Journal of Epidemiology and Global Health最新文献

Background: Public spaces such as parks and playgrounds offer social and ecological benefits to communities, but it might also pose public health risks. This epidemiological survey investigated the presence and risk factors of zoonotic parasites in faecal and soil samples collected from 60 public spaces across Kuala Lumpur and Selangor, Malaysia.

Methods: Eggs, cysts and larvae of parasites were collected from 71 faecal and 300 soil samples using flotation-sedimentation techniques. Species identification was done using both morphological and conventional PCR.

Results: A total of 71 faecal samples were collected, comprising 40 cat faeces and 31 dog faeces. Of these, 63 samples (88.7%) were positive for at least one intestinal parasite. The prevalence of parasite in cat faeces (95.0%, 38/40) was higher than dogs (80.7%, 25/31). Overall, six genera of parasites were detected in faecal samples. Cystoisospora spp. (62.0%) was the most prevalent, followed by hookworms (46.5%) and Giardia spp. (22.5%). Among the 33 faecal samples that tested positive for hookworms, Ancylostoma ceylanicum was the most common species (81.8%). Hookworm coinfections with Cystoisospora spp. were commonly detected in faecal samples (37.5%). Viability testing revealed that 37.7% of collected hookworm eggs and 74.6% of collected Toxocara eggs were viable. In soil samples, hookworm larvae were found in 28 out of the 300 samples, and 16 out of 60 sampling sites (26.7%). Hookworm burdens were significantly higher in rural areas and beaches. Risk factor analysis revealed that the presence of dustbin was associated with reduced hookworm infections (OR=0.075, 95% CI: 0.007-0.520) in dogs. Higher odds of hookworms were found in cat faeces (OR=4.961, 95% CI: 1.10-25.98) and soil (OR=5.77, 95% CI: 1.54-20.26) from residential parks. Notably, faecal-soil concordance was observed at 43.8% sampling sites, all located in residential parks. It highlights that these areas are potential active transmission hotspots.

Conclusions: These findings provide essential information for public health officials to develop targeted interventions to reduce the risk of transmission of zoonotic parasites in public spaces.

Background: Cholera remains a persistent public health threat in fragile and conflict affected settings where inadequate water, sanitation, and hygiene infrastructure, population displacement, and climate shocks contribute to recurrent outbreaks. Somalia has experienced cyclical cholera epidemics for decades, yet recent national level analyses of mortality predictors remain limited.

Methods: A retrospective analysis of national cholera surveillance data was conducted using line lists from cholera treatment centers across Somalia for the period January to December 2024. Suspected and confirmed cases were defined according to national guidelines. Demographic, clinical, nutritional, environmental, and laboratory variables were analyzed. Multivariable logistic regression was used to identify factors associated with mortality.

Results: A total of 21,945 suspected cholera cases and 138 deaths were reported, corresponding to a case fatality rate of 0.6%. Children under five years accounted for 42% of cases. In the adjusted analysis, use of river water compared with piped water had an adjusted odds ratio of 2.34 (95% CI: 1.12-4.87). Severe dehydration had an adjusted odds ratio of 5.67 (95% CI: 3.21-10.01), and malnutrition had an adjusted odds ratio of 2.12 (95% CI: 1.17-3.83). Residence in Jubaland compared with Banadir had an adjusted odds ratio of 1.91 (95% CI: 1.05-3.47). Children aged 5-14 years and individuals aged 15-44 years had lower adjusted odds of death compared with children under five years. Laboratory confirmation was limited.

Conclusion: The 2024 cholera outbreak in Somalia was characterized by substantial pediatric burden and marked differences in mortality by water source, nutritional status, dehydration severity, and region. Strengthening water safety, expanding access to timely case management, integrating nutrition services, improving surveillance capacity, and implementing targeted oral cholera vaccination in high-risk areas are critical to reducing cholera mortality and advancing long term control efforts in Somalia.

Background: Indigenous populations in Brazil are highly susceptible to neglected tropical diseases (NTDs) due to socio-economic and environmental factors. Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is a significant NTD with severe health implications. This study aimed to evaluate the seroprevalence of CD among Indigenous communities living in regions with the largest Indigenous populations in Brazil and to analyze their sociodemographic characteristics, housing conditions, comorbidities, and knowledge about CD and its vector.

Methods: Data were collected using structured questionnaires via the REDCap system and analyzed descriptively and univariately. Laboratory diagnosis employed two methodologies: LCA with chimeric T. cruzi recombinant antigens and Gold ELISA Chagas test, with Biolisa Chagas Recombinante used for discordant results.

Results: Among 2,897 individuals, the seroprevalence of CD was 0.07%, with only two positive cases confirmed. The study highlighted low educational attainment, poor housing conditions, and high prevalence of comorbidities such as hypertension and diabetes. A significant knowledge gap about CD and its vector was identified, with 99.5% of participants never having been tested for CD.

Conclusions: These findings underscore the urgent need for tailored public health interventions, enhanced health education, and improved diagnostic strategies to address CD in these vulnerable communities. Further research is needed to explore CD epidemiology and develop effective prevention and control measures for Indigenous populations.

Background: Respiratory syncytial virus (RSV) incidence among adults in Finland remains underreported, mostly due to non-specific RSV symptoms, infrequent standard-of-care testing, and reduced sensitivity of single-specimen nasal/nasopharyngeal RT-PCR testing among adults. We retrospectively estimated RSV-attributable incidence of all-cause respiratory hospitalizations and mortality in adults in Finland between 2011 and 2019.

Methods: We estimated incidence using time-series modeling by comparing the week-to-week variability in RSV diagnosis trends with the week-to-week variability in the events with any respiratory diagnosis. Weekly aggregated data on all-cause respiratory hospitalizations and deaths (J00-J99) were obtained from the Care Register for Health Care (HILMO) and Statistics Finland, respectively. Hospitalization data on RSV and influenza were obtained from HILMO. Data on all-cause respiratory diseases for age groups that showed a seasonal pattern were included in a hierarchical Bayesian model, sharing information across the age groups while accounting for seasonal fluctuations, and RSV and influenza circulation.

Results: The highest annual incidence rates of RSV-attributable respiratory hospitalizations were observed in adults aged ≥ 75 years (range 145-240 hospitalizations per 100,000 person-years), on average 7-fold higher than in adults aged 45-64 years (range 19-37 hospitalizations per 100,000 person-years). A biennial (low-high incidence) fluctuation of all-cause respiratory hospitalization incidence and mortality rate was observed in all age groups. A seasonal pattern for all-cause respiratory deaths was observed only for adults aged ≥ 75 years, who had an estimated RSV-attributable mortality rate of 8-14 deaths per 100,000 person-years. RSV-attributable deaths accounted for 3-5% of all all-cause respiratory deaths in this age group.

Conclusions: Respiratory morbidity and mortality associated with RSV infection among adults in Finland are substantial, particularly for those aged ≥ 75 years. Newly introduced RSV vaccines, which appear effective for the oldest adults, could have a substantial impact on this respiratory disease burden.

Background: Jordan faces significant challenges in cervical cancer prevention due to low screening participation and limited coverage. This study examined the sociodemographic factors associated with cervical cancer screening uptake among ever-married Jordanian women aged 20-49 years using data from the 2023 Jordan Population and Family Health Survey (JPFHS).  METHODS: We analyzed data from the 2023 JPFHS, which initially included 12,595 ever-married women. binary logistic regression analyses were conducted to identify sociodemographic predictors of cervical cancer screening uptake.

Results: A total of 12,405 ever-married women were included in the study. Among them, 2,038 (16.4%) reported having undergone cervical cancer screening through methods such as the Pap smear, human papillomavirus test, or visual inspection with acetic acid, while 10,367 (83.6%) had never been screened. Multivariable analysis revealed that older women, residents of Ajloun governorate, those with higher socioeconomic status, multiparous women, daily smokers, frequent internet users, and women with a history of HIV or sexually transmitted disease testing were more likely to undergo cervical cancer screening. Conversely, screening uptake was significantly lower among women residing in Irbid, Mafraq, Tafiela, and Aqaba governorates.

Conclusion: To improve cervical cancer screening rates, policymakers should prioritize poor and underserved women, particularly younger women who have lower participation rates. Strengthening healthcare infrastructure, especially in the southern governorates, and integrating preventive health education into school curricula are crucial steps toward increasing awareness and early detection. Additionally, primary prevention programs should adopt a more inclusive approach, targeting all population groups including those with healthy lifestyles rather than focusing solely on women with high-risk behaviors.

Concurrent HBV, HCV, and HDV infections pose a global health challenge, worsening disease, treatment, and patient outcomes, and burdening healthcare. In Iran, no comprehensive review has assessed HBV/HCV and HBV/HDV coinfection rates. This study conducted a systematic review and meta-analysis per PRISMA 2020 guidelines. The study was prospectively registered in PROSPERO (CRD420251007210). A comprehensive search was conducted across international (PubMed, Scopus, Embase, Web of Science, Cochrane Library) and Iranian databases (SID, Magiran), supplemented by Google Scholar, for studies published between January 2000 and March 2025. Eligible studies reported laboratory-confirmed cases of HBV, HCV, and/or HDV coinfections using ELISA, PCR, or real-time PCR. Because HDV replication depends on hepatitis B surface antigen (HBsAg), biologically independent HCV/HDV coinfection cannot occur. Consequently, studies that reported HCV/HDV coinfection without HBV were excluded. Two researchers independently conducted screening and data extraction and assessed study quality using the Newcastle-Ottawa Scale (NOS). To account for variability across studies, a random-effects model was used to estimate the pooled prevalence and its 95% confidence interval. Our analysis included 99 studies, encompassing more than 182,000 participants from regions of Iran. The pooled prevalence rates were 3% for HBV/HCV coinfection, 7% for HBV/HDV coinfection, and 1% for triple HBV/HCV/HDV infection. Due to significant heterogeneity across studies, random-effects models were used to obtain combined estimates. Substantial heterogeneity (I² up to 98%) was observed, attributable to variations in study populations, geographic regions, and diagnostic methods, as confirmed by sensitivity analyses and meta-regression. Publication bias was evident in most analyses. Key risk factors included blood transfusions, injection drug use, incarceration, and chronic liver disease. These findings underscore the urgent need for tailored prevention and surveillance programs. The high prevalence of coinfections in Iran, coupled with marked regional and population-based disparities, calls for standardized diagnostic protocols and targeted interventions that address behavioral and healthcare-associated risk factors.