Alex R Cook's research while affiliated with National University of Singapore and other places
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Publications (325)
Background
Despite its well-regarded vector control program, Singapore remains susceptible to dengue epidemics. To assist evaluation of dengue interventions, we aimed to synthesize current data on the epidemiologic and economic burden of dengue in Singapore.
Methodology
We used multiple databases (PubMed, Embase, Cochrane, international/national r...
Wastewater-based surveillance has been put into practice during the pandemic. Persistence of SARS-CoV-2 in faeces of infected individuals, and high volume of passengers travelling by air, make it possible to detect virus from aircraft wastewater, lending itself to the potential identification of a novel pathogen prior to clinical diagnosis. In this...
Background
COVID-19 vaccines effectively reduced the severity of the pandemic, but the mass rollout was challenged by vaccine hesitancy, which was related to heterogenous factors—such as religiosity, mistrust, and a lack of scientific knowledge—around the globe. Distinguishing these potential influencers and quantifying their impacts would help aut...
Conducting real-world public health experiments is often costly, time-consuming, and ethically challenging, so mathematical models have a long-standing history of being used to inform policy. Applications include estimating disease burden, performing economic evaluation of interventions, and responding to health emergencies such as pandemics. Model...
This study aimed to elicit the preferences and willingness-to-pay for blood pressure (BP) telemonitoring programs. This study also investigated the different factors or participant characteristics that could influence preferences and choice behaviors. Participants with hypertension were identified from an online survey panel demographically represe...
Introduction
Singapore relies heavily on migrant workers to build its country and harbours a relatively large population of these workers. Importantly, tuberculosis (TB) remains a pernicious threat to the health of these workers and in line with the United Nations High-Level Meeting in 2023, this paper aims to uncover the qualitative discourse faci...
Japan has implemented a cluster-based approach for coronavirus disease 2019 (COVID-19) from the pandemic’s beginning based on the transmission heterogeneity (overdispersion) of severe acute respiratory coronavirus 2 (SARS-CoV-2). However, studies analyzing overdispersion of transmission among new variants of concerns (VOCs), especially for Omicron,...
Wastewater testing of SARS-CoV-2 has been adopted globally and has shown to be a useful, non-intrusive surveillance method for monitoring COVID-19 trends. In Singapore, wastewater surveillance has been widely implemented across various sites and has facilitated timely COVID-19 management and response. From April 2020 to February 2022, SARS-CoV-2 RN...
We thank Lee et al. who suggested that confounding may be present and proposed that we perform propensity score methods,¹,² traditionally used to address non-random allocation to treatment and control groups to overcome selection effects. We were careful to avoid the language of causality in our paper³ as we completely agree that confounding is a p...
Containment measures in high-risk closed settings, like migrant worker (MW) dormitories, are critical for mitigating emerging infectious disease outbreaks and protecting potentially vulnerable populations in outbreaks such as coronavirus disease 2019 (COVID-19). The direct impact of social distancing measures can be assessed through wearable contac...
Background:
An increasing number of countries are pursuing a tobacco 'endgame'. We sought to determine the combination of measures it would take to achieve a tobacco endgame in the city-state of Singapore.
Methods:
Using an open-cohort microsimulation model, we estimated the impact of existing measures (quit programmes, tobacco taxes, flavours b...
Transmission potential of a pathogen, often quantified by the time-varying reproduction number Rt, provides the current pace of infection for a disease and indicates whether an emerging epidemic is under control. In this study, we proposed a novel method, EpiMix, for Rt estimation, wherein we incorporated the impacts of exogenous factors and random...
Chatbots have become an increasingly popular tool in the field of health services and communications. Despite chatbots' significance amid the COVID-19 pandemic, few studies have performed a rigorous evaluation of the effectiveness of chatbots in improving vaccine confidence and acceptance. In Thailand, Hong Kong, and Singapore, from February 11th t...
[This corrects the article DOI: 10.1016/j.lanwpc.2021.100299.].
Introduction:
Singapore lacks robust data on the sizes of the key populations that are most at risk for HIV. Using the network scale-up method for hidden or hard-to-reach populations, we estimate the sizes of five key populations-male clients of female sex workers (MCFSW), men who have sex with men (MSM), female sex workers (FSW), people who injec...
Aedes aegypti abundance in residential estates is hypothesized to contribute to localised outbreaks of dengue in Singapore. Knowing the factors in the urban environment underlying high Ae. aegypti abundance could guide intervention efforts to reduce Ae. aegypti breeding and the incidence of dengue. In this study, objective data on Ae. aegypti abund...
Globally, gender-neutral Human Papillomavirus (HPV) vaccination programmes are gaining traction. Although cervical cancer remains the most prevalent, other HPV-related cancers are increasingly recognised as important, especially among men who have sex with men. We assessed if including adolescent boys in Singapore's school-based HPV vaccination pro...
Objective
We analysed birth anthropometry of babies of Chinese, Malay and Indian ancestry living in Singapore with an aim to develop gestational age (GA) and gender-specific birth anthropometry charts and compare these with the widely used Fenton charts.
Design
Retrospective observational study.
Setting
Department of Neonatology, National Univers...
Background
It is unclear whether unintentional ingestion of povidone-iodine following its application to the oropharyngeal space could affect thyroid function.
Objective
To examine thyroid function among individuals who regularly apply povidone-iodine throat spray for SARS-CoV-2 prophylaxis.
Methods
We designed a case-control study to compare thy...
Dengue is a major vector-borne disease worldwide. Here, we examined the spatial distribution of extreme weekly dengue outbreak risk in Singapore from 2007 to 2020. We divided Singapore into equal-sized hexagons with a circumradius of 165 m and obtained the weekly number of dengue cases and the surface characteristics of each hexagon. We accounted f...
Background
The COVID-19 pandemic has led to a fall of over 70% in international travel, resulting in substantial economic damages. The impact is especially pronounced in the Asia-Pacific region, where governments have been slow to relax border restrictions.
Methods
For eight Asia-Pacific countries or regions, we utilized a retrospective approach t...
During the COVID-19 pandemic, the emergence of the infodemic and vaccine hesitancy posed a significant challenge to adequate vaccine uptake. In response, conversational AI services such as chatbots have become an increasingly popular tool in the field of health service delivery and communication to increase individuals’ health literacy and vaccinat...
Importance
Assessing booster effectiveness of COVID-19 mRNA vaccine and inactivated SARS-CoV-2 vaccine over longer time intervals and in response to any further SARS-CoV-2 variants is crucial in determining optimal COVID-19 vaccination strategies.
Objective
To determine levels of protection against severe COVID-19 and confirmed SARS-CoV-2 infectio...
The time-varying reproduction (Rt) provides a real-time estimate of pathogen transmissibility and may be influenced by exogenous factors such as mobility and mitigation measures which are not directly related to epidemiology parameters and observations. Meanwhile, evaluating the impacts of these factors is vital for policy makers to propose and adj...
Background:
Since it was first identified in early November 2021, the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread quickly and replaced the B.1.617.2 (delta) variant as the dominant variant in many countries. Data on the real-world effectiveness of vaccines against the omicron variant in ch...
Introduction
Large, localised outbreaks of COVID-19 have been repeatedly reported in high-density residential institutions. Understanding the transmission dynamics will inform outbreak response and the design of living environments that are more resilient to future outbreaks.
Methods
We developed an individual-based, multilevel transmission dynami...
Secondhand smoke (SHS) remains a common health threat in densely populated, urban settings. We estimated the prevalence of exposure and associated respiratory symptoms, knowledge, attitudes, and behaviors in a multi‐ethnic, weighted sample of Singapore residents using a cross‐sectional survey of 1806 adults. We weighted data to match the national p...
Carbapenemase-producing Enterobacterales (CPE) infection control practices are based on the paradigm that detected carriers in the hospital transmit to other patients who stay in the same ward. The role of plasmid-mediated transmission at population level remains largely unknown. In this retrospective cohort study over 4.7 years involving all multi...
The Incompatible Insect Technique (IIT) strategy involves the release of male mosquitoes infected with the bacterium Wolbachia. Regular releases of male Wolbachia-infected mosquitoes can lead to the suppression of mosquito populations, thereby reducing the risk of transmission of vector-borne diseases such as dengue. However, due to imperfect sex-s...
As countries transition from pandemic mitigation to endemic COVID-19, mass testing may blunt the impact on the healthcare system of the liminal wave. We used GeoDEMOS-R, an agent-based model of Singapore’s population with demographic distributions and vaccination status. A 250-day COVID-19 Delta variant model was run at varying maximal rapid antige...
Park use is associated with health, yet our understanding of park features related to their use is limited. Singapore's parks were audited for 30 micro-features, then geospatial analysis characterized micro-features scores for parks nearest to participants' homes. Adults (3,435) reported their park use and park-based physical activity. Using linear...
Background. Continuous glucose monitoring (CGM) offers an opportunity for patients with diabetes to modify their lifestyle to better manage their condition and for clinicians to provide personalized healthcare and lifestyle advice. However, analytic tools are needed to standardize and analyze the rich data that emerge from CGM devices. This would a...
This economic evaluation investigates the health outcomes and costs associated with use of monoclonal antibodies for treatment of SARS-CoV-2 in 14 scenarios stratified by age, vaccination status, and source of infection.
Objective
We analyse birth anthropometry of Asian babies and its socioeconomic exposures, develop gestational age and gender-specific birth anthropometry charts and compare to the widely used Fenton chart.
Design
Retrospective observational study.
Setting
Department of Neonatology at the National University Hospital in Singapore.
Population or s...
Background
Tobacco flavours such as menthol and fruits, which appeal to youth, remain unregulated in Western Pacific countries. Our goal was to evaluate the potential impact of tobacco flavour bans in Singapore, which has the region's highest flavoured cigarette market share.
Methods
Using an open-cohort microsimulation model, we estimated the imp...
As the most widespread viral infection transmitted by the Aedes mosquitoes, dengue has been estimated to cause 51 million febrile disease cases globally each year. Although sustained vector control remains key to reducing the burden of dengue, current understanding of the key factors that explain the observed variation in the short- and long-term v...
Background:
The impact of SARS-CoV-2 vaccination status and paediatric age on transmission of the Delta variant is key to preventing COVID-19 spread. In Singapore, quarantine of all close-contacts, and quarantine-entry and exit PCR testing, enabled evaluation of these factors.
Methods:
This retrospective cohort study included all household close...
Asia is home to the most rapidly aging populations in the world. This study focuses on two countries in Asia that are advanced in terms of their demographic transition: the Republic of Korea and Singapore. We developed a demographic and economic state-transition microsimulation model based on the Korean Longitudinal Study of Aging and the Singapore...
"Secondary transmissions of SARS-CoV2 during the first two waves in Japan: Demographic characteristics and overdispersion"
DOI:https://doi.org/10.1016/j.ijid.2022.01.036
Supplementary materials
The effective reproduction number R t is an epidemiological quantity that provides an instantaneous measure of transmission potential of an infectious disease. While dengue is an increasingly important vector-borne disease, few have used R t as a measure to inform public health operations and policy for dengue. This study demonstrates the utility o...
Objsectives: Super-spreading events caused by overdispersed secondary transmission is crucial in the transmission of coronavirus disease 2019 (COVID-19). However, the exact level of overdispersion, demographics, and other factors associated with secondary transmission remain elusive. In this study, we aimed to elucidate the frequency and patterns o...
Introduction
COVID-19 transmission within overcrowded migrant worker dormitories is an ongoing global issue. Many countries have implemented extensive control measures to prevent the entire migrant worker population from becoming infected. Here, we explore case count outcomes when utilizing lockdown and testing under different testing measures and...
Aims/hypothesis
Prediabetes and type 2 diabetes are highly prevalent in Asia. Understanding the pathophysiology of abnormal glucose homeostasis in Asians will have important implications for reducing disease burden, but there have been conflicting reports on the relative contributions of insulin secretion and action in disease progression. In this...
Background
Impact of the Delta variant and vaccination on SARS-CoV-2 transmission remains unclear. In Singapore, quarantine of all close contacts, including entry and exit PCR testing, provided the opportunity to determine risk of infection by the Delta variant compared to other variants, vaccine efficacy against SARS-CoV-2 acquisition, symptomatic...
Background
We studied humoral and cellular responses against SARS-CoV-2 longitudinally in a homogeneous population of healthy young/middle-aged men of South Asian ethnicity with mild COVID-19.
Methods
In total, we recruited 994 men (median age: 34 years) post-COVID-19 diagnosis. Repeated cross-sectional surveys were conducted between May 2020 and...
The release of Wolbachia-infected mosquitoes is a promising disease intervention strategy that aims to control dengue and other arboviral infections. While early field trials and modelling studies suggest promising epidemiological and entomological outcomes, the overall cost effectiveness of the technology is not well studied in a resource rich set...
Background
Nicaragua experienced a large Zika epidemic in 2016, with up to 50% of the population in Managua infected. With the domesticated Aedes aegypti mosquito as its vector, it is widely assumed that Zika virus transmission occurs within the household and/or via human mobility. We investigated these assumptions by using viral genomes to trace Z...
Over 105 million dengue infections are estimated to occur annually. Understanding the disease dynamics of dengue is often difficult due to multiple strains circulating within a population. Interactions between dengue serotype dynamics may result in complex cross-immunity dynamics at the population level and create difficulties in terms of formulati...
Objectives
The WHO’s Global Action Plan on Antimicrobial Resistance (AMR) includes increasing overall public awareness of appropriate antibiotic use and resistance as a key priority area. We aimed to measure public knowledge, attitudes and practices of antibiotics and antibiotic resistance in Singapore, as well as their healthcare-seeking behaviour...
The sex ratio at birth (SRB) is defined as the ratio of male to female live births. The SRB imbalance in parts of the world over the past several decades is a direct consequence of sex-selective abortion, driven by the coexistence of son preference, readily available technology of prenatal sex determination and fertility decline. Estimation and pro...
Introduction:
The COVID-19 pandemic has affected the world for more than a year, with multiple waves of infections resulting in morbidity, mortality and disruption to the economy and society. Response measures employed to control it have generally been effective but are unlikely to be sustainable over the long term.
Methods:
We examined the evid...
Data supplement 3 for:
Chao F, Gerland P, Cook AR, Guilmoto CZ, Alkema L, Projecting sex imbalances at birth at global, regional and national levels from 2021 to 2100: scenario-based Bayesian probabilistic projections of the sex ratio at birth and missing female births based on 3.26 billion birth records. BMJ Global Health 2021;6:e005516.
Data supplement 2 for:
Chao F, Gerland P, Cook AR, Guilmoto CZ, Alkema L, Projecting sex imbalances at birth at global, regional and national levels from 2021 to 2100: scenario-based Bayesian probabilistic projections of the sex ratio at birth and missing female births based on 3.26 billion birth records. BMJ Global Health 2021;6:e005516.
Introduction
Skewed levels of the sex ratio at birth (SRB) due to sex-selective abortions have been observed in several countries since the 1970s. They will lead to long-term sex imbalances in more than one-third of the world’s population with yet unknown social and economic impacts on affected countries. Understanding the potential evolution of se...
Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid transmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories in Singapore. The aim of the study is to identify combination of factors facilitating SARS-CoV-2 tr...
Mathematical models have played a key role in understanding the spread of directly-transmissible infectious diseases such as Coronavirus Disease 2019 (COVID-19), as well as the effectiveness of public health responses. As the risk of contracting directly-transmitted infections depends on who interacts with whom, mathematical models often use contac...
Respiratory Syncytial Virus (RSV) is a leading cause of lower respiratory tract infection worldwide. The report of temporal changes in the risk of transmission among close contacts has been scarce. This study aims to examine an association between the viral load trajectory and transmission risk to develop a better control strategy for the disease s...
Abstract Background Relationships between park access, park use, and wellbeing remain poorly understood. The objectives of this study were to investigate: (1) perceived and objective park access in relation to park use and physical activity in parks; and; (2) perceived and objective park access, park use and physical activity in parks and their ass...
Background
Gay, bisexual, and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of...
BACKGROUND
Gay, bisexual and other men who have sex with men (GBMSM) are at disproportionately higher risk of acquiring HIV and other sexually transmitted infections (STI). While HIV/STI testing rates among GBMSM are increasing worldwide, they remain suboptimal in a variety of settings. While many studies have attempted to evaluate the efficacy of...
Purpose: No prior study has been published on suicide-related behaviors among gay, bisexual, transgender, and queer (GBTQ) men in Singapore, where sexual relations between men are criminalized. This study explores the association and mediational pathways between experienced homophobia and suicidal ideation or suicide attempts among young GBTQ men i...
Background:
Limited evidence on the effectiveness of various types of social distancing measures, from voluntary physical distancing to a community-wide quarantine, exists for the Western Pacific Region (WPR) which has large urban and rural populations.
Methods:
We estimated the time-varying reproduction number (R t ) in a Bayesian framework usi...
Background
The COVID-19 pandemic has resulted in the closure or partial closure of international borders in almost all countries. Here we investigate the efficacy of imported case detection considering quarantine length and different testing measures for travellers on arrival.
Methods
We examine 8 broad border control strategies from utilising qua...
Mass gathering events have been identified as high-risk environments for community transmission of coronavirus disease 2019 (COVID-19). Empirical estimates of their direct and spill-over effects however remain challenging to identify. In this study, we propose the use of a novel synthetic control framework to obtain causal estimates for direct and...
Chronic disease burdens continue to rise in highly dense urban environments where clustering of type II diabetes mellitus, acute myocardial infarction, stroke, or any combination of these three conditions is occurring. Many individuals suffering from these conditions will require longer-term care and access to clinics which specialize in managing t...
Background:
We examined whether existing licensed pharmacotherapies could reduce the spread of coronavirus disease 2019 (COVID-19).
Methods:
An open-label parallel randomized controlled trial was performed among healthy migrant workers quarantined in a large multi-storey dormitory in Singapore. Forty clusters (each defined as individual floors o...
Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, acco...
Globally, many countries are facing an increasing burden of chronic disease due to ageing populations, of which cardiovascular disease forms a large proportion. Excess dietary sodium contributes to cardiovascular disease risk and requires intervention at a population level. This study aimed to quantify the impact of several salt reduction initiativ...
Objectives
We considered how decision making around human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBMSM) is made in the context of one’s perceived risk of HIV acquisition and the availability of condoms.
Methods
We recruited 648 GBMSM aged 18 years old and residing in S...
Introduction: Skewed levels of the sex ratio at birth (SRB) due to sex-selective abortions have been observed in several countries since the 1970s. They will lead to long-term sex imbalances in more than a third of the world’s population with yet unknown social and economic impacts on affected countries. Understanding the potential evolution of sex...
High-density communal residences are at elevated risk of large outbreaks of respiratory disease.¹,2 After an initial nationwide outbreak of 231 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Singapore, which was contained as of March 24, 2020, a surge of 244 cases among migrant workers residing in dormitories, l...
Background
Despite the licensure of the world’s first dengue vaccine and the current development of additional vaccine candidates, successful Aedes control remains critical to the reduction of dengue virus transmission. To date, there is still limited literature that attempts to explain the spatio-temporal population dynamics of Aedes mosquitoes wi...
Background
Zika virus (ZIKV) emerged as a global epidemic in 2015–2016 from Latin America with its true geographical extent remaining unclear due to widely presumed underreporting. The identification of locations with potential and unknown spread of ZIKV is a key yet understudied component for outbreak preparedness. Here, we aim to identify locatio...
Background
Thailand is home to around 69 million individuals. Dengue is hyper-endemic and all 4 serotypes are in active circulation in the country. Dengue outbreaks occur almost annually within Thailand in at least one province but the spatio-temporal and environmental interface of these outbreaks has not been studied.
Methods
We develop Bayesian...
Background
We examined the impact of SARS-CoV-2 social distancing and quarantine policies on dengue transmission in the general and migrant worker populations in Singapore.
Methods
We utilized all nationally reported dengue cases in the general and migrant worker populations from 1st January 2013 to 31st May 2020. A difference-in-difference identi...
Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid tranmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories. Extensive epidemiological, serological and phylogentic investigations, supported by simulation mode...
Background: The proportion of asymptomatic carriers and transmission risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among household and non-household contacts remains unclear. In Singapore, extensive contact tracing by the Ministry of Health for every diagnosed COVID-19 case, and legally enforced quarantine
and intensi...
Background:
By estimating N95 respirator demand based on simulated epidemics, we aim to assist planning efforts requiring estimations of respirator demand for the healthcare system to continue operating safely in the coming months.
Methods:
We assess respiratory needs over the course of mild, moderate and severe epidemic scenarios within Singapo...
Background
Migrant worker dormitories—residential complexes where 10–24 workers share living spaces—account for the majority of cases of SARS-CoV-2 infection in Singapore. To prevent spill-over of transmission to the wider population, starting in early April 2020, residents were confined to their dormitories while measures were put in place to arre...
An estimated 105 million dengue infections occur per year across 120 countries, where traditional vector control is the primary control strategy to reduce contact between mosquito vectors and people. The ongoing sars-cov-2 pandemic has resulted in dramatic reductions in human mobility due to social distancing measures; the effects on vector-borne i...
Dengue is an arbovirus affecting global populations. Frequent outbreaks occur, especially in equatorial cities such as Singapore, where year-round tropical climate, large daily influx of travelers and population density provide the ideal conditions for dengue to transmit. Little work has, however, quantified the peaks of dengue outbreaks, when heal...
Citations
... This creates ideal conditions for population replacement and should be managed by resorting to additional treatments like 'irradiation' at the minimal dose capable of preventing the reproduction of released females. 30 However, BiCI IIT presents a notable advantage in controlling Ae. albopictus. After the end of the IIT protocol, inadvertently coreleased 'wPip' females had to compete with Wolbachia superinfected mosquitoes, and in the majority of cases, the wild-type Wolbachia superinfection reasserted dominance. ...
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... According to the WHO's program for selecting cost-effective interventions and published literature, a threshold of three times the GDP per capita in 2021 was adopted as the willingness-to-pay criterion (China's GDP per capita in 2021 is 80,976 yuan). 17 ; 18 Additionally, we analyzed how variations in willingness to pay impact the cost-effectiveness of screening measures for individuals at high risk of stroke using a willingness-to-pay threshold derived from a global study (0.51 times China's GDP per capita) 19 . ...
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... Contemporary epidemiological practice uses effective reproduction numbers (RNs), the estimate of the average number of secondary infections caused by a single primary infector, to compare alternative control measures (Diekmann et al., 1990;Heesterbeek, 2002;Nishiura & Chowell, 2009;Zhan et al., 2020). To do so, the current standard is to employ reported infection data, often regardless of their spatial nature (Bok anyi et al., 2023;Cereda et al., 2021;Cori et al., 2013;Gostic et al., 2020;Heesterbeek et al., 2015;Jin et al., 2023;Lipsitch et al., 2003;Liu et al., 2018;Parag, 2021;Thompson et al., 2019;Wallinga & Teunis, 2004;Yang et al., 2015). Effective RNs are commonly used as a proxy to gauge the spread of a pathogen in a population where values larger than unity indicate rampaging infections, while subunit values typically denote a receding epidemic and the asymptotic stability of the disease-free equilibrium (DFE) (Anderson et al., 1992). ...
... Furthermore, the tobacco endgame goal was predicted to be attained by the TFG alone, which was expected to be more effective than gradually raising the minimum legal age of smoking to 25 years 10 . However, it will take a long time to lower smoking prevalence and reap health gains because current smokers are unaffected by the TFG 10,12 . Therefore, we suggest introducing the TFG together with aggressive tax increases and implementation of MPOWER policies to end the tobacco epidemic. ...
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... A total of 12 studies published from 2019 to 2023 were analyzed and summarized (Altay et al., 2022;Amith et al., 2019Amith et al., , 2020Brand & Stafford, 2022;EI Ayadi et al., 2022;Hong et al., 2021;Kobayashi et al., 2022Kobayashi et al., , 2023Lee et al., 2022;Luk et al., 2022;Wang et al., 2023;Weeks et al., 2023) (Appendix C). Regarding the time of the studies, two were conducted before 2020 (before the COVID-19 pandemic), and ten were conducted in 2020 or the following years (during the COVID-19 pandemic). ...
... Other factors affecting transmission include symptom type, such as coughing; the overall health status of the exposed individual; the environment in which the contact occurred (such as home or workplace); and the likelihood of the contact undergoing testing. Vaccination offers protection to both the initial carrier and their contacts, with a more pronounced protective effect observed in the latter, reflecting earlier findings [88]. The diminishing efficacy of vaccination over time and the ability of subsequent variants to better evade immunity when compared to their predecessors underscore the importance of the timing of the most recent vaccination and the variant of concern (VoC) for the level of protection for contacts [88,89]. ...
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... A sample size of 171 was needed to achieve a 95% confidence and 7.5% margin of error, based on an estimated population size of 139 000. 15 ...
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... One study used probabilistic sensitivity analysis only [24]. One study combined one-way and multi-way sensitivity analysis [12], two studies used both deterministic and probabilistic sensitivity analysis [13], [20], [21]. Interestingly, there was a study used different type of sensitivity analysis named Latin model output [23]. ...
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... The data would be used to explore and adjust for imbalances in variables which may potentially confound historical dengue risk, using propensity scoring models as described in the revised statistical analysis below. Several of these factors were previously found to be associated to Aegypti abundance and dengue transmission from previous baseline studies in the same study setting [5][6][7]. ...
... The associations were studied by sub-setting our datasets into the primary type of housing found in each spatial unit, with associations for each exposure estimated to be generally consistent across datasets. The findings obtained from this study build upon previous work [26][27][28][29] that sought to establish a thorough understanding of DENV transmission. ...
