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  1. Article ; Online: Singapore's HIV disclosure law in the context of progress towards the 90-90-90 goals

    Rayner Kay Jin Tan / Alex R. Cook

    The Lancet Regional Health. Western Pacific, Vol 29, Iss , Pp 100588- (2022)

    A call for greater action in the Western Pacific

    2022  

    Keywords Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Towards better contact-tracing in the UK

    Alex R Cook / Hannah E Clapham

    The Lancet: Digital Health, Vol 2, Iss 12, Pp e630-e

    2020  Volume 631

    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Short-term and long-term epidemiological impacts of sustained vector control in various dengue endemic settings

    Haoyang Sun / Joel Koo / Borame L Dickens / Hannah E Clapham / Alex R Cook

    PLoS Computational Biology, Vol 18, Iss 4, p e

    A modelling study.

    2022  Volume 1009979

    Abstract: 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 ... ...

    Abstract 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 vector control effectiveness across different transmission settings remains limited. We used a detailed individual-based model to simulate dengue transmission with and without sustained vector control over a 30-year time frame, under different transmission scenarios. Vector control effectiveness was derived for different time windows within the 30-year intervention period. We then used the extreme gradient boosting algorithm to predict the effectiveness of vector control given the simulation parameters, and the resulting machine learning model was interpreted using Shapley Additive Explanations. According to our simulation outputs, dengue transmission would be nearly eliminated during the early stage of sustained and intensive vector control, but over time incidence would gradually bounce back to the pre-intervention level unless the intervention is implemented at a very high level of intensity. The time point at which intervention ceases to be effective is strongly influenced not only by the intensity of vector control, but also by the pre-intervention transmission intensity and the individual-level heterogeneity in biting risk. Moreover, the impact of many transmission model parameters on the intervention effectiveness is shown to be modified by the intensity of vector control, as well as to vary over time. Our study has identified some of the critical drivers for the difference in the time-varying effectiveness of sustained vector control across different dengue endemic settings, and the insights obtained will be useful to inform future model-based studies that seek to predict the impact of dengue vector control in their local contexts.
    Keywords Biology (General) ; QH301-705.5
    Subject code 330
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Evaluating the public health impact of partial and full tobacco flavour bans

    Zitong Zeng / Alex R Cook / Jacinta I-Pei Chen / Yvette van der Eijk

    The Lancet Regional Health. Western Pacific, Vol 21, Iss , Pp 100414- (2022)

    A simulation study

    2022  

    Abstract: Summary: 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 ... ...

    Abstract Summary: 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 impact of full ban and partial ban (excluding menthol and clove) scenarios versus the status quo (no ban) over a 50-year horizon. We used a Markov chain with four states (never, unflavoured, flavoured and ex-smokers), updating each individual's state across each year. We estimated between-state transition probabilities using Markov chain Monte Carlo, with prior distributions derived from national survey data. Findings: Without a ban, smoking prevalence gradually increases from 12.7% (2018) to 15.2% (2068). In both ban scenarios, smoking prevalence decreases immediately after the ban: by 1.6% points in the full ban, and 0.4% points in the partial ban scenario. In addition, there is a sustained long-term impact as fewer initiate. In the full ban scenario, smoking prevalence decreases to 10.6% by 2068 with a cumulative gain of over 40,000 QALYs. In the partial ban scenario, it remains stable at 12.5% with a cumulative gain of over 20,000 QALYs. Interpretations: A tobacco flavours ban would reap substantial public health benefits in countries that, like Singapore, have a large flavoured cigarette market share, especially with a full ban compared to a partial ban not covering menthol or clove-flavoured cigarettes. Funding: This study was funded by the Singapore Ministry of Health.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 200
    Language English
    Publishing date 2022-04-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Features of the urban environment associated with Aedes aegypti abundance in high-rise public apartments in Singapore

    Stephanie A Fernandez / Haoyang Sun / Borame L Dickens / Lee Ching Ng / Alex R Cook / Jue Tao Lim

    PLoS Neglected Tropical Diseases, Vol 17, Iss 2, p e

    An environmental case-control study.

    2023  Volume 0011075

    Abstract: 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. ... ...

    Abstract 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 abundance in public apartment blocks estimated by Singapore's nationally representative Gravitrap surveillance system was obtained from the National Environmental Agency. Low and high abundance status public apartment blocks were classified based on the Gravitrap Aegypti Index, corresponding to the lowest and highest quartiles respectively. An environmental case-control study was conducted, wherein a blinded assessment of urban features hypothesised to form breeding habitats was conducted in 50 randomly sampled public apartment blocks with low and high abundance statuses each. Logistic regression was performed to identify features that correlated with abundance status. A multivariable logistic model was created to determine key urban features found in corridors and void decks which were predictive of the Ae. aegypti abundance status of the public apartment block. At a statistical level of significance of 0.20, the presence of gully traps [Odds Ratio (OR): 1.34, 95% Confidence Interval (CI): 1.10, 1.66], age of the public apartment block [OR: 2.23, 95% CI: 1.48, 3.60], housing price [OR: 0.33, 95% CI: 0.16, 0.61] and corridor cleanliness [OR: 0.67, 95% CI: 0.40, 1.07] were identified as important predictors of abundance status. To reduce Ae. aegypti abundance around public apartment blocks and potential onward dengue transmission, gully traps could be remodelled or replaced by other drainage types. Routine inspections of Ae. aegypti breeding should be targeted at older and low-income neighbourhoods. Campaigns for cleaner corridors should be promoted.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
    Subject code 720
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Use of Bluetooth contact tracing technology to model COVID-19 quarantine policies in high-risk closed populations

    Yinxiaohe Sun / Joel Ruihan Koo / Minah Park / Huso Yi / Borame L Dickens / Alex R Cook

    Digital Health, Vol

    2023  Volume 9

    Abstract: 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 ( ... ...

    Abstract 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 contact tracing devices. Here, we developed an individual-based model using data collected through a Bluetooth wearable device that collected 33.6M and 52.8M contact events in two dormitories in Singapore, one apartment style and the other a barrack style, to assess the impact of measures to reduce the social contact of cases and their contacts. The simulation of highly detailed contact networks accounts for different infrastructural levels, including room, floor, block, and dormitory, and intensity in terms of being regular or transient. Via a branching process model, we then simulated outbreaks that matched the prevalence during the COVID-19 outbreak in the two dormitories and explored alternative scenarios for control. We found that strict isolation of all cases and quarantine of all contacts would lead to very low prevalence but that quarantining only regular contacts would lead to only marginally higher prevalence but substantially fewer total man-hours lost in quarantine. Reducing the density of contacts by 30% through the construction of additional dormitories was modelled to reduce the prevalence by 14 and 9% under smaller and larger outbreaks, respectively. Wearable contact tracing devices may be used not just for contact tracing efforts but also to inform alternative containment measures in high-risk closed settings.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 600
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Preferences and willingness-to-pay for a blood pressure telemonitoring program using a discrete choice experiment

    Ian Yi Han Ang / Yi Wang / Shilpa Tyagi / Gerald Choon Huat Koh / Alex R. Cook

    npj Digital Medicine, Vol 6, Iss 1, Pp 1-

    2023  Volume 9

    Abstract: Abstract 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 ... ...

    Abstract Abstract 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 representative of Singapore’s general population. Participants completed a discrete choice experiment (DCE) with 12 choice sets, selecting their preferred BP monitoring program differing on five attributes: mode of consultation, BP machine type (with Bluetooth or not), BP machine price, monthly fee, and program duration. The base reference population (male, married, higher income, more formal education years, full-time worker, aged 55 to <65 years, and digital skills score of 36) preferred teleconsultation over in-person consultation, Bluetooth feature, lower machine price, lower monthly fee, and shorter program duration. A subgroup of participants can be considered teleconsultation-resistant, and three demographic factors were associated with lower preference for teleconsultation: female, fewer formal education years, and lower income. Considering the reference population and Bluetooth attribute, participants were willing to pay 66 SGD (~49 USD) additional for the machine to obtain the Bluetooth feature. Considering the reference population and teleconsultation attribute, participants were willing to pay 6.80 SGD (~5.10 USD) extra monthly fee for a program using teleconsultation. Here we report that amongst participants with hypertension, there is strong preference for the use of teleconsultation and a BP machine with Bluetooth feature in a BP monitoring program. However, a subgroup of participants are teleconsultation-resistant and would prefer in-person consultation.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 336
    Language English
    Publishing date 2023-09-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Book ; Online: Author response for "Age‐related risk of household transmission of COVID‐19 in Singapore"

    Rachael Pung / Minah Park / Alex R. Cook / Vernon J. Lee

    2020  

    Keywords covid19
    Publisher Wiley
    Publishing country us
    Document type Book ; Online
    DOI 10.1111/irv.12809/v3/response1
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Book ; Online: Author response for "Age‐related risk of household transmission of COVID‐19 in Singapore"

    Rachael Pung / Minah Park / Alex R. Cook / Vernon J. Lee

    2020  

    Keywords covid19
    Publisher Wiley
    Publishing country us
    Document type Book ; Online
    DOI 10.1111/irv.12809/v2/response1
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Urban-Rural Disparities for COVID-19

    Minah Park / Jue Tao Lim / Lin Wang / Alex R. Cook / Borame L. Dickens

    Health Data Science, Vol

    Evidence from 10 Countries and Areas in the Western Pacific

    2021  Volume 2021

    Abstract: 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. ... ...

    Abstract 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 (Rt) in a Bayesian framework using district-level mobility data provided by Facebook (i) to assess how various social distancing policies have contributed to the reduction in transmissibility of SARS-COV-2 and (ii) to examine within-country variations in behavioural responses, quantified by reductions in mobility, for urban and rural areas. Results. Social distancing measures were largely effective in reducing transmissibility, with Rt estimates decreased to around the threshold of 1. Within-country analysis showed substantial variation in public compliance across regions. Reductions in mobility were significantly lower in rural and remote areas than in urban areas and metropolitan cities (p<0.001) which had the same scale of social distancing orders in place. Conclusions. Our findings provide empirical evidence that public compliance and consequent intervention effectiveness differ between urban and rural areas in the WPR. Further work is required to ascertain the factors affecting these differing behavioural responses, which can assist in policy-making efforts and increase public compliance in rural areas where populations are older and have poorer access to healthcare.
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 910
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher American Association for the Advancement of Science (AAAS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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