Infectious Diseases of Poverty

RationaleSeveral studies have estimated basic production number of novel coronavirus pneumonia (NCP). However, the time-varying transmission dynamics of NCP during the outbreak remain unclear. ObjectivesWe aimed to estimate the basic and time-varying transmission dynamics of NCP across China, and compared them with SARS. MethodsData on NCP cases by February 7, 2020 were collected from epidemiological investigations or official websites. Data on severe acute respiratory syndrome (SARS) cases in Guangdong Province, Beijing and Hong Kong during 2002-2003 were also obtained. We estimated the doubling time, basic reproduction number (R0) and time-varying reproduction number (Rt) of NCP and SARS. Measurements and main resultsAs of February 7, 2020, 34,598 NCP cases were identified in China, and daily confirmed cases decreased after February 4. The doubling time of NCP nationwide was 2.4 days which was shorter than that of SARS in Guangdong (14.3 days), Hong Kong (5.7 days) and Beijing (12.4 days). The R0 of NCP cases nationwide and in Wuhan were 4.5 and 4.4 respectively, which were higher than R0 of SARS in Guangdong (R0=2.3), Hongkong (R0=2.3), and Beijing (R0=2.6). The Rt for NCP continuously decreased especially after January 16 nationwide and in Wuhan. The R0 for secondary NCP cases in Guangdong was 0.6, and the Rt values were less than 1 during the epidemic. ConclusionsNCP may have a higher transmissibility than SARS, and the efforts of containing the outbreak are effective. However, the efforts are needed to persist in for reducing time-varying reproduction number below one. At a Glance CommentaryO_ST_ABSScientific Knowledge on the SubjectC_ST_ABSSince December 29, 2019, pneumonia infection with 2019-nCoV, now named as Novel Coronavirus Pneumonia (NCP), occurred in Wuhan, Hubei Province, China. The disease has rapidly spread from Wuhan to other areas. As a novel virus, the time-varying transmission dynamics of NCP remain unclear, and it is also important to compare it with SARS. What This Study Adds to the FieldWe compared the transmission dynamics of NCP with SARS, and found that NCP has a higher transmissibility than SARS. Time-varying production number indicates that rigorous control measures taken by governments are effective across China, and persistent efforts are needed to be taken for reducing instantaneous reproduction number below one.

Backgroud and ObjectiveTo predict the epidemic of COVID-19 based on quarantined surveillance from real world in China by modified SEIR model different from the previous simply mathematical model. Design and MethodsWe forecasted the epidemic of COVID-19 based on current clinical and epidemiological data and built a modified SEIR model to consider both the infectivity during incubation period and the influence on the epidemic from strict quarantined measures. ResultsThe peak time of the curve for the infected newly diagnosed as COVID-19 should substantially present on Feb. 5, 2020 (in non-Hubei areas) and Feb. 19, 2020 (in Hubei). It is estimated that the peak of the curve of the cumulative confirmed cases will appear in non-Hubei areas on Mar. 3, 2020 and in Hubei province on Mar. 10, 2020, and the total number of the patients diagnosed as COVID-19 is 18,000 in non-Hubei areas and 78,000-96,000 in Hubei. The Chinese COVID-19 epidemic can be completetly controlled in May, 2020. ConclusionsCOVID-19 is only a local outbreak in Hubei Province, China. It can be probably avoided the pandemic of global SARS-CoV-2 cases rise with the great efforts by Chinese government and its people.

Huanglongbing (HLB, ex-greening) is the most devastating citrus disease around the world. We modelled HLB spread in scenarios with different populational levels of the main alternative host (Murraya paniculata) and Diaphorina citri Kuwayama, vector of HLB associated bacteria; and removal of HLB-symptomatic plants. A compartmental deterministic mathematical model was built for representing the HLB dynamics in the Reconcavo Baiano, Bahia State, Brazil. The model encompasses delays on latency and incubation disease periods and on the D. citri nymphal stages. The simulations indicated that the presence of alternative hosts at low proportion would not play a crucial role in HLB dynamics in situations of poor D. citri management, regardless of HLB-symptomatic plants eradication. Symptomatic citrus plants contribute more to increase the HLB-incidence than the alternative host in scenarios without a suitable D. citri management.

Eastern equine encephalitis virus (EEEV) is a deadly arboviral pathogen with 30% severe case fatality. EEEV exhibits pronounced 2-3 year cyclical outbreak patterns in the northeastern United States, linked to shifts in mosquito feeding preferences between hatch-year and adult avians. We developed an age-structured vector-host model incorporating differential feeding patterns of Culiseta melanura mosquitoes on European Starlings and American Robins. Global sensitivity analysis revealed mosquito biting rate (a) as the dominant driver in transmission, with avian infectivity ({delta}) and exposure () playing secondary roles. Pairing tree-based machine learning algorithms with SHAP analysis on 100,000 parameter sets identified parameter hierarchies that govern cyclic transmission. Adult avian mortality ({micro}a) was identified as the key parameter underlying cyclic and stable transmission patterns. SHAP further revealed these patterns to be grounded on opposite sides of the same epidemiological mechanism. Stable endemics emerge from demographic stability paired with transmission optimization, while cyclic endemics emerge from demographic instability paired with minimal transmission optimization. Numerical simulations illustrated critical threshold dynamics at 0.2 [≤] [≤] 0.4, where heightened hatch-year exposure triggers demographic instability responsible for observed 2-3 year cycles, while balanced exposure ( {approx} 0.5) leads to stable endemics. These mechanisms provide a foundation for targeted surveillance and control interventions.

Tick distribution in China has significantly expanded with urbanization and climate change. Chongqing faces a significant risk of severe fever with thrombocytopenia syndrome (SFTS), but targeted prevention efforts are challenging due to unclear exposure pathways. This study combined generalized linear model (GLM), Bayesian networks, and Bayesian multivariate GLM to assess environmental, agricultural, and socioeconomic drivers of tick exposure in southwestern China. Direct tick exposure risks primarily arose from proximity to shrublands, forests, and cattle farming. Pet ownership also increased risk, while proximity to croplands reduced exposure, likely due to the pesticide/herbicide use and tillage. Bayesian networks revealed that socioeconomic factors indirectly mediated risk. Higher education levels reduced cattle farming likelihood and increased income tier, lowering exposure by altering land-use proximity and agricultural activities. Key factors showing no significant association included demographics (age/gender), grassland proximity, and crop cultivation. Bayesian methods resolved collinearity and mediation effects in GLM, clarifying township-level tick exposure mechanisms in Southwest China and mapping driver networks. Findings demonstrate that tick exposure stems from complex interactions among environmental, agricultural, and socioeconomic factors. Prevention in mountainous southwest China should prioritize the shrubland/forest-cattle farming ecological interface. Future studies should integrate geospatial data for enhanced risk mapping.

The role of modelling in predicting the spread of an epidemic is important for health planning and policies. This study aimed to apply a compartmental model for predicting the variations of epidemiological parameters in Sri Lanka. We used a dynamic Susceptible-Exposed-Infected-Recovered-Vaccinated (SEIRV) model and simulated potential vaccine strategies under a range of epidemic conditions. The predictions were based on different vaccination coverages (5% to 90%), vaccination-rates (1%, 2%, 5%) and vaccine-efficacies (40%, 60%, 80%) under different R0 (2,4,6). We estimated the duration, exposed, and infected populations. When the R0 was increased, the days of reduction of susceptibility and the days to reach the peak of the infection were reduced gradually. At least 45% vaccine coverage is required for reducing the infected population to mitigate a disastrous situation in Sri Lanka. The results revealed that when R0 is increased in the SEIRV model along with the increase of vaccination efficacy and vaccination rate, the population to be vaccinated is reducing. Thus, the vaccination offers greater benefits to the local population by reducing the time to reach the peak, exposed and infected population through flattening the curves.

BackgroundBoth hemorrhagic fever with renal syndrome (HFRS) and scrub typhus (ST) are acute zoonotic infectious diseases. There is an overlap in their epidemiological characteristics and clinical manifestations, posing challenges for early differential diagnosis. This study aims to identify predictive factors for these two diseases to provide a basis for early diagnosis. Method/FindingsA retrospective analysis was conducted on the clinical data of patients diagnosed with HFRS and ST at the First Affiliated Hospital of Dali University. Logistic regression analysis was employed to explore independent risk factors for the early differential diagnosis of these two diseases, and a nomogram model was constructed based on these risk factors. The performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC). The nomogram was utilized to visually present the predictive variables. Decision curve analysis (DCA) was performed to assess the clinical utility of the model. ResultsA total of 235 patients each with HFRS and ST were included in this study. After adjusting for confounding factors, the results of multivariate logistic regression analysis revealed that sex (male) (adjusted odds ratio [ajOR]: 2.093, 95% confidence interval [CI]: 1.107 - 3.957, P = 0.018), positive proteinuria (ajOR: 4.937, 95% CI: 2.427 - 10.042, P < 0.001), creatinine (CREA) (ajOR: 1.009, 95% CI: 1.003 - 1.015, P = 0.005), heart rate (ajOR: 0.981, 95% CI: 0.966 - 0.997, P = 0.018), and conjunctival congestion (ajOR: 16.167, 95% CI: 5.326 - 49.072, P < 0.001) were independent risk factors for differentiating HFRS from ST. The AUC of the model constructed based on these five independent risk factors was 0.856. ConclusionSex (male), positive proteinuria, elevated CREA, decreased heart rate, and conjunctival congestion are effective predictive factors.

BackgroundWhile the COVID-19 pandemic seemed far from the end, the booster vaccine project was proposed to further reduce the transmission risk and infections. However, handful studies have focused on questions that with limited vaccine capacity ether boosting high-risk workers first or prioritizing susceptible normal individuals is optimal, and vaccinating how many people can lead us to the goal of herd immunity. In this study we aimed to explore the conclusions of such two problems with consideration of non-pharmacological interventions including mandatory quarantine for international entrants, keeping social distance and wearing masks. MethodsBy implementing the corresponding proportion of individuals who remain infectious after four lengths of quarantine strategies to the novel population-stratified model, we quantified the impact of such measures on optimizing vaccine prioritization between high-risk workers and normal populations. Furthermore, by setting the hypothetical COVID-19 transmission severity (reproduction number, R0) to the level of the most contagious COVID-19 variant (B.1.617.2, delta variant, R0 = 5.0), we separately estimated the threshold vaccine coverage of five countries (China, United States, India, South Africa and Brazil) to reach herd immunity, with and without the consideration of interventions including wearings masks and keeping social distance. At last, the sensitive analysis of essential parameter settings was performed to examine the robustness of conclusions. ResultsFor Chinese scenarios considered with moderate hypothetical transmission rate (R0 = 1.15-1.8), prioritizing high-risk workers the booster dose reached lower cumulative infections and deaths if at least 7-days of quarantine for international travelers is maintained, and the required screening time to remain such vaccinating strategy as optimal increased from 7-days to 21-days with the transmission severity. Although simply maintaining at least 7-days quarantine can lead to over 69.12% reduction in total infections, the improvement of longer quarantine strategies was becoming minimum and the least one was 2.28% between the 21 and the 28-days of quarantine. Besides, without the vaccination program, the impact of such measures on transmission control dropped significantly when R0 exceeded 1.5 and reached its minimal level when R0 equal to 2.5. On the other hand, when we combat the delta variant, the threshold vaccine coverage of total population to reach herd immunity lay within 74%-89% (corresponding to the vaccine efficiency from 70% to 50%), and such range decreased to 71%-84% if interventions including wearing mask and keeping social distance were implemented. Furthermore, Results of other countries with 85% vaccine efficiency were estimated at 79%, 91%, 94% and 96% for South Africa, Brazil, India and United States respectively. ConclusionsNon-pharmacological interventions can substantially affect booster vaccination prioritization and the threshold condition to reach herd immunity. To combat the delta variant, restrictions need to be integrated with mass vaccination so that can reduce the transmission to the minimum level, and the 21-days might be the suggested maximum quarantine duration according to the cost-effectiveness. Besides, by implementing interventions, the requirement to reach herd immunity can be lower in all countries. Lastly, the following surveillance after vaccination can help ensure the real-time proportion of vaccinated individuals with sufficient protection.

BackgroundIncidence in children was much less than in adults during the COVID-19 outbreak. Sports and entertainment events were canceled (VEC) in Japan for two weeks during 26 February - 13 March. Most schools were closed (SC). ObjectWe construct a susceptible-infected-recovered model using three age classes and estimate the basic reproduction number (R0) and protection level among children simultaneously. Then we simulate SC and VEC effects. MethodWe used data of patients with symptoms in Japan during 14 January to assess SC and VEC introduction. Effects of SC and VEC were incorporated into the model through change in the contact pattern or frequencies among age classes. ResultsResults suggest R0 as 2.86 [95%CI of 2.73, 2.97]. The protection level was estimated as 0.4 [0.2, 0.7]. SC and VEC can reduce the total number of patients significantly, by 6-7%. Discussion and ConclusionThe estimated R0 was similar to that found from other studies in China and Japan. We found a significant protection level among children, and by effects of SC and VEC. Introduction

Bovine cysticercosis is an infection of cattle caused by the larval stage of Cysticercus Bovis, the human intestinal cestodes and it has economic important and public health importance. Across-sectional study was conducted from March 2022 to August 2022 to determine the prevalence of Bovine Cysticercosis, Human Taeniasis and associated risk factors in selected towns of Silte zone. The study was conducted in Silte zone municipal abbatoir, Southern Ethiopia in cattle slaughtered randomly selected towns,namely, at Kilto,Kutery,Kirate and Werabe Tawon municipal abattoirs. Systematic random sampling technique was used to collect all the necessary data from abattoir survey of the study animals and questionnaire survey collected data stored by using in Epi data software and analyzed using (SPSS-22) software program. The sample size required for this study was determined to be based on the expected prevalence (50%) of C. bovis and the 5% desired absolute precision and 95% CI. Out of 422 carcasses examined during the study period in 4 municipality abattoirs, 36 % were infected with C.bovis. A prevalence of 35.7%, 35.92%, 37.96% and 34.11% were Kilto,Kutery,Kirate and Werabe Tawon were observed, respectively. Among considered risk factors, sex, body condition and breed showed statistically significant difference in prevalence of C. bovis in study area. Regarding the anatomical distribution of the cysts, shoulder muscle showed highest prevalence 28.44%, was followed by tongue 20.79% tricepsbrachi muscle 18.35%, masseter muscle 17.74%, heart 12.84%, and Liver 1.8%. Out of 110 respondents, 64.5% had contracted T.saginata. Among considered risk factors, sex, age, occupation, education status, raw meat consumption and knowledge about the disease showed statistically significant difference in prevalence of T.saginata in study area. The findings of this study indicated that importance of Bovine Cysticercosis and Taeniasis in the study area. Therefore, attention should be given to the public awareness, detailed meat inspection to be safe to public health, consumption of well-cooked cattle meat should be implemented for breaking the cycle of the diseases and promote meat industry in the country.

Large-scale outbreaks of scrub typhus combined with the emergence of this vector-borne rickettsiosis in new areas indicate that this disease remains seriously neglected. This study aimed to explore the long-term changes and regional leading factors of scrub typhus in China, so as to provide fresh insights for the prevention and control of this disease. In this study, a Bayesian space-time hierarchical model (BSTHM) was used to identify the long-term spatiotemporal heterogeneity of scrub typhus and quantify the association between meteorological factors and scrub typhus in southern and northern China from 2012 to 2018. GeoDetector model was used to quantify the dominant forces of environmental and socioeconomic factors in the Northern and the Southern China. Scrub typhus often appeared in summer and autumn (June to November), and epidemically peaked in October, with obvious temporal seasonality. Spatially, the hot spots (high-risk regions) were concentrated in the south, on the contrary the cold spots (low-risk regions) in the north. In addition, the main meteorological factor, average temperature, gave a significant impact in both areas. The average temperature increased by 1 {degrees}C, resulting in a decrease of 1.10% in southern China and an increase of 0.96% in northern China in the risk of scrub typhus. The determinant environmental and socio-economic factors of scrub typhus in the two areas were altitude and per capita GDP, with q-values of 0.91 and 0.87, respectively. Meteorological, environmental and socio-economic factors had a significant impact on the distribution of scrub typhus, with obvious seasonality and spatial heterogeneity. This study provides helpful suggestions and basis for reasonably allocating resources and controlling the occurrence of scrub typhus. Author summaryScrub typhus is a natural-focus disease caused by the bite of chigger mite larval. In this study, we use BSTHM to capture the overall temporal trend and spatial hot spots of scrub typhus, and quantify the relationship between the disease and major meteorological factors. Meanwhile, Geodetector model was used to quantify the influence of other potential risk factors and estimate the spatio-temporal heterogeneity of scrub typhus. The results showed that scrub typhus had significant seasonality, with a q value of 0.52, and spatial heterogeneity, with a q-value of 0.64. Scrub typhus mainly occurred in summer and autumn, and high-risk areas were mainly distributed in southern China (Yunnan, Hainan and Guangdong). These heterogeneity were closely related to the vector and host. Whether in the South or the north, scrub typhus was closely related to risk factors such as temperature, per capita GDP, NDVI, altitude and the percentage of children aged 0-14. These results suggest that the relevant departments should strengthen the monitoring of the ecological environment, the host and vector of Orientia tsutsugamushi, and strengthen the risk awareness, so as to prevent and control the possible increased risk of scrub typhus under these meteorological, environmental and socio-economic conditions. Considering the differences in different regions, resources should be allocated reasonably.

The current outbreak of novel coronavirus disease 2019 (COVID-19) is already causing a serious disease burden worldwide, this paper analyzed data of a delta variant Covid-19 outbreak in Hunan, China, and proposed an optimal dose-wise dynamical vaccinating process based on local contact pattern and vaccine coverage that minimize the accumulative cases in a certain future time interval. The optimized result requires an immediate vaccination to that none vaccinated at age group 30 to 39, which is coherent to the prevailing strategies. The dose-wise optimal vaccinating process can be directive for countries or regions where vaccines are not abundant. We recommend that vaccination should be further intensified to increase the coverage of booster shots, thus effectively reducing the spread of COVID-19.

Against the backdrop of global climate change and accelerating population mobility in 2025, chikungunya fever (CHIKF) exhibited a trend of worldwide spread, significantly increasing the difficulty of controlling tropical mosquito-borne diseases. To enhance the precision of intervention strategies, this study developed an age- and sex-structured human-mosquito interaction dynamic model based on data from the largest CHIKF outbreak ever recorded in China, and conducted a targeted analysis of prevention and control strategies. By decomposing the basic reproduction number and examining population heterogeneity, asymptomatic males aged 15-59 years were identified as the core transmission group. Optimal control analysis revealed that the synergistic implementation of three measures-- reducing the effective human-to-mosquito transmission rate, reducing the effective mosquito-to-human transmission rate, and suppressing mosquito population density--could reduce the overall infection rate by 95.7586%. Among these, mosquito population suppression should be prioritized as a universal core strategy; however, its protective effect on females aged 60 years and above was relatively weak, warranting particular attention. The study further demonstrated that asymmetric intensity combinations targeting these three intervention pathways--such as intensity profiles of "10%, 90%, 90%" or "60%, 80%, 90%"--could achieve effective outbreak control. This research elucidates population-specific transmission patterns and key pathways for intervention intensity, providing a theoretical and strategic foundation for the precise control of mosquito-borne diseases. It also provides actionable operational insights to support rapid response and strategy optimization for future emerging outbreaks. Author summaryCHIKF is a mosquito-borne viral disease that is gradually spreading from tropical regions to other areas. To achieve more precise control of this disease, we developed an age- and sex-structured analytical model based on the largest CHIKF outbreak in China, aiming to provide a scientific basis for responding to potential future outbreaks with inherent uncertainties. The study found that asymptomatic males aged 15-59 years were the primary drivers of transmission and should be prioritized as a key population for reducing viral spread in prevention efforts. When evaluating the effectiveness of different intervention strategies, females aged 60 years and above were the least affected by the implemented measures, indicating that this group should strengthen personal protection to lower their infection risk. Among all control measures, mosquito suppression was the most effective, suggesting that vector control strategies should be prioritized in future outbreak responses.

BackgroundThe number of patients of COVID-19 in Tokyo has been increasing gradually through the end of March, 2020. ObjectSupport for policymaking requires forecasting of the entire course and outcome of the outbreak if a self-restraint in going out is not initiated. Moreover, the effects of a self-restraint in going out must be considered when choosing to initiate one. Method: Data of Tokyo patients with symptoms during January 14 - March 28, 2020 were used to formulate a susceptible-infected-recovered (SIR) model using three age classes and to estimate the basic reproduction number (R0). Based on the estimated R0, We inferred outbreak outcomes and medical burden if a self-restraint in going out were not enacted. Then we estimate the self-restraint in going out effects. ResultsResults suggest R0 as 2.86, with a 95% confidence interval of [2.73, 2.97]. Exhaustion of medical resources can be expected to occur on April 26 if no self-restraint in going out occurs. If a self-restraint in going out were enacted from April 6, and if more than 60% of trips outside the home were restricted voluntarily, then medical care service could be maintained. Discussion and ConclusionThe estimated R0 was similar to that found from other studies conducted in China and Japan. Results demonstrate that a self-restraint in going out with reasonable cooperation of residents is required to maintain medical care.

Coronavirus disease 2019 (COVID-19), a novel infectious disease first identified in December 2019 in the city of Wuhan of Chinas Hubei province, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease has become a pandemic in just a few months and spread globally with more than 2.89 million cases and 203,000 deaths across 185 countries, as of April 26th, 2020. Ecuador has reported one of the highest rates of COVID-19 in Latin America, with more than 10K cases and 500 deaths in a country of approximately 17 million people. The dynamics of the outbreak is being observed quite different in different provinces of Ecuador with high reported prevalence in some low population density provinces. In this study, we aim to understand variations in outbreaks between provinces and provide assistance in essential preparedness planning in order to respond effectively to ongoing COVID-19 outbreak. The study estimated the critical level of quarantine rate along with corresponding leakage in order to avoid overwhelming the local health care system. The results suggest that provinces with high population density can avoid a large disease burden provided they initiate early and stricter quarantine measures even under low isolation rate. To best of our knowledge, this study is first from the region to determine which provinces will need much preparation for current outbreak in fall and which might need more help.

BackgroundWest Nile virus (WNV), a mosquito-borne flavivirus, has circulated in the USA since 1999. In 2025, Florida was home to 24 million people, with projected increases in population and urbanization in a changing climate. The southern house mosquito, Culex quinquefasciatus, is found in every county, and is a major vector for WNV. Describing shifting WNV transmission risk is important to inform public health and vector control planning. Materials and MethodsUsing published estimates of thermal suitability of WNV transmission by Cx quinquefasciatus, with climate models and population data, we calculated and mapped baseline and projected county-level transmission suitability and people at risk (PAR) for 2000, 2030, and 2050. Five general circulation models (GCMs) and two mitigation scenarios (SSP2-4.5, SSP5-8.5) were used to explore future trajectories. ResultsAt baseline, all 67 counties in Florida experienced 5-9 months transmission suitability. Using the year 2000 census estimates, 2.33 million people in 2 counties experienced 9 months, and in 2030, across climate models, 8.93-12.26 million people (10-20 counties; SSP2-4.5), and 8.95-18.10 million people (11-26 counties; SSP5-8.5) are projected to experience 9 or more months of transmission suitability. In 2050, for both SSP2-4.5 and SSP5-8.5, 17.08-20.42 million people (23-26 counties), ranging to approximately 70% of the projected population of Florida will experience 9 or more months. The 10 most populated counties in 2000 are projected to experience 1-3 months of additional climate driven transmission suitability in the future. ConclusionThe southern house mosquito was previously managed as a seasonal nuisance in Florida but now represents an increasing public health exposure risk. Projections across climate trajectories underscore an increasing suitability and exposure risk for WNV in Florida, ranging as high as around 70% of the population exposed to suitable climate conditions for transmission for 9 or more months of the year in the 2050s. This means the types of operations and number of employees needed in vector control and public health will also increase.

At present, the factors influencing Tuberculosis (TB) treatment effectiveness in HIV/TB co-infected patients need to be supported by more substantial real-world evidence. A retrospective study is conducted to fill the vacancy. 461 TB patients with HIV are defined as 742 samples according to each TB detection period. 7788 valid treatment records corresponding to 17 drug compositions for TB and 150 clinical indicators with more than 100 records are used to conduct data mining with consensus clustering, Fishers exact test, stratified analysis, and three modeling approaches, including logistic regression, support vector machine, and random forest. We find that A CD4+ T cell count of 42 cells per L may serve as a sensitive classification standard for the immune level to assist in evaluating or predicting the efficacy of TB (P=0.007); Rifabutin and levofloxacin alone or in combination may be more effective than other first- and second-line anti-TB agents in combination (P=0.037); Samples with low immune levels (CD4[less double equals]42) may be more resistant to first-line TB drugs (P=0.049); Age (P=0.015), bicarbonate radical (P=0.007), high-density lipoprotein cholesterol (P=0.026), pre-treatment CD8+ T cell count (P=0.015, age<60, male), neutrophil percentage (P=0.033, age<60), rifabutin (P=0.010, age<60), and cycloserine (P=0.027, age<60) may influence the TB treatment effectiveness; More evidence is needed to support the relationship between pre-treatment clinical indicators or drug regimens and TB treatment effectiveness (The best AUC is 0.560[~]0.763); The percentage of lymphocytes (P=0.028) can be used as an effective TB therapeutic target. These perspectives supplement knowledge in relevant clinical aspects.

The co-existence of coronavirus disease 2019 (COVID-19) and seasonal influenza epidemics has become a potential threat to human health, particularly in China in the oncoming season. However, with the relaxation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic, the rebound extent of the influenza activities is still poorly understood. In this study, we constructed a susceptible-vaccinated-infectious-recovered-susceptible (SVIRS) model to simulate influenza transmission and calibrated it using influenza surveillance data from 2018 to 2022. We projected the influenza transmission over the next 3 years using the SVIRS model. We observed that, in epidemiological year 2021-2022, the reproduction numbers of influenza in southern and northern China were reduced by 64.0% and 34.5%, respectively, compared with those before the pandemic. The percentage of people susceptible to influenza virus increased by 138.6% and 57.3% in southern and northern China by October 1, 2022, respectively. After relaxing NPIs, the potential accumulation of susceptibility to influenza infection may lead to a large-scale influenza outbreak in the year 2022-2023, the scale of which may be affected by the intensity of the NPIs. And later relaxation of NPIs in the year 2023 would not lead to much larger rebound of influenza activities in the year 2023-2024. To control the influenza epidemic to the pre-pandemic level after relaxing NPIs, the influenza vaccination rates in southern and northern China should increase to 53.8% and 33.8%, respectively. Vaccination for influenza should be advocated to reduce the potential reemergence of the influenza epidemic in the next few years.

Realized vaccine efficacy in population is highly different from the individual vaccine efficacy measured in clinical trial. The realized vaccine efficacy in population is substantially affected by the vaccine age-stratified prioritization strategy, population age-structure, non-pharmaceutical intervention (NPI). We proposed a population vaccine efficacy which integrated individual vaccine efficacy, vaccine prioritization strategy and NPI to measure and monitor the control of the spread of COVID-19. We found that 11 states in the US had low population vaccine efficacy and 20 states had high population efficacy. We demonstrated that although the proportion of the population who received at least one dose of COVID-19 vaccine across 11 low population vaccine efficacy states, in general, was greater than that in 20 high population vaccine efficacy states, the 11 low population vaccine efficacy states experienced the recent COVID-19 surge, while the number of new cases in the 20 high population vaccine efficacy states exponentially decreased. We demonstrated that the proportions of adults in the population across 50 states were significantly associated with the forecasted ending date of the COVID-19. We show that it was recent low proportion of adults vaccinated in Michigan that caused its COVID-19 surge. Using population vaccination efficacy, we forecasted that the earliest COVID-19 ending states were Hawaii, Arizona, Arkansas, and California (in the end of June, 2021) and the last COVID-19 ending states were Colorado, New York and Michigan (in the Spring, 2022).

COVID-19 has become a global pandemic. However, the impact of the public health interventions in China needs to be evaluated. We established a SEIRD model to simulate the transmission trend of China. In addition, the reduction of the reproductive number was estimated under the current forty public health interventions policies. Furthermore, the infection curve, daily transmission replication curve, and the trend of cumulative confirmed cases were used to evaluate the effects of the public health interventions. Our results showed that the SEIRD curve model we established had a good fit and the basic reproductive number is 3.38 (95% CI, 3.25-3.48). The SEIRD curve show a small difference between the simulated number of cases and the actual number; the correlation index (H2) is 0.934, and the reproductive number (R) has been reduced from 3.38 to 0.5 under the current forty public health interventions policies of China. The actual growth curve of new cases, the virus infection curve, and the daily transmission replication curve were significantly going down under the current public health interventions. Our results suggest that the current public health interventions of China are effective and should be maintained until COVID-19 is no longer considered a global threat.