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Epidemiology, transmission dynamics, risk factors, and future directions of rabies in the Arabian Peninsula using one health approach: a review. 阿拉伯半岛狂犬病流行病学、传播动力学、危险因素及未来发展方向综述
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae164
Md Mazharul Islam, Aisha Naeem, Philip P Mshelbwala, Pronesh Dutta, Mohammad Mahmudul Hassan, Ahmed K Elfadl, Chiori Kodama, Susu M Zughaier, Elmoubashar Farag, Devendra Bansal

Despite global initiatives to eliminate dog-mediated human rabies by 2030, the Arabian Peninsula faces challenges due to insufficient data. This review addresses the current rabies situation and knowledge gaps in the region and proposes One Health interventions. Employing a mixed-method approach combining scoping and systematic review, the study commenced with a Delphi discussion to identify knowledge gaps and set objectives. The literature search encompassed published articles and grey literature. The spatial and temporal distribution of rabies was analysed, alongside quantitative meta-analyses to assess prevalence. Rabies virus gene sequences from the NCBI database were examined for reservoir hosts and evolutionary patterns. The final Delphi discussion with experts focused on addressing knowledge gaps and formulating One Health interventions. The first reported human rabies case in this region occurred in Saudi Arabia in 1980. Yemen reported the highest number of cases (439), followed by Iraq (249), Saudi Arabia (91), Jordan (14), and Oman (9). Fox bites accounted for the most cases (47.4%), followed by dog (36.8%) and wild animal (15.8%) bites. The virus was detected in at least 21 animal species. Phylogenetic analysis detected a single strain with two clades, with foxes being the primary virus reservoir. However, the experts expressed scepticism about the accuracy of rabies reports in scientific literature. To achieve the 2030 goal of eliminating dog-mediated human rabies, a stepwise approach towards rabies elimination assessment is crucial in the region. Enhanced surveillance, awareness campaigns, and access to post exposure prophylaxis are essential to address the disease burden.

尽管全球倡议到2030年消除狗传播的人类狂犬病,但由于数据不足,阿拉伯半岛面临挑战。本综述解决了该地区目前的狂犬病状况和知识差距,并提出了One Health干预措施。采用结合范围界定和系统回顾的混合方法,研究开始于德尔菲讨论,以确定知识差距和设定目标。文献检索包括已发表的文章和灰色文献。分析了狂犬病的时空分布,并进行了定量荟萃分析以评估患病率。研究了来自NCBI数据库的狂犬病毒基因序列,以确定宿主和进化模式。与专家的最后德尔菲讨论侧重于解决知识差距和制定“一个健康”干预措施。本地区报告的首例人类狂犬病病例于1980年在沙特阿拉伯发生。也门报告病例数最多(439例),其次是伊拉克(249例)、沙特阿拉伯(91例)、约旦(14例)和阿曼(9例)。狐狸咬伤病例最多(47.4%),其次是狗咬伤(36.8%)和野生动物咬伤(15.8%)。在至少21种动物中发现了这种病毒。系统发育分析发现一株病毒具有两个进化枝,狐狸是主要的病毒宿主。然而,专家们对科学文献中狂犬病报告的准确性表示怀疑。为实现2030年消除狗介导的人类狂犬病的目标,在该区域采取逐步消除狂犬病评估的方法至关重要。加强监测、提高认识运动和获得接触后预防对于解决疾病负担至关重要。
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引用次数: 0
Molecular diagnosis and phylogenetic analysis of a Middle East respiratory syndrome coronavirus human case in Jordan. 约旦一例中东呼吸综合征冠状病毒人间病例的分子诊断和系统发育分析
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae106
Ehab A Abu-Basha, Zuhair B Ismail, Mohammad H Alboom, Ayesha Alkofahi, Basil H Amarneh, Omar Al-Omari, Alaa Fahmawi, Abdullah Alshammari, Mais Lakaideh, Shereen Shaban, Bilal Al-Omari, Hani Talafha, Zaidoun Hijazeen, Yasmin Daradkeh, Rabeh El-Shesheny, Ghazi Kayali, Whitney Bagge, William B Karesh

Middle East respiratory syndrome coronavirus (MERS-CoV) is an important zoonotic pathogen. The aim of this paper is to report one polymerase chain reaction (PCR)-positive case of MERS-CoV in a 27-year-old man who was involved in a nationwide longitudinal surveillance study of certain zoonotic diseases in Jordan including MERS-CoV. Whole-blood and nasal swab samples were collected from the man and five camels in the vicinity of his living area. The samples were subjected to enzyme-linked immunosorbent assay (ELISA) and real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV-specific antibodies and MERS-CoV genetic material, respectively. Genomic sequencing and phylogenetic analysis were also performed to detect similarities with known strains of the virus in the region. In January 2021, an ongoing surveillance study detected a MERS-CoV-positive nasal swab sample from an asymptomatic male and camels using RT-PCR. Phylogenetically, the MERS-CoV isolated in this case belonged to clade B and is clustered with other strains originating in the Arabian Peninsula. The case report represents the first PCR-positive case of MERS-CoV in an asymptomatic individual in Jordan, indicating active circulation of the virus within the population.

中东呼吸综合征冠状病毒(MERS-CoV)是一种重要的人畜共患病原体。本文的目的是报告1例聚合酶链反应(PCR)阳性的中东呼吸综合征冠状病毒病例,该病例发生在一名27岁男子身上,他曾参与约旦包括中东呼吸综合征冠状病毒在内的某些人畜共患疾病的全国性纵向监测研究。从该男子及其生活区附近的五头骆驼身上采集了全血和鼻拭子样本。采用酶联免疫吸附法(ELISA)和实时反转录PCR (RT-PCR)检测MERS-CoV特异性抗体和MERS-CoV遗传物质。还进行了基因组测序和系统发育分析,以发现与该地区已知病毒株的相似性。2021年1月,一项正在进行的监测研究使用RT-PCR技术从一名无症状男性和骆驼身上检测到一例中东呼吸综合征冠状病毒阳性鼻拭子样本。在系统发育上,本病例分离的中东呼吸综合征冠状病毒属于B支,并与源自阿拉伯半岛的其他毒株聚集在一起。该病例报告是约旦无症状个体中首例中东呼吸综合征冠状病毒聚合酶链反应阳性病例,表明该病毒在人群中活跃传播。
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引用次数: 0
An epidemiological risk assessment of imported malaria cases and potential local transmission in Qatar. 卡塔尔输入性疟疾病例和可能的当地传播的流行病学风险评估。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae127
Devendra Bansal, Nada Assaad, Hend Omar Mohamed, Muralitharan Shanmugakonar, Dorothy Pacate, Khider Mohamed, Perumal Balakrishnan, Redentor Cuizon Ramiscal, Nandakumar Ganesan, Maha Hammam M A Al-Shamali, Ali A Sultan, Waqar Munir, Mohammed Abukhattab, Francis Schaffner, Muna A Al-Maslamani, Hamad Eid Al-Romaihi, Mohammed Al-Thani, Fatima Al Khayat, Elmoubashar Abd Farag

Preventing local transmission of malaria from imported cases is crucial for achieving and maintaining malaria elimination. This study aimed to investigate the epidemiological characteristics of imported malaria cases and assess the distribution of malaria vectors in Qatar. Data from January 2016 to December 2022 on imported malaria, including demographic and epidemiological characteristics, travel-related information, and diagnostic results, were collected and analysed using descriptive statistics. Field surveys conducted in 2021-22 collected mosquitoes using various traps across Qatar. The collected samples underwent morphological and molecular characterization at Qatar University. A total of 2693 cases were reported, with a mean incidence of 13.5/100 000 population, decreasing from 18.8/100 000 in 2016 to 5.5/100 000 in 2020. Most cases were Plasmodium vivax (57.4%) followed by P. falciparum (40.4%). The median age was 32.9 ± 12.5 years, primarily males (86.7%), expatriates (99.6%) and notified during the hot months (July to September). Cases were mainly imported from the Eastern Mediterranean Region followed by the African and South-East Asia Region with no deaths and indigenous cases. Anopheles stephensi was identified as a widely distributed species, but none carried the Plasmodium pathogen. Despite no reports of local transmission, the presence of An. stephensi and favourable environmental conditions pose a risk in Qatar. Strengthening surveillance for imported malaria and reviewing epidemic protocols are necessary. Conventional field studies are imperative to address knowledge gaps in Anopheles mosquito ecology and biting habits in Qatar, accurately assessing the risk of local malaria transmission to support Qatar's malaria-free status.

防止输入病例在当地传播疟疾对于实现和维持消除疟疾至关重要。本研究旨在调查卡塔尔输入性疟疾病例的流行病学特征,评估疟疾媒介的分布情况。收集2016年1月至2022年12月输入性疟疾的人口和流行病学特征、旅行相关信息和诊断结果等数据,并采用描述性统计方法进行分析。2021- 2022年进行的实地调查在卡塔尔各地使用各种陷阱收集蚊子。收集的样品在卡塔尔大学进行了形态和分子表征。报告病例2693例,平均发病率为13.5/10万人,由2016年的18.8/10万人下降到2020年的5.5/10万人。以间日疟原虫最多(57.4%),其次为恶性疟原虫(40.4%)。中位年龄为32.9±12.5岁,以男性(86.7%)为主,外籍人士(99.6%)居多,发病时间为7 ~ 9月。病例主要来自东地中海区域,其次是非洲和东南亚区域,无死亡病例和本土病例。斯氏按蚊是分布广泛的一种,但没有携带疟原虫病原体。尽管没有本地传播的报告,但安。斯蒂芬斯和有利的环境条件在卡塔尔构成了风险。加强对输入性疟疾的监测和审查流行病议定书是必要的。传统的实地研究对于解决卡塔尔按蚊生态和叮咬习惯方面的知识空白、准确评估当地疟疾传播的风险以支持卡塔尔的无疟疾地位至关重要。
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引用次数: 0
Epidemiological analysis and potential factors affecting the 2022-23 Crimean-Congo hemorrhagic fever outbreak in Iraq. 2022-23年伊拉克克里米亚-刚果出血热疫情流行病学分析及潜在影响因素
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae147
Chiori Kodama, Riyadh Abdulameer Alhilfi, Ihab Aakef, Adnan Khamasi, Sinan Mahdi, Hameeda Mohammed Hasan, Raghad Ibrahim Khaleel, Mazin Mahdi Naji, Noor Khalid Esmaeel, Sundus Haji-Jama, Anais Legand, Olivia Keiser, Isabella Eckerle, Pierre B H Formenty

Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne disease with a case fatality rate of up to 40% in humans, posing a significant health threat. This study investigates the 2022-23 CCHF outbreaks in Iraq, the highest recorded to date, and analyzes potential factors at the human-animal-environmental interface. Data from the Iraqi government, the World Health Organization, and the World Bank were used to analyze CCHF trends and affecting factors. This included epidemiological reports, clinical data, tick infestation and seroprevalence studies, and climate data. Descriptive and statistical analyses examined case trends, geographic and demographic characteristics, clinical manifestations, risk factors, seasonal patterns, and influencing factors. A sudden rise in CCHF cases began in southern Iraq in April 2022 and expanded across all governorates, with a shift toward urban areas. Higher incidence was observed among males, aged 25-44, and those involved in slaughtering. The most common clinical manifestation was fever (97%), followed by hemorrhagic symptoms (54%). Bleeding from the gums or mouth and subcutaneous bleeding were more frequent in patients with fatal outcomes. Seasonal patterns showed peaks during spring and fall, correlating with tick activity and potentially exacerbated by climate change. Tick infestation and seroprevalence studies indicated a high prevalence of Hyalomma ticks and CCHF seropositivity among domestic animals in southern Iraq (60%), consistent with the distribution of CCHF human cases. Iraq's ongoing CCHF outbreak demands multidisciplinary One Health strategies. The Iraqi government has adopted such a control strategy, contributing to regional and global efforts to enhance pandemic preparedness.

克里米亚-刚果出血热(CCHF)是一种急性蜱传疾病,人类病死率高达40%,构成重大健康威胁。本研究调查了伊拉克迄今记录最高的2022-23年CCHF暴发,并分析了人-动物-环境界面的潜在因素。来自伊拉克政府、世界卫生组织和世界银行的数据被用来分析CCHF的趋势和影响因素。这包括流行病学报告、临床数据、蜱虫侵扰和血清患病率研究以及气候数据。描述性和统计分析检查了病例趋势、地理和人口特征、临床表现、风险因素、季节模式和影响因素。CCHF病例于2022年4月在伊拉克南部突然增加,并扩大到所有省份,并向城市地区转移。在25-44岁的男性和参与屠宰的人中发病率较高。最常见的临床表现是发热(97%),其次是出血性症状(54%)。牙龈或口腔出血和皮下出血在死亡患者中更为常见。季节性模式在春季和秋季达到峰值,与蜱虫活动相关,并可能因气候变化而加剧。蜱虫感染和血清阳性率研究表明,伊拉克南部家畜中透明体蜱和CCHF血清阳性率很高(60%),与CCHF人间病例的分布一致。伊拉克目前的埃博拉疫情需要多学科的“同一个卫生”战略。伊拉克政府采取了这样一项控制战略,为加强大流行病防范的区域和全球努力作出了贡献。
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引用次数: 0
Evaluating the burden and transmission dynamics of chikungunya virus infections in the Eastern Mediterranean Region: a systematic review and meta-analysis. 评估东地中海区域基孔肯雅病毒感染的负担和传播动态:系统回顾和荟萃分析。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae165
Riyaz Ahamed Shaik, Mohammad Shakil Ahmad, Mohammad Miraj, Waqas Sami, Alashjaee Ahmed Azam, Patrick Okwarah

The Chikungunya virus (CHIKV) presents substantial public health challenges in the Eastern Mediterranean Region (EMR), with its prevalence and interaction with other arboviruses (ABVs) remaining poorly understood. This systematic review and meta-analysis aimed to assess the prevalence of CHIKV and its association with other ABVs, such as dengue virus (DENV), Rift Valley fever virus (RVFV), malaria, and yellow fever virus (YFV), in the EMR. We systematically searched databases including PubMed, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, PsycINFO, and ScienceDirect to identify epidemiological studies that report CHIKV prevalence and provide odds ratios (ORs) for CHIKV compared to other ABVs. Data analysis was performed using a random-effects model. Heterogeneity was evaluated using the χ2 test and I2 statistic. The GRADE approach was used to evaluate the quality of the studies while the AXIS tool, NOS tool, and AHRQ checklist assessed the risk of bias. The meta-analysis revealed a significant prevalence of CHIKV in the EMR. However, the studies exhibited heterogeneity, indicating variability in the results. A comparison of CHIKV with other ABVs did not show any statistically significant differences in prevalence. The meta-analysis found a notable prevalence of CHIKV in the EMR. The results also indicated that the prevalence of CHIKV is comparable to that of other ABVs in the region. These findings provide an overview of the burden of CHIKV in the EMR.

基孔肯雅病毒(CHIKV)在东地中海区域(EMR)构成了重大的公共卫生挑战,其流行情况及其与其他虫媒病毒(abv)的相互作用仍然知之甚少。本系统综述和荟萃分析旨在评估CHIKV在EMR中的流行情况及其与其他abv(如登革热病毒(DENV)、裂谷热病毒(RVFV)、疟疾和黄热病病毒(YFV)的关系。我们系统地检索了PubMed、Embase、Web of Science、Scopus、Cochrane Library、CINAHL、PsycINFO和ScienceDirect等数据库,以确定报告CHIKV患病率的流行病学研究,并提供CHIKV与其他abv的比值比(or)。数据分析采用随机效应模型。采用χ2检验和I2统计量评价异质性。GRADE方法用于评价研究质量,AXIS工具、NOS工具和AHRQ检查表评估偏倚风险。荟萃分析显示,CHIKV在EMR的流行率很高。然而,这些研究显示出异质性,表明结果存在差异。CHIKV与其他abv的比较没有显示出任何统计学上的显著差异。荟萃分析发现,CHIKV在EMR的流行率显著。结果还表明,该地区CHIKV的流行程度与其他abv相当。这些发现提供了EMR中CHIKV负担的概述。
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引用次数: 0
Bartonellosis in World Health Organization Eastern Mediterranean Region, a systematic review and meta-analysis. 世界卫生组织东地中海区域巴尔通体病的系统回顾和荟萃分析。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1093/eurpub/ckae123
Zahra Tahmasebi Ashtiani, Fahimeh Bagheri Amiri, Mozhgan Ahmadinezhad, Ehsan Mostafavi, Saber Esmaeili

Bartonella is a vector-borne zoonotic pathogen, which could also be transmitted directly and cause a variety of clinical illnesses. This study aimed to investigate the prevalence of Bartonella in countries in the WHO Eastern Mediterranean Region (WHO-EMR) region. We searched using the keywords Bartonella and the name of each country in the WHO-EMR in databases such as PubMed, ISI (Web of Science), Scopus, and Google Scholar, with a publication date range of 1990-2022 and limited to English articles. We evaluated the quality of the studies using the STROBE 6-item checklist and used the random effects model to integrate the findings of the included studies. A total of 45 papers out of 240 were included in the analysis. The results showed the prevalence of Bartonella infection among endocarditis patients was 3.8% (95% CI: 0.2-7.4) and the seroprevalence of Bartonella among other people was 27.5% (95% CI: 13.5-41.5). The overall prevalence of Bartonella spp. among animals, as determined by molecular, serological, and culture methods, was 11.9% (95% CI: 5.7-18.2), 38.9% (95% CI: 27.5-50.2), and 1.7% (95% CI: 0.5-2.9), respectively. Furthermore, the prevalence of Bartonella spp. in ectoparasites was 3.9% (95% CI: 3.5-5.2), with fleas (6.2%) showing a higher prevalence compared to lice (4.9%) and ticks (1.0%). The detection of Bartonella in all animal and ectoparasites species and human populations in the WHO-EMR with prevalence ranging from 0.3% to 23% is concerning, emphasizes the importance of conducting more comprehensive studies to gain a deeper understanding of the spread of Bartonella in these areas.

巴尔通体是一种媒介传播的人畜共患病原体,可直接传播,引起多种临床疾病。本研究旨在调查世卫组织东地中海区域(WHO- emr)各国巴尔通体流行情况。我们在PubMed、ISI (Web of Science)、Scopus和谷歌Scholar等数据库中使用关键字巴尔通体和WHO-EMR中每个国家的名称进行检索,出版日期范围为1990-2022年,仅限于英文文章。我们使用STROBE 6项检查表评估研究的质量,并使用随机效应模型整合纳入研究的结果。240篇论文中有45篇被纳入分析。结果显示心内膜炎患者巴尔通体感染率为3.8% (95% CI: 0.2 ~ 7.4),其他人群巴尔通体血清感染率为27.5% (95% CI: 13.5 ~ 41.5)。通过分子、血清学和培养方法确定的巴尔通体在动物中的总体流行率分别为11.9% (95% CI: 5.7-18.2)、38.9% (95% CI: 27.5-50.2)和1.7% (95% CI: 0.5-2.9)。此外,巴尔通体在体外寄生虫中的流行率为3.9% (95% CI: 3.5 ~ 5.2),蚤(6.2%)的流行率高于虱(4.9%)和蜱(1.0%)。世卫组织emr在所有动物和体外寄生虫种类以及人群中检测到巴尔通体,其流行率为0.3%至23%,这令人担忧,强调了开展更全面研究以更深入了解巴尔通体在这些地区传播的重要性。
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引用次数: 0
Correction to: Breastfeeding duration, children's diet and physical activity in immigrant children living in Lisbon. 更正:居住在里斯本的移民儿童的母乳喂养时间、儿童饮食和身体活动。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-24 DOI: 10.1093/eurpub/ckae210
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引用次数: 0
Opinion of Polish doctors on the use of futile therapy. 波兰医生对无效治疗的看法。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-20 DOI: 10.1093/eurpub/ckae202
Maria Damps, Maksymilian Gajda, Łukasz Wiktor, Elżbieta Byrska-Maciejasz, Beata Rybojad, Małgorzata Kowalska, Alicja Bartkowska-Śniatkowska, Anna Paprocka-Lipińska, Ewa Kucewicz-Czech

The discontinuation of futile therapy is increasingly discussed in Polish clinical practice. Given the need to ensure patient well-being, it is essential to consider whether all clinical options resulting from medical progress should be used for every patient and on what grounds decisions to limit therapy should be based. The aim of our study was to determine the opinions of Polish medical doctors on this topic. We anonymously surveyed physicians across various specialties. An analysis of the collected data was carried out using descriptive and analytical methods. A total of 323 physicians participated in the study; 93% of them were aware of the problem of futile therapy in adults, with intensivists being significantly more aware (P = 0.002). Additionally, 95% of respondents supported the idea of discontinuing futile therapy, and over 68% used the therapy discontinuation protocol. Among the most common reasons for undertaking futile therapy, respondents cited fear of legal liability (93.5%), as well as fear of being accused of unethical behavior (62.2%) and fear before talking to the patient/patient's family and their reactions (57.9%). Respondents also identified factors that would facilitate making decisions about limiting futile therapy, including precise qualification criteria for limiting therapy and education in this area (95.3%), the patient's declaration of will (87.5%), and a clear legal act (81.3%). The majority of study participants supported the idea of limiting futile therapy, and this issue is well known among Polish physicians.

在波兰的临床实践中,越来越多地讨论了无效治疗的停止。考虑到需要确保病人的健康,必须考虑是否应该对每一个病人使用医学进展产生的所有临床选择,以及限制治疗的决定应该基于什么理由。我们研究的目的是确定波兰医生对这个话题的看法。我们匿名调查了不同专业的医生。使用描述性和分析性方法对收集的数据进行了分析。共有323名医生参与了这项研究;93%的受访医师意识到成人治疗无效的问题,其中强化医师的意识明显更高(P = 0.002)。此外,95%的受访者支持停止无效治疗的想法,超过68%的人使用了治疗停止方案。在接受无效治疗的最常见原因中,受访者表示害怕承担法律责任(93.5%),以及害怕被指控不道德行为(62.2%)和害怕与患者/患者家属交谈及其反应(57.9%)。受访者还确定了有助于做出限制无效治疗决定的因素,包括限制治疗的精确资格标准和该领域的教育(95.3%),患者的遗嘱声明(87.5%)和明确的法律行为(81.3%)。大多数研究参与者支持限制无效治疗的想法,这个问题在波兰医生中是众所周知的。
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引用次数: 0
Correction to: Prospective relationship between family screen time rules, obesogenic behaviours, and childhood obesity. 更正:家庭屏幕时间规则、致肥行为和儿童肥胖之间的前瞻性关系。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-15 DOI: 10.1093/eurpub/ckae207
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引用次数: 0
Screen-detected breast cancer and cancer stage by area-level deprivation: a descriptive analysis using data from the National Cancer Registry Ireland. 按地区贫困程度分列的筛查出的乳腺癌和癌症分期:利用爱尔兰国家癌症登记处的数据进行的描述性分析。
IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-13 DOI: 10.1093/eurpub/ckae204
Philippa White, Aline Brennan, Joe McDevitt, Deirdre Murray, Caroline Mason Mohan, Patricia Fitzpatrick, Therese Mooney, Alan Smith, Maeve Mullooly, Niamh Bambury

Breast cancer screening programmes can lead to better disease outcomes, but women from deprived backgrounds are less likely to participate and more likely to present with late-stage cancer. This study aimed to explore associations between deprivation and breast cancer screening outcomes in Ireland during 2009-2018. Data on all female breast cancer cases diagnosed in Ireland during 2009-2018 were extracted from the National Cancer Registry Ireland. Associations between area-level deprivation, using the Pobal Haase-Pratschke deprivation index, and detection of breast cancer through BreastCheck, Ireland's breast screening programme, and stage of screen-detected breast cancer were explored. Unadjusted risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Among screening eligible women in Ireland in 2009-2018, there was no difference in risk of breast cancer detection through BreastCheck across deprivation quintiles (RR for most compared to least deprived group: 1.01, 95% CI: 0.96-1.06). In women with screen-detected breast cancer, the risk of late-stage cancer detection increased with deprivation in 2009-2013 (RR for most compared to least deprived group: 1.45, 95% CI: 1.10-1.93), but no association was observed between deprivation and cancer stage in 2014-2018. Notwithstanding its limitations, including the risk of confounding by uncontrolled variables, this study suggests screening eligible women in Ireland have had similar outcomes from breast cancer screening, regardless of deprivation level, since the national roll-out of BreastCheck. Associations between deprivation and screening outcomes should continue to be monitored to ensure Ireland's breast cancer screening programme is helping to reduce health inequities.

乳腺癌筛查项目可以带来更好的疾病结果,但是来自贫困背景的妇女参与的可能性较小,而且更有可能出现晚期癌症。本研究旨在探讨2009-2018年爱尔兰贫困与乳腺癌筛查结果之间的关系。2009-2018年期间爱尔兰诊断出的所有女性乳腺癌病例的数据来自爱尔兰国家癌症登记处。使用Pobal Haase-Pratschke剥夺指数的地区剥夺与通过BreastCheck(爱尔兰的乳房筛查计划)检测乳腺癌以及筛查发现的乳腺癌阶段之间的联系进行了探讨。计算未调整风险比(RRs)和95%置信区间(ci)。在2009-2018年爱尔兰符合筛查条件的女性中,通过乳房检查发现乳腺癌的风险在剥夺五分位数之间没有差异(大多数与最不剥夺组的RR: 1.01, 95% CI: 0.96-1.06)。在筛查出乳腺癌的女性中,在2009-2013年,随着剥夺剥夺,晚期癌症检测的风险增加(与最剥夺组相比,剥夺剥夺组的RR: 1.45, 95% CI: 1.10-1.93),但在2014-2018年,剥夺剥夺与癌症分期之间没有观察到关联。尽管有其局限性,包括不受控制的变量混淆的风险,但该研究表明,自全国推广乳房检查以来,爱尔兰筛查符合条件的妇女从乳腺癌筛查中获得了相似的结果,无论剥夺程度如何。应继续监测贫困与筛查结果之间的关系,以确保爱尔兰的乳腺癌筛查方案有助于减少保健不平等现象。
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引用次数: 0
期刊
European Journal of Public Health
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