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Article ; Online: Editorial

Ann Borda / Andreea Molnar / Michelle Heys / Christine Musyimi / Patty Kostkova

Frontiers in Public Health, Vol

Digital interventions and serious mobile games for health in low- and middle-income countries (LMICs)

2023 Volume 11

Keywords	LMICs ; digital interventions ; serious mobile games ; citizen participation ; digital health technologies ; mhealth ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Ethical Issues in AI-Enabled Disease Surveillance

Ann Borda / Andreea Molnar / Cristina Neesham / Patty Kostkova

Applied Sciences, Vol 12, Iss 3890, p

Perspectives from Global Health

2022 Volume 3890

Abstract: Infectious diseases, as COVID-19 is proving, pose a global health threat in an interconnected world. In the last 20 years, resistant infectious diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), H1N1 ... ...

Abstract	Infectious diseases, as COVID-19 is proving, pose a global health threat in an interconnected world. In the last 20 years, resistant infectious diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), H1N1 influenza (swine flu), Ebola virus, Zika virus, and now COVID-19 have been impacting global health defences, and aggressively flourishing with the rise of global travel, urbanization, climate change, and ecological degradation. In parallel, this extraordinary episode in global human health highlights the potential for artificial intelligence (AI)-enabled disease surveillance to collect and analyse vast amounts of unstructured and real-time data to inform epidemiological and public health emergency responses. The uses of AI in these dynamic environments are increasingly complex, challenging the potential for human autonomous decisions. In this context, our study of qualitative perspectives will consider a responsible AI framework to explore its potential application to disease surveillance in a global health context. Thus far, there is a gap in the literature in considering these multiple and interconnected levels of disease surveillance and emergency health management through the lens of a responsible AI framework.
Keywords	AI ; disease surveillance ; pandemics ; global public health ; ethics ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Understanding COVID-19 Vaccine Hesitancy in Ethnic Minorities Groups in the UK

Maryam Naqvi / Lan Li / Michael Woodrow / Punam Yadav / Patty Kostkova

Frontiers in Public Health, Vol

2022 Volume 10

Abstract: COVID-19 vaccines have been developed and administered at record pace in order to curtail the impact of the COVID-19 pandemic. Vaccine hesitancy has impacted uptake unequally across different groups. This study explores the drivers for vaccine hesitancy ... ...

Abstract	COVID-19 vaccines have been developed and administered at record pace in order to curtail the impact of the COVID-19 pandemic. Vaccine hesitancy has impacted uptake unequally across different groups. This study explores the drivers for vaccine hesitancy in ethnic minority groups in the UK, the impact of social media on vaccine hesitancy and how vaccine hesitancy may be overcome. Twelve semi-structured interviews were conducted, coded and thematically analyzed with participants from ethnic minority groups in the UK who identified as vaccine hesitant. Social media played a significant role in vaccine hesitancy. For those who considered themselves healthy, seeing misinformation of extreme side effects relating to COVID-19 vaccinations on social media resulted in the opinion that the risk of vaccination is greater than risk from COVID-19 infection. For women, misinformation on social media regarding fertility was a reason for delaying or not getting vaccinated. Participants who had sources of information they trusted in outside of social media were more likely to choose to get vaccinated. This study identified the broad spectrum of views on vaccine hesitancy in ethnic minority groups in the UK. Enabling factors such as a desire to travel, and positive public health messaging can increase vaccine uptake, whereas a lack of trusted sources of information may cause vaccine hesitancy. Further research is required to combat misinformation and conspiracy theories. Effective methods include actively responding and disproving the misinformation. For an inclusive vaccination programme that reduces health inequality, policy makers should build trust amongst marginalized communities and address their concerns through tailored public health messaging.
Keywords	vaccine ; hesitancy ; COVID-19 ; ethnic minorities ; social media ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Digital Data Sources and Their Impact on People's Health

Lan Li / David Novillo-Ortiz / Natasha Azzopardi-Muscat / Patty Kostkova

Frontiers in Public Health, Vol

A Systematic Review of Systematic Reviews

2021 Volume 9

Abstract: Background: Digital data sources have become ubiquitous in modern culture in the era of digital technology but often tend to be under-researched because of restricted access to data sources due to fragmentation, privacy issues, or industry ownership, and ...

Abstract	Background: Digital data sources have become ubiquitous in modern culture in the era of digital technology but often tend to be under-researched because of restricted access to data sources due to fragmentation, privacy issues, or industry ownership, and the methodological complexity of demonstrating their measurable impact on human health. Even though new big data sources have shown unprecedented potential for disease diagnosis and outbreak detection, we need to investigate results in the existing literature to gain a comprehensive understanding of their impact on and benefits to human health.Objective: A systematic review of systematic reviews on identifying digital data sources and their impact area on people's health, including challenges, opportunities, and good practices.Methods: A multidatabase search was performed. Peer-reviewed papers published between January 2010 and November 2020 relevant to digital data sources on health were extracted, assessed, and reviewed.Results: The 64 reviews are covered by three domains, that is, universal health coverage (UHC), public health emergencies, and healthier populations, defined in WHO's General Programme of Work, 2019–2023, and the European Programme of Work, 2020–2025. In all three categories, social media platforms are the most popular digital data source, accounting for 47% (N = 8), 84% (N = 11), and 76% (N = 26) of studies, respectively. The second most utilized data source are electronic health records (EHRs) (N = 13), followed by websites (N = 7) and mass media (N = 5). In all three categories, the most studied impact of digital data sources is on prevention, management, and intervention of diseases (N = 40), and as a tool, there are also many studies (N = 10) on early warning systems for infectious diseases. However, they could also pose health hazards (N = 13), for instance, by exacerbating mental health issues and promoting smoking and drinking behavior among young people.Conclusions: The digital data sources presented are essential for collecting and ...
Keywords	digital data source ; social media ; healthier population ; universal health coverage ; health emergency ; digital intervention ; Public aspects of medicine ; RA1-1270
Subject code	360 ; 306
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Reported rates of all-cause serious adverse events following immunization with BNT-162b in 5-17-year-old children in the United States.

Halinder S Mangat / Brady Rippon / Nikita T Reddy / Akheel A Syed / Joel M Maruthanal / Susanne Luedtke / Jyothy J Puthumana / Abhinash Srivatsa / Arnold Bosman / Patty Kostkova

PLoS ONE, Vol 18, Iss 2, p e

2023 Volume 0281993

Abstract: Vaccine development against COVID-19 has mitigated severe disease. However, reports of rare but serious adverse events following immunization (sAEFI) in the young populations are fuelling parental anxiety and vaccine hesitancy. With a very early season ... ...

Abstract	Vaccine development against COVID-19 has mitigated severe disease. However, reports of rare but serious adverse events following immunization (sAEFI) in the young populations are fuelling parental anxiety and vaccine hesitancy. With a very early season of viral illnesses including COVID-19, respiratory syncytial virus (RSV), influenza, metapneumovirus and several others, children are facing a winter with significant respiratory illness burdens. Yet, COVID-19 vaccine and booster uptake remain sluggish due to the mistaken beliefs that children have low rates of severe COVID-19 illness as well as rare but severe complications from COVID-19 vaccine are common. In this study we examined composite sAEFI reported in association with COVID-19 vaccines in the United States (US) amongst 5-17-year-old children, to ascertain the composite reported risk associated with vaccination. Between December 13, 2020, and April 13, 2022, a total of 467,890,599 COVID-19 vaccine doses were administered to individuals aged 5-65 years in the US, of which 180 million people received at least 2 doses. In association with these, a total of 177,679 AEFI were reported to the Vaccine Adverse Event reporting System (VAERS) of which 31,797 (17.9%) were serious. The rates of ED visits per 100,000 recipients were 2.56 (95% CI: 2.70-3.47) amongst 5-11-year-olds, 18.25 (17.57-18.95) amongst 12-17-year-olds and 33.74 (33.36-34.13) amongst 18-65-year olds; hospitalizations were 1.07 (95% CI 0.87-1.32) per 100,000 in 5-11-year-olds, 6.83 (6.42-7.26) in 12-17-year olds and 8.15 (7.96-8.35) in 18-65 years; life-threatening events were 0.14 (95% CI: 0.08-0.25) per 100,000 in 5-11-year olds, 1.22 (1.05-1.41) in 12-17-year-olds and 2.96 (2.85-3.08) in 18-65 year olds; and death 0.03 (95% CI 0.01-0.10) per 100,000 in 5-11 year olds, 0.08 (0.05-0.14) amongst 12-17-year olds and 0.76 (0.71-0.82) in 18-65 years age group. The results of our study from national population surveillance data demonstrate rates of reported serious AEFIs amongst 5-17-year-olds which ...
Keywords	Medicine ; R ; Science ; Q
Subject code	380
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Data and Digital Solutions to Support Surveillance Strategies in the Context of the COVID-19 Pandemic

Patty Kostkova / Francesc Saigí-Rubió / Hans Eguia / Damian Borbolla / Marieke Verschuuren / Clayton Hamilton / Natasha Azzopardi-Muscat / David Novillo-Ortiz

Frontiers in Digital Health, Vol

2021 Volume 3

Abstract: Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential ... ...

Abstract	Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential for early warning, rapid response, and disease control. The quantity of data potentially useful for early warning and surveillance has increased exponentially due to social media and other big data streams. Digital epidemiology is a novel discipline that includes harvesting, analysing, and interpreting data that were not initially collected for healthcare needs to enhance traditional surveillance. During the current COVID-19 pandemic, the importance of digital epidemiology complementing traditional public health approaches has been highlighted.Objective: The aim of this paper is to provide a comprehensive overview for the application of data and digital solutions to support surveillance strategies and draw implications for surveillance in the context of the COVID-19 pandemic and beyond.Methods: A search was conducted in PubMed databases. Articles published between January 2005 and May 2020 on the use of digital solutions to support surveillance strategies in pandemic settings and health emergencies were evaluated.Results: In this paper, we provide a comprehensive overview of digital epidemiology, available data sources, and components of 21st-century digital surveillance, early warning and response, outbreak management and control, and digital interventions.Conclusions: Our main purpose was to highlight the plausible use of new surveillance strategies, with implications for the COVID-19 pandemic strategies and then to identify opportunities and challenges for the successful development and implementation of digital solutions during non-emergency times of routine surveillance, with readiness for early-warning and response for future pandemics. The enhancement of traditional surveillance systems with novel digital surveillance methods opens a direction for the most effective framework for preparedness and response to future pandemics.
Keywords	digital surveillance ; digital epidemiology ; data sources ; outbreak ; COVID-19 ; Medicine ; R ; Public aspects of medicine ; RA1-1270 ; Electronic computers. Computer science ; QA75.5-76.95
Subject code	028
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Response of Governments and Public Health Agencies to COVID-19 Pandemics on Social Media

Lan Li / Aisha Aldosery / Fedor Vitiugin / Naomi Nathan / David Novillo-Ortiz / Carlos Castillo / Patty Kostkova

Frontiers in Public Health, Vol

A Multi-Country Analysis of Twitter Discourse

2021 Volume 9

Abstract: During the COVID-19 pandemic, information is being rapidly shared by public health experts and researchers through social media platforms. Whilst government policies were disseminated and discussed, fake news and misinformation simultaneously created a ... ...

Abstract	During the COVID-19 pandemic, information is being rapidly shared by public health experts and researchers through social media platforms. Whilst government policies were disseminated and discussed, fake news and misinformation simultaneously created a corresponding wave of “infodemics.” This study analyzed the discourse on Twitter in several languages, investigating the reactions to government and public health agency social media accounts that share policy decisions and official messages. The study collected messages from 21 official Twitter accounts of governments and public health authorities in the UK, US, Mexico, Canada, Brazil, Spain, and Nigeria, from 15 March to 29 May 2020. Over 2 million tweets in various languages were analyzed using a mixed-methods approach to understand the messages both quantitatively and qualitatively. Using automatic, text-based clustering, five topics were identified for each account and then categorized into 10 emerging themes. Identified themes include political, socio-economic, and population-protection issues, encompassing global, national, and individual levels. A comparison was performed amongst the seven countries analyzed and the United Kingdom (Scotland, Northern Ireland, and England) to find similarities and differences between countries and government agencies. Despite the difference in language, country of origin, epidemiological contexts within the countries, significant similarities emerged. Our results suggest that other than general announcement and reportage messages, the most-discussed topic is evidence-based leadership and policymaking, followed by how to manage socio-economic consequences.
Keywords	social media ; Twitter ; COVID-19 ; topic modeling ; government ; public health agencies ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MEWAR

Aisha Aldosery / Anwar Musah / Georgiana Birjovanu / Giselle Moreno / Andrei Boscor / Livia Dutra / George Santos / Vania Nunes / Rossandra Oliveira / Tercio Ambrizzi / Tiago Massoni / Wellington Pinheiro dos Santos / Patty Kostkova

Frontiers in Public Health, Vol

Development of a Cross-Platform Mobile Application and Web Dashboard System for Real-Time Mosquito Surveillance in Northeast Brazil

2021 Volume 9

Abstract: Mosquito surveillance is a crucial process for understanding the population dynamics of mosquitoes, as well as implementing interventional programs for controlling and preventing the spread of mosquito-borne diseases. Environmental surveillance agents ... ...

Abstract	Mosquito surveillance is a crucial process for understanding the population dynamics of mosquitoes, as well as implementing interventional programs for controlling and preventing the spread of mosquito-borne diseases. Environmental surveillance agents who performing routine entomological surveys at properties in areas where mosquito-borne diseases are endemic play a critical role in vector surveillance by searching and destroying mosquito hotspots as well as collate information on locations with increased infestation. Currently, the process of recording information on paper-based forms is time-consuming and painstaking due to manual effort. The introduction of mobile surveillance applications will therefore improve the process of data collection, timely reporting, and field worker performance. Digital-based surveillance is critical in reporting real-time data; indeed, the real-time capture of data with phones could be used for predictive analytical models to predict mosquito population dynamics, enabling early warning detection of hotspots and thus alerting fieldworker agents into immediate action. This paper describes the development of a cross-platform digital system for improving mosquito surveillance in Brazil. It comprises of two components: a dashboard for managers and a mobile application for health agents. The former enables managers to assign properties to health workers who then survey them for mosquitoes and to monitor the progress of inspection visits in real-time. The latter, which is primarily designed as a data collection tool, enables the environmental surveillance agents to act on their assigned tasks of recording the details of the properties at inspections by filling out digital forms built into the mobile application, as well as details relating to mosquito infestation. The system presented in this paper was co-developed with significant input with environmental agents in two Brazilian cities where it is currently being piloted.
Keywords	mobile technology ; real-time ; surveillance ; mosquito ; environmental surveillance agents ; environmental health agents ; Public aspects of medicine ; RA1-1270
Subject code	333
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Do Women in Nepal Like Playing a Mobile Game? MANTRA

Rachya Kayastha / Sonja Mueller / Punam Yadav / Ilan Kelman / Andrei Boscor / Naomi Saville / Abriti Arjyal / Sushil Baral / Maureen Fordham / Gareth Hearn / Patty Kostkova

Frontiers in Public Health, Vol

A Mobile Gamified App for Improving Healthcare Seeking Behavior in Rural Nepal

2021 Volume 9

Abstract: In Low and Middle Income Countries (LMIC), one of the causes of maternal and child mortality is a lack of medical knowledge and consequently the inability to seek timely healthcare. Mobile health (mHealth) technology is gradually becoming a universal ... ...

Abstract	In Low and Middle Income Countries (LMIC), one of the causes of maternal and child mortality is a lack of medical knowledge and consequently the inability to seek timely healthcare. Mobile health (mHealth) technology is gradually becoming a universal intervention platform across the globe due to ubiquity of mobile phones and network coverage. MANTRA is a novel mHealth intervention developed to tackle maternal and child health issues through a serious mobile game app in rural Nepal, which demonstrated a statistically significant knowledge improvement in rural women. This paper explores the perceptions and usability of the MANTRA app amongst rural women and Female Community Health Volunteers (FCHVs) in Nepal. Despite the challenges of a target user group with limited educational levels and low smartphone experience, all participants viewed the MANTRA app with approval and enthusiasm. They were willing to engage further with the mHealth intervention and to share their experience and knowledge with fellow community members. Participants also showed an increase in awareness of danger signs enabling them to make better informed health decisions in the future. FCHVs viewed the app as a validation tool providing and support for greater impact of their efforts in rural Nepal. Growing mobile ownership, network coverage and availability of smartphones along with acceptance of the prototype MANTRA app in rural communities suggest encouraging prospects for mHealth interventions to be incorporated in the national health infrastructure in Nepal and other LMICs.
Keywords	maternal health ; neonatal health ; mHealth ; LMIC ; educational game ; knowledge gain ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MANTRA

Sonja Mueller / Delphine Soriano / Andrei Boscor / Naomi M. Saville / Abriti Arjyal / Sushil Baral / Maureen Fordham / Gareth Hearn / Rachya Kayastha / Patty Kostkova

Frontiers in Public Health, Vol

Improving Knowledge of Maternal Health, Neonatal Health, and Geohazards in Women in Rural Nepal Using a Mobile Serious Game

2020 Volume 8

Abstract: Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in ... ...

Abstract	Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in low-and-middle-income countries that limit access to health information, such as social barriers like low-literacy and gender. MANTRA: Increasing maternal and child health resilience before, during and after disasters using mobile technology in Nepal takes on these challenges with a novel digital health intervention; a serious mobile game aimed at vulnerable low-literacy female audiences in rural Nepal. The serious game teaches 28 learning objectives of danger signs in geohazards, maternal, and neonatal health to improve knowledge and self-assessment of common conditions and risks to inform healthcare-seeking behavior. Evaluations consisted of recruiting 35 end users to participate in a pre-test assessment, playing the game, post-test assessment, and focus groups to elicit qualitative feedback. Assessments analyzed knowledge gain in two ways; by learning objective with McNemar tests for each learning objective, and by participant scores with paired t-tests of overall scores and by module. Results of assessments of knowledge gain by learning objective (McNemar tests) indicate participants had sufficient prior knowledge to correctly interpret and respond to 26% of pictograms (coded AA), which is a desirable result although without the possibility of improvement through the intervention. The geohazard module had greatest impact as 16% of responses showed knowledge gain (coded BA). The two most successful learning objectives showing statistically significant positive change were evidence of rockfalls and small cracks in the ground (p = < 0.05). Assessment of knowledge gain by participant scores (paired t-tests) showed the 35 participants averaged a 7.7 point improvement (p < 0.001) in the assessment (28 learning objectives). Average change in knowledge of ...
Keywords	user evaluation ; serious mobile game ; digital health intervention ; interdisciplinary research ; knowledge assessment ; mobile learning ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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