We propose a model for multiple waves of an epidemic that decomposes the health outcome of interest into the sum of scaled skew normal curves. When applied to daily COVID-19 mortality in six regions (Japan, Italy, Belgium, Ontario, Texas, and Peru), this model provides three notable results. First, when fit to data from early 2020 to May 31, 2022, the estimated skew normal curves substantially overlap with the dates of COVID-19 waves in Ontario and Belgium, as determined by their respective health authorities.
View Article and Find Full Text PDFOver the last three decades, case-crossover designs have found many applications in health sciences, especially in air pollution epidemiology. They are typically used, in combination with partial likelihood techniques, to define a conditional logistic model for the responses, usually health outcomes, conditional on the exposures. Despite the fact that conditional logistic models have been shown equivalent, in typical air pollution epidemiology setups, to specific instances of the well-known Poisson time series model, it is often claimed that they cannot allow for overdispersion.
View Article and Find Full Text PDFPLOS Glob Public Health
September 2024
While SARS-CoV-2 infection appears to have spread widely throughout Africa, documentation of associated mortality is limited. We implemented a representative serosurvey in one city of Sierra Leone in Western Africa, paired with nationally representative mortality and selected death registration data. Cumulative seroincidence using high quality SARS-CoV-2 serological assays was 69% by July 2021, rising to 84% by April 2022, mostly preceding SARS-CoV-2 vaccination.
View Article and Find Full Text PDFBackground: Few national-level studies have evaluated the impact of 'hybrid' immunity (vaccination coupled with recovery from infection) from the Omicron variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: From May 2020 to December 2022, we conducted serial assessments (each of ~4000-9000 adults) examining SARS-CoV-2 antibodies within a mostly representative Canadian cohort drawn from a national online polling platform. Adults, most of whom were vaccinated, reported viral test-confirmed infections and mailed self-collected dried blood spots (DBSs) to a central lab.
Background: The extent to which the Omicron variant of SARS-CoV-2 raised death rates in China during its viral wave of December 2022-January 2023 remains largely undocumented.
Methods: We worked with an established national survey organization to survey 8,004 adults in all 31 administrative areas of China to ask about deaths in families since January 2020. We examined age-specific death rates, focusing on deaths above age 60 years, and at 15-59 years.
BACKGROUND: Smoking cessation reduces mortality and morbidity. However, the extent and rapidity at which cessation reduces contemporary death rates from smoking-related illnesses remain uncertain. METHODS: We pooled current or former versus never cigarette smoker hazard ratios from four national cohorts with linkage to death registries in the United States, United Kingdom, Norway, and Canada among adults 20 to 79 years of age from 1974 to 2018.
View Article and Find Full Text PDFBackground: During the first year of the COVID-19 pandemic, the proportion of reported cases of COVID-19 among Canadians was under 6%. Although high vaccine coverage was achieved in Canada by fall 2021, the Omicron variant caused unprecedented numbers of infections, overwhelming testing capacity and making it difficult to quantify the trajectory of population immunity.
Methods: Using a time-series approach and data from more than 900 000 samples collected by 7 research studies collaborating with the COVID-19 Immunity Task Force (CITF), we estimated trends in SARS-CoV-2 seroprevalence owing to infection and vaccination for the Canadian population over 3 intervals: prevaccination (March to November 2020), vaccine roll-out (December 2020 to November 2021), and the arrival of the Omicron variant (December 2021 to March 2023).
SARS-CoV-2 polymerase chain reaction (PCR) tests generally report only binary (positive or negative) outcomes. Quantitative PCR tests can provide epidemiological information on viral transmission patterns in populations. SARS-CoV-2 transmission patterns during India's SARS-CoV-2 viral waves remain largely undocumented.
View Article and Find Full Text PDFGlobally, cancer is a leading cause of death and morbidity and its burden is increasing worldwide. It is established that medical approaches alone will not solve this cancer crisis. Moreover, while cancer treatment can be effective, it is costly and access to treatment and health care is vastly inequitable.
View Article and Find Full Text PDFNaive estimates of incidence and infection fatality rates (IFR) of coronavirus disease 2019 suffer from a variety of biases, many of which relate to preferential testing. This has motivated epidemiologists from around the globe to conduct serosurveys that measure the immunity of individuals by testing for the presence of SARS-CoV-2 antibodies in the blood. These quantitative measures (titer values) are then used as a proxy for previous or current infection.
View Article and Find Full Text PDFEnviron Health Perspect
September 2022
Background: Studies on the extent to which long-term exposure to ambient particulate matter (PM) with aerodynamic diameter () contributes to adult mortality in India are few, despite over 99% of Indians being exposed to levels that the World Health Organization (WHO) considers unsafe.
Objective: We conducted a retrospective cohort study within the Million Death Study (MDS) to provide the first-ever quantification of national mortality from exposure to in India from 1999 to 2014.
Methods: We calculated relative risks (RRs) by linking a total of ten 3-y intervals of satellite-based estimated exposure to deaths 3 to 5 y later in over 7,400 small villages or urban blocks covering a total population of .
Spat Spatiotemporal Epidemiol
November 2021
The study of the impacts of air pollution on COVID-19 has gained increasing attention. However, most of the existing studies are based on a single country, with a high degree of variation in the results reported in different papers. We attempt to inform the debate about the long-term effects of air pollution on COVID-19 by conducting a multi-country analysis using a spatial ecological design, including Canada, Italy, England and the United States.
View Article and Find Full Text PDFSpatial dependence is usually introduced into spatial models using some measure of physical proximity. When analysing COVID-19 case counts, this makes sense as regions that are close together are more likely to have more people moving between them, spreading the disease. However, using the actual number of trips between each region may explain COVID-19 case counts better than physical proximity.
View Article and Find Full Text PDFMany countries have enforced social distancing to stop the spread of COVID-19. Within countries, although the measures taken by governments are similar, the incidence rate varies among areas (e.g.
View Article and Find Full Text PDFObjective: Although juvenile-onset proliferative lupus nephritis (PLN) leads to significant morbidity and mortality, there is no clinical trials-based evidence to support the treatment effectiveness of any therapy for juvenile-onset PLN. Marginal structural models enable us to estimate treatment effectiveness using observational data while accounting for confounding by indication.
Methods: We used prospectively collected data to examine the effect of mycophenolate mofetil (MMF), compared to the use of other therapies, on the long-term outcome of a juvenile-onset PLN cohort (age at PLN onset <18 years).
Background: Determining the spatial patterns of infection among young children living in a malaria-endemic area may provide a means of locating high-risk populations who could benefit from additional resources for treatment and improved access to healthcare. The objective of this secondary analysis of baseline data from a cluster-randomized trial among 1943 young Ghanaian children (6-35 months of age) was to determine the geo-spatial factors associated with malaria and non-malaria infection status.
Methods: Spatial analyses were conducted using a generalized linear geostatistical model with a Matern spatial correlation function and four definitions of infection status using different combinations of inflammation (C-reactive protein, CRP > 5 mg/L) and malaria parasitaemia (with or without fever).
Background: Several factors may mitigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) over sham rTMS in patients with treatment-resistant depression (TRD). These factors include unilateral stimulation (i.e.
View Article and Find Full Text PDFObjective: To determine the most effective immunosuppressive therapy for the longterm management of proliferative lupus nephritis (PLN) based on the outcome of renal failure.
Methods: A systematic review of randomized controlled trials (RCT) was conducted. MEDLINE and EMBASE were searched.
Cancer Epidemiol Biomarkers Prev
November 2014
Objective: To evaluate and determine the most effective immunosuppressive therapy for the induction treatment of proliferative lupus nephritis (PLN) based on renal remission.
Methods: A systematic review of randomized controlled trials was conducted. The outcomes were renal remission at 6 months: (1) normalization of serum creatinine [(sCr), or within 15% of the normal range, i.