Nepal Journal of Epidemiology最新文献

{"title":"Is Robotics the real game changer for Urological cancer care during COVID-19 crisis?","authors":"Indraneel Banerjee, Indrajit Banerjee, Shantimoy Banerjee","doi":"10.3126/nje.v11i2.38133","DOIUrl":"https://doi.org/10.3126/nje.v11i2.38133","url":null,"abstract":"The COVID-19 pandemic has not only led to unprecedented loss of human life and a financial crisis but also has influenced the health care system in a big way. While dealing with this crisis, a non COVID-19 deadly disease like cancer care have been greatly compromised. Robotic surgery has revolutionized management of Urological cancer care in India over last few years. It decreases pain, reduces blood loss, promotes early discharge and may be more cost effective in long term as compared to open surgery. During the ongoing pandemic Robotic surgery can be the real game changer by promoting contactless surgery, utilizing minimal personnel and less instruments in the operating room and encouraging early discharge from the hospital.","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 2","pages":"988-993"},"PeriodicalIF":3.9,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39207332","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":"Effect of cooking food in iron-containing cookware on increase in blood hemoglobin level and iron content of the food: A systematic review.","authors":"Shally Sharma,&nbsp;Ritika Khandelwal,&nbsp;Kapil Yadav,&nbsp;Gomathi Ramaswamy,&nbsp;Kashish Vohra","doi":"10.3126/nje.v11i2.36682","DOIUrl":"https://doi.org/10.3126/nje.v11i2.36682","url":null,"abstract":"<p><p>In developing countries there is a need for simple and cost-effective strategies to reduce the prevalence of iron deficiency anemia. The objective of the current systematic review is to summarize how cooking food in iron pots or iron ingots can increase the blood hemoglobin level and iron content of the food. Literature search was conducted using databases namely PubMed, Google Scholar, Medline-Ovid, IndMed, Cochrane library, World Health Organization bulletin and by cross-referencing articles. Thirteen researches were found to be suitable for inclusion in this systematic review. Four studies reported significant increase in blood hemoglobin levels while others reported only a minor increase. Significant improvement in amount of iron in food and iron bioavailability was also observed when food was cooked using iron pot or ingots. This can be used as a strategy for reduction of iron deficiency anemia. However, more research is required to understand the efficacy of this approach.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 2","pages":"994-1005"},"PeriodicalIF":3.9,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39207333","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":"Mucormycosis and COVID-19 an epidemic in a pandemic?","authors":"Indrajit Banerjee,&nbsp;Jared Robinson,&nbsp;Mohammad Asim,&nbsp;Brijesh Sathian,&nbsp;Indraneel Banerjee","doi":"10.3126/nje.v11i2.37342","DOIUrl":"https://doi.org/10.3126/nje.v11i2.37342","url":null,"abstract":"<p><p>Mucormycosis and aspergillosis are rare, invasive and life-threatening infections primarily caused by Rhizopus arrhizus and Aspergillus fumigatus with higher case fatality rates (>50%), respectively. Invasive Aspergillosis and Mucormycosis have been established and recognized as complications of the SARS-CoV-2 infection. Such cases have been intimately linked and related to prior corticosteroid therapy. With the new highly infectious Delta strain (B.1.617.2 and B.1.617.2.1 or AY.1) of the coronavirus which is running rampant throughout India causing unprecedented death tolls, a new crisis is evolving. Invasive \"black fungus\" (Mucormycosis) is creating an epidemic within a global pandemic. The unique socio-economic, genetic and health status of Indian population culminates into a melting pot which sustains the viable triad for the \"black fungus\" infection to gain a stronghold. Diabetes mellitus, immunosuppression and the current COVID-19 global pandemic with its massive surges in the country have produced the \"perfect storm.\" Ophthalmologist across India have reported a surge in invasive Mucormycosis cases with a rise in orbital compartment syndrome often calling for radical procedures such as enucleation surgeries. The \"black fungus\" pandemic and invasive Mucormycosis resulted in the sinister secondary infections and complications are closely linked with the COVID-19 infection in India. It is therefore of the upmost importance that neighbouring countries particularly Nepal and other Asiatic nations take great cognizance of this indolent \"black fungus killer\" and ensure new screening and testing protocols for early identification to ensure effective management.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 2","pages":"1034-1039"},"PeriodicalIF":3.9,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39207336","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":"The mortality burden of hematological malignancies in Ecuador.","authors":"David Garrido,&nbsp;Andrés Orquera,&nbsp;Johanna Rojas,&nbsp;Manuel Granja","doi":"10.3126/nje.v11i2.37057","DOIUrl":"https://doi.org/10.3126/nje.v11i2.37057","url":null,"abstract":"<p><strong>Background: </strong>The Hematological neoplasms (HN) are a heterogeneous group of cancers that originated in the hematopoietic or lymphoid tissues. There is reduced information published regarding HN mortality in Ecuador. This study aims to present the crude and age-specific mortality rates for HN in the Ecuadorian population.</p><p><strong>Methods: </strong>We performed a cross-sectional study through the national database of defunctions published by the Ecuadorian National Institute of Statistics and Census, 2019. We used the ICD-10 codes to classify the HN.</p><p><strong>Results: </strong>During 2019, 1462 deaths were reported, 53.83% were males, 87.96% of mestizo ethnicity, and 78.32% residents in urban areas. The median age was 62 years, with an interquartile range of 34.The crude mortality rate obtained was 8.49 per 100000 inhabitants, and the higher age-specific mortality rates was 43.29 per 100000 inhabitants aged ≥ 60 years, contrasting with the 2.63 per 100000 inhabitants in people aged < 20 years. Considering each ICD-10 group, we found the following rates by 100000 inhabitants; C85 2.04, C91 1.92, C92 1.46, C90 1.11, C83 0.70, C95 0.48, C81 0.38, C84 0.16, C82 0.10, C96 0.05, C93 0.04, C86 and C94 0.02, and C88 0.01.</p><p><strong>Conclusion: </strong>In Ecuador, during 2019, approximately eight people died due to HN by 100000 inhabitants, affecting mainly people aged ≥ 60 years. The most frequent neoplasms were Non-Hodgkin lymphomas, similar to other reports globally. These results should be analyzed considering some deficiencies in the Ecuadorian health system and the national registry. Therefore, we suggest conducting more studies regarding HN.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 2","pages":"1040-1048"},"PeriodicalIF":3.9,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39206808","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":"COVID-19: Lockdown and its impact on medical students: A cross sectional study from a medical school in Mauritius.","authors":"Indrajit Banerjee, Jared Robinson, Poornasha Mohabeer, Abhishek Kashyap, Ananya Shukla, Brijesh Sathian","doi":"10.3126/nje.v11i2.36951","DOIUrl":"10.3126/nje.v11i2.36951","url":null,"abstract":"<p><strong>Background: </strong>The objectives of the study were to identify the psychological impacts of lockdown on medical students due to COVID-19 and to discover the educational perplexities being faced by these students during the lockdown.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Sir Seewoosagur Ramgoolam Medical College (SSRMC), Mauritius. Questions were designed after an extensive review of the literature, so as to ensure relevance to meet the objectives of the study.</p><p><strong>Results: </strong>Out of 700 undergraduate medical students, 663 participated, which equates to a response rate of 95%. 348 (52.5 %) of the students were stationed in their hometown and the remaining 315 (47.5 %) were stationed in Mauritius. 464(70%) of the students suffered from the psychological impacts of lockdown whereas 634(95.6%) of students suffered from the educational impact thereof. Mauritian students suffered a greater educational impact aOR4.236[1.606-11.173]. Psychological impacts aOR 1.280 [0.917-1.789] and educational impacts aOR 2.464 [1.076-5.647] were more prevalent in hometown-based students. Students pursuing their clinical studies had aOR1.219 [ 0.531-2.798] a greater educational impact as compared to preclinical studies.</p><p><strong>Conclusion: </strong>Lockdown triggered both educational and psychological impacts on medical students. On a psychological basis it was proven that the lockdown induced a feeling of guilt and had a greater psychological impact in pre-clinical students. The COVID-19 situation was simultaneously indicated to be a motivator in the majority of students; however, juxtaposed to this was the fact that various students felt as if they couldn't study at the same level that they were accustomed to due to the uncertainty of the situation.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 2","pages":"1006-1022"},"PeriodicalIF":1.7,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39207334","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":"COVID-19 and mutations a threat level assessment.","authors":"Jared Robinson,&nbsp;Indrajit Banerjee,&nbsp;Alexandra Leclézio,&nbsp;Brijesh Sathian","doi":"10.3126/nje.v11i1.35659","DOIUrl":"10.3126/nje.v11i1.35659","url":null,"abstract":"<p><p>A mutation is defined as an alteration in the DNA or RNA sequences of a genome which may consequently confer a new phenotypic and or genotypic advantage both increasing the virulence as well as the survival of a virus or pathogen. At this current point in time there are 4 known major variants of the original SARS-CoV-2 virus, namely the English variant (B.1.1.7), the South African variant (B.1.351), Brazilian variants (VOC202101/02 (P.1) and VUI202101/01) and a variant similar to that of the South African variant found in North America (B.1.526), all of which have varying levels of resistance and infectivity. It is evident that the SARS-CoV-2 variants pose an international health risk, the mutations of E484K and N501Y are the two most implicated mutations. E484K being the most concerning as it aids in immune evasion and drastically causes the efficacy of the current vaccines to be reduced by large margins. The most worrisome variant is the South African or B.1.351 which harbors the above mutations. It is of the upmost importance that targeted vaccines are synthesized to ensure that immunized individuals have effective protection against these variants. Until these specific targeted vaccines are synthesized the current vaccines offer little long-term protection, however do confer a level of immunity to stop severe infections. It is thus advised that current vaccination programs should continue in earnest as a degree of protection is conferred.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":"11 1","pages":"983-987"},"PeriodicalIF":3.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10297052","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":"A contemporary insight into the sero-epidemiology of <i>Toxoplasma gondii</i> infection in the foot-hills of Himalayas: A cross-sectional study from a tertiary care center in Northern India.","authors":"Sangeeta Deka,&nbsp;Deepjyoti Kalita,&nbsp;Pratima Gupta,&nbsp;Yogendra Pratap Mathuria","doi":"10.3126/nje.v11i1.34228","DOIUrl":"https://doi.org/10.3126/nje.v11i1.34228","url":null,"abstract":"<p><strong>Background: </strong><i>Toxoplasma gondii</i> infects 30-50% of the world's population with high diversity in the geo-epidemiology and seroprevalence. The burden of toxoplasmosis and its determinants from remote and vulnerable regions of India is unknown. Therefore, this study aim to evaluate the prevalence of toxoplasma antibodies and factors associated with seropositivity among individuals from Uttarakhand and adjoining areas.</p><p><strong>Methods: </strong>Serum samples from 442 cases were tested for anti-Toxoplasma IgG and IgM antibodies by Enzyme-linked Immunosorbent Assay. Association of seropositivity of toxoplasmosis with age, gender, place of residence, dietary habits, and comorbidities were analyzed using binary logistic regression analysis.</p><p><strong>Results: </strong>The overall Toxoplasma seropositivity was found to be 36.88% [95% Confidence Interval (CI)=30.40-39.28]. While anti-T. gondii IgG was present in 34.84% [95% CI=30.40-39.28], anti-IgM was detected in 6.33% [95% CI=4.06-8.61]. The overall and IgG seroprevalence increased with age in both the genders and there was a sharp increase in the seropositivity after the age of 40 years [adjusted Odds Ratio (aOR)=2.98, p-value=0.030]. The seropositivity rate was significantly higher in individuals from Uttarakhand in both the hilly region (aOR=5.61; 95%CI:[2.14-14.68]) and plains (aOR=5.14; 95%CI:[2.2-12.02]). Multivariable logistic regression analysis also showed that being rural residents (aOR=3.23; 95%CI:[1.67-6.23]) and presence of comorbidities (aOR=8.64; 95%CI:[4.62-16.18]) were potential risk factors of Toxoplasmosis. On the other hand, consumption of vegetarian diet was found to have a protective effect (aOR=0.46; 95%CI:[0.28-0.75]).</p><p><strong>Conclusion: </strong>Seroprevalence of T. gondii antibodies was relatively high in Uttarakhand, particularly in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":" ","pages":"937-948"},"PeriodicalIF":3.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38886435","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":"A 13 year hospital based study on the Trend of Urinary Stone Disease in Uttarakhand, India.","authors":"Monica Kakkar,&nbsp;Rakesh Kakkar","doi":"10.3126/nje.v11i1.35896","DOIUrl":"https://doi.org/10.3126/nje.v11i1.35896","url":null,"abstract":"<p><strong>Background: </strong>The present retrospective study on urinary stone disease in the Uttarakhand state was necessitated as no study has been done yet.</p><p><strong>Methods: </strong>A 13 year retrospective study (from 2005 to 2018) was conducted on the urinary stones removed from the patients, admitted at Himalayan Institute of Medical Sciences, Dehradun. The incidence of the disease, site of stones in urinary tract upon diagnosis, composition of removed stones and occurrence of a possible co-relationship between the incidence of the urinary stone disease at different times, age, sex, religion of the patients was investigated.</p><p><strong>Results: </strong>The frequency of occurrence of urinary stones in males was found to be almost three times more as compared to their female counterparts. The above trend was consistent over the entire period of the study. Interestingly, in the Muslim and Sikh population of the area, females were found to be less prone to the problem as compared to their Hindu counterparts. However, in all religious groups, 21-40 years old subjects were found to be most susceptible to the problem and approximately 90% of the urinary stones were recovered from the kidneys and primarily composed of calcium oxalate.</p><p><strong>Conclusion: </strong>The co-relationship between the occurrence of urinary stones with age, sex of the patients, their religion & site of stones on diagnosis was found to be statistically significant.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":" ","pages":"949-958"},"PeriodicalIF":3.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38886436","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":"Development and implementation of a potential coronavirus disease 2019 (COVID-19) vaccine: A systematic review and meta-analysis of vaccine clinical trials.","authors":"Brijesh Sathian,&nbsp;Mohammad Asim,&nbsp;Indrajit Banerjee,&nbsp;Bedanta Roy,&nbsp;Ana Beatriz Pizarro,&nbsp;Maraeh Angela Mancha,&nbsp;Edwin R van Teijlingen,&nbsp;Hamed Kord-Varkaneh,&nbsp;Ahammed A Mekkodathil,&nbsp;Supram Hosuru Subramanya,&nbsp;Israel Júnior Borges do Nascimento,&nbsp;Neema Antony,&nbsp;Ritesh G Menezes,&nbsp;Padam Simkhada,&nbsp;Hanadi Al Hamad","doi":"10.3126/nje.v11i1.36163","DOIUrl":"https://doi.org/10.3126/nje.v11i1.36163","url":null,"abstract":"<p><strong>Background: </strong>To date, there is no comprehensive systematic review and meta-analysis to assess the suitability of COVID-19 vaccines for mass immunization. The current systematic review and meta-analysis was conducted to evaluate the safety and immunogenicity of novel COVID-19 vaccine candidates under clinical trial evaluation and present a contemporary update on the development and implementation of a potential vaccines.</p><p><strong>Methods: </strong>For this study PubMed, MEDLINE, and Embase electronic databases were used to search for eligible studies on the interface between novel coronavirus and vaccine design until December 31, 2020.</p><p><strong>Results: </strong>We have included fourteen non-randomized and randomized controlled phase I-III trials. Implementation of a universal vaccination program with proven safety and efficacy through robust clinical evaluation is the long-term goal for preventing COVID-19. The immunization program must be cost-effective for mass production and accessibility. Despite pioneering techniques for the fast-track development of the vaccine in the current global emergency, mass production and availability of an effective COVID-19 vaccine could take some more time.</p><p><strong>Conclusion: </strong>Our findings suggest a revisiting of the reported solicited and unsolicited systemic adverse events for COVID-19 candidate vaccines. Hence, it is alarming to judiciously expose thousands of participants to COVID-19 candidate vaccines at Phase-3 trials that have adverse events and insufficient evidence on safety and effectiveness that necessitates further justification.</p>","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":" ","pages":"959-982"},"PeriodicalIF":3.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38886437","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":"COVID-19: Are reinfections a global health threat?","authors":"Indrajit Banerjee,&nbsp;Jared Robinson,&nbsp;Brijesh Sathian","doi":"10.3126/nje.v11i1.34903","DOIUrl":"https://doi.org/10.3126/nje.v11i1.34903","url":null,"abstract":"The SARS-CoV-2 virus has plagued the planet and caused unfathomable disruptions in every facet of our lives. The undue and unforeseen losses as a consequence of this pandemic will take years to quantify and even longer to curtail. This phenomenon creates an innate pressure on humans as it synergistically charges the environment to propel the movement of restarting enterprise and life as it was before the pandemic in order to curb this “loss”. \u0000A plethora of hurdles however are still in question. Firstly, the re-opening of enterprise and a country has to be done in a safe manner. To overcome this hurdle the development of multiple vaccinations to this novel virus has been streamlined. \u0000The greatest matter in question however, is the efficacy of these vaccines and whether they will be the answer to allow a safe re-ignition of global enterprise and countries as multiple cases of reinfections have been recorded, namely reinfections post recovery from the disease. After the initiation of the immunization with both the Moderna mRNA-1273 vaccine and the Pfizer BNT162b2 vaccine, cases of infection with COVID-19 have been reported.  \u0000It is evident that reinfections of the SARS-CoV-2 virus can be attributed to two major benefactors. The first being a decrease in production or failure of natural acquired immunity thus leading to the reinfection by the same strain of the virus rendering the person ill and or asymptomatic. The second benefactor is that of mutations. Mutations of the virus will predispose to reinfections as the already established naturally acquired immunity is not beneficial or useful to combat a mutated strain. It is thus poignant for cases of reinfection to be investigated thoroughly as to determine whether the reinfection was caused due to an innate lack of immunity or due to a new strain where no prior immunity existed. It must however be noted that the cases of reinfections are a rather rare event and even if a reinfection does occur, the case if usually mild and or asymptomatic. The impact of reinfection on immunization at this point of time is difficult to quantify however, initial reports do show positive signs even in cases where the vaccine is not fully effective against a mutated strain.","PeriodicalId":43600,"journal":{"name":"Nepal Journal of Epidemiology","volume":" ","pages":"933-936"},"PeriodicalIF":3.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38890928","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}