Actus Santé

Inferring the differences in incubation-period and generation-interval distributions of the Delta and Omicron variants of SARS-CoV-2

Estimating the differences in the incubation-period, serial-interval, and generation-interval distributions of SARS-CoV-2 variants is critical to understanding their transmission and control. However, the impact of epidemic dynamics is often neglected in estimating the timing of infection and transmission---for example, when an epidemic is growing exponentially, a cohort of infected individuals who developed symptoms at the same time are more likely to have been infected recently. Here, we re-analyze incubation-period and serial-interval data describing transmissions of the Delta and Omicron variants from the Netherlands at the end of December 2021. Previous analysis of the same data set reported shorter mean observed incubation period (3.2 days vs 4.4 days) and serial interval (3.5 days vs 4.1 days) for the Omicron variant, but the number of infections caused by the Delta variant decreased during this period as the number of Omicron infections increased. When we account for growth-rate differences of two variants during the study period, we estimate similar mean incubation periods (3.8--4.5 days) for both variants but a shorter mean generation interval for the Omicron variant (3.0 days; 95% CI: 2.7--3.2 days) than for the Delta variant (3.8 days; 95% CI: 3.7--4.0 days). We further note that the differences in estimated generation intervals may be driven by the "network effect"---higher effective transmissibility of the Omicron variant can cause faster susceptible depletion among contact networks, which in turn prevents late transmission (therefore shortening realized generation intervals). Using up-to-date generation-interval distributions is critical to accurately estimating the reproduction advantage of the Omicron variant.
Catégories: Actus Santé

Using the sanitation safety planning tool to improve the occupational health and safety of de-sludging operators in Uganda: a protocol for a controlled before and after study

Background De-sludging operators play a critical role in ensuring access to safe sanitation services. De-sludging activities, however, increase the operators risk of exposure to physical, chemical, ergonomic, psychological, and biological hazards, which eventually affect their health-related quality of life (HRQoL). Despite immense exposure to occupational hazards, only a few evidence-based interventions have been implemented to improve the occupational health and safety (OHS) of de-sludging operators. Objective The proposed study intends to utilise the sanitation safety planning (SSP) tool to improve the OHS of de-sludging operators in Uganda. The study aims to generate evidence of the prevalence of exposure to occupational hazards and the associated health outcomes, knowledge, attitude and uptake of OHS measures, as well as the HRQoL of de-sludging operators. The facilitators and barriers to the promotion of OHS shall also be explored. Methods A mixed-methods study will be conducted among 356 desludging operators in the Greater Kampala Metropolitan Area. A structured questionnaire pre-loaded on the KoboCollect mobile data collection application will be used to obtain information on socio-demographic characteristics, history of work-related accidents and diseases, uptake of safety measures, and health-related quality of life. A total of 10 focus group discussions (FGDs) will be conducted among desludging operators, to understand how they cope with associated occupational hazards. In addition, 25 in-depth interviews (IDIs) will be conducted among purposively selected employers to understand the barriers and facilitators of provision and implementation of safety measures among desludging operators. Quantitative data will be analyzed using STATA version 15 while qualitative data will be transcribed verbatim and the analysis aided by the NVIVO software. Expected outcomes The study will generate evidence of the occupational health and safety of desludging operators and the effectiveness of the SSP tool. These findings will be critical in informing the design and implementation of occupational health and safety programmes among desludging operators.
Catégories: Actus Santé

Impact of age-structure and vaccine prioritization on COVID-19 in West Africa

The ongoing COVID-19 pandemic has been a major global health challenge since its emergence in 2019. Contrary to early predictions that sub-Saharan Africa (SSA) would bear a disproportionate share of the burden of COVID-19 due to the region's vulnerability to other infectious diseases, weak healthcare systems, and socioeconomic conditions, the pandemic's effects in SSA have been very mild in comparison to other regions. Interestingly, the number of cases, hospitalizations, and disease-induced deaths in SSA remain low, despite the loose implementation of non-pharmaceutical interventions (NPIs) and the low availability and administration of vaccines. Possible explanations for this low burden include epidemiological disparities, under-reporting (due to limited testing), climatic factors, population structure, and government policy initiatives. In this study, we formulate a model framework consisting of a basic model (in which only susceptible individuals are vaccinated), a vaccine-structured model, and a hybrid vaccine-age-structured model to reflect the dynamics of COVID-19 in West Africa (WA). The framework is trained with a portion of the confirmed daily COVID-19 case data for 16 West African countries, validated with the remaining portion of the data, and used to (i) assess the effect of age structure on the incidence of COVID-19 in WA, (ii) evaluate the impact of vaccination and vaccine prioritization based on age brackets on the burden of COVID-19 in the sub-region, and (iii) explore plausible reasons for the low burden of COVID-19 in WA compared to other parts of the world. Calibration of the model parameters and global sensitivity analysis show that asymptomatic youths are the primary drivers of the pandemic in WA. Also, the basic and control reproduction numbers of the hybrid vaccine-age-structured model are smaller than those of the other two models indicating that the disease burden is overestimated in the models which do not account for age-structure. This result is also confirmed through the vaccine-derived herd immunity thresholds. In particular, a comprehensive analysis of the basic (vaccine-structured) model reveals that if 84% (73%) of the West African populace is fully immunized with the vaccines authorized for use in WA, vaccine-derived herd immunity can be achieved. This herd immunity threshold is lower (68%) for the hybrid model. Also, all three thresholds are lower (60% for the basic model, 51% for the vaccine structured model, and 48% for the hybrid model) if vaccines of higher efficacies (e.g., the Pfizer or Moderna vaccine) are prioritized, and higher if vaccines of lower efficacy are prioritized. Simulations of the models show that controlling the COVID-19 pandemic in WA (by reducing transmission) requires a proactive approach, including prioritizing vaccination of more youths or vaccination of more youths and elderly simultaneously. Moreover, complementing vaccination with a higher level of mask compliance will improve the prospects of containing the pandemic. Additionally, simulations of the model predict another COVID-19 wave (with a smaller peak size compared to the Omicron wave) by mid-July 2022. Furthermore, the emergence of a more transmissible variant or easing the existing measures that are effective in reducing transmission will result in more devastating COVID-19 waves in the future. To conclude, accounting for age-structure is important in understanding why the burden of COVID-19 has been low in WA and sustaining the current vaccination level, complemented with the WHO recommended NPIs is critical in curbing the spread of the disease in WA.
Catégories: Actus Santé

The size of myocardial infarction and peri-infarction edema are not major determinants of diastolic impairment after acute myocardial infarction

Aims: Diastolic dysfunction after myocardial infarction (MI) is a marker of poor prognosis. The relationship between myocardial infarction size (IS), myocardial edema, and diastolic dysfunction is poorly understood, both in the acute phase, and in the development of diastolic dysfunction in the follow-up setting. Using a mechanistic approach could potentially add insights. Methods and results: Patients underwent cardiovascular magnetic resonance (CMR) imaging and echocardiography including mechanistic analysis using the parameterized diastolic filling method within 4-7 days (acute) and 6 months after a first acute anterior MI (n=74). Linear regression modeling of echocardiographic diastolic parameters using CMR IS with and without inclusion of the myocardium at risk (MAR) and model comparisons with likelihood ratio tests were performed. Diastolic parameters at 6 months follow-up were modelled using final IS. For most parameters there was no association with acute IS, except for deceleration time (R2=0.24, p<0.001), left atrial volume index (R2=0.13, p=0.01) and the mechanistic stiffness parameter (R2=0.21, p<0.001). Adding MAR improved only the e'; model (adjusted R2 increase: 0.08, p=0.02). At 6 months follow-up, final IS was only associated with viscoelastic energy loss (R2=0.22, p=0.001). Conclusion: In acute MI, both IS and MAR are related to diastolic function but only to a limited extent. At 6 months after infarction, increasing IS is related to less viscoelastic energy loss, albeit also to a limited extent. The relationship between IS and diastolic dysfunction seems to be mediated by mechanisms beyond simply the spatial extent of ischemia or infarction.
Catégories: Actus Santé

Functional analysis across model systems implicates ribosomal proteins in growth and proliferation defects associated with hypoplastic left heart syndrome

Hypoplastic left heart syndrome (HLHS) is the most lethal congenital heart disease (CHD). The pathogenesis of HLHS is poorly understood and due to the likely oligogenic complexity of the disease, definitive HLHS-causing genes have not yet been identified. Postulating that impaired cardiomyocyte proliferation as a likely important contributing mechanism to HLHS pathogenesis, and we conducted a genome-wide siRNA screen to identify genes affecting proliferation of human iPSC-derived cardiomyocytes (hPSC-CMs). This yielded ribosomal protein (RP) genes as the most prominent class of effectors of CM proliferation. In parallel, whole genome sequencing and rare variant filtering of a cohort of 25 HLHS proband-parent trios with poor clinical outcome revealed enrichment of rare variants of RP genes. In addition, in another familial CHD case of HLHS proband we identified a rare, predicted-damaging promoter variant affecting RPS15A that was shared between the proband and a distant relative with CHD. Functional testing with an integrated multi-model system approach reinforced the idea that RP genes are major regulators of cardiac growth and proliferation, thus potentially contributing to hypoplastic phenotype observed in HLHS patients. Cardiac knockdown (KD) of RP genes with promoter or coding variants (RPS15A, RPS17, RPL26L1, RPL39, RPS15) reduced proliferation in generic hPSC-CMs and caused malformed hearts, heart-loss or even lethality in Drosophila. In zebrafish, diminished rps15a function caused reduced CM numbers, heart looping defects, or weakened contractility, while reduced rps17 or rpl39 function caused reduced ventricular size or systolic atrial dysfunction, respectively. Importantly, genetic interactions between RPS15A and core cardiac transcription factors TBX5 in CMs, Drosocross, pannier and tinman in flies, and tbx5 and nkx2-7 (nkx2-5 paralog) in fish, support a specific role for RP genes in heart development. Furthermore, RPS15A KD-induced heart/CM proliferation defects were significantly attenuated by p53 KD in both hPSC-CMs and zebrafish, and by Hippo activation (YAP/yorkie overexpression) in developing fly hearts. Based on these findings, we conclude that RP genes play critical roles in cardiogenesis and constitute an emerging novel class of gene candidates likely involved in HLHS and other CHDs.
Catégories: Actus Santé

LDAK-GBAT: fast and powerful gene-based association testing using summary statistics

We present LDAK-GBAT, a novel tool for gene-based association testing using summary statistics from genome-wide association studies. We first evaluate LDAK-GBAT using ten phenotypes from the UK Biobank. We show that LDAK-GBAT is computationally efficient, taking approximately 30 minutes to analyze imputed data (2.9M common, genic SNPs), and requiring less than 10Gb memory. In total, LDAK-GBAT finds 680 genome-wide significant genes (P[≤]2.8x10-6), which is at least 25% more than each of five existing tools (MAGMA, GCTA-fastBAT, sumFREGAT-SKAT-O, sumFREGAT-PCA and sumFREGAT-ACAT), and 48% more than found by single-SNP analysis. We then analyze 99 additional phenotypes from the UK Biobank, the Million Veterans Project and the Psychiatric Genetics Consortium. In total, LDAK-GBAT finds 7957 significant genes, which is at least 24% more than the best existing tools, and 42% more than found by single-SNP analysis.
Catégories: Actus Santé

Genome-wide association study meta-analysis of suicide attempt in 43,871 cases identifies twelve genome-wide significant loci

Objective: Suicidal behavior is moderately heritable and a major cause of death worldwide. Two large-scale genome-wide association studies (GWAS) have recently discovered and cross-validated genome-wide significant (GWS) loci for suicide attempts (SA). The current study leveraged the genetic cohorts from these two studies to conduct the largest GWAS meta-analysis of SA to date. Ancestry-specific GWAS meta-analyses were also conducted with African, East Asian, and European ancestry cohorts. Methods: This study comprised 22 cohorts, including 43,871 SA cases and 915,025 ancestry-matched controls. Analytical methods across multi-ancestry and African, East Asian, and European ancestral groups included inverse variance-weighted fixed effects models, gene/gene set and tissue enrichment testing, drug-gene interaction analyses, and summary-based Mendelian Randomization with eQTL MetaBrain data. Results: Multi-ancestry and European GWAS meta-analyses identified 12 risk loci, including 28 independent GWS variants at p<5x10-8. Risk loci were mostly intergenic and implicated DRD2, SLC6A9, FURIN, NLGN1, SOX5, PDE4B, and CACNG2. The SNP-based heritability estimate of SA was 5.7% on the liability scale (SE=0.003, p = 5.70x10-80). Significant brain tissue gene expression and drug set enrichment was observed, along with shared genetic variation of SA with ADHD, smoking, and risk tolerance after conditioning on both major depressive disorder and post-traumatic stress disorder. Conclusions: This multi-ancestry GWAS identified several loci contributing to risk of suicide attempt, and suggests significant shared genetic covariation with relevant clinical phenotypes that is not accounted for by major depressive disorder or post-traumatic stress disorder. These findings outline molecular pathways of risk for suicide, and provide new insight into shared genetic architecture with psychiatric phenotypes across ancestries.
Catégories: Actus Santé

Neopterin level can be measured by intraocular liquid biopsy

Robust intraocular markers are needed in clinical practice for several inflammatory ophthalmological conditions in addition to advanced imaging, histology and immunohistochemistry tests in order to assure reliable diagnosis. Neopterin (NPt) is produced by activated lymphocyte T cells and is known to increase within the CNS in proinflammatory or early infectious states. This study aimed to measure intraocular NPt in aqueous liquid following intraocular liquid biopsy using standard methods. We enrolled 20 healthy patients without known inflammatory history or medication underdoing cataract surgery and analyzed samples for 19 out of 20. NPt level was measured below 1,9 nmol/l in 16 patients (84 %) and less than 3 nmol/l in 94,74%. Given the first time that NPt is measured in intraocular liquids we compared with the established reference limits within the CSF. These findings suggest that NPt could serve as a potential additional signature in ophthalmological conditions to differentiate between any or proinflammatory intraocular state, as well in follow-up.
Catégories: Actus Santé

Philosophical Studies of Non-Pharmacological Pain Management with Transcultural Nursing Approach

This article will discuss the philosophical study of non-pharmacological pain management by looking at perspectives in ontology, epistemology and axiology. Pain is an unpleasant sensory and emotional experience associated with tissue damage. The impact of pain can generate tension that can stimulate the central nerve to release catecholamines that cause arterial and tachycardial constriction. This can increase the afterload and decrease the cardiac output. Pain is influenced by biological, psychological, and social factors at varying degrees. Pain is a subjective experience of the patient so in the provision of nursing care to pain patients, it is necessary to pay attention to the factors that affect pain among other cultures. Understanding and knowledge of transcultural nursing theory, one of which is the Theory of Diversity-Based Diversity and Cultural Universality by Madeleine M. Leinenger with the sunrise model, must be owned by the nurse in conducting the assessment, making the diagnosis and arrange nursing intervention. Non-pharmacological pain management also needs to be done by nurses in overcoming pain problems in patients
Catégories: Actus Santé

CD19+ B cell numbers predict the increase of anti-SARS CoV2 antibodies in fingolimod-treated and COVID-19-vaccinated patients with multiple sclerosis

Treatment with fingolimod for multiple sclerosis (MS) reduces the efficacy of COVID-19 vaccination. We evaluated by a multivariate linear regression model whether main lymphocyte subsets and demographic feature correlated to the subsequent increase in anti-SARS-CoV2 antibodies following the third dose of COVID-19 vaccination. We found that number and proportion of peripheral blood CD19+ B lymphocytes before the third dose of vaccination in MS patients treated with fingolimod, predict the subsequent increase of anti-SARS-CoV2 antibodies (respectively p = 0.013; p = 0.015). This work suggests that evaluating the numbers of CD19+ B cells may be important to identify patients at risk of not producing SARS-CoV-2 antibodies, with possible reduced protection from COVID-19.
Catégories: Actus Santé

Single-cell sequencing identifies a novel T-lymphocyte cluster expressing stemness genes in amyotrophic lateral sclerosis patients

Sporadic amyotrophic lateral sclerosis (sALS) is a fatal adult-onset neurodegenerative disease with unknown causes and few treatment options. This study employed single-cell RNA sequencing and immune profiling to analyze peripheral blood mononuclear cell samples from sALS patients and depicted the first cellular landscape at single-cell resolution. Compared to healthy controls, ALS patients exhibit markedly reduced naive T cell and B cell populations, with significant clonal expansion of terminal effector T cells. However, no common recognition patterns were detected among CDR3 regions of expanded T cell receptor clonotypes, suggesting that each ALS patient may have been triggered by different antigens. We discovered a novel CD8+ T cell type with heterogenous expression profiles of stemness genes and carrying signature genes specific for monocytes and terminal effector T cells, which may play a critical role in ALS pathogenesis. Using differentially expressed genes between the ALS and Control groups within the novel CD8+ T cell type, we identified 80 genes that collectively distinguished ALS patients from healthy controls with an unprecedented accuracy of 0.929 (sensitivity: 0.928, specificity: 0.930). Our findings from this study have important implications for understanding the pathogenesis of sALS, and provide new strategies for accurate diagnosis and potential therapeutic development.
Catégories: Actus Santé

Neurological and psychiatric presentations associated with human monkeypox virus infection: a systematic review and meta-analysis

Objectives Neuropsychiatric presentations of monkeypox (MPX) infection have not been well characterised, Despite evidence of nervous system involvement associated with two related Orthopoxviruses, in the case of smallpox infection (with the variola virus) and smallpox vaccination (which contains live vaccinia virus). In this systematic review and meta-analysis, we aim to determine the prevalence and describe the spectrum of neurological and psychiatric presentations of MPX. Design Systematic review and meta-analysis Data sources MEDLINE, EMBASE, PsycINFO, AMED and pre-print server (MedRxiv) searched up to 31/05/2022 Eligibility criteria for study selection and analysis Any study design of humans infected with MPX that reported neurological or psychiatric presentation. Studies which included more than ten individuals, and symptoms that were reported in a minimum of two separate studies were eligible for meta-analysis Data synthesis Results were pooled with random-effects meta-analysis to calculate generalised linear mixed models and corresponding 95% confidence intervals for each prevalence outcome. Heterogeneity was measured with the I2 statistic. All included studies are summarised through a narrative synthesis. Risk of bias was assessed with the Newcastle Ottawa Scale and the Joanna Briggs Institute quality assessment tool. Results From 1,702 unique studies, we extracted data on 19 eligible studies (1,512 participants, 1,031 with confirmed infection using CDC criteria or PCR testing) most of which were cohort studies and case series with no controlled populations. Study quality was generally moderate. Six clinical features were eligible for meta-analysis, of which the most prevalent were myalgia in 55.5% [95%CI 12.1-91.9%], headache 53.8% [30.6-75.4%], fatigue 36.2% [2.0-94.0%], seizure 2.7% [0.6-10.2%], confusion 2.4% [1.1-5.2%] and encephalitis 2.0% [0.5-8.2%]. Heterogeneity significantly varied across clinical features (I2=0%-98.7%). Other reported presentations not eligible for meta-analysis included sensory-perceptual disturbance (altered vision, dizziness, and photophobia) and psychiatric symptoms (anxiety and depression). Conclusions There is preliminary evidence for a range of neurological and psychiatric presentations of MPX, ranging from commonly reported and nonspecific neurological symptoms (myalgia and headache) to rarer but more severe neurological complications, such as encephalitis and seizures. There is less evidence regarding the psychiatric sequelae of MPX, and although there are multiple reports of anxiety and depression the prevalence of these symptoms is unknown. MPX-related nervous system presentations may warrant surveillance within the current MPX outbreak, with prospective longitudinal studies evaluating the mid to long-term sequelae of the virus. Robust methods to evaluate the potential causality of MPX with these clinical features are required at an individual and epidemiological level. Systematic review registration PROSPERO ID 336649
Catégories: Actus Santé

Interest of structured reporting and combined automated co-registration and lesion color-coding maps for longitudinal magnetic resonance imaging analysis in patients with multiple sclerosis, the MS-LOBI-SR study protocol.

MS is characterized by chronic and immune-mediated inflammatory lesions of the brain white matter, disseminated in time and space . As the technology improved over the next three decades, MRI quickly grew to become the single most important paraclinical diagnostic and monitoring tool available. A lesion will be defined as having a high T2FLAIR signal [≥] 3 millimeters in diameter. The purpose of this study, witch includes 95 patients, was to investigate the benefit of a computer assisted detection reading using combined automated co-registration and lesion color-coding method approach, over a conventional reading approach in follow-up examinations of patients with MS, especially regarding diagnostic accuracy, inter and intra-reader agreement and required reading time. The impact of the use of a structured report on these variables will also be evaluated. The main judgment criteria will be diagnostic accuracy (effectiveness) to assess the progression activity of the disease based on the appearance of a T2wFLAIR hyperintensity or a T1w enhancement on the follow-up examination, compared between consensus corrected CADR and CR readings.The reading of the examinations will be made by radiologists and radiology technician.
Catégories: Actus Santé

Current Knowledge on Potential Determinants of Mass Public Shooting Perpetration and Casualties: A Systematic Review

Background: In the United States, mass shootings can be regarded as a public health issue due to its ubiquitous and public nature. A systematic review of the literature with adoption of the social ecological model for interpretation of the evidence can help inform relevant stakeholders and the public regarding the coherence between proposed gun control legislations and the body of empirical evidence. Aims: To conduct a systematic review of factors associated with: 1) perpetration of mass shooting events, and; 2) injuries and fatalities at mass shooting events. Material and Methods: The author conducted a search of the literatures on PubMed using the term "mass shooting", filtering manuscripts from 2017 to 2022. The author included only articles in peer-reviewed academic journals with primary data collection for the review. Results: The author reviewed 36 of the 336 articles initially found from a search on PubMed. All but two studies focused on mass shootings in the United States. Factors associated with perpetration of mass shootings included having mental illness and experience of acute life stressors (intra-personal), relationship issues with family and friends (inter-personal), gun ownership and access (community), permissive firearm laws or lack of gun control (policy). Factors associated with injuries and fatalities at mass shootings included use of semi-automatic rifles (intrapersonal), targeting women (interpersonal), presence of armed officers at schools (organizational), and lack of gun control measures (policy). Conclusion: The author found that easy access to high-power firearms and lack of gun control were associated with both mass shooting perpetration and casualty. However, caveats including a limited time frame, limited sources of publications, and subjectivity in building the model should be considered in the interpretation of the study findings.
Catégories: Actus Santé

Let's just ask them. Perspectives on urban dwelling and air quality: a cross-sectional survey of 3,222 children, young people and parents

Introduction: 93% of all children in the world breathe dangerously polluted, and urban children in low- and middle- income countries (LMICs) are especially affected. This air pollution is one part of a broader climate crisis that threatens to undermine the health of the next generation. Despite young people being increasingly engaged in these issues, their perceptions concerning air pollution (AP) and urban environmental health more broadly have not been well documented. Methods: The Children, Cities and Climate (CCC) project used targeted social media adverts to recruit children, young people, parents and expectant parents (CYPP) to complete an online survey with a combination of open and closed questions in order to collect perceptions about air quality in their home cities, the main sources of AP, and how they would improve their cities. Results: The survey was completed by 3,222 CYPP in 59 of the most polluted cities in 14 countries. Nearly two in five (39%) CYPP cited AP as one of the worst things about their city, with motor transport perceived as the main contributor. CYPP reported differing views on whether their cities were becoming better (43%) or worse (34%) places to live (33% reported it was 'staying the same'). Numerous specific ideas to improve cities and urban air quality emerged, alongside an emphasis on also addressing structural barriers to change. A clear set of principles that should guide how city leaders act was also described, including the need to engage with young people meaningfully. Conclusions: CYPPs articulated good and bad experiences of urban living and perceived AP and traffic as pressing concerns. They provided a clear set of suggestions for improving their cities. Further efforts to engage young people on these issues are warranted.
Catégories: Actus Santé

Clinical characteristics and factors associated with COVID-19-related mortality and hospital admission in 5 rural provinces in Indonesia: a retrospective cohort study

Background Data on COVID-19 clinical characteristics and severity from resource-limited settings are limited. This study examined clinical characteristics and factors associated with COVID-19 mortality and hospitalisation in rural settings of Indonesia, from 1 January to 31 July, 2021. Methods This retrospective cohort included individuals diagnosed with COVID-19 based on polymerase chain reaction or rapid antigen diagnostic test, from Lampung, Gorontalo, Central Sulawesi, Southeast Sulawesi, and East Nusa Tenggara Provinces. We extracted demographic and clinical data, including hospitalisation and mortality from COVID-19 surveillance records. We used mixed-effect logistic regression to examine factors associated with COVID-19-related mortality and hospitalisation. Results Of 6,583 confirmed cases, 205 (3.1%) died, and 1,727 (26%) were hospitalised. The median age was 37 years (IQR 26-52), with 825 (12.53%) under 20 years, and 3,371 (51.21%) females. 4,533 (68.86%) cases were symptomatic, 319 (4.85%) had a clinical diagnosis of pneumonia, and 945 (14.36%) with at least one pre-existing comorbidity. The mortality and hospitalisation rate ranged from 2.0% and 13.4% in East Nusa Tenggara to 4.3% and 36.1% in Lampung. Age-specific mortality rates were 0.9% (2/340) for 0-4 years; 0% (0/112) for 5-9 years; 0.2% (1/498) for 10-19 years; 0.8% (11/1,385) for 20-29 years; 0.9% (12/1,382) for 30-39 years; 2% (23/1,095) for 40-49 years; 5% (57/1,064) for 50-59 years; 11% (62/576) for 60-69 years; 16% (37/232) for [≥]70 years. Older age, pre-existing diabetes, liver diseases, malignancy, and pneumonia were associated with higher risk of mortality and hospitalisation. Pre-existing hypertension, cardiac diseases, chronic kidney disease, COPD, and immunocompromised condition were associated with risk of hospitalisation but not with mortality. Conclusion Clinical characteristics and risk factors of severe COVID-19 outcomes in rural provinces were broadly similar to those in urban settings. The risk of COVID-19-related mortality and hospitalisation was associated with higher age, pre-existing chronic comorbidities, and clinical presentation of pneumonia.
Catégories: Actus Santé

Digital Services Package: Commission welcomes the adoption by the European Parliament of the EU&#039;s new rulebook for digital services

EU Newsroom - Research and innovation - mar, 05/07/2022 - 00:00

European Commission Press release Brussels, 05 Jul 2022 The Commission welcomes the adoption by the European Parliament of the Digital Services Act and Digital Markets Act, proposed by the Commission in December 2020.

Catégories: Actus Santé

Commission presents new European Innovation Agenda to spearhead the new innovation wave

EU Newsroom - Research and innovation - mar, 05/07/2022 - 00:00

European Commission Press release Strasbourg, 05 Jul 2022 Today, the Commission adopted a New European Innovation Agenda to position Europe at the forefront of the new wave of deep tech innovation and start-ups.

Catégories: Actus Santé

New Research and Innovation Performance report: Building a sustainable future in uncertain times

EU Newsroom - Research and innovation - mar, 05/07/2022 - 00:00

European Commission Press release Brussels, 05 Jul 2022 The Commission has released the 2022 edition of the Science, Research and Innovation Performance (SRIP) report, analysing the EU's innovation performance in a global context.

Catégories: Actus Santé

Digital Services Package: Commission welcomes the adoption by the European Parliament of the EU&#039;s new rulebook for digital services

European Commission Press release Brussels, 05 Jul 2022 The Commission welcomes the adoption by the European Parliament of the Digital Services Act and Digital Markets Act, proposed by the Commission in December 2020.

Catégories: Actus Santé

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