Monitoramento das Produções

by Sara Ornaghi, Clelia Callegari, Roberta Milazzo, Laura La Milia, Federica Brunetti, Chiara Lubrano, Chiara Tasca, Stefania Livio, Valeria Maria Savasi, Irene Cetin, Patrizia Vergani
Objectives 1. To assess the performance of an extended questionnaire in identifying cases of SARS-CoV-2 infection among obstetric patients. 2. To evaluate the rate of infection among healthcare workers involved in women’s care. Study design A prospective cohort study of obstetric patients admitted to MBBM Foundation and Buzzi Hospital (Lombardy, Northern Italy) from March 16th to May 22nd, 2020. Women were screened on admission by a questionnaire investigating major and minor symptoms of infection and high-risk contacts in the last 14 days. SARS-CoV-2 assessment was performed by RT-PCR on nasopharyngeal swabs. Till April 7th, a targeted SARS-CoV-2 testing triggered by a positive questionnaire was used; from April 8th, a universal testing approach was implemented. Results There were 1,177 women screened by the questionnaire, which yielded a positive result in 130 (11.0%) cases. SARS-CoV-2 RT-PCR was performed in 865 (73.5%) patients, identifying 51 (5.9%) infections. During the first period, there were 29 infected mothers, 4 (13.8%) of whom had a negative questionnaire. After universal testing implementation, there were 22 (3%, 95% CI 1.94% - 4.04%) infected mothers, 13 (59.1%) of whom had a negative questionnaire; rate of infection among asymptomatic women was 1.9%. Six of the 17 SARS-CoV-2-positive women with a negative questionnaire reported symptoms more than 14 but within 30 days before admission. Isolated olfactory or taste disorders were identified in 15.7% of infected patients. Rate of infection among healthcare workers was 5.8%. Conclusions An exhaustive triage questionnaire can effectively discriminate women at low risk of SARS-CoV-2 infection in the context of a targeted and a universal viral testing approach. In 15.7% of infected women, correct classification as a suspected case of infection was due to investigation of olfactory and taste disorders. Extension of the assessed time-frame to 30 days may be worth considering to increase the questionnaire’s performance.

by Nina N. Harke, Jan P. Radtke, Boris A. Hadaschik, Christian Bach, Frank P. Berger, Andreas Blana, Hendrik Borgmann, Florian A. Distler, Sebastian Edeling, Tobias Egner, Christina L. Engels, Mahmoud Farzat, Alexander Haese, Rainer Hein, Markus A. Kuczyk, Andreas Manseck, Rudolf Moritz, Michael Musch, Inga Peters, Sasa Pokupic, Bernardo Rocco, Andreas Schneider, André Schumann, Christian Schwentner, Chiara M. Sighinolfi, Stephan Buse, Jens-Uwe Stolzenburg, Michael C. Truß, Michael Waldner, Christian Wülfing, Volker Zimmermanns, Jörn H. Witt, Christian Wagner
Introduction After the outbreak of COVID-19 unprecedented changes in the healthcare systems worldwide were necessary resulting in a reduction of urological capacities with postponements of consultations and surgeries. Material and methods An email was sent to 66 urological hospitals with focus on robotic surgery (RS) including a link to a questionnaire (e.g. bed/staff capacity, surgical caseload, protection measures during RS) that covered three time points: a representative baseline week prior to COVID-19, the week of March 16th-22nd and April 20th-26th 2020. The results were evaluated using descriptive analyses. Results 27 out of 66 questionnaires were analyzed (response rate: 41%). We found a decrease of 11% in hospital beds and 25% in OR capacity with equal reductions for endourological, open and robotic procedures. Primary surgical treatment of urolithiasis and benign prostate syndrome (BPS) but also of testicular and penile cancer dropped by at least 50% while the decrease of surgeries for prostate, renal and urothelial cancer (TUR-B and cystectomies) ranged from 15 to 37%. The use of personal protection equipment (PPE), screening of staff and patients and protection during RS was unevenly distributed in the different centers–however, the number of COVID-19 patients and urologists did not reach double digits. Conclusion The German urological landscape has changed since the outbreak of COVID-19 with a significant shift of high priority surgeries but also continuation of elective surgical treatments. While screening and staff protection is employed heterogeneously, the number of infected German urologists stays low.

Title: Knowledge about coronavirus disease 19 (COVID-19) and its professional repercussions among brazilian endodontists
Authors: Candeiro, George Táccio de Miranda; Gavini, Giulio; Vivan, Rodrigo Ricci; Carvalho, Bruna Marjorie Dias Frota de; Duarte, Marco Antonio Hungaro; Feijão, Camila Pontes; Vieira-Meyer, Anya Pimentel Gomes Fernandes

by Philippe Dussart, Veasna Duong, Kevin Bleakley, Camille Fortas, Patrich Lorn Try, Kim Srorn Kim, Rithy Choeung, Saraden In, Anne-Claire Andries, Tineke Cantaert, Marie Flamand, Philippe Buchy, Anavaj Sakuntabhai
Background The World Health Organization (WHO) proposed guidelines on dengue clinical classification in 1997 and more recently in 2009 for the clinical management of patients. The WHO 1997 classification defines three categories of dengue infection according to severity: dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Alternative WHO 2009 guidelines provide a cross-sectional classification aiming to discriminate dengue fever from dengue with warning signs (DWWS) and severe dengue (SD). The primary objective of this study was to perform a comparison of two dengue classifications. The secondary objective was to describe the changes of hematological and biochemical parameters occurring in patients presenting with different degrees of severity during the course of the disease, since progression to more severe clinical forms is unpredictable. Methodology/Principal findings We performed a prospective, monocentric, cross-sectional study of hospitalized children in Cambodia, aged from 2 to 15 years old with severe and non-severe dengue. We enrolled 243 patients with acute dengue-like illness: 71.2% were dengue infections confirmed using quantitative reverse transcription PCR or NS1 antigen capture ELISA, of which 87.2% and 9.0% of DF cases were respectively classified DWWS and SD, and 35.9% of DHF were designated SD using an adapted WHO 2009 classification for SD case definition. Systematic use of ultrasound at patient admission was crucial for detecting plasma leakage. No difference was observed in the concentration of secreted NS1 protein between different dengue severity groups. Lipid profiles were different between DWWS and SD at admission, characterized by a decrease in total cholesterol, HDL cholesterol, and LDL cholesterol, in SD. Conclusions/Significance Our results show discrepancies between the two classifications, including misclassification of severe dengue cases as mild cases by the WHO 1997 classification. Using an adapted WHO 2009 classification, SD more precisely defines the group of patients requiring careful clinical care at a given time during hospitalization.

by María Isabel Estupiñán Cárdenas, Víctor Mauricio Herrera, María Consuelo Miranda Montoya, Anyela Lozano Parra, Zuly Milena Zaraza Moncayo, Janeth Patricia Flórez García, Isabel Rodríguez Barraquer, Luis Ángel Villar Centeno

Population based serological surveys are the gold-standard to quantify dengue (DENV) transmission. The purpose of this study was to estimate the age-specific seroprevalence and the force of infection of DENV in an endemic area of Colombia. Between July and October 2014, we conducted a household based cross-sectional survey among 1.037 individuals aged 2 to 40 years living in 40 randomly selected locations in urban Piedecuesta, Santander, Colombia. In addition, we also enrolled 246 indviduals living in rural “veredas”. Participants were asked to answer a questionnaire that included demographic, socioeconomic and environmental questions and to provide a 5 ml blood sample. Sera were tested using the IgG indirect ELISA (Panbio) kit to determine past DENV infection. The overall DENV seroprevalence was 70% (95% CI = 67%-71%), but was significantly higher in urban (81%, 95% CI = 78%-83%) as compared to rural (21%, 95% CI = 17%-27%) locations. Age was a major predictor of seropositivity, consistent with endemic circulation of the virus. Using catalytic models we estimated that on average, 12% (95%CI = 11%-13%) of susceptible individuals living in the city are infected by DENV each year. Beyond age, the only predictor of seropositivity in urban locations was prior history of dengue diagnosed by a physician (aPR 1.15, 95% CI = 0.98–1.35). Among participants living in rural settings, those that reported traveling outside of their vereda were more likely to be seropositive (aPR 3.60, 95%CI = 1.54–8.42) as well as those who were born outside of Santander department (aPR = 2.77, 95%CI = 1.20–6.37). These results are consistent with long term endemic circulation of DENV in Piedecuesta, with large heterogeneities between urban and rural areas located just a few kilometers apart. Design of DENV control interventions, including vaccination, will need to consider this fine scale spatial heterogeneity.

Title: Cadernos CRIS-Fiocruz: Panorama da Resposta Global à COVID-19 - Informe 17 - Agosto/Setembro - 2020
Description: Informe produzido pelo CRIS-Fiocruz, sobre a semana de 26 de agosto a 8 de setembro de 2020.

Title: Simple, Low-Cost and Long-Lasting Film for Virus Inactivation Using Avian Coronavirus Model as Challeng
Authors: Colnago, Luiz Alberto; Trevisol, Iara Maria; Rech, Daiane Voss; Forato, Lucimara Aparecida; Mitre, Cirlei Igreja do Nascimento; Leite, José Paulo Gagliardi; Giglioti, Rodrigo; Okino, Cintia Hiromi

by Md. Tanvir Hossain, Benojir Ahammed, Sanjoy Kumar Chanda, Nusrat Jahan, Mahfuza Zaman Ela, Md. Nazrul Islam

Classified as a pandemic by the World Health Organization, the novel Coronavirus Disease (COVID-19) has spread to Bangladesh since early March of 2020, and people are getting daily updates from the social and electronic media. We aimed at assessing the prevalence of anxiety among Bangladeshi people during the pandemic in connection with social media exposure (SME) and electronic media exposure (EME). For this cross-sectional study, data were collected from 880 participants by a self-administered online-based questionnaire relating personal characteristics, self-rate health (SRH), SME, and EME with anxiety. Findings show that around half of the surveyed population experienced a spike of anxiety (49.1%) during the pandemic, ten times higher than the national anxiety rate in 2019. The participants with an increased SME of over four hours per day experienced a higher level of anxiety than individuals with = 2 hours exposure to social media. Similarly, the anxiety was higher among people with fair/bad SRH compared to individuals with excellent SRH. It is highly recommended to develop active surveillance and effective monitoring systems to reduce the spread of misinformation from both social and electronic media to improve the state of mental health conditions during the pandemic.

by Nina B. Masters, Shu-Fang Shih, Allen Bukoff, Kaitlyn B. Akel, Lindsay C. Kobayashi, Alison L. Miller, Harapan Harapan, Yihan Lu, Abram L. Wagner

In order to reduce the spread of SARS-CoV-2, much of the US was placed under social distancing guidelines during March 2020. We characterized risk perceptions and adherence to social distancing recommendations in March 2020 among US adults aged 18+ in an online survey with age and gender quotas to match the general US population (N = 713). We used multivariable logistic and linear regression to estimate associations between age (by generational cohort) and these outcomes. The median perceived risk of infection with COVID-19 within the next month was 32%, and 65% of individuals were practicing more social distancing than before the outbreak. Baby Boomers had lower perceived risk than Millennials (-10.6%, 95% CI: -16.2%, -5.0%), yet were more frequently social distancing (OR = 1.64; 95% CI: 1.05, 2.56). Public health outreach should focus on raising compliance with social distancing recommendations, especially among high risk groups. Efforts to address risk perceptions alone may be inadequate.

by Anna Wnuk, Tomasz Oleksy, Dominika Maison

New technological solutions play an important role in preventing the spread of Covid-19. Many countries have implemented tracking applications or other surveillance systems, which may raise concerns about privacy and civil rights violations but may be also perceived by citizens as a way to reduce threat and uncertainty. Our research examined whether feelings evoked by the pandemic (perceived threat and lack of control) as well as more stable ideological views predict the acceptance of such technologies. In two studies conducted in Poland, we found that perceived personal threat and lack of personal control were significantly positively related to the acceptance of surveillance technologies, but their predictive value was smaller than that of individual differences in authoritarianism and endorsement of liberty. Moreover, we found that the relationship between the acceptance of surveillance technologies and both perceived threat and lack of control was particularly strong among people high in authoritarianism. Our research shows that the negative feelings evoked by the unprecedented global crisis may inspire positive attitudes towards helpful but controversial surveillance technologies but that they do so to a lesser extent than ideological beliefs.

by Ramit Debnath, Ronita Bardhan

India locked down 1.3 billion people on March 25, 2020, in the wake of COVID-19 pandemic. The economic cost of it was estimated at USD 98 billion, while the social costs are still unknown. This study investigated how government formed reactive policies to fight coronavirus across its policy sectors. Primary data was collected from the Press Information Bureau (PIB) in the form press releases of government plans, policies, programme initiatives and achievements. A text corpus of 260,852 words was created from 396 documents from the PIB. An unsupervised machine-based topic modelling using Latent Dirichlet Allocation (LDA) algorithm was performed on the text corpus. It was done to extract high probability topics in the policy sectors. The interpretation of the extracted topics was made through a nudge theoretic lens to derive the critical policy heuristics of the government. Results showed that most interventions were targeted to generate endogenous nudge by using external triggers. Notably, the nudges from the Prime Minister of India was critical in creating herd effect on lockdown and social distancing norms across the nation. A similar effect was also observed around the public health (e.g., masks in public spaces; Yoga and Ayurveda for immunity), transport (e.g., old trains converted to isolation wards), micro, small and medium enterprises (e.g., rapid production of PPE and masks), science and technology sector (e.g., diagnostic kits, robots and nano-technology), home affairs (e.g., surveillance and lockdown), urban (e.g. drones, GIS-tools) and education (e.g., online learning). A conclusion was drawn on leveraging these heuristics are crucial for lockdown easement planning.

by Harriet Affran Bonful, Adolphina Addo-Lartey, Justice M. K. Aheto, John Kuumouri Ganle, Bismark Sarfo, Richmond Aryeetey

Globally, little evidence exists on transmission patterns of COVID-19. Recommendations to prevent infection include appropriate and frequent handwashing plus physical and social distancing. We conducted an exploratory observational study to assess compliance with these recommendations in selected transportation stations in Ghana. A one-hour audit of 45 public transport stations in the Greater Accra region was carried out between 27th and 29th March 2020. Using an adapted World Health Organization (WHO) hand hygiene assessment scale, the availability and use of handwashing facilities, social distancing, and ongoing public education on COVID-19 prevention measures were assessed, weighted and scored to determine the level of compliance of stations. Compliance with recommendations was categorized as “inadequate” “basic”, “intermediate” and “advanced”, based on the overall score. Majority (80%) of stations in Accra have at least one Veronica Bucket with flowing water and soap, but the number of washing places at each station is not adequate. Only a small minority (18%) of stations were communicating the need to wash hands frequently and appropriately, and to practice social/physical distancing while at the station. In most stations (95%), hand washing practice was either not observed, or only infrequently. Almost all stations (93%) did not have alcohol-based hand sanitizers available for public use, while social distancing was rarely practiced (only 2%). In over 90% of the stations, face masks were either not worn or only worn by a few passengers. Compliance with COVID-19 prevention measures was inadequate in 13 stations, basic in 16 stations, intermediate in 7 stations, and advanced in 9 stations. Compliance with COVID-19 prevention measures in public transportation stations in the Greater Accra region remains a challenge. Awareness creation should aim to elevate COVID-19 risk perception of transportation operators and clients. Transport operators and stations need support and guidance to enforce hand washing and social distancing.

by Carmen Herrero, Antonio Villar

The expansion of Covid-19 has severely hit the community’s health all over the world, killing hundreds of thousands of people, subjecting health systems to an enormous stress (besides derailing economic activities and altering personal and social behavior). Two elements are essential to monitor the evolution of the pandemic as well as to analyze the effectiveness of the response measures: reliable data and useful indicators. We present an indicator that helps to assess the impact of Covid-19 on the community’s health, combining two different components: the extent of the pandemics (i.e. the share of the population affected) and its severity (the intensity of the disease on those affected). The severity measure derives from the application of an evaluation protocol that allows comparing population distributions based on the proportions of those affected with different health conditions. We illustrate the functioning of this indicator over a case study regarding the situation of the Italian regions on March 9 (the beginning of the confinement) and April 8, 2020, one month later.

Title: Schikhobalotrema Solitaria sp. n. and S. Acanthuri Yamaguti, 1970 (Haplosplanchinidae: Digenea) in Brazilian marine fishes
Authors: Fernandes, Berenice M. M.; Goulart, Miriam B.

by Christian Dudel, Tim Riffe, Enrique Acosta, Alyson van Raalte, Cosmo Strozza, Mikko Myrskylä

The population-level case-fatality rate (CFR) associated with COVID-19 varies substantially, both across countries at any given time and within countries over time. We analyze the contribution of two key determinants of the variation in the observed CFR: the age-structure of diagnosed infection cases and age-specific case-fatality rates. We use data on diagnosed COVID-19 cases and death counts attributable to COVID-19 by age for China, Germany, Italy, South Korea, Spain, the United States, and New York City. We calculate the CFR for each population at the latest data point and also for Italy, Germany, Spain, and New York City over time. We use demographic decomposition to break the difference between CFRs into unique contributions arising from the age-structure of confirmed cases and the age-specific case-fatality. In late June 2020, CFRs varied from 2.2% in South Korea to 14.0% in Italy. The age-structure of detected cases often explains more than two-thirds of cross-country variation in the CFR. In Italy, the CFR increased from 4.2% to 14.0% between March 9 and June 30, 2020, and more than 90% of the change was due to increasing age-specific case-fatality rates. The importance of the age-structure of confirmed cases likely reflects several factors, including different testing regimes and differences in transmission trajectories; while increasing age-specific case-fatality rates in Italy could indicate other factors, such as the worsening health outcomes of those infected with COVID-19. Our findings lend support to recommendations for data to be disaggregated by age, and potentially other variables, to facilitate a better understanding of population-level differences in CFRs. They also show the need for well-designed seroprevalence studies to ascertain the extent to which differences in testing regimes drive differences in the age-structure of detected cases.

by Tracey Smythe, Monica Matos, Julia Reis, Antony Duttine, Silvia Ferrite, Hannah Kuper
Background The Zika virus outbreak in Brazil (2015–2016) affected thousands of children who were born with Congenital Zika Syndrome (CZS). Families play an important role in their care of children with complex needs, yet their knowledge, experience and skills are rarely harnessed in existing interventions to best support these families. Objective This study explores the use of mothers as facilitators for a community-based group intervention for children with CZS and their caregivers in Brazil. Methods Four facilitators were trained to deliver the 10-week intervention called “Juntos”. Two were mothers of a child with CZS (“expert mothers”) and two were therapists (speech therapist and physiotherapist). The intervention was delivered to three groups, generally including 8–10 caregivers. Two researchers, who were psychologists, observed the groups and held focus group discussions at the end of each session. They undertook semi-structured interviews post intervention with a purposive sample of caregivers, and with the facilitators. Observation notes were collated and summarised. Transcripts were transcribed and thematically analysed using five elements to assess feasibility: acceptability, demand, implementation, practicality and adaptation. Results The use of expert mothers as facilitators was considered to be acceptable and there was demand for their role. Their experiential knowledge was viewed as important for sharing and learning, and supporting and encouraging the group. The intervention was delivered with fidelity by the expert mothers. The practicality of the intervention was facilitated by holding the group sessions in the community, providing transport costs to facilitators and participants, paying expert mothers and therapist facilitators equally and supporting the expert mothers through a mentorship programme. Equal payment with the therapist enabled the expert mothers to better facilitate the groups, through increased confidence in the value of their role. Adaptation of the intervention included development of video resources and mentoring guidelines. Conclusion The use of expert mothers as facilitators of caregiver groups provides a unique approach to harness the knowledge, experience, and skills of families to provide care, and is likely to be feasible in similar contexts.

by Shelly X. Bian, Eugene Lin
Introduction During the Covid-19 pandemic, major journals have published a significant number of Covid-19 related articles in a short period of time. While this is necessary to combat the worldwide pandemic, it may have trade-offs with respect to publishing research from other disciplines. Objectives To assess differences in published research design before and after the Covid-19 pandemic. Methods We performed a cross-sectional review of all 322 full-length research studies published between October 1, 2019 and April 30, 2020 in three major medical journals. We compared the number of randomized controlled trials (RCTs) and studies with a control group before and after January 31, 2020, when Covid-19 began garnering international attention. Results The number of full-length research studies per issue was not statistically different before and after the Covid-19 pandemic (from 3.7 to 3.5 per issue, p = 0.17). Compared to before January 31, 2020, 0.7 fewer non-Covid-19 studies per issue were published versus after January 31, 2020 (p

by Anaïs K. Tallon, Marcelo G. Lorenzo, Luciano A. Moreira, Luis E. Martinez Villegas, Sharon Rose Hill, Rickard Ignell

Pathogens may manipulate their human and mosquito hosts to enhance disease transmission. Dengue, caused by four viral serotypes, is the fastest-growing transmissible disease globally resulting in 50–100 million infections annually. Transmission of the disease relies on the interaction between humans and the vector Aedes aegypti and is largely dependent on the odor-mediated host seeking of female mosquitoes. In this study, we use activity monitors to demonstrate that dengue virus-1 affects the locomotion and odor-mediated behavior of Ae. aegypti, reflecting the progression of infection within the mosquito. Mosquitoes 4–6 days post-infection increase locomotion, but do not alter their odor-driven host-seeking response. In contrast, females 14–16 days post-infection are less active, yet more sensitive to human odors as assessed by behavioral and electrophysiological assays. Such an increase in physiological and behavioral sensitivity is reflected by the antennal-specific increase in abundance of neural signaling transcripts in 14 days post-infection females, as determined by transcriptome analysis. This suggests that the sensitivity of the mosquito peripheral olfactory system is altered by the dengue virus by enhancing the overall neural responsiveness of the antenna, rather than the selective regulation of chemosensory-related genes. Our study reveals that dengue virus-1 enhances vector-related behaviors in the early stages post-infection that aid in avoiding predation and increasing spatial exploration. On the other hand, at the later stages of infection, the virus enhances the host-seeking capacity of the vector, thereby increasing the risk of virus transmission. A potential mechanism is discussed.

Title: Convivência com a Covid-19 na Fiocruz: 29 de julho de 2020 (versão 1)

Title: Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis
Authors: Gallo, Luciana Guerra; Martinez-Cajas, Jorge; Peixoto, Henry Maia; Pereira, Ana Carolina Esteves da Silva; Carter, Jillian E.; McKeown, Sandra; Schaub, Bruno; Ventura, Camila V.; França, Giovanny Vinícius Araújo de; Pomar, Léo; Ventura, Liana O.; Nerurkar, Vivek R.; Araújo, Wildo Navegantes de; Velez, Maria P.
Description: Luciana Guerra Gallo - Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. Documento produzido por autor vinculado à Fiocruz, mas não consta à informação no documento.

Title: Resposta da Europa à COVID-19: Cenários diplomáticos, políticos, econômicos, de saúde e de bem-estar - Informes de 6 de abril a 29 de julho de 2020
Authors: Freire, Ana Helena Gigliotti Luna; Vilardo, Ilka; Castro, Letícia Cristina Pereira de

Title: Resposta da OEA à COVID-19 - Informes de 16 de junho a 29 de julho de 2020
Authors: Bermudez, Luana

by Nhan Phuc Thanh Nguyen, Tuyen Dinh Hoang, Vi Thao Tran, Cuc Thi Vu, Joseph Nelson Siewe Fodjo, Robert Colebunders, Michael P. Dunne, Thang Van Vo

We sought to evaluate the adherence of Vietnamese adults to Coronavirus Disease 2019 (COVID-19) preventive measures, and gain insight into the effects of the epidemic on the daily lives of Vietnamese people. An online questionnaire was administered from March 31 to April 6, 2020. The questionnaire assessed personal preventive behavior (such as physical distancing, wearing a face mask, cough etiquette, regular handwashing and using an alcohol hand sanitizer, body temperature check, and disinfecting mobile phones) and community preventive behavior (such as avoiding meetings, large gatherings, going to the market, avoiding travel in a vehicle/bus with more than 10 persons, and not traveling outside of the local area during the lockdown). A total adherence score was calculated by summing the scores of the 9 personal and the 11 community prevention questions. In total, 2175 respondents completed the questionnaire; mean age: 31.4 ± 10.7; (range: 18–69); 66.9% were women; 54.2% were health professionals and 22.8% were medical students. The mean adherence scores for personal and community preventive measures were 7.23 ± 1.63 (range 1–9) and 9.57 ± 1.12 (range 1–11), respectively. Perceived adaptation of the community to lockdown (Beta (β) = 2.64, 95% Confidence Interval (CI) 1.25–4.03), fears/worries concerning one’s health (β = 2.87, 95% CI 0.04–5.70), residing in large cities (β = 19.40, 95% CI 13.78–25.03), access to official COVID-19 information sources (β = 16.45, 95% CI 6.82–26.08), and working in healthcare/medical students (β = 22.53, 95% CI 16.00–29.07) were associated with a higher adherence score to anti-COVID instructions. In conclusion, this study confirmed a high degree of adherence to personal and community preventive behavior among Vietnamese people. Our findings are consistent with the epidemiology of COVID-19 in Vietnam, where there have been few infections and no recorded deaths up to the first week of July 2020.

by Monil Majmundar, Tikal Kansara, Joanna Marta Lenik, Hansang Park, Kuldeep Ghosh, Rajkumar Doshi, Palak Shah, Ashish Kumar, Hossam Amin, Shobhana Chaudhari, Imnett Habtes
Introduction The role of systemic corticosteroid as a therapeutic agent for patients with COVID-19 pneumonia is controversial. Objective The purpose of this study was to evaluate the effect of corticosteroids in non-intensive care unit (ICU) patients with COVID-19 pneumonia complicated by acute hypoxemic respiratory failure (AHRF). Methods This was a single-center retrospective cohort study, from 16th March, 2020 to 30th April, 2020; final follow-up on 10th May, 2020. 265 patients consecutively admitted to the non-ICU wards with laboratory-confirmed COVID-19 pneumonia were screened for inclusion. 205 patients who developed AHRF (SpO2/FiO2 ≤ 440 or PaO2/FiO2 ≤ 300) were only included in the final study. Direct admission to the Intensive care unit (ICU), patients developing composite primary outcome within 24 hours of admission, and patients who never became hypoxic during their stay in the hospital were excluded. Patients were divided into two cohorts based on corticosteroid. The primary outcome was a composite of ICU transfer, intubation, or in-hospital mortality. Secondary outcomes were ICU transfer, intubation, in-hospital mortality, discharge, length of stay, and daily trend of SpO2/FiO2 (SF) ratio from the index date. Cox-proportional hazard regression was implemented to analyze the time to event outcomes. Result Among 205 patients, 60 (29.27%) were treated with corticosteroid. The mean age was ~57 years, and ~75% were men. Thirteen patients (22.41%) developed a primary composite outcome in the corticosteroid cohort vs. 54 (37.5%) patients in the non-corticosteroid cohort (P = 0.039). The adjusted hazard ratio (HR) for the development of the composite primary outcome was 0.15 (95% CI, 0.07–0.33; P

by Thomas M. Randau, Max Jaenisch, Henryk Haffer, Friederike Schömig, Adnan Kasapovic, Katharina Olejniczak, Johannes Flechtenmacher, Carsten Perka, Dieter C. Wirtz, Matthias Pumberger
Objectives The purpose of this study was to assess the impact of the COVID-19 pandemic on orthopedic and trauma surgery in private practices and hospitals in Germany. Design In this cross-sectional study, an online-based anonymous survey was conducted from April 2th to April 16th 2020. Setting The survey was conducted among 15.0000 of 18.000 orthopedic and trauma surgeons in Germany, both in private practices and hospitals. Participants All members of the German Society of Orthopedic and Trauma Surgery (DGOU) and the Professional Association for Orthopedic and Trauma Surgery (BVOU). were invited by e-mail to participate in the survey. Main outcome measures Out of 50 questions 42 were designed to enquire a certain dimension of the pandemic impact and contribute to one of six indices, namely “Preparedness”, “Resources”, “Reduction”, “Informedness”, “Concern”, and “Depletion”. Data was analyzed in multiple stepwise regression, aiming to identify those factors that independently influenced the indices. Results 858 orthopedic and trauma surgeons participated in the survey throughout Germany. In the multiple regression analysis, being employed at a hospital was identified as an independent positive predictor in the indices for “Preparedness”, “Resources”, and “Informedness” and an independent negative predictor regarding “Depletion”. Self-employment was found to be an independent positive predictor of the financial index “Depletion”. Female surgeons were identified as an independent variable for a higher level of “Concern”. Conclusions The study confirms a distinct impact of the COVID-19 pandemic on orthopedic and trauma surgery in Germany. The containment measures are largely considered appropriate despite severe financial constraints. A substantial lack of personal protective equipment (PPE) is reported. The multiple regression analysis shows that self-employed surgeons are more affected by this shortage as well as by the financial consequences than surgeons working in hospitals. What are the new findings The COVID-19 pandemic has a profound impact on orthopedic and trauma surgery as an unrelated specialty. Self-employed surgeons are affected especially by a shortage of PPE and financial consequences. How might it impact on clinical practice in the near future Political and financial support can now be applied more focused to subgroups in the field of orthopedics and trauma surgery with an increased demand for support. A special emphasis should be set on the support of self-employed surgeons which are a more affected by the shortage of PPE and financial consequences than surgeons working in hospitals.

by Thais Chouin-Carneiro, Mariana Rocha David, Fernanda de Bruycker Nogueira, Flavia Barreto dos Santos, Ricardo Lourenço-de-Oliveira
Background Zika virus (ZIKV) emerged in the Pacific Ocean and subsequently caused a dramatic Pan‐American epidemic after its first appearance in the Northeast region of Brazil in 2015. The virus is transmitted by Aedes mosquitoes. We evaluated the role of temperature and infectious doses of ZIKV in vector competence of Brazilian populations of Ae. aegypti and Ae. albopictus. Methodology/Principal findings Two Ae. aegypti (Rio de Janeiro and Natal) and two Ae. albopictus (Rio de Janeiro and Manaus) populations were orally challenged with five viral doses (102 to 106 PFU / ml) of a ZIKV strain (Asian genotype) isolated in Northeastern Brazil, and incubated for 14 and 21 days in temperatures mimicking the spring-summer (28°C) and winter-autumn (22°C) mean values in Brazil. Detection of viral particles in the body, head and saliva samples was done by plaque assays in cell culture for determining the infection, dissemination and transmission rates, respectively. Compared with 28°C, at 22°C, transmission rates were significantly lower for both Ae. aegypti populations, and Ae. albopictus were not able to transmit the virus. Ae. albopictus showed low transmission rates even when challenged with the highest viral dose, while both Ae. aegypti populations presented higher of infection, dissemination and transmission rates than Ae. albopictus. Ae. aegypti showed higher transmission efficiency when taking virus doses of 105 and 106 PFU/mL following incubation at 28°C; both Ae. aegypti and Ae. albopictus were unable to transmit ZIKV with virus doses of 102 and 103 PFU/mL, regardless the incubation temperature. Conclusions/Significance The ingested viral dose and incubation temperature were significant predictors of the proportion of mosquito’s biting becoming infectious. Ae. aegypti and Ae. albopictus have the ability to transmit ZIKV when incubated at 28°C. However Brazilian populations of Ae. aegypti exhibit a much higher transmission potential for ZIKV than Ae. albopictus regardless the combination of infection dose and incubation temperature.

by Edmund J. Norris, Adam S. Mullis, Yashdeep Phanse, Balaji Narasimhan, Joel R. Coats, Lyric C. Bartholomay

Insecticide resistance poses a significant threat to the control of arthropods that transmit disease agents. Nanoparticle carriers offer exciting opportunities to expand the armamentarium of insecticides available for public health and other pests. Most chemical insecticides are delivered by contact or feeding, and from there must penetrate various biological membranes to reach target organs and kill the pest organism. Nanoparticles have been shown to improve bioactive compound navigation of such barriers in vertebrates, but have not been well-explored in arthropods. In this study, we explored the potential of polyanhydride micro- and nanoparticles (250 nm– 3 μm), labeled with rhodamine B to associate with and/or transit across insect biological barriers, including the cuticle, epithelium, midgut and ovaries, in female Ae. aeygpti mosquitoes. Mosquitoes were exposed using conditions to mimic surface contact with a residual spray or paint, topical exposure to mimic contact with aerosolized insecticide, or per os in a sugar meal. In surface contact experiments, microparticles were sometimes observed in association with the exterior of the insect cuticle. Nanoparticles were more uniformly distributed across exterior tissues and present at higher concentrations. Furthermore, by surface contact, topical exposure, or per os, particles were detected in internal organs. In every experiment, amphiphilic polyanhydride nanoparticles associated with internal tissues to a higher degree than hydrophobic nanoparticles. In vitro, nanoparticles associated with Aedes aegypti Aag2 cells within two hours of exposure, and particles were evident in the cytoplasm. Further studies demonstrated that particle uptake is dependent on caveolae-mediated endocytosis. The propensity of these nanoparticles to cross biological barriers including the cuticle, to localize in target tissue sites of interest, and to reach the cytoplasm of cells, provides great promise for targeted delivery of insecticidal candidates that cannot otherwise reach these cellular and subcellular locations.

by Ngwewondo Adela, Lucia Nkengazong, Lum Abienwi Ambe, Jean Thierry Ebogo, Fabrice Medou Mba, Hamadama Oumarou Goni, Nyemb Nyunai, Marie Chantal Ngonde, Jean-Louis Essame Oyono

Severe Acute Respiratory Syndrome Coronavirus 2 (COVID 19) has plagued the world with about 7,8 million confirmed cases and over 430,000 deaths as of June 13th, 2020. The knowledge, attitude, and practices (KAP) people hold towards this new disease could play a major role in the way they accept measures put in place to curb its spread and their willingness to seek and adhere to care. We sought to understand if: a) demographic variables of Cameroonian residents could influence KAP and symptomatology, and b) KAP could influence the risk of having COVID19.A cross-sectional KAP/symptomatology online survey was conducted between April 20 to May 20. All analyses were performed using SPSS version 23. Of all respondents (1006), 53.1% were female, 26.6% were students, 26.9% interacted face to face and 62.8% were residents in Yaoundé with a median age of 33. The overall high score was 84.19% for knowledge, 69% for attitude, and 60.8% for practice towards COVID 19. Age > 20 years was associated with a high knowledge of COVID 19. Women had lower practice scores compared to men (OR = 0.72; 95%CI 0.56–0.92). 41 respondents had ≥3 symptoms and only 9 (22.95%) of them had called 1510 (emergency number). There was no significant difference between KAP and symptomatology. The presence of ≥ 3 symptoms in 4% of respondents (with 56% of them having co-morbidities) supports the current trend in the number of confirmed cases (8681) in Cameroon. The continuous increase in the number of cases and the overall good KAP warrants further investigation to assess the effectiveness of the measures put in place to curb the spread of the disease. Sensitization is paramount to preclude negative health-seeking behaviors and encourage positive preventive and therapeutic practices, for fear of an increase in mortality.

by Hao Zhang, Xu-jing Jiang, Xiao-hua Liu, Hong Ma, Ya-hong Zhang, Yue Rao, Lin Li, Hai-yan Xu, Fa-jin Lyu

In this study, we ascertained the chest CT data of 60 patients admitted to 3 hospitals in Chongqing with confirmed COVID-19. We conducted anatomical and pathological analyses to elucidate the possible reasons for the distribution, morphology, and characteristics of COVID-19 in chest CT. We also shared a semiquantitative scoring of affected lung segments, which was recommended by our local medical association. This scoring system was applied to quantify the severity of the disease. The most frequent imaging findings of COVID-19 were subpleural ground glass opacities and consolidation; there was a significant difference in semiquantitative scores between the early, progressive, and severe stages of the disease. We conclude that the chest CT findings of COVID-19 showed certain characteristics because of the anatomical features of the human body and pathological changes caused by the virus. Therefore, chest CT is a valuable tool for facilitating the diagnosis of COVID-19 and semiquantitative scoring of affected lung segments may further elucidate diagnosis and assessment of disease severity. This will assist healthcare workers in diagnosing COVID-19 and assessing disease severity, facilitate the selection of appropriate treatment options, which is important for reducing the spread of the virus, saving lives, and controlling the pandemic.

by Maria Vittoria Barbarossa, Jan Fuhrmann, Jan H. Meinke, Stefan Krieg, Hridya Vinod Varma, Noemi Castelletti, Thomas Lippert

The novel coronavirus (SARS-CoV-2), identified in China at the end of December 2019 and causing the disease COVID-19, has meanwhile led to outbreaks all over the globe with about 2.2 million confirmed cases and more than 150,000 deaths as of April 17, 2020. In this work, mathematical models are used to reproduce data of the early evolution of the COVID-19 outbreak in Germany, taking into account the effect of actual and hypothetical non-pharmaceutical interventions. Systems of differential equations of SEIR type are extended to account for undetected infections, stages of infection, and age groups. The models are calibrated on data until April 5. Data from April 6 to 14 are used for model validation. We simulate different possible strategies for the mitigation of the current outbreak, slowing down the spread of the virus and thus reducing the peak in daily diagnosed cases, the demand for hospitalization or intensive care units admissions, and eventually the number of fatalities. Our results suggest that a partial (and gradual) lifting of introduced control measures could soon be possible if accompanied by further increased testing activity, strict isolation of detected cases, and reduced contact to risk groups.