Epidemiology and Public Health

Based on the our October paper "A Generalized Viral Infection Mathematical Model Derived from Covid-19 Simulation", at a conceptual level higher than the classic SIR/SEIR model, we have established the 6 laws of infection regarding the final infection ratio within any given population without any artificial intervention and have shown the final infection ratio in a natural, non-interfered pandemic must fall within a specified lower and upper bound as 1 − 1 R 2 0 ≤ F R ≤ 2 (1 − 1 R 0). Whereas R 0 is the intrinsic R 0 value of the disease. In this paper, we show how human intervention strategies alter the previous assumptions based on 2 factors. First, artificial intervention with cycles of restricting measures and relaxations. Based on our May paper "The Predictions on Worldwide Covid-19 Pandemic Cases Based on Historical Data", we have already demonstrated the dynamic falling R 0 (t) curve during lock down measures. With more historical data and observation, we now expand the scope to include a dynamic rising R 0 (t) curve following the relaxation of measures, completing the cycle of restriction and relaxation. Second, the introduction of vaccination at a steady rate introduced a new variable into the existing infection model, we denote it as function V (t). We demonstrate the optimal strategies of vaccination interpreted within our existing established framework.

Objectives. Infodemics of false information on social media is a growing societal problem, aggravated by the occurrence of the COVID-19 pandemic. The development of infodemics has characteristic resemblances to epidemics of infectious diseases. This paper presents several methodologies which aim to measure the extent and development of infodemics through the lens of epidemiology. Methods. Time varying R was used as a measure for the infectiousness of the infodemic, topic modeling was used to create topic clouds and topic similarity heat maps, while network analysis was used to create directed and undirected graphs to identify super-spreader and multiple carrier communities on social media. Results. Forty-two (42) latent topics were discovered. Reproductive trends for a specific topic were observed to have significantly higher peaks (Rt 4-5) than general misinformation (Rt 1-3). From a sample of social media misinformation posts, a total of 385 groups and 804 connections were found w...

OBJECTIVES: Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers. METHODS: This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: The ORs of stillbirth in mothers living in pistachio gardens and thos...

In recent years, urban air quality in developing countries such as Nigeria has continued to degenerate and this has constituted a major environmental risk to human health. It has been shown that an increase in ambient particulate matter (PM 10) load of 10 µg/m 3 reduces life expectancy by 0.64 years. Air Quality Index (AQI) as demonstrated in this study shows how relatively clean or polluted the boundary layer environment of any location can be. The study was designed to measure the level of suspended particulate matter (PM 2.5 and PM 10) for dry and wet seasons, compute the prevalent air quality index of selected locations in Abuja with possible health implications. Suspended particulate matter (PM 2.5 and PM 10) was assessed using handheld aerosol particulate sampler. The US Oak Ridge National AQI was adopted for the eleven (11) locations sampled and monitored. The study results showed that the air quality of the selected areas in Abuja were generally good and healthy. Dry season,...

Background Prolonged sitting time is a risk factor for chronic disease, yet recent global surveillance is not well described. The aims were to clarify: (i) the countries that have collected country-level data on self-reported sitting time; (ii) the single-item tools used to collect these data; and (iii) the duration of sitting time reported across low- to high-income countries. Methods Country-level data collected within the last 10 years using single-item self-report were included. The six-stage methodology: (1) reviewing Global Observatory for Physical Activity! Country Cards; (2–4) country-specific searches of PubMed, the Demographic and Health Survey website and Google; (5) analysing the Eurobarometer 88.4; and (6) country-specific searches for World Health Organization STEPwise reports. Results A total of 7641 records were identified and screened for eligibility. Sixty-two countries (29%) reported sitting time representing 47% of the global adult population. The majority of dat...

Summary Background Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. Methods We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at...

BACKGROUND Timely initiating antenatal care (ANC) is crucial in the countries that have high maternal morbidity and mortality. However, in developing countries including Ethiopia, pregnant mother's time to initiate antenatal care was not well-studied. Therefore, this study aimed to assess time to first ANC and its predictors among pregnant women in Ethiopia. METHODS A community-based cross-sectional study was conducted among 7,543 pregnant women in Ethiopia using the Ethiopian Demographic Health Survey (EDHS), 2016 data. A two-stage stratified cluster sampling was employed. The Kaplan-Meier (KM) method was used to estimate time to first antenatal care visit. Cox-gamma shared frailty model was applied to determine predictors. Adjusted Hazard Ratio (AHR) with 95% confidence interval was reported as the effect size. Model adequacy was assessed by using the Cox-Snell residual plot. Statistical significance was considered at p value <0.05. For data management and analysis Stata 14...

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where lar...

International development and humanitarian organizations are  increasingly calling for digital data to be treated as a public good because of its value in supplementing scarce national statistics and informing interventions, including in emergencies. In response to this claim, a ‘responsible data’ movement has evolved to discuss guidelines and frameworks that will establish ethical principles for data sharing. However, this movement is not gaining traction with those who hold the highest-value data, particularly mobile network operators who are proving reluctant to make data collected in low- and middle-income
countries accessible through intermediaries. This paper evaluates how the argument for ‘data as a public good’ fits with the corporate reality of big data, exploring existing models for data sharing. I draw on the idea of corporate data as an ecosystem involving often conflicting rights, duties and claims, in comparison to the utilitarian claim that data’s humanitarian value makes it imperative to share them. I assess the power dynamics implied by the idea of data as a public good, and how differing incentives lead actors to adopt particular ethical positions with regard to the use of data.

La creación de un centro estatal de salud pública, con una dotación adecuada de recursos, permitirá afrontar los desafíos de la salud pública del presente y del futuro en España. Para ello, las funciones de esta futura institución, que se propone como Agencia Estatal, deben abordar, además de las necesidades habituales de organización de la salud pública, la conexión de estas con los Objetivos de Desarrollo Sostenible, coordinando una estrategia estatal que integre distintos actores de salud en una red generosa y cooperativa, y desarrollando una estrategia de comunicación en salud pública innovadora, referente y priorizada, entre otros aspectos. La falta de recursos, la relativa desconexión actual de las funciones esenciales de salud pública en el ámbito estatal y la inequidad en el desarrollo autonómico y municipal de estas propician el desarrollo del proyecto de la Agencia como una red de redes, tal como se defiende en este trabajo. Aportamos ideas para un proceso que confiamos en que será decisivo para la salud pública española del siglo xxi.

Human beings exhibit daily patterns of rest and activities and until a few years ago, little is known about the sleep process, its benefits, and the possible consequences of inadequate sleep. Scientific advances and input from diverse clinical disciplines have enriched the study and management of sleep disorders. Multiple evidence is now available to show that the sleep process is essential to the improvement and maintenance of mental health (like mood stabilization, good memory, cognitive performance), physical health (like healthy cardiovascular and metabolic systems), and productivity in society. Poor quality and quantity of sleep have been associated with increased risk for accidents, hypertension, cardiovascular diseases, diabetes mellitus, mental disorders, some cancers, and ultimately increase mortality. Health promotion programmes with a focus on healthy living and lifestyle modification are essential in the attainment of individual sleep need and repayment of sleep debt. This article provides a brief insight into the often-misunderstood purpose and architecture of sleep, the benefits of adequate and restorative sleep, and the health consequences of inadequate sleep, especially as it relates to sleep need and sleep debt. It concludes by suggesting practical sleep hygiene and lifestyle intervention measures that can be adopted to harness the full health benefits of this often-neglected component of promotive healthcare.

The purpose of this article is to highlight the present socio-economic impact of the rising prevalence of non-communicable diseases (NCD) on most countries of the world, and how such rising trend poses one of the greatest threats to the actualization of the Sustainable Development Goals in Africa.
The rising prevalence of NCD in many parts of the world have been identified as a threat not only to human health and wellbeing, but also to the sustainability of human developments and economic growth. More than before, economists are increasingly expressing concern that the rising threat of NCD will result in a worldwide long-term negative macroeconomic impacts on the quality and quantity of human resources, capital accumulation and Gross Domestic Product (GDP), with the consequences most severe in the developing countries.
According to the World Health Organization (WHO), the costs to health-care systems from NCD are already high; while significant costs to individuals, families, businesses, and governments are even higher, adding up to major negative macroeconomic impacts on most societies of the world. The greatest effects of NCD falls increasingly on the low- and middle-income countries (LMIC), and on the poorer people within all countries, mirroring the underlying socioeconomic determinants. This situation if unchallenged, will likely threaten the realization of the Sustainable Development Goals, with consequences far beyond the capacity of most African countries.
In conclusion, in order to avoid another failed developmental goals in Africa, the threat of NCD must be given all the seriousness it deserved at the highest level. As pointed out by many authorities, the best approach is to focus on preventive measures that effectively tackles the unhealthy risk factors implicated in the rising prevalence of NCD. This can be done partly through effective health education that focuses on lifestyle intervention.

Some Basic Concepts of Biostatistics and their Applications in Public Health 1. Application of Bayes's Theorem in health sector 2. Application of Poisson probability distribution in public health 3. Different techniques in handling non response rate in survey and missing values in longitudinal data 4. Purpose of design effect in sampling 5. The basic schemes in non probability sampling

Violence has in recent years been framed as a public health problem. The medicalization of violence has involved various public health initiatives, with the USA based violence prevention initiative Cure Violence (CV), being one of the most prominent. CV, which operates in 23 US cities and multiple countries abroad, was launched in 2000 by former WHO epidemiologist Gary Slutkin with the aim to reduce violence. Its public health approach maintains that violence is an actual disease, which can be controlled and contained via epidemiological methods and strategies applied in disease control. This study used discourse analysis to explore how CV’s medicalization of violence is tied to a neoliberal rationality of governing that disentangles violence from structural factors and explains violence solely by reference to individual pathology. In doing so, CV produces new identities based on assumptions concerning biological infection or immunity resistance, which, as its visual language shows, are grounded in race. Through a politics of exclusion, CV turns these ‘at risk’ identities into appropriate targets for health intervention, with the aim of encouraging these to act upon themselves to improve or restore their productive capacities in order to achieve the idealized form of healthy citizenship that CV propagates.

India is the second-most populous country in the world and accounts for one fourth of the global tuberculosis (TB) burden. In spite of the availability of free of cost high quality diagnostic & treatment facilities under the NTEP, a large number of TB patients prefer to avail treatment from private health care providers, resulting delay in early diagnosis and treatment initiation additionally resulting catastrophic expenditures on TB patents. Thus, understanding of patient expectation and their satisfaction with public health care providers is of utmost importance for establishment of good quality of health care and treatment success. This article briefly highlights the implication of patient satisfaction in End TB strategy.

In this study, we tested the validity of the modified version of the Vaccine Attitude Question Battery (VAQB) across 22 different languages. Validity test was conducted with a large-scale international survey dataset, COVIDiSTRESSII Global Survey, collected from 20,601 participants from 62 countries. We employed exploratory and confirmatory factor analysis, measurement invariance test, and measurement alignment for internal validity test. Moreover, we examined correlation between the VAQB score, vaccination intent, compliance with preventive measures, and trust in public health-related agents. The results reported that the modified VAQB, which included five items, showed good validity across 22 languages with measurement alignment. Furthermore, the VAQB score showed negative association with vaccination intent, compliance, and trust as expected. The findings from this study provide additional evidence supporting the validity of the modified VAQB in 22 languages for future large-scale international research on COVID-19 and vaccination.

The global threat posed by the corona virus is transforming mobile media and its software applications into state-organized surveillance technologies. How will Covid-19 change the digital world we live in? Is Covid-19 initiating an authoritarian framing of individual and collective activities? Why the push media will rule the digital world.
Die globale Bedrohung durch das Corona-Virus verwandelt mobile Medien und ihre Software-Applikationen in staatlich organisierte Überwachungstechnologien. Wie wird Covid-19 die digitale Welt, in der wir leben, verändern? Wird mit Covid-19 ein autoritäres Framing von digitalen Kontrollmedien eingeleitet? Erobern Push-Medien die Herrschaft im digitalen Raum?

This article explores the different ways in which gay men in Serbia perceive PrEP as a novel method of HIV prevention. In the article, I draw on data from my research on PrEP use among thirty gay men in Belgrade. The use of PrEP is still very low amongst gay communities in Serbia due to their rejection of PrEP and due to the stigma around PrEP use. In Serbia, the social significance of PrEP relates to HIV status disclosure on gay social/dating media. Paradoxically, on gay dating sites, the signifier "PrEP" blurs the line between HIV positive gay men-who have achieved undetectable HIV status through a potent ARV therapy-and those HIV negative gay men who use PrEP as a preventative tool against HIV transmission. In the article, I will argue that a new form of gay identity has emerged on gay dating apps in Serbia-"undetectable, on PrEP." This new identity emerges from confusion in HIV risk assessment. The use of PrEP has been seen as a marker to denote someone's HIV negative status and to protect them from HIV transmission. However, some gay men with an undetectable HIV status would like to be regarded as HIV negative even though they are not, and thus they use the signifier "on PrEP" to highlight their desire to claim an HIV negative status. PrEP has many symbolic valences: from HIV status disclosure to assumed promiscuity. As I will argue, while the health paradigm is of utmost importance for Serbian gay men, internalized stigma additionally drives the low uptake of PrEP amongst gay communities in Serbia, thus contributing to the confusion regarding PrEP use and the overall approach to HIV prevention. This article finds that those respondents who accept PrEP without stigma or confusion regarding their HIV status are also more willing and ready to recommend using PrEP to other gay men.

In 1918 and 1919, the world was hit by a pandemic that went down in history as "Spanish flu". This article investigated how the flu hit a small rural village in the Grand Duchy of Hesse-Darmstadt in Germany. Entries in the books of the dead of that time were analyzed. The research found a statistically significant increase in the number of people who died of respiratory diseases in 1918 as compared to the reference year of 1914. The results also support the assumption that the age of death (expressed as median) has increased significantly due to the pandemic.

Uganda has had a relatively large share of zoonotic disease outbreaks in the past and this has impacted its preparedness and response level in combatting the COVID-19 outbreak in the country. Compared to most countries in the East African Community, Africa and the world, Uganda seems to be effectively curtailing the spread of the virus and managing the disease despite its relatively weak healthcare system and economy. The first COVID-19 case was confirmed on March 21st, 2020 and as at May 6th, 2020, there has only been 100 cases confirmed from 47,620 tests carried out. Also, as at this date, there has been 55 recoveries and no reported death from the disease. These promising statistics prompts the development of this paper to detail the epidemiology of the disease in the country and discuss the response of the government and other stakeholders to the outbreak.

Vector-borne diseases occur in the chain pathogen-vector-host, with vectors playing the most prominent role. Vectors transmit pathogens between humans, and more often, from animals to humans so that many vector borne diseases are categorized as zoonoses. Vector borne diseases have become more important worldwide, and not exclusively in the tropics as in the past, by causing high morbidity and mortality every year. Out of all infectious diseases, more then 17% are vector-borne. Most significant and widespread vectors are mosquitoes and ticks, and most significant diseases are West Nile fever, yellow fever, Zika virus fever, tick encephalitis, Lyme borelliosis, Crimean-Congo hemorrhagic fever and rickettsioses.
Life and preservation of the vectors, and breakouts and spread of vector-borne diseases are profoundly affected by climate change (rise in temperature and humidity, downfalls, extreme weather conditions), urbanization, deforestation, inadequate waste management, international travel, international commerce and social conditions, with poverty being the most important and directly linked to the rising incidence. In recent years, all factors mentioned above have favored a rising number of the vectors and their spread, so that vector-borne diseases have become emergent or reemergent, meaning their high incidence have been registered in the countries with no previous breakouts; or they reoccurred in the areas where they had earlier been eradicated. Some extra reasons contributing to the increasing incidence are lowered investments and limited resources for monitoring of vector-borne diseases. Most vector-borne diseases are zoonoses, making “One Health” the only appropriate approach, which implies integrated monitoring of the diseases in the sectors of both animal and human health. Prevention of vector-borne diseases should be aimed at raising public awareness on importance of the vectors, education of the professionals and active involvement of the community as a whole.

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. Several coronavirus disease (COVID-19) vaccines are currently in human trials. However, to be effective, a vaccine must be accepted and used by a large majority of the population. This study aimed to investigate the acceptability of COVID-19 vaccines and its predictors in addition to the attitudes towards these vaccines among public. This study did an online survey during the period June-September 2020, were collected from 26,852 individuals aged 19 years or older across six continents as part of 60 nationally representative surveys to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Results revealed that two-thirds of respondents were at least moderately worried about a widespread COVID-19 outbreak. Differences in acceptance rates ranged from almost 93% (in Tonga) to less than 43% (in Egypt). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer's advice to do so. Systematic interventions are required by public health authorities to reduce the levels of vaccines' hesitancy and improve their acceptance. These results and specifically the low rate of acceptability is alarming to public health authorities and should stir further studies on the root causes and the need of awareness campaigns. These interventions should take the form of reviving the trust in national health authorities and structured awareness campaigns that offer transparent information about the safety and efficacy of the vaccines and the technology that was utilized in their production.

The daily-case numbers of Covid-19 were studied and an oscillatory pattern in the numbers was identified. And this oscillatory nature has been present throughout the pandemic data. Although the US has had four waves of varying amplitude, the division of those waves into smaller units also indicate a repetitive, oscillatory pattern. The study of the smaller waves are important and they can be mathematically modelled using fitting techniques in order to accurately forecast daily cases over a short term. Further, the amplitudes of the prior waves {in a holistic sense (an aggregation of small waves)} can be examined to forecast a range for the amplitude of a future wave. As new data becomes available, it can be incorporated into the paradigm and be used to mutate the model to increase prediction accuracy {short term and long term}. During this time, political, social, and economic decisions can be made to curb any behavior indicative of potential spikes or anomalies {either through quarantine and restriction of human movement or by planning a protocol of an effective vaccination schedule}.

Initially published (July 4th) and retrieved from—
https://smanivann.wordpress.com/2021/07/04/mathematical-model-to-fit-and-forecast-daily-case-numbers-and-to-predict-wave-magnitude-scenarios-covid-19/

L'histoire des maladies endémiques, des épidémies et des pandémies en Afrique montre, contrairement à une opinion tenace, que le continent a une longue expérience de la biomédecine, de son savoir, de ses techniques, et de ses modes d'action. Les Africains ont investi la biomédecine en exerçant des modes d'appropriation et de mise en pratique aussi "modernes" et efficaces que dans le reste du monde. Comme les occidentaux, ils ont une longue expérience des théories de la contagion microbienne et de la prophylaxie moderne. Apparues dans les années 1860, celles-ci ne se sont répandues qu'au tournant du vingtième siècle en Europe, coïncidant avec l'expansion coloniale en Afrique. Durant cette période et au-delà, l'Afrique a joué un rôle essentiel dans la découverte et le traitement de nombreuses maladies comme la malaria, la trypanosomiase (maladie du sommeil), la variole, la syphilis, la tuberculose et la peste (Packard 2007, Webb 2013). Les grandes institutions scientifiques, comme l'institut Pasteur à Paris (1887) et la London School of Hygiene and Tropical Medicine (1899) participèrent à une circulation des savoirs impériaux. Leur rôle dans le progrès de la recherche est de mieux en mieux étudié par les historiens (Arnold 1996, Tilley 2012). L'expertise des Africains, chercheurs, soignants et consommateurs ordinaires de la biomédecine, est donc comparable à celle du reste du monde. En de nombreux points, elle est même supérieure.

Introduction: An estimated 78 million babies or every three in five are not breastfed within the first hour of life, putting them at advanced risk of death and disease and most of these babies are born in low- and middle-income countries (WHO, 2018). In the republic of South Sudan mothers who were exposed to the infant, formula advertisements were two times more likely to delay initiation of breastfeeding (Bruno et.al,2018).
Objective: To examine the factors contributing to breastfeeding success at el Sabah children hospital, Juba-South Sudan
Methodology: The study implies both quantitation and qualitative methods of data collection, quantitation methods include, secondary data and structure questioner. While qualitative methods, key informant guide, and observation. The analytical sample comprised 138 respondents from Alsabah children hospital in Juba South Sudan. Epi-Info software and excel 2013 was used to get frequencies and crosstabulation results.
Results: Our results show that the 100-study population, were included in this study and completed their interviews, giving a response rate of 100%. 64% of the respondents are male while 36% of the respondents are female. The majority of 61% of respondents describe nipple disorders as problems faces during breastfeeding. majority of respondents 90% describe colostrum as that first milk from the breasts. Necessary feeding options needed or child 65% of respondents recommended both breastfeeding and formula feeding. The study population had misconceptions breastfeeding practices such as; avoid sex during breastfeeding.
Conclusion: Evidence from this study shows that high knowledge of breastfeeding importance and family planning is not matched with the low exclusive breastfeeding and low contraceptive use in South Sudan. Therefore, more behavior chance communication on breastfeeding and family planning is needed with interventions that should be paying attention to both couples. scientific suggestion to illustrate that untimely weaning leads to an increased risk of disease and poorer outcomes for infants and their mothers both in the short and long term. The effects of which are dose-related more breastfeeding decreases the danger of morbidity and mortality.

En la Argentina la covid-19 puso de manifiesto las diferencias económicas y sociales de la población y las ha incrementado. La desafortunada intervención estatal gubernamental sanitaria y epidemiológica para la atención del fenómeno es desproporcionada en cuanto a la asignación de prioridades, no acorde a las desigualdades regionales, económicas, ambientales, sociales y culturales. El intento de prevenir mediante cuarentena medieval y totalitaria agravó más la situación de salud general de la población, pues se detectaron 130.000 casos de “presunto covid19” en 4 meses, para condenar a la población restante de 45.170.000 de habitantes. Se priorizó esta patología por encima de las enfermedades prevalentes como neoplasias, cardiovasculares, femicidio, trastornos de salud mental, etc. En ningún momento se puso atención a las condiciones de vida, el medio ambiente, la nutrición, condiciones de la vivienda y acceso al agua potable. Tampoco se realizó un sistema de vigilancia epidemiológica de los daños ocasionados por el encierro.  Este trabajo tiene como objetivo conocer las enfermedades prevalentes de la población, así como los daños socio-sanitarios ocasionados por la cuarentena, así como conocer cuáles son los intereses políticos detrás de esta subversión de valores epidemiológicos.
Para tal fin de acude a fuentes primarias y secundarias. En cuanto a lo médico se acude a la evaluación y análisis de los boletínes epidemiológicos, las entrevistas a profesionales de la salud y asociaciones de profesionales. En cuanto a lo social se acude al análisis de documentos gubernamentales emitidos durante la pandemia (leyes, discursos, aplicativo de celular y ciberpatrullaje y créditos del BM) así como otras fuentes de datos complementarias como: INDEC, UCA y CEPAL
Se observa que la cuarentena sin distinguir “tiempo, lugar y persona” ha sido perjudicial para la salud de manera directa e indirecta, tanto a través de la retracción de la economía, el empleo y los derechos constitucionales y ambientales, como en la protección de los derechos de los niños, trabajadores y adultos mayores.

Adolescents are generally thought to be healthier than other age groups having survived many of the diseases of early childhood and being decades away from the diseases associated with aging (WHO, 1998). However, some adolescents are affected by diseases while others die prematurely. A major threat to the health of the adolescents stems primarily from their sexual behavior which is partly influenced by lack of knowledge of reproductive health issues. The main objective of this study was to assess reproductive health knowledge and attitude among secondary school students in Nandi Hills Constituency. This was a cross-sectional study design of male and female secondary school students in Nandi Hills Constituency. Four classes of secondary level were involved in this study. The study assessed knowledge and attitudes of these students towards reproductive health. Data was collected from secondary school forms 1 to 4 students who were selected from 5 of the 10 co-educational secondary schools in Nandi Hills Constituency using a purposive sampling technique. 40 students were sampled from 5 schools using a 10% quota. This made the sample size of this study to be 200 respondents. The study found that majority (71.4%) of the female secondary students interviewed from the different schools had not learnt about puberty and maturation of girls. According to the study findings, majority of the female students believed that one can get pregnant half way between the end of one period and beginning of the next (48.0%). Other 26.5% and 10.3% of the female students interviewed in this study believed that they could get pregnant immediately before and after periods respectively. This study concludes that there are low knowledge levels on reproductive health among secondary school adolescents in Nandi Hills Constituency. It recommends a multi-sectoral approach to addressing of the adolescents reproductive health needs. Such approach should involve parents, peers, teachers and health departments.