Journal of Epidemiology and Global Health最新文献

Background: The COVID-19 pandemic has brought unprecedented changes globally, significantly affecting public health sectors, including paediatric road trauma. This study aims to explore the changes in paediatric road trauma presentations and outcomes before and after the COVID-19 lockdown.

Methods: This retrospective study analysed paediatric trauma data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022, comparing pre- and post-COVID-19 lockdown periods (August 2017-March 2020 and July 2020-December 2022, respectively). The study analysed demographic data, mechanism of injury, severity, ICU admissions, and mortality rates using multivariate logistic regression models.

Results: Out of 950 paediatric trauma cases analysed, there was an 44.2 [561/389 = 1.442] % increase in the number of cases post-lockdown. A significant shift was noted in the age group of 5-9 years, with cases increasing from post-lockdown. Head injuries were the most prevalent type of injury, with their proportion slightly increasing from 163 (20.5%) pre-lockdown to 248 (23.2%) post-lockdown. The ICU admission were consistent across both periods, while the definitive care mode of arrival post-lockdown showed a notable shift towards private or government ambulances.

Conclusion: Our study provides critical insights into the significant impact of the COVID-19 on paediatric road trauma. The observed increase in trauma cases post-pandemic, particularly among younger children and a notable rise in driver-related injuries among adolescents, underscores the profound effect of lockdown measures and subsequent societal changes on paediatric health. Efforts to reduce paediatric traffic injuries require collaboration among parents, educators, healthcare professionals, policymakers, and the community at large.

This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.

Background: There is no consensus on the cause and effect of systemic chronic inflammation (SCI) regarding chronic obstructive pulmonary disease (COPD). The impact of second-hand smoke (SHS) on COPD has reached inconsistent conclusions.

Methods: The China Kadoorie Biobank cohort was followed up from the 2004-08 baseline survey to 31 December 2018. Among the selected 445,523 participants in the final analysis, Cox and linear regressions were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of tobacco exposure with COPD risk and baseline levels of log-transformed inflammatory factors [βs (95% CIs)], respectively.

Results: Participants were followed up for a median of 12.1 years and 11,825 incident COPD events were documented. Ever-smokers were associated with a higher risk of COPD than non-smokers with non-weekly SHS exposure. A younger age to start smoking, a greater amount of daily tobacco consumption, and deeper inhalation were associated with increased risk of COPD and correlated with elevated levels of plasma high-sensitivity C-reactive protein (hs-CRP, all P_trend < 0.001) even two years before COPD onset. Among former smokers, COPD risk declined with longer smoking cessation (P_trend < 0.001) and those quitting smoking for over ten years presented no difference in COPD risk and hs-CRP level from non-smokers [HR (95% CI) = 1.05 (0.89, 1.25), β (95% CI) = 0.17 (- 0.09, 0.43)]. Among non-smokers, weekly SHS exposure was associated with a slightly higher COPD risk [HR (95% CI) = 1.06 (1.01, 1.12)].

Conclusions: Incremental exposure to tobacco smoke was related to elevated SCI level before COPD onset, then an increase in COPD susceptibility. Quitting smoking as early as possible is suggested as a practical approach to reducing COPD risk in smokers. Given the high prevalence of both COPD and SHS exposure, the risk associated with SHS exposure deserves attention.

Objectives: This study aimed to establish the exposure-lag-response effect between daily maximum temperature and stroke-related emergency department visits and to project heat-induced stroke impacts under global warming levels (GWL) of 2 °C and 4 °C.

Methods: Stroke-related emergency department visits in Taiwan from 2001 to 2020 were identified using the National Health Insurance Research Database (NHIRD). The study population consisted of 1,100,074 initial stroke cases matched with 2,200,148 non-stroke controls. We employed Distributed Lag Nonlinear Models (DLNM) in a case-crossover study to investigate the association between temperature and stroke. Generalized Estimating Equations (GEE) models with a Poisson function were used to correlate high-temperature exposure with annual stroke incidence rates. Projections were made under two global warming scenarios, GWL 2.0 °C and 4.0 °C, using Coupled General Circulation Model (GCMs). Baseline data from 1995 to 2014 were transformed for spatial distribution at the township level. Geographic Information System (GIS) spatial analysis was performed using Quantum GIS 3.2.0 software.

Results: DLNM exposure-lag-response effect revealed that daily maximum temperature exceeding 34 °C significantly increased the risk of stroke-related emergency department visits, particularly for ischemic stroke. Under the 2 °C GWL scenario, the frequency of days with temperatures surpassing 34 °C is projected to rise substantially by the median year of 2042, with a further increase to 92.6 ± 18.0 days/year by 2065 under the 4 °C GWL scenario. Ischemic stroke showed the highest increase in temperature-related incidence rates, notably rising from 7.80% under the GWL 2 °C to 36.06% under the GWL 4 °C. Specifically, the annual temperature-related incidence rate for ischemic stroke is expected to increase significantly by 2065. Regions such as Taichung, Hsinchu, Yilan, and Taitung demonstrated pronounced changes in heat-related ischemic stroke incidence under the GWL 4 °C.

Conclusions: The findings emphasize the importance of addressing temperature-related stroke risks, particularly in regions projected to experience significant temperature increases. Effective mitigation strategies are crucial to reduce the impact of rising temperatures on stroke incidence and safeguard public health.

Objective: To analyze the spatial autocorrelation and spatiotemporal clustering characteristics of severe fever with thrombocytopenia syndrome(SFTS) in Anhui Province from 2011 to 2023.

Methods: Data of SFTS in Anhui Province from 2011 to 2023 were collected. Spatial autocorrelation analysis was conducted using GeoDa software, while spatiotemporal scanning was performed using SaTScan 10.0.1 software to identify significant spatiotemporal clusters of SFTS.

Results: From 2011 to 2023, 5720 SFTS cases were reported in Anhui Province, with an average annual incidence rate of 0.7131/100,000. The incidence of SFTS in Anhui Province reached its peak mainly from April to May, with a small peak in October. The spatial autocorrelation results showed that from 2011 to 2023, there was a spatial positive correlation(P < 0.05) in the incidence of SFTS in all counties and districts of Anhui Province. Local autocorrelation high-high clustering areas are mainly located in the south of the Huaihe River. The spatiotemporal scanning results show three main clusters of SFTS in recent years: the first cluster located in the lower reaches of the Yangtze River, the eastern region of Anhui Province; the second cluster primarily focused on the region of the Dabie Mountain range, while the third cluster primarily focused on the region of the Huang Mountain range.

Conclusions: The incidence of SFTS in Anhui Province in 2011-2023 was spatially clustered.

COVID-19 vaccines have demonstrated significant efficacy in reducing severe symptoms and fatalities, although their effectiveness in preventing transmission varies depending on the population's age profile and the dominant variant. This study evaluates the impact of the COVID-19 vaccination campaign in the Basque Country region of Spain, which has the fourth highest proportion of elderly individuals worldwide. Using epidemiological data on hospitalizations, ICU admissions, fatalities, and vaccination coverage, we calibrated four versions of an ordinary differential equations model with varying assumptions on the age structure and transmission function. Counterfactual no-vaccine scenarios were simulated by setting the vaccination rate to zero while all other parameters were held constant. The initial vaccination rollout is estimated to have prevented 46,000 to 75,000 hospitalizations, 6,000 to 11,000 ICU admissions, and 15,000 to 24,000 deaths, reducing these outcomes by 73-86%. The most significant impact occurred during the third quarter of 2021, coinciding with the Delta variant's dominance and a vaccination rate exceeding 60%. Sensitivity analysis revealed that vaccination coverage had a more substantial effect on averted outcomes than vaccine efficacy. Overall, the vaccination campaign in the Basque Country significantly reduced severe COVID-19 outcomes, aligning with global estimates and demonstrating robustness across different modeling approaches.

Cutaneous leishmaniasis (CL) is a parasitic disease that affects individuals worldwide. An epidemiological observational population-cohort study was conducted on the basis of comprehensive research on CL incidence in Saudi and non-Saudi residents. The Ministry of Health recorded the incidence of CL between January 2020 and December 2022. The chi-square test was used to analyze the data and determine CL incidence rates in age-specific incidence rates (ASIRs) and gender between Saudi and non-Saudi residents in Saudi Arabia. The study found that between 2020 and 2022, there were 2280 cases of CL in Saudi Arabia, with 1367 and 913 cases in men and women, respectively. Of Saudi nationals, 64.26% and 12.91% were male and female, respectively. The frequency of CL was higher (87.09%) among non-Saudi residents than among Saudi nationals, with a statistically significant difference (P = 0.001) between the two groups. The ASIRs for CL were higher in patients aged 15-45 years. This study revealed variations in CL incidence rates among the 13 administrative regions; Qassim, followed by Aseer, Ha'il, and Madinah, had higher rates than the other regions. These findings indicate the need for targeted interventions and public health strategies to reduce the burden on CL, particularly among non-Saudi residents.

Introduction: Brucellosis, a globally distributed zoonotic disease, exhibits diverse clinical manifestations, with Brucella peritonitis being a rare but consequential complication.

Methods: Analyzing the medical records of four patients with Brucella peritonitis admitted to the First People's Hospital of Kashi Region from January 2022 to November 2023. A retrospective approach was used to analyze the general data, epidemiological history, clinical features, laboratory tests, and efficacy. All four patients with Brucella peritonitis were farmers.

Results: All of them were combined with decompensated stage of liver cirrhosis. The main manifestations were poor appetite, fatigue, bloating. Two patients were accompanied by moderate-high fever. All patients presented with mildly elevated C-reactive protein and procalcitonin < 0.25ng/ml. Brucella was cultured from blood in 2 cases, from pleural fluid in 1 case, and from ascitic fluid in another case. All patients had moderate-to-large amounts of ascites with elevated leukocytes in the ascites, predominantly mononuclear cells. Symptoms of the above patients were reduced or disappeared after effective anti-infection.

Conclusion: When patients with decompensated cirrhosis present with exudative ascites dominated by elevated mononuclear cells, the possibility of Brucella peritonitis should also be considered in areas where brucellosis is endemic.

The last decade has seen major advances and growth in internet-based surveillance for infectious diseases through advanced computational capacity, growing adoption of smart devices, increased availability of Artificial Intelligence (AI), alongside environmental pressures including climate and land use change contributing to increased threat and spread of pandemics and emerging infectious diseases. With the increasing burden of infectious diseases and the COVID-19 pandemic, the need for developing novel technologies and integrating internet-based data approaches to improving infectious disease surveillance is greater than ever. In this systematic review, we searched the scientific literature for research on internet-based or digital surveillance for influenza, dengue fever and COVID-19 from 2013 to 2023. We have provided an overview of recent internet-based surveillance research for emerging infectious diseases (EID), describing changes in the digital landscape, with recommendations for future research directed at public health policymakers, healthcare providers, and government health departments to enhance traditional surveillance for detecting, monitoring, reporting, and responding to influenza, dengue, and COVID-19.

Introduction: Monitoring changes in cessation behaviors and cessation assistance is critical for policymaking.

Methods: We analyzed two rounds (2009-2014 and 2015-2021) of Global Adult Tobacco Surveys in 13 countries. We estimated the quit ratio, quit attempt, and utilization of cessation assistance. The availability of cessation services was obtained from World Health Organization reports. We calculated absolute and relative changes in quit ratio, quit attempt, and cessation assistance. We assessed socio-economic determinants of cessation behaviors by binary logistic regression analyses on pooled data.

Results: In all countries during both rounds smoking prevalence was 7.6-33.8%, the quit ratio was 0.15-0.54%, and the quit attempt was 17.7-52.8%. Quit ratio improved in Indonesia by 100% but declined in Turkey by 56%. Quit attempts increased in Indonesia (31.9%), Mexico (16.9%) and China (15.9%) but decreased in Turkey (140.4%), Vietnam (43.1%), and Romania (62.4%). In both rounds, using at least one method was 12.5-99.8% while the WHO-recommended method was 4.1-88.4%. In both rounds "try to quit without any assistance" and "other methods" were the most frequently reported cessation assistance. Nicotine replacement therapy (0.2-25.3%) was frequently used as recommended cessation assistance. Nicotine replacement therapy was available in most countries but not quitline and support services.

Conclusion: Limited progress was made in smoking cessation behaviors and cessation assistance in most countries. Health education to improve demand for smoking cessation and availability of evidence-based, low-cost smoking cessation assistance including quit-smoking may improve quit ratios in the population.