore, total vaccination stratified by occupation and age was reported in less than half of state and union territories and there was no adverse event reporting following immunization by vaccine and event type. [PLOS Global Public Health]
Low-birth weight (LBW) infants experience lower test scores than normal birth weight infants. LBW, referring to infants weighing less than 2,500 grams at birth, is a significant public health issue in resource-poor countries. One Health Trust researchers and other experts employed instrumental variable regression models with longitudinal data from the Indian Young Lives survey in Andhra Pradesh to estimate the effect of birth weight on cognitive development during childhood in India. They found that a 10% increase in birth weight raises cognitive test scores by 0.11 standard deviations from ages five to eight years. The positive effect of birth weight on cognitive test scores is greater for girls, children from rural households, and those with less-educated mothers. Health policy must be designed to improve neonatal outcomes in India and other LMICs, with policies and initiatives that promote access to prenatal care and maternal nutrition to reduce the risk of LBW. [Economic Papers]
Migrants in Europe face multiple barriers to vaccination. In a systematic literature review investigating barriers and facilitators of vaccine uptake and sociodemographic determinants of under vaccination among migrants in Europe, researchers identified language, literacy, and communication barriers; practical and legal barriers to accessing and delivering vaccination services; and service barriers. Acceptance barriers were primarily reported among eastern European and Muslim migrants for specific vaccines. Significant determinants of undervaccination for migrants include African origin, recent migration, and being a refugee or asylum seeker. There was no strong overall association with gender or age. Tailored, culturally sensitive, and evidence-informed strategies, unambiguous public health messaging, and improved health systems are needed to remove access and acceptance barriers to vaccination for migrants. [The Lancet Infectious Diseases]
National public health institutes (NPHIs) can unify global health actors and agendas. Researchers conducted semi-structured interviews with 24 public health leaders from 18 countries in six WHO regions between 2019 and 2020 to investigate whether NPHIs unify agendas and actors and identify what factors contribute to success. For NPHIs’ success, there needs to be a strong legal foundation; scientific independence; public trust and legitimacy; networks and partnerships at global, national, and local levels; and stable funding. Scientifically independent NPHIs can bridge health agendas, unify diverse actors, and serve as scientific advisors. [Journal of Public Health Policy]
Comorbidities like tuberculosis and bacterial infections can precipitate severe COVID-19. A study conducted from June 2020 to May 2021 at a tertiary center in North India used a preformed questionnaire to find COVID-19 patients with non-classical or less common preexisting conditions (not listed by the CDC). Among 6,832 patients included in the study, 46 cases were identified to have a non-classical comorbidity, falling under infectious (A) and non-infectious (B) categories. Group A included malaria and bacterial and viral infections such as TB, dengue, hepatitis B and C, and HIV, whereas group B included organ transplants, autoimmune diseases, hematologic conditions, uncommon malignancies, and snakebites. Although group A had a significantly longer duration of illness, mortality rates were higher in group B (43.8% versus 32.1%). [Clinical Epidemiology and Global Health]
Influenza vaccine manufacturing history can inspire preparation for future global pandemics. Before COVID-19, all viral pandemics in the past century, excluding the AIDS pandemic, resulted from influenza viruses. Today influenza remains a future pandemic threat along with new coronaviruses. Novel vaccine platforms will serve a key role in mitigating future pandemics. Still, given their long history of successes, the existing well-established, proven platforms for seasonal and pandemic influenza manufacturing will continue to be leveraged and optimized to quickly combat the next influenza threat. [Vaccines]
Primary healthcare is vital to infectious diarrhea prevention and control. Researchers collected annual infectious diarrhea morbidity and relevant data from 4,321 communities in Sichuan Province, China, from 2017 to 2019 and mapped the spatial clustering of infectious diarrhea morbidity to identify areas where increased primary healthcare resources should be allocated. Assessment of the association between the number of primary healthcare workers per 1,000 residents and infectious diarrhea morbidity revealed that morbidity was negatively associated with the number of primary healthcare workers per 1.000 residents; a 0.172 reduction of infectious diarrhea morbidity (1/10,000) was associated with doubled amounts of primary healthcare workers per 1000 residents. [Nature]
Antigen detection rapid diagnostic tests (Ag-RDTs) are potential screening tools for SARS-CoV-2 detection in low-resource settings. In a systematic review and meta-analysis, researchers assessed the diagnostic accuracy of Ag-RDTs in low- and middle-income countries (LMICs) from studies published between January 2020 and August 2021. Included studies evaluated the diagnostic accuracy of Ag-RDTs (sensitivity and specificity) against reverse transcription-polymerase chain reaction as a reference standard in study populations comprised of people living in LMICs who had undergone testing for COVID-19. The review showed pooled sensitivity value close to the minimum performance requirement for the diagnosis of COVID-19 by WHO, with a specificity value meeting the established standards. [PLOS Global Public Health]
Full approval of the BNT162b2 COVID-19 vaccine had little impact on vaccination intentions. Lack of a formally approved COVID-19 vaccine was a common reason for nonvaccination in polls prior to US Food and Drug Administration (FDA) approval for the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. A national, cross-sectional, convenience online survey completed by 535 US adults who had not received a COVID-19 vaccine dose before full approval of the BNT162b2 COVID-19 vaccine revealed that only 19 (3.6%) of respondents reported receiving their first COVID-19 vaccine dose after FDA approval. The limited impact of full FDA approval of the BNT162b2 COVID-19 vaccine for vaccination intentions could inform vaccine-related interventions and policies during future infectious disease outbreaks. [JAMA Internal Medicine]
Gender disparities in lead authorship of academic articles persisted during the COVID-19 pandemic peak. Researchers collected gender data on first authors of original research articles from US institutions in leading medical journals between March 2019 and June 2021. Articles were grouped into “pre-COVID” (March 2019 to March 2020) and “during COVID” (June 2020 to June 2021) periods. Data was also collected on lead authors’ graduate degrees and years of acquisition of their last degree. Of the 2,856 articles examined, men were the lead authors on 51.1% and women on 46.1%; the lead authors’ gender was not found for 2.8% of articles. Although the pandemic did not seem to impact gender disparities in lead authorship, baseline disparities remained with fewer articles published by women compared to men (notably in higher-impact journals), for authors with clinical degrees, and for those who graduated >20 years ago. [Journal of General Internal Medicine]
