SARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate Among the Non-Congregate Population in Connecticut

BackgroundInfection fatality rate and infection hospitalization rate, defined as the proportion of deaths and hospitalizations, respectively, of the total infected individuals, can estimate the actual toll of coronavirus disease 2019 (COVID-19) on a community, as the denominator is ideally based on a representative sample of a population, which captures the full spectrum of illness, including asymptomatic and untested individuals.ObjectiveTo determine the COVID-19 infection hospitalization rate and infection fatality rate among the non-congregate population in Connecticut between March 1 and June 1, 2020.MethodsThe infection hospitalization rate and infection fatality rate were calculated for adults residing in non-congregate settings in Connecticut prior to June 2020. Individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies were estimated using the seroprevalence estimates from the recently conducted Post-Infection Prevalence study. Information on total hospitalizations and deaths was obtained from the Connecticut Hospital Association and the Connecticut Department of Public Health, respectively.ResultsPrior to June 1, 2020, nearly 113,515 (90% confidence interval [CI] 56,758-170,273) individuals were estimated to have SARS-CoV-2 antibodies, and there were 7792 hospitalizations and 1079 deaths among the non-congregate population. The overall COVID-19 infection hospitalization rate and infection fatality rate were estimated to be 6.86% (90% CI, 4.58%-13.72%) and 0.95% (90% CI, 0.63%-1.90%), respectively, and there was variation in these rate estimates across subgroups; older people, men, non-Hispanic Black people, and those belonging to 2 of the counties had a higher burden of adverse outcomes, although the differences between most subgroups were not statistically significant.ConclusionsUsing representative seroprevalence estimates, the overall COVID-19 infection hospitalization rate and infection fatality rate were estimated to be 6.86% and 0.95%, respectively, among community residents in Connecticut.     

The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study

OBJECTIVE: Although obese children are at increased risk for coronary heart disease in later life, it is not clear if this association results from the persistence of childhood obesity into adulthood. We examined the relation of adiposity at various ages to the carotid intima-media thickness (IMT) at age 35 y. DESIGN: Prior to the determination of IMT by B-mode ultrasound, subjects (203 men, 310 women) had, on average, six measurements of body mass index (BMI) and triceps skinfold thickness (TSF) between the ages of 4 and 35 y. Mixed regression models for longitudinal data were used to assess the relation of these characteristics to adult IMT. RESULTS: Overall, adult IMT was associated with levels of both BMI and TSF (P<0.001), with the magnitudes of the associations with childhood adiposity comparable to those with adult levels of BMI and TSF. Furthermore, adult obesity modified the association between childhood adiposity and IMT: high IMT levels were seen only among overweight (BMI > or =95th percentile) children who became obese (BMI > or =30 kg/m2) adults (P<0.01 for linear trend). In contrast, IMT levels were not elevated among (1) overweight children who were not obese in adulthood, or among (2) thinner children who became obese adults. CONCLUSIONS: These results emphasize the adverse, cumulative effects of childhood-onset obesity that persists into adulthood. Since many overweight children become obese adults, the prevention of childhood obesity should be emphasized.     

“We have to ask and only then do”: Unpacking agency and autonomy in women's reproductive health in urban India

The limited autonomy and agency of women in developing countries is recognized as a key barrier to improving their reproductive health. Using an existing perinatal cohort in urban South India, we interviewed 36 women who had recently been through childbirth, and we carried out observations of family life and clinic encounters. Critical domains involved in women's agency and autonomy were women's participation in employment and group action and their mobility. Household decision making was considered a joint rather than individual responsibility. We call for a more nuanced understanding of these domains and their relationship to women's reproductive health, particularly for urban populations.     

Susceptibility of Phlebotomus argentipes and P. papatasi (Diptera: Psychodidae) to insecticides

Field collected fully fed adults of Phlebotomus argentipes and P. papatasi were screened in the laboratory for susceptibility to DDT, BHC, malathion, deltamethrin, permethrin, lambdacyhalothrin and bendiocarb. Pondichery strain of P. papatasi and P. argentipes showed variations in their susceptibility to insecticides. Both the species were resistant to permethrin but tolerant to DDT and malathion with LD99.99 values of 13.88, 1.92, 1.08 and 34.63, 4.69, 16.32 times more than the deterministic doses respectively. However, they were susceptible to bendiocarb with LD99.99 7.6 and 1.6 times lower than the deterministic doses. While P. papatasi was susceptible to BHC, P. argentipes showed tolerance (1.6 times). The former showed tolerance to deltamethrin and the latter exhibited resistance (34 times). It was reverse in case of lamdacyhalothrin. High susceptibility of the vector sandflies to bendiocarb suggests that this insecticide could be used effectively against OP and pyrethroid resistant populations for Kalaazar control.     

Impact of alphacypermethrin treated bed nets on malaria in villages of Malkangiri district, Orissa, India

The impact of use of bed-nets treated with alphacypermethrin, at 20 mg (ai)/m2, in comparison to untreated nets or no nets on malaria vectors and malaria incidence was studied in tribal villages of Malkangiri district, Orissa state, India, which are highly endemic for falciparum malaria. Treated or untreated nets were supplied to the villagers in June 1999 and the nets were re-treated in September 1999, just before the rise in vector abundance and malaria incidence. The seasonal pattern of indoor resting Anopheles fluviatilis females was similar in all the three groups of villages before the start of intervention and the indoor resting catches were not significantly different between treatment-groups (two-way ANOVA, F = 1.53; d.f. = (2, 78); P = 0.2). During intervention, the indoor resting catches differed significantly among treatment groups (two-way ANOVA, F = 38.9; d.f.= (2, 66); P < 0.005). There was a 99% reduction in the indoor resting catches of An. fluviatilis in villages with treated nets and 61% reduction in villages with untreated nets compared with no-net villages. Comparison between villages with and without treated nets showed that there was 97% reduction in indoor resting catches in villages with treated nets. Pair-wise comparison showed that the reductions between villages with and without nets as well as between villages with treated and untreated nets were significant (Dunnett's C-test, P < 0.05). The indoor resting catches of Anopheles culicifacies did not differ significantly among the three groups of villages either before (F = 0.99; d.f. = (2, 121); P = 0.4) or during intervention (F = 0.21; d.f. = (2, 66); P = 0.8). Bioassay with 3 min exposure to treated bed nets showed 100% mortality of An. culicifacies for 2 months and with An. fluviatilis for 4.5 months after which tests were not carried out. In villages with treated nets, the Annual Parasite Incidence (API) significantly declined (P < 0.05) by about 65.7% and prevalence of infection among children (< 15 years) declined by 57.1%, whereas in villages with untreated nets, there was only 34% reduction in API and 13% in the prevalence of infection. In villages with treated nets, there was 48% reduction in API and 64% in prevalence of infection compared with villages with untreated nets. The impact of use of treated bed nets on other arthropod pests lasted for at least 1.5 months. After 1.5 months, observations on arthropod pests were not continued. The use rate of treated nets varied from 49.8 to 93.7% in three seasons and about 68.3% of treated bed nets and 60% of untreated nets were in good condition 1 year after distribution. Out of 489 users of treated net, five people complained of a burning sensation on the face (skin irritation) for 5 days following the distribution of treated nets. There were no other complaints of any discomfort in using the treated nets. The use of alphacypermethrin treated bed nets at 20 mg (ai)/m2 can be one of the options for reducing the vector abundance and incidence of malaria in this area.     

Analysis of carrageenan-induced suppression of antibody response.

This paper describes the induction of immunosuppression by multiple injections of carrageenan-lambda (cgn) in BALB/c mice. While cgn alone induced non-specific suppression that persisted for up to 25 days, priming with sheep red blood cells (SRBC) of mice within 10 days of cgn treatment prolonged the suppressive state. Also, antigen (SRBC)-specific suppression was observed when these mice were given a secondary challenge 25-30 days afer priming. Thus multiple cgn treatment along with priming SRBC generated non-specific and specific suppressive states which were transferable by Thy-1+ Lyt-2+ splenocytes.