Imperial College London

DrGaryfallosKonstantinoudis

Faculty of MedicineSchool of Public Health

MRC Skills Development Research Fellow
 
 
 
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g.konstantinoudis Website

 
 
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531Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

18 results found

Konstantinoudis G, Cosetta M, Vicedo Cabrera AM, Ballester J, Gasparrini A, Blangiardo Met al., 2022, Ambient heat exposure and COPD hospitalisations in England: a nationwide case-crossover study during 2007-2018, Thorax, ISSN: 0040-6376

Background: There is emerging evidence suggesting a link between ambient heat exposure and chronic obstructive pulmonary disease (COPD) hospitalisations. Individual and contextual characteristics can affect population vulnerabilities to COPD hospitalisation due to heat exposure. This study quantifies the effect of ambient heat on COPD hospitalisations and examines population vulnerabilities by age, sex and contextual characteristics.Methods: Individual data on COPD hospitalisation at high geographical resolution (postcodes) during 2007–2018 in England was retrieved from the small area health statistics unit. Maximum temperature at 1 km ×1 km resolution was available from the UK Met Office. We employed a case-crossover study design and fitted Bayesian conditional Poisson regression models. We adjusted for relative humidity and national holidays, and examined effect modification by age, sex, green space, average temperature, deprivation and urbanicity.Results: After accounting for confounding, we found 1.47% (95% Credible Interval (CrI) 1.19% to 1.73%) increase in the hospitalisation risk for every 1°C increase in temperatures above 23.2°C (lags 0–2 days). We reported weak evidence of an effect modification by sex and age. We found a strong spatial determinant of the COPD hospitalisation risk due to heat exposure, which was alleviated when we accounted for contextual characteristics. 1851 (95% CrI 1 576 to 2 079) COPD hospitalisations were associated with temperatures above 23.2°C annually.Conclusion: Our study suggests that resources should be allocated to support the public health systems, for instance, through developing or expanding heat-health alerts, to challenge the increasing future heat-related COPD hospitalisation burden.

Journal article

Konstantinoudis G, Cameletti M, Gómez-Rubio V, León Gómez I, Pirani M, Baio G, Larrauri A, Riou J, Egger M, Vineis P, Blangiardo Met al., 2022, Regional excess mortality during the 2020 COVID-19 pandemic in five European countries, Nature Communications, Vol: 13, Pages: 1-11, ISSN: 2041-1723

The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015-2019, we applied Bayesian spatio-temporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. With around 30%, Madrid, Castile-La Mancha, Castile-Leon (Spain) and Lombardia (Italy) were the regions with the highest excess mortality. In England, Greece and Switzerland, the regions most affected were Outer London and the West Midlands (England), Eastern, Western and Central Macedonia (Greece), and Ticino (Switzerland), with 15-20% excess mortality in 2020. Our study highlights the importance of the large transportation hubs for establishing community transmission in thefirst stages of the pandemic. Here, we show that acting promptly to limit transmission around these hubs is essential to prevent spread to other regions and countries.

Journal article

Konstantinoudis G, Gómez-Rubio V, Cameletti M, Pirani M, Baio G, Blangiardo Met al., 2022, A framework for estimating and visualising excess mortality during the COVID-19 pandemic., Publisher: arXiv

COVID-19 related deaths underestimate the pandemic burden on mortality because they suffer from completeness and accuracy issues. Excess mortality is a popular alternative, as it compares observed with expected deaths based on the assumption that the pandemic did not occur. Expected deaths had the pandemic not occurred depend on population trends, temperature, and spatio-temporal patterns. In addition to this, high geographical resolution is required to examine within country trends and the effectiveness of the different public health policies. In this tutorial, we propose a framework using R to estimate and visualise excess mortality at high geographical resolution. We show a case study estimating excess deaths during 2020 in Italy. The proposed framework is fast to implement and allows combining different models and presenting the results in any age, sex, spatial and temporal aggregation desired. This makes it particularly powerful and appealing for online monitoring of the pandemic burden and timely policy making.

Working paper

Heydari S, Konstantinoudis G, Behsoodi AW, 2021, Effect of the COVID-19 pandemic on bike-sharing demand and hire time: Evidence from Santander Cycles in London, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Mazzei A, Konstantinoudis G, Kreis C, Diezi M, Ammann RA, Zwahlen M, Kuehni C, Spycher BDet al., 2021, Childhood cancer and residential proximity to petrol stations: a nationwide registry-based case-control study in Switzerland and an updated meta-analysis, INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH, Vol: 95, Pages: 927-938, ISSN: 0340-0131

Journal article

Dhokotera T, Bartels L, Rohrer E, Chammartin F, Johnson L, Singh E, Olago V, Sengayi-Muchengeti M, Egger M, Bohlius J, Konstantinoudis Get al., 2021, Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study, International Journal of Health Geographics, Vol: 20, Pages: 1-12, ISSN: 1476-072X

BackgroundDisparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa.MethodsWe included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors.ResultsWe included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health.ConclusionsThe results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services

Journal article

Konstantinoudis G, Padellini T, Bennett J, Davies B, Ezzati M, Blangiardo Met al., 2021, Response to "re: long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis", Environment International, Vol: 150, ISSN: 0160-4120

Journal article

Lupatsch JE, Kreis C, Konstantinoudis G, Ansari M, Kuehni CE, Spycher BDet al., 2021, Birth characteristics and childhood leukemia in Switzerland: a register-based case-control study, CANCER CAUSES & CONTROL, Vol: 32, Pages: 713-723, ISSN: 0957-5243

Journal article

Folly CL, Konstantinoudis G, Mazzei-Abba A, Kreis C, Bucher B, Furrer R, Spycher BDet al., 2021, Bayesian spatial modelling of terrestrial radiation in Switzerland, JOURNAL OF ENVIRONMENTAL RADIOACTIVITY, Vol: 233, ISSN: 0265-931X

Journal article

Konstantinoudis G, Padellini T, Bennett J, Davies B, Blangiardo M, Konstantinoudis G, Padellini T, Bennett J, Davies B, Ezzati M, Blangiardo M, Konstantinoudis G, Padellini T, Bennett J, Davies B, Ezzati M, Blangiardo Met al., 2021, Long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis, Environment International, Vol: 146, ISSN: 0160-4120

Recent studies suggested a link between long-term exposure to air-pollution and COVID-19 mortality. However, due to their ecological design based on large spatial units, they neglect the strong localised air-pollution patterns, and potentially lead to inadequate confounding adjustment. We investigated the effect of long-term exposure to NO2 and PM2.5 on COVID-19 mortality in England using high geographical resolution. In this nationwide cross-sectional study in England, we included 38,573 COVID-19 deaths up to June 30, 2020 at the Lower Layer Super Output Area level (n = 32,844 small areas). We retrieved averaged NO2 and PM2.5 concentration during 2014–2018 from the Pollution Climate Mapping. We used Bayesian hierarchical models to quantify the effect of air-pollution while adjusting for a series of confounding and spatial autocorrelation. We find a 0.5% (95% credible interval: −0.2%, 1.2%) and 1.4% (95% CrI: −2.1%, 5.1%) increase in COVID-19 mortality risk for every 1 μg/m3 increase in NO2 and PM2.5 respectively, after adjusting for confounding and spatial autocorrelation. This corresponds to a posterior probability of a positive effect equal to 0.93 and 0.78 respectively. The spatial relative risk at LSOA level revealed strong patterns, similar for the different pollutants. This potentially captures the spread of the disease during the first wave of the epidemic. Our study provides some evidence of an effect of long-term NO2 exposure on COVID-19 mortality, while the effect of PM2.5 remains more uncertain.

Journal article

Konstantinoudis G, Padellini T, Bennett J, Davies B, Ezzati M, Blangiardo Met al., 2020, Long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis, Publisher: MedRxiv

Recent studies suggested a link between long-term exposure to air-pollution and COVID-19 mortality. However, due to their ecological design based on large spatial units, they neglect the strong localised air-pollution patterns, and potentially lead to inadequate confounding adjustment. We investigated the effect of long-term exposure to NO2 and PM2.5 on COVID-19 deaths up to June 30, 2020 in England using high geographical resolution. In this nationwide cross-sectional study in England, we included 38,573 COVID-19 deaths up to June 30, 2020 at the Lower Layer Super Output Area level (n=32,844 small areas). We retrieved averaged NO2 and PM2.5 concentration during 2014-2018 from the Pollution Climate Mapping. We used Bayesian hierarchical models to quantify the effect of air-pollution while adjusting for a series of confounding and spatial autocorrelation. We find a 0.5% (95% credible interval: -0.2%, 1.2%) and 1.4% (95% CrI: -2.1%, 5.1%) increase in COVID-19 mortality risk for every 1μg/m3 increase in NO2 and PM2.5 respectively, after adjusting for confounding and spatial autocorrelation. This corresponds to a posterior probability of a positive effect equal to 0.93 and 0.78 respectively. The spatial relative risk at LSOA level revealed strong patterns, similar for the different pollutants. This potentially captures the spread of the disease during the first wave of the epidemic. Our study provides some evidence of an effect of long-term NO2 exposure on COVID-19 mortality, while the effect of PM2.5 remains more uncertain.

Working paper

Hauser A, Counotte MJ, Margossian CC, Konstantinoudis G, Low N, Althaus CL, Riou Jet al., 2020, Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: A modeling study in Hubei, China, and six regions in Europe, PLOS MEDICINE, Vol: 17, ISSN: 1549-1277

Journal article

Konstantinoudis G, Schuhmacher D, Ammann RA, Diesch T, Kuehni CE, Spycher BDet al., 2020, Bayesian spatial modelling of childhood cancer incidence in Switzerland using exact point data: a nationwide study during 1985-2015, INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, Vol: 19, ISSN: 1476-072X

Journal article

Konstantinoudis G, Schuhmacher D, Rue H, Spycher BDet al., 2020, Discrete versus continuous domain models for disease mapping, Publisher: ELSEVIER SCI LTD

Working paper

Chasapis CT, Konstantinoudis G, 2020, Protein isoelectric point distribution in the interactomes across the domains of life, BIOPHYSICAL CHEMISTRY, Vol: 256, ISSN: 0301-4622

Journal article

Riesen M, Konstantinoudis G, Lang P, Low N, Hatz C, Maeusezahl M, Spaar A, Buhlmann M, Spycher BD, Althaus CLet al., 2018, Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey, BMJ Open, Vol: 8, Pages: 1-9, ISSN: 2044-6055

Objective Understanding the factors that influence human papillomavirus (HPV) vaccination uptake is critically important to the design of effective vaccination programmes. In Switzerland, HPV vaccination uptake (≥1 dose) by age 16 years among women ranges from 31% to 80% across 26 cantons (states). Our objective was to identify factors that are associated with the spatial variation in HPV vaccination uptake.Methods We used cross-sectional data from the Swiss National Vaccination Coverage Survey 2009–2016 on HPV vaccination status (≥1 dose) of 14–17-year-old girls, their municipality of residence and their nationality for 21 of 26 cantons (n=8965). We examined covariates at municipality level: language, degree of urbanisation, socioeconomic position, religious denomination, results of a vote about vaccination laws as a proxy for vaccine scepticism and, at cantonal level, availability of school-based vaccination and survey period. We used a series of conditional autoregressive models to assess the effects of covariates while accounting for variability between cantons and municipal-level spatial autocorrelation.Results In the best-fit model, living in cantons that have school-based vaccination (adjusted OR 2.51; 95% credible interval 1.77 to 3.56) was associated with increased uptake, while living in municipalities with lower acceptance of vaccination laws was associated with lower HPV vaccination uptake (OR 0.61; 95% credible interval 0.50 to 0.73). Overall, the covariates explained 88% of the municipal-level variation in uptake.Conclusions In Switzerland, both cantons and community opinion about vaccination play a prominent role in the variation in HPV vaccination uptake. To increase uptake, efforts should be made to mitigate vaccination scepticism and to encourage school-based vaccination.

Journal article

Riesen M, Konstantinoudis G, Lang P, Low N, Hatz C, Maeusezahl M, Spaar A, Bühlmann M, Spycher BD, Althaus CLet al., 2017, Exploring variation in human papillomavirus vaccination uptake: multi-level spatial analysis

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Understanding the factors that influence human papillomavirus (HPV) vaccination uptake is critically important to design effective vaccination programmes. In Switzerland, completed HPV vaccination by age 16 years among women ranges from 30 to 79% across 26 cantons (states). Our objective was to identify factors that are associated with the spatial variation in HPV vaccination uptake.</jats:p></jats:sec><jats:sec><jats:title>Methods and findings</jats:title><jats:p>We used data from the Swiss National Vaccination Coverage Survey 2009-2016 on HPV vaccination status (≥1 dose) of 14-17 year old girls, their municipality of residence and their nationality for 21 of 26 cantons (N=8,965). We examined covariates at municipality level: language, degree of urbanisation, socio-economic position, religious denomination, results of a vote about vaccination laws; and, at cantonal level, availability of school-based vaccination and survey period. We used a series of conditional auto regressive (CAR) models to assess the effects of covariates while accounting for variability between cantons and municipal-level spatial autocorrelation. In the best-fit model, school-based vaccination (adjusted odds ratio, OR: 2.51, 95% credible interval, CI: 1.77-3.56) was associated with increased uptake, while lower acceptance of vaccination laws was associated with lower HPV vaccination uptake (OR 0.61, 95% CI: 0.50-0.73). Overall, the covariates explained 88% of the municipal-level variation in uptake.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In Switzerland, cantons play a prominent role in the variation in HPV vaccination uptake, especially through the provision of school-based vaccination delivery. HPV vaccination uptake is also strongly associated with inhabitants&rsqu

Journal article

Konstantinoudis G, Kreis C, Ammann RA, Niggli F, Kuehni CE, Spycher BDet al., 2017, Spatial clustering of childhood leukaemia in Switzerland: A nationwide study, INTERNATIONAL JOURNAL OF CANCER, Vol: 141, Pages: 1324-1332, ISSN: 0020-7136

Journal article

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