Kate Zinszer

• PhD, MSc
• McGill University

Background Chikungunya, and Zika emerged in the 2010s in the Americas, causing simultaneous epidemics with dengue. However, little is known of these Aedes-borne diseases (ABDs) joint patterns and contributors at the population-level. Methods We applied a novel Poisson-multinomial spatial model to the registered cases of dengue (n = 291,820), chiku...

Background Dengue virus (DENV) seroprevalence studies often rely on Enzyme-Linked Immunosorbent Assay (ELISA) testing of serum samples, but ELISA testing of dried blood spot (DBS) samples offer several advantages for field-based research in resource-limited settings. However, DBS’ limited sample volume can be challenging for test sensitivity, requi...

Importance The Gaza Strip has been enduring a severe humanitarian crisis due to prolonged conflict, blockade, and systemic instability, resulting in the collapse of its healthcare system. Objective To explore the impact of healthcare collapse on the spread of infectious diseases in Gaza, focusing on the challenges faced by healthcare workers, the...

Background Rogers’ diffusion of innovation theory suggests innovations are adopted in stages by different groups (innovators/early adopters, early majority, late majority and late adopters). In healthcare, this could mean that there is the potential to worsen health disparities as later groups tend to also face more social and structural barriers....

Introduction Arboviruses are a broad classification of viral pathogens that require vectors such as mosquitoes for infection transmission. The burden of arboviral diseases worldwide is substantial, affecting millions of people annually, with the Aedes aegypti mosquito responsible for spreading several common arboviruses, including dengue, chikungun...

Introduction The increased burden of climate-sensitive infectious diseases (CSIDs) within the circumpolar region, one of the many impacts of climate change, is impacting human, animal and ecosystem health. An integrated One Health approach to surveillance of CSIDs has been promoted by the scientific community as a prerequisite to enhance preparedne...

Background This study aims to assess the prevalence and associated factors of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) among children in this region during a period of conflict. Methods A cross-sectional study was conducted with a sample of 1,200 children under 5 years old, selected through stratified random sampling f...

The ongoing conflict in the Gaza Strip is a deeply entrenched issue marked by repeated cycles of violence and devastation. While the immediate human toll and political implications often receive global attention, the war's environmental impact is equally profound yet under acknowledged. Environmental destruction itself has become a weapon of war, o...

This study aims to assess the impact of Water, Sanitation, and Hygiene (WaSH) insecurity on the health of displaced populations and identify key factors associated with the spread of infectious diseases. A mixed-methods approach was employed, including both quantitative and qualitative components. The quantitative component involved a cross-section...

Background: Chikungunya, and Zika emerged in the 2010s in the Americas, causing simultaneous epidemics with dengue. However, little is known of these Aedes-borne diseases (ABDs) joint patterns and contributors at the population-level. Methods: We applied a novel Poisson-multinomial spatial model to the registered cases of dengue (n=291,820), chikun...

Objectives To assess the seroprevalence of infection-acquired SARS-CoV-2 and the mental health of school/daycare staff in the months after reopening of schools in Montreal, Quebec (Canada) in the Fall of 2020 and whether these varied by school and participant characteristics. Design A cross-sectional design based on a convenience sample of schools...

Seroprevalence studies on SARS-CoV-2 infections have been often based on study populations with non-random and non-representative samples, limiting the generalizability of their results. In this study, we investigated the representativity and the generalizability of the baseline (collected from October 16th, 2020, to April 18th, 2021) estimate of a...

The COVID-19 pandemic has resulted in widespread issues over the world, creating a crisis in public health, humanitarian aid, and development. In addition to having a direct effect on economies and health systems, the pandemic may aggravate inequities and stop progress towards the Sustainable Development Goals. This cross-sectional research was con...

Importance Hospitalizations for eating disorders rose dramatically during the COVID-19 pandemic. Public health restrictions, or stringency, are believed to have played a role in exacerbating eating disorders. Few studies of eating disorders during the pandemic have extended to the period when public health stringency restrictions were lifted. Obje...

Importance The COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population. Objective To estimate the incidence of hospitalizations for mental health conditions...

Introduction Microbial contamination of drinking water, particularly by pathogens such as Escherichia coli O157: H7, is a significant public health concern worldwide, especially in regions with limited access to clean water like the Gaza Strip. However, few studies have quantified the disease burden associated with E. coli O157: H7 contamination in...

The COVID-19 syndemic has disproportionately affected socially vulnerable populations, such as low-income individuals, Indigenous peoples, and riverine communities. Social Determinants of Health (SDH) have played a crucial role in the state of Amazonas, where unique geography and social disparities pose significant challenges to health access and e...

The COVID-19 syndemic has disproportionately affected socially vulnerable populations, such as low-income individuals, Indigenous peoples, and riverine communities. Social Determinants of Health (SDH) have played a crucial role in the state of Amazonas, where unique geography and social disparities pose significant challenges to health access and e...

Zika, a viral disease transmitted to humans by Aedes mosquitoes, emerged in the Americas in 2015, causing large-scale epidemics. Colombia alone reported over 72,000 Zika cases between 2015 and 2016. Using national surveillance data from 1121 municipalities over 70 weeks, we identified sociodemographic and environmental factors associated with Zika’...

Introduction In the temperate world, Lyme disease (LD) is the most common vector-borne disease affecting humans. In North America, LD surveillance and research have revealed an increasing territorial expansion of hosts, bacteria and vectors that has accompanied an increasing incidence of the disease in humans. To better understand the factors drivi...

In the midst of conflict, the plight of vulnerable populations often remains hidden beneath the rubble and chaos. However, the recent escalation of violence in the Gaza Strip has thrust the dire humanitarian situation into the spotlight, particularly highlighting the devastating impact on children. Prior to the current conflict, more than 75% of th...

Many studies have projected malaria risks with climate change scenarios by modelling one or two environmental variables and without the consideration of malaria control interventions. We aimed to predict the risk of malaria with climate change considering the influence of rainfall, humidity, temperatures, vegetation, and vector control intervention...

Introducción: Se integran resultados de un proyecto desarrollado para incrementar la aplicación del abordaje realista de intervenciones basadas en la comunidad para la prevención de enfermedades transmitidas por vectores. Métodos: Se realizaron análisis secundarios de datos de implementación de una intervención basada en la comunidad en la prevenc...

Context Environmental changes will foster the spread of Ixodes scapularis ticks and increase the incidence of Lyme disease in Québec in the coming years. The objective of this study is to estimate the epidemiological and clinical burden and part of the current economic burden of Lyme disease in Québec and to estimate the number of cases expected by...

Objective We aimed to assess whether the influence of urban vegetation on asthma development in children (<13 years) varies by type (e.g., total vegetation, tree type, and grass) and season. Methods We used a cohort of all children born in Montreal, Canada, between 2000 and 2015. Children and cases were identified from linked medico-administrative...

Background: Few studies have explored how vector control interventions may modify associations between environmental factors and malaria. Methods: We used weekly malaria cases reported from six public health facilities in Uganda. Environmental variables (temperature, rainfall, humidity, and vegetation) were extracted from remote sensing sources....

Even though the Gaza Strip is a low pulmonary tuberculosis (TB) burden region, it is well-known that TB is primarily a socioeconomic problem associated with overcrowding, poor hygiene, a lack of fresh water, and limited access to healthcare, which is the typical case in the Gaza Strip. Therefore, this study aimed at assessing the accuracy of the au...

Background Dengue fever is a mosquito-borne viral disease that is associated with four serotypes of the dengue virus. Children are vulnerable to infection with the dengue virus, particularly those who have been previously infected with a different dengue serotype. Sufficient knowledge, positive attitudes, and proper practices (KAP) are essential fo...

The EnCORE study is a prospective serology study of SARS‐CoV‐2 in a cohort of children from Montreal, Canada. Based on data from our fourth round of data collection (May–October 2022), we estimated SARS‐CoV‐2 seroprevalence and seroconversion. Using multivariable regression, we identified factors associated with seroconversion. Our results show tha...

Background: This paper aims to assess the extent to which the COVID-19 vaccine's speed to market affected Canadian residents' decision to remain unvaccinated. Method: A cross-sectional survey conducted in late 2021 asked participants whether they had received the vaccine and their reasons for abstaining. Results: Of the 2,712 participants who...

Globally, the COVID-19 pandemic took a high toll on health human resources, especially in contexts where these resources were already fragile. In Quebec, to make up for the shortage of health human resources, and to contain the COVID-19 outbreaks in long-term care facilities, many hospital staff (including a majority of nurses) were sent to those f...

Background: This study examines how the functioning of healthcare providers during the COVID-19 pandemic was affected by the government financing response, which was shaped by existing healthcare financing systems. Methods: The study applied a single case study design at a tertiary hospital in Bamako during the 1st and 2nd waves of the COVID-19...

Objectives: During the first wave of COVID-19 in Québec, healthcare workers (HCWs) represented 25% of the cases in Montréal. A study was conducted to describe SARS-CoV-2-infected HCWs in Montréal, and certain workplace and household characteristics. Secondary objectives included estimating the associations between having had access to personal pro...

Zika, a viral disease transmitted to humans by the bite of infected Aedes mosquitoes, emerged in the Americas in 2015, causing large-scale epidemics. Colombia alone reported 72,031 Zika cases between 31/May/2015 and 01/October/2016. We used national surveillance data from 1,121 municipalities over 70 epidemiological weeks to identify sociodemograph...

During the COVID-19 pandemic outbreak, COVID-19 healthcare-associated infections (HAI) and risk management became major challenges facing hospitals. Using evidence from a research project, this commentary presents: 1) various communication and information strategies implemented by four hospitals and their staff in Brazil, Canada and France to reduc...

In this concluding article of the special issue, we examine lessons learned from hospitals’ resilience to the COVID-19 pandemic in Brazil, Canada, France, Japan, and Mali. A quality lesson learned (QLL) results from a systematic process of collecting, compiling, and analyzing data derived ideally from sustained effort over the life of a research pr...

Since the beginning of the pandemic, hospitals have been central to the COVID-19 response, often experiencing severe financial, material, and human constraints. In this special issue, we present some of the findings of the HoSPiCOVID research project. One of its main objectives was to compare hospital responses to the first and second waves of the...

Few studies have focused on the presence of families in the hospital in the context of an epidemic. The present study aims to contribute to filling this gap by answering the following question: How did professionals, patients and their families cope with more or less drastic restrictions to family visits and presence during the COVID-19 pandemic in...

Introduction As the number of people living in cities increases worldwide, particularly in low-income and middle-income countries (LMICs), urban health is a growing priority of public and global health. Rapid unplanned urbanisation in LMICs has exacerbated inequalities, putting the urban poor at increased risk of ill health due to difficult living...

In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals’ governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hos...

The EnCORE study is a prospective serology study of SARS-CoV-2 in a cohort of children from Montreal, Canada. Based on data from our fourth round of data collection (May-October 2022), we estimated SARS-CoV-2 seroprevalence and seroconversion. Using multivariable regression, we identified factors associated with seroconversion. Our results show tha...

Purpose: Disparities in youth COVID-19 vaccine acceptance and uptake have been documented in several countries, yet few studies have explored the attitudes and perceptions underlying vaccine-related decision-making among adolescent populations with unique sociocultural, environmental, and/or structural contexts that may influence vaccine uptake....

Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospita...

The analysis of hospital resilience is essential in understanding how health services prepared for and responded to sudden shocks and unexpected challenges in the COVID-19 health crisis. This study aimed to analyze the resilience of a referral hospital in the state of Pernambuco, Brazil, in the context of the COVID-19 pandemic. The main theoretical...

Innovation by health service organizations can enable adaptation to and transformation of challenges caused by health shocks. Drawing on results from case studies in Brazil, Canada, and Japan, this study looked at innovations the study hospitals introduced in response to challenges caused by COVID-19 to identify: 1) attributes of the innovations th...

During the first and second waves of the pandemic, Quebec was among the Canadian provinces with the highest COVID-19 mortality rates. Facing particularly large COVID-19 outbreaks in its facilities, an integrated health and social services center in the province of Quebec (Canada), developed resilience strategies. To explore these diverse responses...

Social media usage is growing globally, with an exponential increase in low- and middle-income countries. Social media changes the ways in which information-sharing occurs, intensifying the population’s exposure to misinformation, including fake news. This has important repercussions for global health. The spread of fake news can undermine the impl...

Objective: In Canada and globally, the COVID-19 pandemic has increased social inequalities in health (SIH), furthering the vulnerability of certain groups and communities. Contact-tracing is a cornerstone intervention with COVID-19 prevention and control programs. The aim of this study was to describe whether and how SIH were considered during the...

Objective: To use serological testing to assess the pre-Omicron seroprevalence, seroconversion, and seroreversion of infection-induced SARS-CoV-2 antibodies in children and adolescents in Montreal, Canada. Design: This analysis is from a prospective cohort study of children aged 2 to 17 years (at baseline) that included blood spots (DBS) for ant...

Introduction: The Caribbean region is repeatedly exposed to extreme climate-related events, such as hurricanes and tropical storms, which are expected to increase in severity with climate change. This study aims to better understand how extreme climate events affect human mobility, social circumstances, and health-related issues in the Eastern Cari...

Since the beginning of the COVID-19 pandemic, few studies have focused on crisis management of multiple services within one hospital over several waves of the pandemic. The purpose of this study was to provide an overview of the COVID-19 crisis response of a Parisian referral hospital which managed the first three COVID cases in France and to analy...

Background Dengue fever is a mosquito-borne viral disease that is associated with four serotypes of the dengue virus. Children are vulnerable to infection with the dengue virus and the risk of severe dengue disease is the highest among infants and children, particularly those who have been previously infected with a different dengue serotype. Suffi...

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key...

Background: SARS-CoV-2 transmission has an impact on education. In this study, we assessed the performance of rapid antigen detection tests (RADTs) versus polymerase chain reaction (PCR) for the diagnosis of SARS-CoV-2 infection in school settings, and RADT use for monitoring exposed contacts. Methods: In this real-world, prospective observation...

In the fight against infectious diseases, social inequalities in health (SIH) are generally forgotten. Mali, already weakened by security and political unrest, has not been spared by the COVID-19 pandemic. Although the country was unprepared, the authorities were quick to implement public health measures, including a SARS-CoV-2 testing program. Thi...

Background: Lyme disease (LD) is the most common tick-borne illness in North America. LD is acquired through exposure to the tick vector, Ixodes scapularis, known as the blacklegged tick. In Canada, LD is rapidly emerging, with the establishment of I. scapularis in many newly endemic regions posing a growing risk to local communities. In the Canadi...

Introduction: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Cardiac calcium calcification scoring (CAC) is an imaging test that helps physicians classify asymptomatic people as low, intermediate, or high risk for heart attack. This study aimed to identify the association between macronutrient intake, physi...

Importance Repeated serological testing for SARS-CoV-2 allows the monitoring of antibody dynamics in populations, including detecting infections that are missed by RT-PCR or antigen testing. Understanding the factors associated with seroconversion and seroreversion as well as the duration of infection-induced antibodies can also inform public healt...

The burden of maternal mortality in sub-Saharan Africa is the highest in the world. As high fertility rates present an increased risk to women’s health, programmes and services have been put in place to increase access to family planning. Several studies have identified sociocultural factors as limiting access to family planning, including male res...

In Uganda, almost half of children under 5 years old suffer from undernutrition. Undernutrition, a common form of malnutrition in children, encompasses stunting, wasting and underweight. The causes of child undernutrition are complex, suggesting that interventions to tackle malnutrition must be multifaceted. Furthermore, limited access to healthcar...

Background Health systems in many West African countries have suffered due to low public spending on health. Further, the requirement for high out-of-pocket payments by healthcare users accessing care has raised concerns about equitable access to COVID-19-related services. This study examines how the functioning of healthcare providers during the C...

Objective: The aim of this descriptive article was to compare mass testing for SARS-CoV-2 during the first wave of the COVID-19 pandemic in Montreal, Canada; Bamako, Mali; Paris, France; and Recife, Brazil. Methods: Data was collected through interviews with key informants involved in the testing response and a review of the grey literature. The TI...

Background Colombia has one of the highest burdens of arboviruses in South America. The country was in a state of hyperendemicity between 2014 and 2016, with co-circulation of several Aedes-borne viruses, including a syndemic of dengue, chikungunya, and Zika in 2015. Methodology/Principal findings We analyzed the cases of dengue, chikungunya, and...

Background: Canadian long-term care facility (LTCF) residents experienced higher death rates compared to other countries during the first wave of the COVID-19 pandemic. This cohort study analyzes the individual, therapeutic, and institutional factors associated with death in LTCFs. Methods: Institutional data for 17 LTCFs in Montreal, Canada wer...

Background The global debate on the efficacy of hydroxychloroquine (HCQ) on COVID-19 has gone far beyond the scientific framework and has been highly politicized. These issues immediately invested the debate on HCQ and made it an object of particular crystallization. This study analyzes, through the Malian press, the echo of this debate in the nati...

Studies have estimated the impact of the environment on malaria incidence although few have explored the differential impact due to malaria control interventions. Therefore, the objective of the study was to evaluate the effect of indoor residual spraying (IRS) on the relationship between malaria and environment (i.e. rainfall, temperatures, humidi...

Background: Quantitative microbial risk assessment (QMRA) with Monte Carlo simulation is the process of estimating the risk of infection through exposure to microorganisms. Worldwide, certain Shiga-toxin-producing types of Escherichia coli, such as E coli O157:H7, have been recognised as pathogens leading to waterborne outbreaks of infection. We a...

Background Evidence continues to demonstrate that certain marginalised populations are disproportionately affected by COVID-19. While many studies document the impacts of COVID-19 on social inequalities in health, none has examined how public health responses to the pandemic have unfolded to address these inequities in Canada. The purpose of our st...

Introduction To successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of...

One Health (OH) is an integrated approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. On the basis of a review of OH doctoral programs, we advocate for integrating social-ecological systems thinking in OH doctoral training to maximize the impact of future OH research and interventions.

Background Colombia has one of the highest burdens of arboviruses in South America. The country was in a state of hyperendemicity between 2014 and 2016, with co-circulation of several Aedes -borne viruses, including a syndemic of dengue, chikungunya, and Zika in 2015. Methodology/Principal Findings We analyzed the cases of dengue, chikungunya, and...

Aim: The objective of this research is to report the strategies of resilience mobilized by the Hospital of Mali to face Coronavirus disease (COVID-19). Method: The data collected within the hospital covered the first months of the pandemic (April to July 2020). A total of 32 semi-structured interviews and 53 observation sessions were conducted....

Background The United Nations through universal health coverage, including sexual and reproductive health (SRH), pledges to include all people, leaving no one behind. However, people with disabilities continue to experience multiple barriers in accessing SRH services. Studies analysing the impacts of disability in conjunction with other social iden...

While One Health initiatives are gaining in popularity, it is unclear if and how they are evaluated when implementation at scale is intended. The main purpose of this scoping review was to describe how One Health initiatives targeting infectious diseases and antimicrobial resistance at a large scale are evaluated. Secondary objectives included iden...

Background: Since the beginning of the COVID-19 pandemic, there have been differences in the mitigation strategies implemented by governments worldwide. In addition, people's acceptance and adherence to these strategies, such as avoiding large gatherings and shelter in place, varied. The current study aims to assess the attitude and satisfaction w...

The Secretary General of the United Nations described the impact of COVID-19-related school closures as a “generational catastrophe.” What will be the legacy of the 2020–2021 pandemic-related disruptions in 5, 10, 20 years from now, as regards education and well-being of children and youth? Addressing the disproportionate impact on those growing up...

UNSTRUCTURED This is the authors responses to peer review reports related to MS #31272.

BACKGROUND: Since the beginning of the COVID-19 pandemic, there have been differences in the mitigation strategies implemented by governments worldwide. In addition, people's acceptance and adherence to these strategies, such as avoiding large gatherings and shelter in place, varied. The current study aims to assess the attitude and satisfaction wi...