Category: Publications

Four PANSOC-affiliated researchers have just published a new open access paper in BMC Infectious Diseases examining the COVID-19 pandemic in Chiapas, Mexico, a region with a large indigenous population.

Elienai Joaquin-Damas, PANSOC collaborator during the 2022–23 Centre for Advanced Study project on Indigenous Peoples and Pandemics, is the lead author of this study that uses survey data from secondary school students to capture the prevalence of COVID-19 infections, deaths, and vaccine uptake. Centre leader Svenn-Erik Mamelund, postdoc Ben Schneider, and researcher Gerardo Chowell also contributed to the paper.

The study suggests substantial underreporting of COVID-related deaths in Chiapas: while national statistics reported just 212 cases and one death in the municipality of Chamula, which had a population of more than 75,000, 14% of survey respondents reported at least one COVID infection for themselves, and 4.7% reported at least one death in their household. Compounding these findings, at the time of the survey in September-October 2023 almost 80% of respondents had not received a single dose of a COVID-19 vaccine.

The study suggests that despite increased attention to indigenous communities in public health research and practice in recent decades, large disparities remain both in data collection and policies to reduce health inequalities.

While at PANSOC, postdoc Maria Bekker-Nielsen Dunbar co-authored a new preprint systematically reviewing the prevalance of Aedes-borne (mosquito-carried) Arboviral infections in Europe in recent decades.

The authors carried out a registered systematic review of studies that discuss the spread of various diseases transmitted to humans by Aedes mosquitoes in Europe from 2000 to 2023. These diseases, including dengue, Zika, yellow fever, and West Nile virus, pose a substantial and growing threat to public health. The review found that while most cases identified in the literature were travel-related, more than 15% originated in Europe. The overall case fatality rate in the 479 studies reviewed was about 1%. Most of these diseases do not have available treatments or vaccination, which increases the importance of surveillance and prevention policies.

Recent PANSOC postdoc Maria Bekker-Nielsen Dunbar contributed a co-authored chapter during her time with us to the Springer Handbook of Epidemiology on reproducibility in this scientific field.

The authors establish a stepwise framework for epidemiologists to improve reproducibility, which is a topic of increasing interest and relevance in science and metascience. The ten steps discussed cover the entire research process from idea development to paper submission, and in each step the chapter discusses researcher concerns and implementation of the step. The chapter then presents how the use of these steps enhanced the reliability of research using a practical example of epidemiology from the UK.

During her time at PANSOC, postdoc Maria Bekker-Nielsen Dunbar published an article in the Proceedings of the Computational Humanities Research Conference providing an explanation of the use of the term “influenza” in English, in contrast to the more common “grippe” of other Indo-European languages.

While most Indo-European languages refer to the disease using some variant of “grippe”, Italian, English, Uralic, and Nordic languages have preferred “influenza” (which has an Italian origin). The authors argue that “influenza” in contrast to “grippe”, sounds sufficiently different from other English words to avoid ambiguity in understanding. They test the linguistic space available for possible terms that could be used to describe influenza and posit that the term selected provided less ambiguity than the terms used in other Indo-European languages.

Drivers and barriers of seasonal influenza vaccination 2015/16 & 2019/20 to 2022/23 – a survey on why most Norwegians don’t get the flu vaccine | BMC Public Health (springer.com)

Background:

This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage.

Methods:

Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked “What was the most important reason why you did/did not get vaccinated?”. The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023.

Results:

The study included 9 705 individuals aged 18–79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were “no need” for the vaccine and “no specific reason”, followed by “not recommended/offered the vaccine”, “worry about side effects” and “vaccine refusal”. The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting “no need” for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic.

Conclusions:

The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with “no need” and “no specific reason” as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.

This new paper is part of our 2022-23 Centre for Advanced Study – CAS project: https://cas-nor.no/project/social-science-meets-biology

Comparative analysis of COVID-19 diagnoses and mortality among hospitalized indigenous and non-indigenous populations in Chile: 2020–2021 | BMC Public Health (springer.com)

Background

Current literature presents mixed effects of the COVID-19 pandemic on Indigenous communities. We aim to highlight potential disparities and temporal shifts in both the impact of COVID-19 and vaccine uptake among hospitalized Indigenous populations in Chile.

Methods

We conducted an observational analysis utilizing 1,598,492 hospitalization records from 2020 to 2021 based on publicly accessible hospital discharge data spanning 65 healthcare facilities of medium and high complexity funded through the Diagnosis-Related Groups (DRG) mechanism in Chile, representing roughly 70% of the country’s total hospitalizations. This was supplemented with publicly available municipal data on COVID-19 vaccinations and socio-demographic variables. We performed logistic regression analysis at 0.05 level of significance to assess the bivariate and multivariable association of Indigenous status with COVID-19 diagnosis and COVID-19 deaths among hospitalized populations. We also performed univariate and multiple linear regression to assess the association of COVID-19 vaccination rate and Indigenous status at the municipality level. In addition, we report the distribution of top 10 secondary diagnoses among hospitalized COVID-19 cases and deaths separately for Indigenous and non-Indigenous populations.

Results

Indigenous populations displayed lower adjusted odds for both COVID-19 diagnosis (OR: 0.76, 95% CI: 0.74, 0.77) and death (OR: 0.91, 95% CI: 0.85, 0.97) when compared to non-Indigenous groups. Notably, the adjusted odds ratio for COVID-19 diagnosis in Indigenous populations rose from 0.59 (95% CI: 0.57, 0.61) in 2020 to 1.17 (95% CI: 1.13, 1.21) in 2021. Factors such as the significantly higher median age and greater number of comorbidities in the non-Indigenous hospitalized groups could account for their increased odds of COVID-19 diagnosis and mortality. Additionally, our data indicates a significantly negative adjusted association between COVID-19 vaccination rates and the proportion of Indigenous individuals.

Conclusion

Although Indigenous populations initially showed lower odds of COVID-19 diagnosis and mortality, a marked rise in diagnosis odds among these groups in 2021 underscores the urgency of targeted interventions. The observed negative association between the proportion of Indigenous populations and vaccination rates further underscores the necessity to tackle vaccine access barriers and work towards equitable distribution.

Gerardo Chowell has written a new commentary piece. You can read it here: Political Determinants of Health: Has COVID-19 Exposed the Worst of It? | AJPH | Vol. Issue (aphapublications.org)

We are proud to have published yet another paper from our Social Science Meets Biology | CAS (cas-nor.no) project:

Read press release from OsloMet here: New research sheds light on mortality rate disparities in Alaska during the 1918 flu pandemic – OsloMet

Read full paper here: Death on the permafrost: Revisiting the 1918-20 influenza pandemic in Alaska using death certificates | American Journal of Epidemiology | Oxford Academic (oup.com)

Abstract: The 1918-20 influenza pandemic devastated Alaska’s Indigenous populations. We report on quantitative analyses of pandemic deaths due to pneumonia and influenza (P&I) using information from Alaska death certificates dating between 1915 and 1921 (n=7,147). Goals include a reassessment of pandemic death numbers, analysis of P&I deaths beyond 1919, estimates of excess mortality patterns overall and by age using intercensal population estimates based on Alaska’s demographic history, and comparisons between Alaska Native (AN) and non-AN residents. Results indicate that ANs experienced 83% of all P&I deaths and 87% of all-cause excess deaths during the pandemic. AN mortality was 8.1 times higher than non-AN mortality. Analyses also uncovered previously unknown mortality peaks in 1920. Both subpopulations showed characteristically high mortality of young adults, possibly due to imprinting with the 1889-90 pandemic virus, but their age-specific mortality patterns were different: non-AN mortality declined after age 25-29 and stayed relatively low for the elderly, while AN mortality increased after age 25-29, peaked at age 40-44, and remained high up to age 64. This suggests a relative lack of exposure to H1-type viruses pre-1889 among AN persons. In contrast, non-AN persons, often temporary residents, may have gained immunity before moving to Alaska.

Responses to the letters on “Mortality in Norway and Sweden during the COVID-19 pandemic 2020 – 22: A comparative study.” in Journal of Infection and Public Health.

Responses to the letters on “Mortality in Norway and Sweden during the COVID-19 pandemic 2020 – 22: A comparative study.” – ScienceDirect

We are proud to announce yet another publication from the project PANRISK: Socioeconomic risk groups, vaccination and pandemic influenza (Research Council of Norway grant agreement No 302336)

The paper is joint for with colleagues from the Norwegian Institute of Public Health. You can read the paper here:

Higher educational attainment associated with higher confidence in influenza vaccination in Norway – ScienceDirect