Browsing by Author "Al Suwaidi, Hanan"

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Coinfections in Patients Hospitalized with COVID-19: A Descriptive Study from the United Arab Emirates
(2021) Senok, Abiola; Nassar, Rania; Hachim, Mahmood Yaseen; Al Suwaidi, Hanan; Alsheikh-Ali, Alawi
Purpose: Microbial coinfections in COVID-19 patients carry a risk of poor outcomes. This study aimed to characterize the clinical and microbiological profiles of coinfections in patients with COVID-19. Methods: A retrospective review of the clinical and laboratory records of COVID-19 patients with laboratory-confirmed infections with bacteria, fungi, and viruses was conducted. Only adult COVID-19 patients hospitalized at participating health-care facilities between February 1 and July 31, 2020 were included. Data were collected from the centralized electronic system of Dubai Health Authority hospitals and Sheikh Khalifa General Hospital Umm Al Quwain. Results: Of 29,802 patients hospitalized with COVID-19, 392 (1.3%) had laboratory-confirmed coinfections. The mean age of patients with coinfections was 49.3±12.5 years, and a majority were male (n=330 of 392, 84.2%). Mean interval to commencement of empirical antibiotics was 1.2±3.6) days postadmission, with ceftriaxone, azithromycin, and piperacillin–tazobactam the most commonly used. Median interval between admission and first positive culture (mostly from blood, endotracheal aspirates, and urine specimens) was 15 (IQR 8–25) days. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were predominant in first positive cultures, with increased occurrence of Stenotrophomonas maltophilia, methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Candida auris, and Candida parapsilosis in subsequent cultures. The top three Gram-positive organisms were Staphylococcus epidermidis, Enterococcus faecalis, and Staphylococcus aureus. There was variability in levels of sensitivity to antibiotics and isolates harboring mecA, ESBL, AmpC, and carbapenemase-resistance genes were prevalent. A total of 130 (33.2%) patients died, predominantly those in the intensive-care unit undergoing mechanical ventilation or extracorporeal membrane oxygenation. Conclusion: Despite the low occurrence of coinfections among patients with COVID-19 in our setting, clinical outcomes remained poor. Predominance of Gram-negative pathogens, emergence of Candida species, and prevalence of isolates harboring drug-resistance genes are of concern.
Contextual Conversational Agent to Address Vaccine Hesitancy: Protocol for a Design-Based Research Study
(2022-08) Zidoun, Youness; Kaladhara, Sreelekshmi; Powell, Leigh; Nour, Radwa; Al Suwaidi, Hanan; Zary, Nabil
Abstract: Background: Since the beginning of the COVID-19 pandemic, people have been exposed to misinformation, leading to many myths about SARS-CoV-2 and the vaccines against it. As this situation does not seem to end soon, many authorities and health organizations, including the World Health Organization (WHO), are utilizing conversational agents (CAs) in their fight against it. Although the impact and usage of these novel digital strategies are noticeable, the design of the CAs remains key to their success. Objective: This study describes the use of design-based research (DBR) for contextual CA design to address vaccine hesitancy. In addition, this protocol will examine the impact of DBR on CA design to understand how this iterative process can enhance accuracy and performance. Methods: A DBR methodology will be used for this study. Each phase of analysis, design, and evaluation of each design cycle inform the next one via its outcomes. An anticipated generic strategy will be formed after completing the first iteration. Using multiple research studies, frameworks and theoretical approaches are tested and evaluated through the different design cycles. User perception of the CA will be analyzed or collected by implementing a usability assessment during every evaluation phase using the System Usability Scale. The PARADISE (PARAdigm for Dialogue System Evaluation) method will be adopted to calculate the performance of this text-based CA. Results: Two phases of the first design cycle (design and evaluation) were completed at the time of this writing (April 2022). The research team is currently reviewing the natural-language understanding model as part of the conversation-driven development (CDD) process in preparation for the first pilot intervention, which will conclude the CA’s first design cycle. In addition, conversational data will be analyzed quantitatively and qualitatively as part of the reflection and revision process to inform the subsequent design cycles. This project plans for three rounds of design cycles, resulting in various studies spreading outcomes and conclusions. The results of the first study describing the entire first design cycle are expected to be submitted for publication before the end of 2022. Conclusions: CAs constitute an innovative way of delivering health communication information. However, they are primarily used to contribute to behavioral change or educate people about health issues. Therefore, health chatbots’ impact should be carefully designed to meet outcomes. DBR can help shape a holistic understanding of the process of CA conception. This protocol describes the design of VWise, a contextual CA that aims to address vaccine hesitancy using the DBR methodology. The results of this study will help identify the strengths and flaws of DBR’s application to such innovative projects.
Conversational Agents in Health Education:Protocol for a Scoping Review
(2022) Al Suwaidi, Hanan; Powell, Leigh; Nizam, Mohammed Zayan; Nour, Radwa; Zidoun, Youness; Sleibi, Randa; Warrier, Sreelekshmi Kaladhara; Zary, Nabil
Background: Conversational agents have the ability to reach people through multiple mediums, including the online space, mobile phones, and hardware devices like Alexa and Google Home. Conversational agents provide an engaging method of interaction while making information easier to access. Their emergence into areas related to public health and health education is perhaps unsurprising. While the building of conversational agents is getting more simplified with time, there are still requirements of time and effort. There is also a lack of clarity and consistent terminology regarding what constitutes a conversational agent, how these agents are developed, and the kinds of resources that are needed to develop and sustain them. This lack of clarity creates a daunting task for those seeking to build conversational agents for health education initiatives. Objective: This scoping review aims to identify literature that reports on the design and implementation of conversational agents to promote and educate the public on matters related to health. We will categorize conversational agents in health education in alignment with current classifications and terminology emerging from the marketplace. We will clearly define the variety levels of conversational agents, categorize currently existing agents within these levels, and describe the development models, tools, and resources being used to build conversational agents for health care education purposes. Methods: This scoping review will be conducted by employing the Arksey and O’Malley framework. We will also be adhering to the enhancements and updates proposed by Levac et al and Peters et al. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews will guide the reporting of this scoping review. A systematic search for published and grey literature will be undertaken from the following databases: (1) PubMed, (2) PsychINFO, (3) Embase, (4) Web of Science, (5) SCOPUS, (6) CINAHL, (7) ERIC, (8) MEDLINE, and (9) Google Scholar. Data charting will be done using a structured format. Results: Initial searches of the databases retrieved 1305 results. The results will be presented in the final scoping review in a narrative and illustrative manner. Conclusions: This scoping review will report on conversational agents being used in health education today, and will include categorization of the levels of the agents and report on the kinds of tools, resources, and design and development methods used.
Effects of space flight on sperm function and integrity: A systematic review
(2022-08) Ahrari, Khulood; Omolaoye, Temidayo S; Goswami, Nandu; Al Suwaidi, Hanan; Du Plessis, Stefan
Abstract: With the advancement in space exploration and the intention to establish an inhabitable human settlement on Mars, it is important to investigate the effects of exposure to space/microgravity and the associated radiations on procreation. Sperm function and integrity are fundamental to male reproduction and can potentially be affected by the environmental changes experienced in space. Therefore, this study was conducted to systematically gather, filter, and collate all the relevant information on the effects of spaceflight on male reproductive parameters and functions. A search was performed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted from the major electronic databases including PubMed, and other credible literature sources. MeSH search terms that were employed included "spermatozoa", "microgravity", and "ionizing radiation". The literature search did not discriminate against papers published before a certain date due to the very limited number of articles available. However, there was a restriction on the male gender and language (English). The parameters included in this study are sperm motility, total sperm count, sperm DNA fragmentation hormonal levels and testicular histology. Following a comprehensive literature search, a total of 273 articles were retrieved and screened, 252 articles were excluded due to the irrelevance to the topic, duplication, and non-original articles. A total of 21 articles met the inclusion criteria and are included in the current study. Findings from these studies showed that sperm motility was decreased after exposure to microgravity and ionizing radiation. Total sperm count was also found to be reduced by microgravity only. Sperm DNA fragmentation was increased by both ionizing radiation and microgravity. Testosterone levels and testicular weight were also decreased by microgravity. Although there is a dearth in the literature regarding the effects of microgravity and ionizing radiation on male reproductive parameters, the available findings showed that exposure to microgravity poses a risk to male reproductive health. Therefore, it is essential to develop countermeasures to either manage, treat, or prevent these consequential adverse effects. Hence, this review also highlights some potential countermeasure approaches that may mitigate the harmful effects of microgravity and associated exposures on male reproductive health.
Genetic and Clinical Characteristics of Patients in the Middle East With Multisystem Inflammatory Syndrome in Children
(2022) Uddin, Mohammed; Al Suwaidi, Hanan; Al-Hammadi, Suleiman; Loney, Tom; Nowotny, Norbert; Alsheikh-Ali, Alawi; Tayoun, Ahmad Abou
Importance: Clinical, genetic, and laboratory characteristics of Middle Eastern patients with multisystem in‐ flammatory syndrome in children (MIS-C) have not yet been documented. Objective: To assess the genetic and clinical characteristics of patients with MIS-C of primarily Arab and Asian origin. Design, Setting, and Participants : A prospective, multicenter cohort study was conducted from September 1, 2020, to August 31, 2021, in the United Arab Emirates and Jordan. Forty-five patients with MIS-C and a matched control group of 25 healthy children with a confirmed SARS-CoV-2 infection status were re‐ cruited. Whole exome sequencing in all 70 participants was performed to identify rare, likely deleterious variants in patients with MIS-C and to correlate genetic findings with the clinical course of illness. Exposures: SARS-CoV-2. Main Outcomes and Measures: Fever, organ system complications, laboratory biomarkers, whole exome sequencing findings, treatments, and clinical outcomes were measured. The Mann-Whitney U test was used to as‐ sess the association between genetic variants and MIS-C attributes. The Fisher exact test was used to compute the genetic burden in MIS-C relative to controls. Results: A total of 45 patients with MIS-C (23 [51.1%] male; 30 [66.7%] of Middle Eastern origin; mean [SD] age, 6.7 [3.6] years) and 25 controls (17 [68.0%] male; 24 [96.0%] of Middle Eastern ori‐ gin; mean [SD] age 7.4 [4.0] years) participated in the study. Key inflammatory markers were significantly dysregulated in all patients with MIS-C. Mucocutaneous and gastrointestinal mani‐ festations were each reported in 36 patients (80.0%; 95% CI, 66.1%-89.1%), cardiac findings were reported in 22 (48.9%; 95% CI, 35.0%-63.0%), and neurologic findings were reported in 14 (31.1%; 95% CI, 19.5%-45.6%). Rare, likely deleterious heterozygous variants in immunerelated genes, including TLR3, TLR6, IL22RA2, IFNB1, and IFNA6, were identified in 19 patients (42.2%; 95% CI, 29.0%-56.7%), of whom 7 had multiple variants. There was higher enrichment of genetic variants in patients relative to controls (29 vs 3, P < .001). Patients with those vari‐ ants tended to have earlier disease onset (7 patients [36.8%; 95% CI, 19.1%-58.9%] with ge‐ netic findings vs 2 [7.7%; 95% CI, 2.1%-24.1%] without genetic findings were younger than 3 years at onset) and resistance to treatment (8 patients [42.1%; 95% CI, 23.1%-63.7%] with ge‐ netic findings vs 3 patients [11.5%; 95% CI, 4.0%-29.0%] without genetic findings received 2 doses of intravenous immunoglobulin). Conclusions and Relevance: The results of this cohort study suggest that rare, likely deleterious genetic variants may con‐ tribute to MIS-C disease. This finding paves the way for additional studies with larger, diverse populations to fully characterize the genetic contribution to this new disease entity.
Genetic determinants of severe COVID 19 in young Asian and Middle Eastern patients: a case series
(2023) Badla, Beshr Abdulaziz; Hanifa, Mohamed Samer; Al Suwaidi, Hanan; Nowotny, Norbert; Popatia, Rizwana; Alsheikh-Ali, Alawi; Loney, Tom; Tayoun, Ahmad Abou
Abstract: Studies of genetic factors associated with severe COVID-19 in young adults have been limited in non-Caucasian populations. Here, we clinically characterize a case series of patients with COVID19, who were otherwise healthy, young adults (N= 55; mean age 34.1 ±SD 5.0 years) from 16 Asian, Middle Eastern, and North African countries. Using whole exome sequencing, we identify rare, likely deleterious variants afecting 16 immune-related genes in 17 out of 55 patients (31%), including 7 patients (41% of all carriers or 12.7% of all patients) who harbored multiple such variants mainly in interferon and toll-like receptor genes. Protein network analysis as well as transcriptomic analysis of nasopharyngeal swabs from an independent COVID-19 cohort (N= 50; 42% Asians and 22% Arabs) revealed that most of the altered genes, as identifed by whole exome sequencing, and the associated molecular pathways were signifcantly altered in COVID-19 patients. Genetic variants tended to be associated with mortality, intensive care admission, and ventilation support. Our clinical cases series, genomic and transcriptomic fndings suggest a possible role for interferon pathway genes in severe COVID-19 and highlight the importance of extending genetic studies to diverse populations to better understand the human genetics of disease.
Genotype-phenotype correlation identified a novel SARS-CoV-2 variant possibly linked to severe disease
(2021) Loney, Tom; Al Suwaidi, Hanan; Uddin, Mohammed; Senok, Abiola; Nowotny, Norbert; Alsheikh-Ali, Alawi; Tayoun, Ahmad Abou
Abstract: The geographic location and heterogeneous multi-ethnic population of Dubai (United Arab Emirates; UAE) provide a unique setting to explore the global molecular epidemiology of SARS-CoV-2 and relationship between different viral strains and disease severity. We systematically selected (i.e. every 100th individual in the central Dubai COVID-19 database) 256 patients by age, sex, disease severity and month to provide a representative sample of laboratory-confirmed COVID-19 patients (nasopharyngeal swab PCR positive) during the first wave of the UAE outbreak (January to June 2020). Sociodemographic and clinical data were extracted from medical records and full SARS-CoV-2 genome sequences extracted from nasopharyngeal swabs were analysed. Older age was significantly associated with COVID-19-associated hospital admission and mortality. Overweight/obese or diabetic patients were 3–4 times more likely to be admitted to hospital and intensive care unit (ICU). Sequencing data showed multiple independent viral introductions into the UAE from Europe, Iran and Asia (29 January–18 March), and these early strains seeded significant clustering consistent with almost exclusive community-based transmission between April and June 2020. Majority of sequenced strains (N = 60, 52%) were from the European cluster consistent with the higher infectivity rates associated with the D614G mutation carried by most strains in this cluster. A total of 986 mutations were identified in 115 genomes, 272 were unique (majority were missense, n = 134) and 20/272 mutations were novel. A missense (Q271R) and synonymous (R41R) mutation in the S and N proteins, respectively, were identified in 2/27 patients with severe COVID-19 but not in patients with mild or moderate disease (0/86; p = .05, Fisher's Exact Test). Both patients were women (51–64 years) with no significant underlying health conditions. The same two mutations were identified in a healthy 37-year-old Indian man who was hospitalized in India due to COVID-19. Our findings provide evidence for continued communitybased transmission of the European strains in the Dubai population and highlight new mutations that might be associated with severe disease in otherwise healthy adults.
Identification of Key Factors for Optimized Healthcare Services: A Protocol for a Multi-phase Study of the Dubai Vaccination Campaign
(2022) Faroun, Hayette; Zary, Nabil; Gad, Kareem; Al Suwaidi, Hanan
Background: Mass vaccination of the global population against the novel coronavirus (COVID-19) posed multiple challenges, including effectively administering millions of doses in a short period of time while ensuring public safety and accessibility. The Government of Dubai launched a mass campaign in December 2020 to vaccinate all its citizens and residents, targeting the population over the age of 18 against COVID-19. The vaccination campaign involved a transformation of multiple commercial spaces into mass vaccination centers (MVCs) across the city of Dubai, the largest of which was the Dubai One Central (DOC) Vaccination Center. It was operational between 17 January 2021 and 27 January 2022. Objective: The multi-phase research study aims to empirically explore the opinions of multiple healthcare stakeholders, elicit the key success factors that can influence the effective delivery of emergency healthcare services such as COVID-19 MVCs, and explore how these factors relate to one another. Method: To understand more about the operations of the Dubai One Central vaccination center, the study follows a multi-phase design divided into two main sections. The study is conducted by the Institute for Excellence in Health Professions Education (ieHPE) at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) between December 2021 and January 2023. To elicit the key success factors that contributed to the vaccination campaign administered at DOC, the research team conducted 30 semi-structured interviews (SSI) with a sample of staff and volunteers who worked at the DOC vaccination center. Stratified random sampling was used to select the participants, and the interview cohort included representatives from the management team, team leaders, administration and registration team, vaccinators, and volunteers. A total of 103 people were invited to take part in the research study and 30 people accepted to participate in the SSI interviews. To validate the participation of various stakeholders, the second phase analytically investigated one’s subjectivity through Q-methodology and empirically investigating the opinions obtained from the research participants during phase 1. Results: As of July 2022, 30 semi-structured interviews were conducted with the research participants. The expected results from the project's first phase will be the identification of key success factors, enablers, and barriers of the design and operation of the Covid-19 vaccination center at DOC. While the expected results from the study's second phase will identify patterns of similarities and differences in the ranking of the Q-sets. The final set of results from this dataset will quantitatively interpret the common answers amongst participants and the correlation between the selected success factors relating to the study. Conclusions: The study will provide a comprehensive two-phase approach to obtaining the key success factors that can influence the delivery of high-quality healthcare services such as emergency services launched during a global pandemic. The study's findings will be translated into key factors that could support designing future healthcare services utilizing evidence-based practice. In line with future plans, a study will use data, collected through the One Central vaccination center, to develop a simulation model outlining the process of the customer journey and center workflow.
Multiple early introductions of SARS‑CoV‑2 into a global travel hub in the Middle East
(2020) Tayoun, Ahmad Abou; Loney, Tom; Uddin, Mohammed; Senok, Abiola; Nowotny, Norbert; Alsheikh-Ali, Alawi; Al Suwaidi, Hanan
Abstract: International travel played a significant role in the early global spread of SARS-CoV-2. Understanding transmission patterns from different regions of the world will further inform global dynamics of the pandemic. Using data from Dubai in the United Arab Emirates (UAE), a major international travel hub in the Middle East, we establish SARS-CoV-2 full genome sequences from the index and early COVID-19 patients in the UAE. The genome sequences are analysed in the context of virus introductions, chain of transmissions, and possible links to earlier strains from other regions of the world. Phylogenetic analysis showed multiple spatiotemporal introductions of SARS-CoV-2 into the UAE from Asia, Europe, and the Middle East during the early phase of the pandemic. We also provide evidence for early community-based transmission and catalogue new mutations in SARS-CoV-2 strains in the UAE. Our findings contribute to the understanding of the global transmission network of SARS-CoV-2.
Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a populationbased cross-sectional survey in Dubai, the United Arab Emirates
(2023) Alawadi, Fatheya; Hassanein, Mohamed; Al Zarooni, Amer; Al Suwaidi, Hanan; Hassan Khamis, Amar; Alsheikh-Ali, Alawi; Alnakhi, Wafa Khamis
Objective: To study the prevalence of overweight and obesity and determine the associated risk factors among adults in Dubai. Design and setting: A cross-sectional survey with a multistage, stratified random sampling design was conducted in the Emirate of Dubai in 2019. Participants: The study included 2142 adults aged 18+ years in the Emirate of Dubai. Results: The overall prevalence of obesity, which was defined as body mass index (BMI) ≥30 kg/m2 , was 17.8%. The highest obesity rates were reported among women (21.6%) and the United Arab Emirates (UAE)- nationals (39.6%). Moreover, 39.8% of the population was overweight (BMI ≥25–29.9 kg/m2 ). Multivariate logistic regression showed associations between obesity and age, sex, nationality, hypertension and occupation. Obesity increases with age, with the highest risk at age group 50–59 years (OR 4.30; 95%CI 1.57 to 11.78) compared with the reference group (18–24 years). Females had a higher risk of obesity than males (OR 1.62; 95%CI 1.10 to 2.38). Compared with those in the reference group (Western and others), UAE nationals, other Arabs and Asians were more likely to be obese ((OR 2.08; 95%CI 1.18 to 3.67), (OR 3.61; 95%CI 2.41 to 5.44) and (OR 1.98; 95%CI 1.12 to 3.50), respectively). Clerical and service workers (OR 4.50; 95%CI 2.54 to 8.00) and elementary and unskilled occupation categories (OR 2.57; 95%CI 1.56 to 4.25) had higher risks of obesity than the reference group (professionals), p<0.01). Hypertensive individuals had a higher risk of obesity than normotensive individuals (OR=3.96; p<0.01). Conclusions: Obesity and overweight are highly prevalent among adults in Dubai and are remarkably associated with sociodemographic and behavioural risk factors. Comprehensive strategic initiatives are urgently needed to control obesity in the high-risk populations in the Emirate of Dubai.
Results from the United Arab Emirates 2022 report card on physical activity for children and adolescents
(2023) Al Suwaidi, Hanan; AlGurg, Reem; Loney, Tom
Background/Objective: The United Arab Emirates (UAE) 2022 Report Card provides a systematic evaluation of the physical activity (PA) levels of children and adolescents in the UAE. Methods: The 2022 Report Card utilized data from 2017 to 2021 to inform 10 core PA indicators that were common to the Global Matrix 4.0. Results: One in five (19%) UAE school children achieved the recommended amount of moderate-tovigorous PA (i.e. 60 min/d; Total Physical Activity Grade F). Less than 1% of school children used active transport to and from school (Active Transportation Grade F). One in four (26%) secondary school children achieved the recreational screen time recommendations (i.e. 2 h/d; Sedentary Behaviours Grade D-). A quarter of adults reported achieving the recommended PA level (i.e. 150 min of moderate-intensity PA per week, or equivalent) (Family and Peers Grade D-). All school children are taught physical education (PE) by a specialist with at least a bachelor's degree in PE; however, the duration of weekly PE classes varied between schools (School Grade A-). The UAE Government has invested significant funds and resources into developing and implementing strategies and facilities that will increase PA across the entire population (Government Grade Bþ). Organised Sport and Physical Activity, Active Play, Physical Fitness, and Community and Environment indicators were graded ‘Incomplete’ (INC) due to a lack of available data. Conclusions: Overall, PA levels remain low and sedentary behaviours remain high amongst UAE children and adolescents. The UAE Government has sustained investment in further developing PA opportunities for all children and adults which should translate to increased PA and health improvements at a population level.
Saliva for molecular detection of SARS-CoV-2 in school-age children
(2021) Al Suwaidi, Hanan; Senok, Abiola; Loney, Tom; Alsheikh-Ali, Alawi
Objectives: The high diagnostic accuracy indices for saliva severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) reported in adults has not been demonstrated in children, and adequately powered studies focused on the paediatric population are lacking. This study was carried out to determine the diagnostic accuracy of saliva for SARS-CoV-2 RT-PCR in ambulatory children. Methods: During 1 to 23 October 2020, we recruited a population-based sample of children presenting for coronavirus disease 2019 (COVID-19) screening in Dubai, United Arab Emirates. Each child provided paired nasopharyngeal (NP) swab and saliva for SARS-CoV-2 RT-PCR N, E and RdRp gene detection. Results: Paired NP swab and saliva samples were obtained from 476 children with mean ± standard deviation age of 10.8 ± 3.9 years, and 58.2% were male (277/476). Nine participants were sampled twice, so 485 pairs of NP swab/saliva were tested. Virus detection in at least one specimen type was reported in 17.9% (87/485), with similar detection in NP swab (16.7%, 81/485) and saliva (15.9%, 77/485). Sensitivity and specificity of saliva RT-PCR was 87.7% (95% confidence interval (CI) 78.5e93.9) and 98.5% (95% CI 96.8 e99.5). The positive and negative predictive values were 92.2% (95% CI 84.2e96.3) and 97.6% (95% CI 95.7 e98.6), with a kappa coefficient of 0.879 (95% CI 0.821e0.937). Concordance of findings between NP swab and saliva did not differ by age (p 0.67) or gender (p 0.29). Cycle threshold (Ct) values were significantly higher in NP swab/saliva pairs with discordant findings compared to those with both specimens positive. Conclusions: In light of these findings, we recommend saliva as a diagnostic specimen for COVID-19 screening in children.
SARS-CoV-2 Whole Genome Amplification and Sequencing for Effective Population-Based Surveillance and Control of Viral Transmission
(2020) Loney, Tom; Al Suwaidi, Hanan; Nowotny, Norbert; Alsheikh-Ali, Alawi; Tayoun, Ahmad Abou
BACKGROUND: With the gradual reopening of economies and resumption of social life, robust surveillance mechanisms should be implemented to control the ongoing COVID-19 pandemic. Unlike RT-qPCR, SARSCoV- 2 whole genome sequencing (cWGS) has the added advantage of identifying cryptic origins of the virus, and the extent of community-based transmissions versus new viral introductions, which can in turn influence public health policy decisions. However, the practical and cost considerations of cWGS should be addressed before it is widely implemented. METHODS: We performed shotgun transcriptome sequencing using RNA extracted from nasopharyngeal swabs of patients with COVID-19, and compared it to targeted SARS-CoV-2 genome amplification and sequencing with respect to virus detection, scalability, and cost-effectiveness. To track virus origin, we used opensource multiple sequence alignment and phylogenetic tools to compare the assembled SARS-CoV-2 genomes to publicly available sequences. RESULTS: We found considerable improvement in whole genome sequencing data quality and viral detection using amplicon-based target enrichment of SARSCoV- 2. With enrichment, more than 99% of the sequencing reads mapped to the viral genome, compared to an average of 0.63% without enrichment. Consequently, an increase in genome coverage was obtained using substantially less sequencing data, enabling higher scalability and sizable cost reductions. We also demonstrated how SARS-CoV-2 genome sequences can be used to determine their possible origin through phylogenetic analysis including other viral strains. CONCLUSIONS: SARS-CoV-2 whole genome sequencing is a practical, cost-effective, and powerful approach for population-based surveillance and control of viral transmission in the next phase of the COVID-19 pandemic.
SARS-CoV-2/COVID-19: Viral Genomics, Epidemiology, Vaccines, and Therapeutic Interventions
(2020) Uddin, Mohammed; Loney, Tom; Al Suwaidi, Hanan; Adrian, Thomas E; Nowotny, Norbert; Alsheikh-Ali, Alawi; Senok, Abiola C
Abstract: The COVID-19 pandemic is due to infection caused by the novel SARS-CoV-2 virus that impacts the lower respiratory tract. The spectrum of symptoms ranges from asymptomatic infections to mild respiratory symptoms to the lethal form of COVID-19 which is associated with severe pneumonia, acute respiratory distress, and fatality. To address this global crisis, up-to-date information on viral genomics and transcriptomics is crucial for understanding the origins and global dispersion of the virus, providing insights into viral pathogenicity, transmission, and epidemiology, and enabling strategies for therapeutic interventions, drug discovery, and vaccine development. Therefore, this review provides a comprehensive overview of COVID-19 epidemiology, genomic etiology, findings from recent transcriptomic map analysis, viral-human protein interactions, molecular diagnostics, and the current status of vaccine and novel therapeutic intervention development. Moreover, we provide an extensive list of resources that will help the scientific community access numerous types of databases related to SARS-CoV-2 OMICs and approaches to therapeutics related to COVID-19 treatment.
A Web-Based Public Health Intervention for Addressing Vaccine Misinformation: Analysis of Learner Engagement and Shift in Hesitancy to Vaccinate
(2023) Powell, Leigh; Nour, Radwa; Al Suwaidi, Hanan; Zary, Nabil
Abstract: Web-based public health interventions can be a useful tool for disseminating evidence-based information to the public. However, completion rates are traditionally low, and misinformation often travels at a faster pace than evidencebased sources. This study describes the design of a web-based public health intervention to address COVID-19 vaccine hesitancy. A quasi-experimental approach was used in which a validated instrument, the Adult Vaccine Hesitancy Survey, was given to learners both pre and post intervention to observe any change in attitude towards vaccination. Our pilot observed a small positive shift in vaccine hesitancy and experienced higher than average completion rates. By integrating motivational learning design into public health interventions we increase the likelihood that learners finish the entire intervention, creating greater chance for positive behavior change.
A Web-Based Public Health Intervention for Addressing Vaccine Misinformation: Protocol for Analyzing Learner Engagement and Impacts on the Hesitancy to Vaccinate
(2022) Powell, Leigh; Nour, Radwa; Zidoun, Youness; Kaladhara, Sreelekshmi; Al Suwaidi, Hanan; Zary, Nabil
Background: A barrier to successful COVID-19 vaccine campaigns is the ongoing misinformation pandemic, or infodemic, which is contributing to vaccine hesitancy. Web-based population health interventions have been shown to impact health behaviors positively. For web-based interventions to be successful, they must use effective learning design strategies that seek to address known issues with learner engagement and retention. To know if an intervention successfully addresses vaccine hesitancy, there must be some embedded measure for comparing learners preintervention and postintervention. Objective: This protocol aims to describe a study on the effectiveness of a web-based population health intervention that is designed to address vaccine misinformation and hesitancy. The study will examine learner analytics to understand what aspects of the learning design for the intervention were effective and implement a validated instrument—the Adult Vaccine Hesitancy Scale—to measure if any changes in vaccine hesitancy were observed preintervention and postintervention. Methods: We developed a fully web-based population health intervention to help learners identify misinformation concerning COVID-19 and share the science behind vaccinations. Intervention development involves using a design-based research approach to output more effective interventions in which data can be analyzed to improve future health interventions. The study will use a quasi-experimental design in which a pre-post survey will be provided and compared statistically. Learning analytics will also be generated based on the engagement and retention data collected through the intervention to understand what aspects of our learning design are effective. Results: The web-based intervention was released to the public in September 2021, and data collection is ongoing. No external marketing or advertising has been done to market the course, making our current population of 486 participants our pilot study population. An analysis of this initial population will enable the revision of the intervention, which will then be marketed to a broader audience. Study outcomes are expected to be published by August 2022. We anticipate the release of the revised intervention by May 2022. Conclusions: Disseminating accurate information to the public during pandemic situations is vital to contributing to positive health outcomes, such as those among people getting vaccinated. Web-based interventions are valuable, as they can reach people anytime and anywhere. However, web-based interventions must use sound learning design to help incentivize engagement and motivate learners to learn and must provide a means of evaluating the intervention to determine its impact. Our study will examine both the learning design and the effectiveness of the intervention by using the analytics collected within the intervention and a statistical analysis of a validated instrument to determine if learners had a change in vaccine hesitancy as a result of what they learned.