Gates Open Research最新文献

{"title":"Understanding how they really feel: Lesson learned from four approaches to soliciting user preferences for new contraceptive products in development","authors":"Aurélie Brunie, Rebecca L. Callahan","doi":"10.12688/gatesopenres.14679.2","DOIUrl":"https://doi.org/10.12688/gatesopenres.14679.2","url":null,"abstract":"Background An expanded range of contraceptive methods could reduce unintended pregnancies. User preferences research is important for successful development of products people want to use. This paper describes four approaches to preferences research soliciting user input in different ways: 1) perspectives on contraceptive method characteristics, 2) reactions to products in development, 3) trade-offs between contraceptive method characteristics, and 4) “blue-sky” ideas on novel contraceptive technologies. Methods We conducted two mixed-method studies: one implemented in Burkina Faso and Uganda combining three of these approaches, and the other implemented in India and Nigeria using two approaches. We share observations on the strengths and weaknesses of each approach and draw on our experience to highlight lessons learned for future user preferences studies. Results Each approach contributes to product development in different ways, and the usefulness of each methodology depends on the product development stage and corresponding informational needs. Conclusions Recommendations for future research include combining different methods, angles, and perspectives; using sequential designs whenever possible; tailoring product descriptions to user understanding for optimal feedback; and acknowledging the value and limitations of both quantitative results for modeling demand and idiosyncratic ideas to inspire development of new products.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community health worker-led household screening and management of neonatal hyperbilirubinemia in rural Bangladesh: a cluster randomized control trial protocol.","authors":"Eric M Foote, Farjana Jahan, Mahbubur Rahman, Sarker Masood Parvez, Tasnim Ahmed, Rezaul Hasan, Farzana Yeasmin, Shams El Arifeen, Sk Masum Billah, Md Mahbubul Hoque, Mohammod Shahidullah, Muhammad Shariful Islam, Vinod K Bhutani, Gary L Darmstadt","doi":"10.12688/gatesopenres.14033.2","DOIUrl":"10.12688/gatesopenres.14033.2","url":null,"abstract":"<p><strong>Background: </strong>Extreme hyperbilirubinemia leading to neurologic disability and death is disproportionately higher in low- and middle-income countries (LMIC) such as Bangladesh, and is largely preventable through timely treatment. In LMICs, an estimated half of all newborns are born at home and few receive screening or treatment for hyperbilirubinemia, leading to 6 million newborns per year who need phototherapy treatment for hyperbilirubinemia but are untreated. Household screening and treatment for neonatal hyperbilirubinemia with phototherapy administered by a trained community health worker (CHW) may increase indicated treatment for neonatal hyperbilirubinemia in comparison to the existing care system in Bangladesh.</p><p><strong>Methods: </strong>530 Bangladeshi women in their second or third trimester of pregnancy from the rural community of Sakhipur, Bangladesh will be recruited for a cluster randomized trial and randomized to the intervention arm - home screening and treatment for neonatal hyperbilirubinemia - or the comparison arm to receive usual care. In the intervention arm, CHWs will provide mothers with two prenatal visits, visit newborns by 2 days of age and then daily for 3 days to measure transcutaneous bilirubin (TcB) and monitor for clinical danger signs. Newborns without danger signs but with a TcB above the treatment threshold, but >15 mg/dL will be treated with light-emitting diode (LED) phototherapy at home. Newborns with danger signs or TcB ≥15 mg/dL will be referred to a hospital for treatment. Treatment rates for neonatal hyperbilirubinemia in each arm will be compared.</p><p><strong>Conclusion: </strong>This study will evaluate the effectiveness of CHW-led home phototherapy to increase neonatal hyperbilirubinemia treatment rates in rural Bangladesh. LMICs are expanding access to postnatal care by using CHWs, and our work will give CHWs a curative treatment option for neonatal hyperbilirubinemia. Similar projects in other LMICs can be pursued to dramatically extend healthcare access to vulnerable newborns with hyperbilirubinemia.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"58"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward person-centred measures of contraceptive demand: a systematic review of the intentions to use contraception and actual use","authors":"Victoria Boydell, Kelsey Quinn Wright, Shatha Elnakib, Christine Galavotti","doi":"10.12688/gatesopenres.15078.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15078.1","url":null,"abstract":"Background Understanding people’s motivation and need for modern contraception is critical to ensuring access to quality rights-based contraceptive care and supporting reproductive justice. Current population level measures of contraception demand are proving limited; but there is a promising, more person-centred alternative - intention to use (ITU) contraception. ITU captures a person’s self-reported preferences and could better predict contraceptive use. This systematic review examines whether ITU predicts future contraceptive use and may be a better way to estimate desire to use contraception. Methods We searched PubMed, PsycInfo, Web of Science, and the Cochrane Collaboration to identify studies published from 1975-2020 that: (1) examined contraceptive behaviour, (2) included measures of ITU and future contraceptive use, and (3) included at least one quantitative measure of association between ITU and actual use. The inclusion criteria were: 1) examined contraceptive behaviour (excluding condom use only), (2) included disaggregated integral measures of ITU contraceptives and later contraceptive use, (3) included at least one quantitative measure of the association between ITU contraceptives and actual contraceptive use, (4) study population was women of reproductive age, (5) were peer-reviewed, and (6) written in English. Results 10 prospective cohort studies were included. Six indicated significant, increased, unadjusted odds of subsequent contraceptive use after reporting ITU. Of those, three reported adjusted values for contraceptive use across several covariates that were also significant and positive. The range of potential confounding factors indicate that contraceptive behaviour is a complex psychosocial process shaped by individual and contextual factors. Conclusions People’s self-reported ITU contraception have the potential to be a strong predictor of subsequent contraceptive use. Few studies directly examined the relationship between ITU and contraceptive uptake and recruitment was primarily pregnant or postpartum samples. Further high-quality research measuring the relationship between ITU and contraceptive use using standardized measures and variables are needed.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"77 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139388242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of machine learning techniques to profile smoking behavior of adolescent girls in Ghana","authors":"Sara V. Flanagan, Ariadna Vargas, Jana Smith","doi":"10.12688/gatesopenres.14991.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.14991.1","url":null,"abstract":"Background Tobacco use trends among adolescents in low- and middle-income countries, and in particular narrowing gender gaps, highlight the need for interventions to prevent and/or reduce tobacco use among adolescent girls. We evaluated a social marketing program in Ghana discouraging tobacco use among adolescent girls and additionally investigated the pathways influencing smoking behaviors to identify programmatic opportunities for impact. Leveraging the data collected through the stepped wedge cluster randomized trial and panel survey of 9000 girls aged 13–19 , we sought to apply machine learning (ML) techniques to identify the most important variables for predicting initiation of smoking. Methods To identify predictors of smoking initiation we sought to develop a model which could accurately differentiate smokers from non-smokers and evaluated various ML approaches for training classifier algorithms to achieve this. We selected a Synthetic Minority Over-sampling Technique (SMOTE) because it optimized the recall and precision of the model. We then utilized the technique of feature importance for greater insight into how the model arrived at its decisions and to rank the most important variables for predicting smokers. To explore different dimensions of smoking behavior, including initiation and continuation, we trained our model by using several combinations of target outcomes and input variables from the panel survey. Results The resulting features of smokers highlight the importance of girls’ independence and connectivity, social environment, and peer influence on likelihood of smoking, and in particular subsequent initiation. These results were largely consistent with our formative research findings based on qualitative interviews informed by behavioral science. Conclusions This novel application of ML techniques demonstrates how data science approaches can generate new programmatic insights from rigorous evaluation data, especially when data collection is informed by behavioral theory. Such insights about the relative importance of different features can be valuable input for program planning and outreach.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"3 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hybrid effectiveness-implementation study protocol to assess the effectiveness and chemoprevention efficacy of implementing seasonal malaria chemoprevention in five districts in Karamoja region, Uganda.","authors":"Richard Kajubi, Jennifer Ainsworth, Kevin Baker, Sol Richardson, Craig Bonnington, Christian Rassi, Jane Achan, Godfrey Magumba, Denis Rubahika, Jane Nabakooza, James Tibenderana, Anthony Nuwa, Jimmy Opigo","doi":"10.12688/gatesopenres.14287.2","DOIUrl":"10.12688/gatesopenres.14287.2","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) recommends seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine (SPAQ) for children aged 3 to 59 months, living in areas where malaria transmission is highly seasonal. However, due to widespread prevalence of resistance markers, SMC has not been implemented at scale in East and Southern Africa. An initial study in Uganda showed that SMC with SPAQ was feasible, acceptable, and protective against malaria in eligible children in Karamoja region. Nonetheless, exploration of alternative regimens is warranted since parasite resistance threats persist.</p><p><strong>Objective: </strong>The study aims to test the effectiveness of SMC with Dihydroartemisinin-piperaquine (DP) or SPAQ (DP-SMC & SPAQ-SMC), chemoprevention efficacy as well as the safety and tolerability of DP compared to that of SPAQ among 3-59 months old children in Karamoja region, an area of Uganda where malaria transmission is highly seasonal.</p><p><strong>Methods: </strong>A Type II hybrid effectiveness-implementation study design consisting of four components: 1) a cluster randomized controlled trial (cRCT) using passive surveillance to establish confirmed malaria cases in children using both SPAQ and DP; 2a) a prospective cohort study to determine the chemoprevention efficacy of SPAQ and DP (if SPAQ or DP clears sub-patent infection and provides 28 days of protection from new infection) and whether drug concentrations and/or resistance influence the ability to clear and prevent infection; 2b) a sub study examining pharmacokinetics of DP in children between 3 to <6 months; 3) a resistance markers study in children 3-59 months in the research districts plus the standard intervention districts to measure changes in resistance marker prevalence over time and finally; 4) a process evaluation.</p><p><strong>Discussion: </strong>This study evaluates the effects of SPAQ-SMC versus DP-SMC on clinical malaria in vulnerable children in the context of high parasite SP resistance, whilst informing on the best implementation strategies.</p><p><strong>Conclusion: </strong>This study will inform malaria policy in high-burden countries, specifically on utility of SMC outside the sahel, and contribute to progress in malaria control.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol and statistical analysis plan for a randomized controlled trial of the effect of intravenous iron on anemia in Malawian pregnant women in their third trimester (REVAMP - TT).","authors":"Rebecca Harding, Ernest Moya, Ricardo Ataíde, Zinenani Truwah, Glory Mzembe, Gomezgani Mhango, Ayşe V Demir, William Stones, Louise Randall, Marc Seal, Katherine Johnson, Stefan Bode, Martin N Mwangi, Sant-Rayn Pasricha, Sabine Braat, Kamija S Phiri","doi":"10.12688/gatesopenres.14710.2","DOIUrl":"10.12688/gatesopenres.14710.2","url":null,"abstract":"<p><strong>Background: </strong>Anemia affects 40% of pregnant women globally, leading to maternal mortality, premature birth, low birth weight, and poor baby development. Iron deficiency causes over 40% of anemia cases in Africa. Oral iron supplementation is insufficient for Low-and-Middle-Income-Countries (LMICs) to meet current WHO targets. We hypothesized that a single intravenous dose of Ferric Carboxymaltose (FCM) may be more effective than oral iron treatment for anemia recovery, particularly in these settings where women present late for antenatal care.</p><p><strong>Methods: </strong>This is a two-arm parallel open-label individual-randomized controlled trial in third trimester, in malaria Rapid Diagnostic Test-negative pregnant women with moderate or severe anemia - capillary hemoglobin <10 g/dL - who are randomized to receive either parenteral iron - with FCM - or standard-of-care oral iron for the remainder of pregnancy. This is the sister trial to the second-trimester <b>REVAMP</b> trial, funded by the Bill and Melinda Gates Foundation (trial registration ACTRN12618001268235, Gates Grant number INV-010612). In REVAMP-TT, recruitment and treatment are performed within primary health centers. The trial will recruit 590 women across Zomba district, Malawi. The primary outcome is the proportion of anemic women - venous hemoglobin <11 g/dL - at 36 weeks' gestation or delivery (whichever occurs first). Other pre-specified key secondary clinical and safety outcomes include maternal iron-status and hypophosphatemia, neonate birth weight, infant growth and infant iron and hematological parameters.</p><p><strong>Discussion: </strong>This study will determine whether FCM, delivered within primary health centers, is effective, safe and feasible for treating moderate to severe anemia in third-trimester pregnant Malawian women. This intervention could have long-term benefits for maternal and child health, resulting in improved survival and child development.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"117"},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?","authors":"Ali Sié, Habibou Fofana, M. Kagoné, Moussa Ouédraogo, Obinna Onwujekwe, Chinyere O. Mbachu, M. Chokshi, Latha Chilgod, T. Mokashi, Arun B. Nair, Peter Muriuki, A. Taddese, Leah Ewald, Apoorva Handigol","doi":"10.12688/gatesopenres.14973.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.14973.1","url":null,"abstract":"Background This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods The study used mixed methods drawing on analysis from key informant interviews and surveys, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"50 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasectomy provider decision-making balancing autonomy and non-maleficence: qualitative interviews with providers","authors":"Alison T. Hoover, Dominick Shattuck, Karen L. Andes","doi":"10.12688/gatesopenres.15036.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15036.1","url":null,"abstract":"Background Male sterilization, or vasectomy, is 99.9% effective at preventing pregnancy with less than a 2% risk of complications. Despite the high efficacy, low risk, low cost, and gender equity benefits of vasectomy, just 2% of women reported that they and their partners relied on vasectomy as their contraceptive method globally in 2019. Health care providers can be both a facilitator and a barrier in men’s health generally, and may be in vasectomy provision as well. This study sought to describe the decision-making rationales of experienced vasectomy providers when evaluating patient candidacy in complex cases. Methods Fifteen vasectomy providers belonging to the global Vasectomy Network google group from seven countries participated in online interviews using a semi-structured in-depth interview guide. Providers were asked about their vasectomy training, their reasons for vasectomy provision, challenging cases they have faced, and approaches used to manage challenging cases. Vignettes were used to further elicit decision-making rationale. Thematic analysis was conducted using MAXQDA20. Results Provider decision-making was predicated on ensuring patients were well-informed, able to consent, and certain about their choice to have a vasectomy. Once those foundational conditions were met, providers filtered patient characteristics through their training, laws and policies, sociocultural norms, experience, and peer influence to produce a cost-benefit breakdown. Based on the cost-benefit analysis, providers determined whether to weigh autonomy or non-maleficence more heavily when determining vasectomy patient candidacy. Conclusions Despite clinical best practices that promote prioritizing patient autonomy over non-maleficence, some providers continued to weigh non-maleficence over autonomy in vasectomy patient candidacy evaluations. Non-maleficence was particularly prioritized in cases providers deemed to be at higher risk of regret. The findings of this study suggest vasectomy provider training should emphasize evidence-based best practices in shared decision-making and patient-centered care to facilitate vasectomy provision that honors patient autonomy and rights.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portable ultrasound devices for obstetric care in resource-constrained environments: mapping the landscape","authors":"Bryan J. Ranger, E. Bradburn, Qingchao Chen, Micah Kim, J. A. Noble, Aris T. Papageorghiou","doi":"10.12688/gatesopenres.15088.1","DOIUrl":"https://doi.org/10.12688/gatesopenres.15088.1","url":null,"abstract":"Background The WHO’s recommendations on antenatal care underscore the need for ultrasound assessment during pregnancy. Given that maternal and perinatal mortality remains unacceptably high in low- and middle-income countries (LMICs), these guidelines are imperative for achieving better outcomes. In recent years, portable ultrasound devices have become increasingly popular in LMICs due to their cost-effectiveness, useability, and adoptability in resource-constrained settings. This desk review presents the capabilities and costs of currently available portable ultrasound devices, and is meant to serve as a resource for clinicians and researchers in the imaging community. Methods A list of ideal technical features for portable ultrasound devices was developed in consultation with subject matter experts (SMEs). Features included image acquisition modes, cost, portability, compatibility, connectivity, data storage and security, and regulatory certification status. Information on each of the devices was collected from publicly available information, input from SMEs and/or discussions with company representatives. Results 14 devices were identified and included in this review. The output is meant to provide objective information on ideal technical features for available ultrasound systems to researchers and clinicians working in obstetric ultrasound in LMICs. No product endorsements are provided. Conclusions This desk review provides an overview of the landscape of low-cost portable ultrasound probes for use in obstetrics in LMICs, and provides a description of key capabilities and costs for each. Methods could be applied to mapping the landscape of portable ultrasound devices for other clinical applications, or may be extended to reviewing other types of healthcare technologies. Further studies are recommended to evaluate portable ultrasound devices for usability and durability in global field settings.","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"37 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional clustering and waves patterns due to COVID-19 by the index virus and the lambda/gamma, and delta/omicron SARS-CoV-2 variants in Peru.","authors":"Melissa Toyama, Lucía Vargas, Sofía Ticliahuanca, Antonio M Quispe","doi":"10.12688/gatesopenres.13644.2","DOIUrl":"10.12688/gatesopenres.13644.2","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) impact varies substantially due to various factors, so it is critical to characterize its main differences to inform decision-makers about where to focus their interventions and differentiate mitigation strategies. Up to this date, little is known about the patterns and regional clustering of COVID-19 waves worldwide.</p><p><strong>Methods: </strong>We assessed the patterns and regional clustering of COVID-19 waves in Peru by using the weekly mortality rates for each of the 25 regions as an outcome of interest. We obtained the death counts from the National Informatics System of Deaths and population estimates from the National Registry of Identification and Civil Status. In addition, we characterized each wave according to its duration, peak, and mortality rates by age group and gender. Additionally, we used polynomial regression models to compare them graphically and performed a cluster analysis to identify regional patterns.</p><p><strong>Results: </strong>We estimated the average mortality rate at the first, second, and third waves at 13.01, 14.12, and 9.82 per 100,000 inhabitants, respectively, with higher mortality rates among elders and men. The patterns of each wave varied substantially in terms of duration, peak, impact, and wave shapes. Based on our clustering analysis, during the first wave caused by the index virus, the 25 regions of Peru presented six different wave patterns. However, the regions were clustered in two different wave patterns during the second and third, caused by alpha/lambda/delta and omicron.</p><p><strong>Conclusions: </strong>The propagation of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) variants behaved in Peru with varying wave patterns and regional clustering. During the COVID-19 pandemic, the weekly mortality rates followed different spatiotemporal patterns with solid clustering, which might help project the impact of future waves of COVID-19.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"74"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}