Pub Date : 2024-03-28DOI: 10.1007/s44197-024-00216-6
Michele M Stephenson, Margaret E Coleman, Nicholas A Azzolina
Background: Robust solutions to global, national, and regional burdens of communicable and non-communicable diseases, particularly related to diet, demand interdisciplinary or transdisciplinary collaborations to effectively inform risk analysis and policy decisions.
Objective: U.S. outbreak data for 2005-2020 from all transmission sources were analyzed for trends in the burden of infectious disease and foodborne outbreaks.
Methods: Outbreak data from 58 Microsoft Access® data tables were structured using systematic queries and pivot tables for analysis by transmission source, pathogen, and date. Trends were examined using graphical representations, smoothing splines, Spearman's rho rank correlations, and non-parametric testing for trend. Hazard Identification was conducted based on the number and severity of illnesses.
Results: The evidence does not support increasing trends in the burden of infectious foodborne disease, though strongly increasing trends were observed for other transmission sources. Morbidity and mortality were dominated by person-to-person transmission; foodborne and other transmission sources accounted for small portions of the disease burden. Foods representing the greatest hazards associated with the four major foodborne bacterial diseases were identified. Fatal foodborne disease was dominated by fruits, vegetables, peanut butter, and pasteurized dairy.
Conclusion: The available evidence conflicts with assumptions of zero risk for pasteurized milk and increasing trends in the burden of illness for raw milk. For future evidence-based risk management, transdisciplinary risk analysis methodologies are essential to balance both communicable and non-communicable diseases and both food safety and food security, considering scientific, sustainable, economic, cultural, social, and political factors to support health and wellness for humans and ecosystems.
背景:全球、国家和地区的传染性和非传染性疾病负担,尤其是与饮食有关的疾病负担,需要跨学科或跨学科合作才能有效地为风险分析和政策决策提供信息:对 2005-2020 年美国所有传播源的疫情数据进行分析,以了解传染病和食源性疫情的负担趋势:方法:使用系统查询和数据透视表对 58 个 Microsoft Access® 数据表中的疫情数据进行结构化处理,以便按传播源、病原体和日期进行分析。使用图形表示法、平滑样条、Spearman's rho 等级相关性和非参数趋势测试对趋势进行检验。根据疾病的数量和严重程度进行了危害识别:证据不支持食源性传染病负担呈上升趋势,但观察到其他传染源呈强烈上升趋势。发病率和死亡率以人传人为主;食源性和其他传播源占疾病负担的一小部分。确定了与四种主要食源性细菌疾病相关的危害最大的食物。致命的食源性疾病主要是水果、蔬菜、花生酱和巴氏杀菌乳制品:现有证据与巴氏杀菌奶的零风险假设和生奶的疾病负担增加趋势相冲突。对于未来以证据为基础的风险管理,跨学科风险分析方法对于平衡传染性和非传染性疾病以及食品安全和粮食安全至关重要,同时要考虑科学、可持续、经济、文化、社会和政治因素,以支持人类和生态系统的健康和福祉。
{"title":"Trends in Burdens of Disease by Transmission Source (USA, 2005-2020) and Hazard Identification for Foods: Focus on Milkborne Disease.","authors":"Michele M Stephenson, Margaret E Coleman, Nicholas A Azzolina","doi":"10.1007/s44197-024-00216-6","DOIUrl":"https://doi.org/10.1007/s44197-024-00216-6","url":null,"abstract":"<p><strong>Background: </strong>Robust solutions to global, national, and regional burdens of communicable and non-communicable diseases, particularly related to diet, demand interdisciplinary or transdisciplinary collaborations to effectively inform risk analysis and policy decisions.</p><p><strong>Objective: </strong>U.S. outbreak data for 2005-2020 from all transmission sources were analyzed for trends in the burden of infectious disease and foodborne outbreaks.</p><p><strong>Methods: </strong>Outbreak data from 58 Microsoft Access<sup>®</sup> data tables were structured using systematic queries and pivot tables for analysis by transmission source, pathogen, and date. Trends were examined using graphical representations, smoothing splines, Spearman's rho rank correlations, and non-parametric testing for trend. Hazard Identification was conducted based on the number and severity of illnesses.</p><p><strong>Results: </strong>The evidence does not support increasing trends in the burden of infectious foodborne disease, though strongly increasing trends were observed for other transmission sources. Morbidity and mortality were dominated by person-to-person transmission; foodborne and other transmission sources accounted for small portions of the disease burden. Foods representing the greatest hazards associated with the four major foodborne bacterial diseases were identified. Fatal foodborne disease was dominated by fruits, vegetables, peanut butter, and pasteurized dairy.</p><p><strong>Conclusion: </strong>The available evidence conflicts with assumptions of zero risk for pasteurized milk and increasing trends in the burden of illness for raw milk. For future evidence-based risk management, transdisciplinary risk analysis methodologies are essential to balance both communicable and non-communicable diseases and both food safety and food security, considering scientific, sustainable, economic, cultural, social, and political factors to support health and wellness for humans and ecosystems.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.1007/s44197-024-00220-w
Camila A Picchio, Aina Nicolàs, Ironne Valdèse Ayemfouo Fofou, Viola Kasone, Magellan Guewo-Fokeng, Claude T Tagny, Teddy Nanyonjo, Hellen Nansumba, Yves Nacel Kouongni, Rita Gaëlle Epse Sezawo Kamdjeu, Emmanuel Seremba, Charles Kouanfack, Isaac Ssewanyana, Richard Njouom, Ariadna Rando Segura, Francisco Rodríguez-Frías, Jean Claude Mbanya, Ponsiano Ocama, Jeffrey V Lazarus
Background: Sub-Saharan African countries have a high burden of viral hepatitis and poor access to screening and care. The aim of this study was to evaluate the feasibility and acceptability of using the plasma separation card (PSC) for viral hepatitis B and C screening among people living with HIV (PLHIV) in Cameroon and Uganda.
Methods: This is a cross-sectional study carried out between 05/2021 and 03/2023 including 192 PLHIV in Cameroon (n = 104) and Uganda (n = 88). Basic sociodemographic variables and whole blood samples were collected. Adequate filling with blood of PSCs was used to determine feasibility together with participant responses to questions on acceptability. A logistic regression model was carried out to assess the relationship between PSC acceptability and factors of interest.
Results: 70% of participants reported PSC as an acceptable viral hepatitis screening tool, and it was significantly more accepted in Uganda than Cameroon (100% vs. 43.2%, p < 0.001). Similarly, 75% of PSCs had at least one spot sample filled and were viable for analysis, 99% were correctly filled in Uganda and 53.4% in Cameroon. Reported ease of method performance (aOR: 24.77 95% CI 2.97-206.42, p = 0.003) and reduced collection time (aOR: 3.73 95% CI 1.26-11.04, p = 0.017) were associated with greater odds of PSC acceptance. HBsAg + and anti-HCV + prevalence were 11.1% and 1.0%, respectively.
Conclusions: In spite of country differences, overall, the PSC was reported as a feasible and acceptable viral hepatitis testing method. Acceptability and feasibility of the method must be explored in heterogeneous target communities and qualitative research to better understand country-specific barriers and facilitators should be carried out.
{"title":"Acceptability and Feasibility of the Plasma Separation Card for an Integrated Model of Care for HBV and HCV Screening Among People Attending HIV Clinics in Cameroon and Uganda.","authors":"Camila A Picchio, Aina Nicolàs, Ironne Valdèse Ayemfouo Fofou, Viola Kasone, Magellan Guewo-Fokeng, Claude T Tagny, Teddy Nanyonjo, Hellen Nansumba, Yves Nacel Kouongni, Rita Gaëlle Epse Sezawo Kamdjeu, Emmanuel Seremba, Charles Kouanfack, Isaac Ssewanyana, Richard Njouom, Ariadna Rando Segura, Francisco Rodríguez-Frías, Jean Claude Mbanya, Ponsiano Ocama, Jeffrey V Lazarus","doi":"10.1007/s44197-024-00220-w","DOIUrl":"https://doi.org/10.1007/s44197-024-00220-w","url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan African countries have a high burden of viral hepatitis and poor access to screening and care. The aim of this study was to evaluate the feasibility and acceptability of using the plasma separation card (PSC) for viral hepatitis B and C screening among people living with HIV (PLHIV) in Cameroon and Uganda.</p><p><strong>Methods: </strong>This is a cross-sectional study carried out between 05/2021 and 03/2023 including 192 PLHIV in Cameroon (n = 104) and Uganda (n = 88). Basic sociodemographic variables and whole blood samples were collected. Adequate filling with blood of PSCs was used to determine feasibility together with participant responses to questions on acceptability. A logistic regression model was carried out to assess the relationship between PSC acceptability and factors of interest.</p><p><strong>Results: </strong>70% of participants reported PSC as an acceptable viral hepatitis screening tool, and it was significantly more accepted in Uganda than Cameroon (100% vs. 43.2%, p < 0.001). Similarly, 75% of PSCs had at least one spot sample filled and were viable for analysis, 99% were correctly filled in Uganda and 53.4% in Cameroon. Reported ease of method performance (aOR: 24.77 95% CI 2.97-206.42, p = 0.003) and reduced collection time (aOR: 3.73 95% CI 1.26-11.04, p = 0.017) were associated with greater odds of PSC acceptance. HBsAg + and anti-HCV + prevalence were 11.1% and 1.0%, respectively.</p><p><strong>Conclusions: </strong>In spite of country differences, overall, the PSC was reported as a feasible and acceptable viral hepatitis testing method. Acceptability and feasibility of the method must be explored in heterogeneous target communities and qualitative research to better understand country-specific barriers and facilitators should be carried out.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.1007/s44197-024-00210-y
Jesse D Contreras, Mahfuza Islam, Andrew Mertens, Amy J Pickering, Benjamin F Arnold, Jade Benjamin-Chung, Alan E Hubbard, Mahbubur Rahman, Leanne Unicomb, Stephen P Luby, John M Colford, Ayse Ercumen
Background: The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.
Methods: We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator.
Results: The intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3-8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3-8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5-2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways.
Discussion: The effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions.
{"title":"Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.","authors":"Jesse D Contreras, Mahfuza Islam, Andrew Mertens, Amy J Pickering, Benjamin F Arnold, Jade Benjamin-Chung, Alan E Hubbard, Mahbubur Rahman, Leanne Unicomb, Stephen P Luby, John M Colford, Ayse Ercumen","doi":"10.1007/s44197-024-00210-y","DOIUrl":"10.1007/s44197-024-00210-y","url":null,"abstract":"<p><strong>Background: </strong>The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.</p><p><strong>Methods: </strong>We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator.</p><p><strong>Results: </strong>The intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3-8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3-8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5-2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways.</p><p><strong>Discussion: </strong>The effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-14DOI: 10.1007/s44197-024-00217-5
Naif Alrashdi, Mansour Alotaibi, Moqfa Alharthi, Faizan Kashoo, Sultan Alanazi, Ahmad Alanazi, Msaad Alzhrani, Thamer Alhussainan, Rami Alanazi, Rakan Almutairi, Matthew Ithurburn
Background: Developmental dysplasia of the hip (DDH) leads to pain, joint instability, and early degenerative joint disease. Incidence, prevalence, and management strategies of DDH have been well-documented in several countries, but not in Saudi Arabia.
Objective: We synthesized the current evidence regarding incidence, prevalence, risk factors, and clinical treatment for children with DDH in Saudi Arabia.
Methods: We searched 3 databases to locate studies. Studies that included children with DDH in Saudi Arabia; reported either incidence rate, prevalence, risk factors, and/or clinical practice; and were available in English or Arabic were included. We excluded reviews, case studies, or animal studies. Two independent authors reviewed potential studies and assessed study's quality.
Results: Our search yielded 67 potential studies, of which 16 studies were included (total DDH sample = 3,127; age range = 2.5 to 86.4 months). Three studies reported incidence rates ranging from 3.1 to 4.9 per 1000 births, and 3 studies reported prevalence ranging from 6 to 78%. Nine studies reported that female sex, breech position, family history, and age less than 3 years were risk factors associated with DDH. Four studies reported that brace applications and closed reduction were conservative treatments, and 9 studies reported that open hip reduction, adductor tenotomy, and/or pelvic osteotomy were surgical approaches to treat DDH.
Conclusions: In Saudi Arabia, the Incidence and prevalence rates of DDH are 3.1 to 4.9 per 1,000 births, and 6-78%, respectively (differ from what has been reported in other countries), but the risk factors of DDH in Saudi Arabia appear to be similar in comparison to other countries (female, breech presentation, family history of DDH).
{"title":"Incidence, Prevalence, Risk Factors, and Clinical Treatment for Children with Developmental Dysplasia of the Hip in Saudi Arabia. A Systematic Review.","authors":"Naif Alrashdi, Mansour Alotaibi, Moqfa Alharthi, Faizan Kashoo, Sultan Alanazi, Ahmad Alanazi, Msaad Alzhrani, Thamer Alhussainan, Rami Alanazi, Rakan Almutairi, Matthew Ithurburn","doi":"10.1007/s44197-024-00217-5","DOIUrl":"10.1007/s44197-024-00217-5","url":null,"abstract":"<p><strong>Background: </strong>Developmental dysplasia of the hip (DDH) leads to pain, joint instability, and early degenerative joint disease. Incidence, prevalence, and management strategies of DDH have been well-documented in several countries, but not in Saudi Arabia.</p><p><strong>Objective: </strong>We synthesized the current evidence regarding incidence, prevalence, risk factors, and clinical treatment for children with DDH in Saudi Arabia.</p><p><strong>Methods: </strong>We searched 3 databases to locate studies. Studies that included children with DDH in Saudi Arabia; reported either incidence rate, prevalence, risk factors, and/or clinical practice; and were available in English or Arabic were included. We excluded reviews, case studies, or animal studies. Two independent authors reviewed potential studies and assessed study's quality.</p><p><strong>Results: </strong>Our search yielded 67 potential studies, of which 16 studies were included (total DDH sample = 3,127; age range = 2.5 to 86.4 months). Three studies reported incidence rates ranging from 3.1 to 4.9 per 1000 births, and 3 studies reported prevalence ranging from 6 to 78%. Nine studies reported that female sex, breech position, family history, and age less than 3 years were risk factors associated with DDH. Four studies reported that brace applications and closed reduction were conservative treatments, and 9 studies reported that open hip reduction, adductor tenotomy, and/or pelvic osteotomy were surgical approaches to treat DDH.</p><p><strong>Conclusions: </strong>In Saudi Arabia, the Incidence and prevalence rates of DDH are 3.1 to 4.9 per 1,000 births, and 6-78%, respectively (differ from what has been reported in other countries), but the risk factors of DDH in Saudi Arabia appear to be similar in comparison to other countries (female, breech presentation, family history of DDH).</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-13DOI: 10.1007/s44197-024-00214-8
Yossef Alnasser, Alvaro Proaño, Christine Loock, John Chuo, Robert H Gilman
Objectives: Caring for children in low- and middle-income countries (LMIC) can be challenging. This review article aims to explore role of telemedicine in supporting pediatric care in LMIC.
Methodology: A narrative review of existing English and Spanish literature was conducted to assess role of telemedicine to support pediatric care in LMIC.
Results: Beside medical education and direct pediatric care, telemedicine can provide sub-specialties consultations without extra burden on families. Additionally, telemedicine can help in lowering under-5 mortality by supporting neonatal care, infectious illnesses, and non-communicable diseases (NCDs). Telemedicine can be a gate for universal coverage for all children at a lower cost. For over a decade, it has been implemented successfully and sustained in a few LMIC. However, challenges in implementing telemedicine are enormous. Still, opportunities arise by using simpler technology, low-width band internet, smartphones, instant messaging applications and solar energy. COVID-19 pandemic facilitated acceptance and applicability of telemedicine worldwide including LMIC. Nevertheless, governments must regulate telemedicine by issuing policies and ensuring employment of local experts when possible to meet local resources and cultural competency.
Conclusion: Telemedicine has proven successful in improving pediatrics care. Many LMIC should take advantage of this innovation to promote equity and access to high quality pediatric care.
{"title":"Telemedicine and Pediatric Care in Rural and Remote Areas of Middle-and-Low-Income Countries: Narrative Review.","authors":"Yossef Alnasser, Alvaro Proaño, Christine Loock, John Chuo, Robert H Gilman","doi":"10.1007/s44197-024-00214-8","DOIUrl":"https://doi.org/10.1007/s44197-024-00214-8","url":null,"abstract":"<p><strong>Objectives: </strong>Caring for children in low- and middle-income countries (LMIC) can be challenging. This review article aims to explore role of telemedicine in supporting pediatric care in LMIC.</p><p><strong>Methodology: </strong>A narrative review of existing English and Spanish literature was conducted to assess role of telemedicine to support pediatric care in LMIC.</p><p><strong>Results: </strong>Beside medical education and direct pediatric care, telemedicine can provide sub-specialties consultations without extra burden on families. Additionally, telemedicine can help in lowering under-5 mortality by supporting neonatal care, infectious illnesses, and non-communicable diseases (NCDs). Telemedicine can be a gate for universal coverage for all children at a lower cost. For over a decade, it has been implemented successfully and sustained in a few LMIC. However, challenges in implementing telemedicine are enormous. Still, opportunities arise by using simpler technology, low-width band internet, smartphones, instant messaging applications and solar energy. COVID-19 pandemic facilitated acceptance and applicability of telemedicine worldwide including LMIC. Nevertheless, governments must regulate telemedicine by issuing policies and ensuring employment of local experts when possible to meet local resources and cultural competency.</p><p><strong>Conclusion: </strong>Telemedicine has proven successful in improving pediatrics care. Many LMIC should take advantage of this innovation to promote equity and access to high quality pediatric care.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic condition characterized by progressive, partially reversible airflow obstruction. Osteoporosis represents a significant comorbidity in individuals with COPD. However, the incidence and prevalence of osteoporosis among the COPD population remain unclear in Taiwan. Therefore, our objective is to investigate the incidence and prevalence of osteoporosis in patients with COPD.
Methods: In this cross-sectional study, we enrolled a COPD population retrieved from the Taiwan National Health Insurance Research Database (NHIRD) spanning the years 2003 to 2016. Osteoporosis patients were identified using diagnosis codes. The study included newly diagnosed COPD patients from 2003 to 2016. The case group comprised patients who developed osteoporosis or osteoporotic fractures after their COPD diagnosis. We calculated the prevalence and incidence of osteoporosis in individuals with COPD and conducted trend tests.
Results: A total of 1,297,579 COPD patients were identified during the period from 2003 to 2016, with 275,233 of them in the osteoporosis group. The average prevalence of osteoporosis among individuals with COPD was 21.21% from 2003 to 2016 in Taiwan. The number of osteoporosis cases increased from 6,727 in 2003 to 24,184 in 2016. The prevalence of osteoporosis among COPD patients increased from 3.62% in 2003 to 18.72% in 2016. The number of osteoporosis cases among individuals with COPD continued to rise over the years, reaching its highest point in 2016 with 24,184 new cases. The incidence of osteoporosis fluctuated during the study period but generally remained around 3,000 cases per 100,000 person-years. Notably, there was a significant upward trend in incidence from 2003 to 2006, after which the trend stabilized and remained relatively constant.
Conclusions: Our study highlights an increase in both the prevalence and incidence of osteoporosis in individuals with COPD. Given the significant medical, economic, and social implications associated with osteoporosis, a comprehensive and robust assessment of its healthcare burden can offer valuable insights for healthcare system planning and policymaking.
{"title":"Epidemiology of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease in Taiwan.","authors":"Kuang-Ming Liao, Chuan-Wei Shen, Kai-Lin Chiu, Chun-Hui Lu, Chih-Wun Fang, Chung-Yu Chen","doi":"10.1007/s44197-023-00183-4","DOIUrl":"10.1007/s44197-023-00183-4","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic condition characterized by progressive, partially reversible airflow obstruction. Osteoporosis represents a significant comorbidity in individuals with COPD. However, the incidence and prevalence of osteoporosis among the COPD population remain unclear in Taiwan. Therefore, our objective is to investigate the incidence and prevalence of osteoporosis in patients with COPD.</p><p><strong>Methods: </strong>In this cross-sectional study, we enrolled a COPD population retrieved from the Taiwan National Health Insurance Research Database (NHIRD) spanning the years 2003 to 2016. Osteoporosis patients were identified using diagnosis codes. The study included newly diagnosed COPD patients from 2003 to 2016. The case group comprised patients who developed osteoporosis or osteoporotic fractures after their COPD diagnosis. We calculated the prevalence and incidence of osteoporosis in individuals with COPD and conducted trend tests.</p><p><strong>Results: </strong>A total of 1,297,579 COPD patients were identified during the period from 2003 to 2016, with 275,233 of them in the osteoporosis group. The average prevalence of osteoporosis among individuals with COPD was 21.21% from 2003 to 2016 in Taiwan. The number of osteoporosis cases increased from 6,727 in 2003 to 24,184 in 2016. The prevalence of osteoporosis among COPD patients increased from 3.62% in 2003 to 18.72% in 2016. The number of osteoporosis cases among individuals with COPD continued to rise over the years, reaching its highest point in 2016 with 24,184 new cases. The incidence of osteoporosis fluctuated during the study period but generally remained around 3,000 cases per 100,000 person-years. Notably, there was a significant upward trend in incidence from 2003 to 2006, after which the trend stabilized and remained relatively constant.</p><p><strong>Conclusions: </strong>Our study highlights an increase in both the prevalence and incidence of osteoporosis in individuals with COPD. Given the significant medical, economic, and social implications associated with osteoporosis, a comprehensive and robust assessment of its healthcare burden can offer valuable insights for healthcare system planning and policymaking.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cholera continues to severely threaten public health, particularly in regions with inadequate access to clean water and sanitation. Zimbabwe, a southern African nation, has witnessed recurrent cholera outbreaks, highlighting the enduring vulnerabilities faced by communities grappling with these underlying challenges. The 2023 cholera outbreak in Chegutu resulted in a devastating impact, with approximately 100 reported deaths and nearly 5000 confirmed and suspected cases. Beyond its immediate health consequences, the outbreak has strained the already fragile healthcare system, exacerbated issues of malnutrition, and disrupted education, particularly affecting vulnerable populations. The Zimbabwean government, non-governmental organisations (NGOs), and international agencies have initiated comprehensive efforts to combat the outbreak, encompassing medical treatment, surveillance, public health measures, infrastructure improvement, and community empowerment. Policy recommendations and future directions are discussed, emphasising risk communication, stakeholder engagement, standardisation, evaluation, resource allocation, and capacity-building to bolster prevention and control measures.
{"title":"A Perspective on the 2023 Cholera Outbreaks in Zimbabwe: Implications, Response Strategies, and Policy Recommendations.","authors":"Gbolahan Olatunji, Emmanuel Kokori, Abdulrahmon Moradeyo, Doyin Olatunji, Folake Ajibola, Oluwaseun Otolorin, Nicholas Aderinto","doi":"10.1007/s44197-023-00165-6","DOIUrl":"10.1007/s44197-023-00165-6","url":null,"abstract":"<p><p>Cholera continues to severely threaten public health, particularly in regions with inadequate access to clean water and sanitation. Zimbabwe, a southern African nation, has witnessed recurrent cholera outbreaks, highlighting the enduring vulnerabilities faced by communities grappling with these underlying challenges. The 2023 cholera outbreak in Chegutu resulted in a devastating impact, with approximately 100 reported deaths and nearly 5000 confirmed and suspected cases. Beyond its immediate health consequences, the outbreak has strained the already fragile healthcare system, exacerbated issues of malnutrition, and disrupted education, particularly affecting vulnerable populations. The Zimbabwean government, non-governmental organisations (NGOs), and international agencies have initiated comprehensive efforts to combat the outbreak, encompassing medical treatment, surveillance, public health measures, infrastructure improvement, and community empowerment. Policy recommendations and future directions are discussed, emphasising risk communication, stakeholder engagement, standardisation, evaluation, resource allocation, and capacity-building to bolster prevention and control measures.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-01-11DOI: 10.1007/s44197-023-00169-2
Amal A Alhaidary, Ahmad R Al-Qudimat, Haitham Arabi, Raed M Al-Zoubi
Background and aim: Breast cancer is the most frequently occurring malignant disease in women and remains the leading cause of cancer-related deaths among females worldwide. The aim of this study is to evaluate the imaging findings of breast cancer in women under the age of 40 and analyze their pathological patterns.
Method: A retrospective study was conducted from 2013 to 2019, involving 120 patients below 40 years of age with pathologically confirmed primary epithelial breast cancers. The data were collected from the electronic records of a tertiary hospital in Riyadh, Saudi Arabia. Mammograms were performed for 115 patients, ultrasounds were conducted for all patients, and MRI scans were carried out for 47 patients.
Results: All radiological findings and clinical characteristics of the 120 cases were retrieved from our digital-based system. The majority of breast cancer patients (83.4%) were between 30 and 40 years old, and the most common clinical presentation was a mass (45.8%). Out of the 73 patients who underwent genetic tests, 32.9% tested positive for gene mutations. No statistically significant correlation was found between specific age groups and breast composition (P = 0.216), specific mammogram abnormalities such as masses (P = 0.262), or microcalcifications (P = 0.421). Ultrasonography was performed for all patients, with abnormalities detected in only one patient who was diagnosed with Paget's disease of the nipple. Masses, with or without parenchymal changes, were the predominant feature in 88.3% of cases.
Conclusion: The imaging findings in breast cancer cases typically involve masses with suspicious features, irregular shape, and spiculated margins on mammograms, and irregular shape with microlobulated or angular margins on ultrasound. MRI features commonly include masses with irregular shape and heterogeneous enhancement. The luminal B subtype was identified as the most prevalent pathological feature, characterized by a high proliferative index (Ki-67%).
{"title":"Imaging Patterns in Breast Cancer for Women Under 40 Years: A Descriptive Cohort Study.","authors":"Amal A Alhaidary, Ahmad R Al-Qudimat, Haitham Arabi, Raed M Al-Zoubi","doi":"10.1007/s44197-023-00169-2","DOIUrl":"10.1007/s44197-023-00169-2","url":null,"abstract":"<p><strong>Background and aim: </strong>Breast cancer is the most frequently occurring malignant disease in women and remains the leading cause of cancer-related deaths among females worldwide. The aim of this study is to evaluate the imaging findings of breast cancer in women under the age of 40 and analyze their pathological patterns.</p><p><strong>Method: </strong>A retrospective study was conducted from 2013 to 2019, involving 120 patients below 40 years of age with pathologically confirmed primary epithelial breast cancers. The data were collected from the electronic records of a tertiary hospital in Riyadh, Saudi Arabia. Mammograms were performed for 115 patients, ultrasounds were conducted for all patients, and MRI scans were carried out for 47 patients.</p><p><strong>Results: </strong>All radiological findings and clinical characteristics of the 120 cases were retrieved from our digital-based system. The majority of breast cancer patients (83.4%) were between 30 and 40 years old, and the most common clinical presentation was a mass (45.8%). Out of the 73 patients who underwent genetic tests, 32.9% tested positive for gene mutations. No statistically significant correlation was found between specific age groups and breast composition (P = 0.216), specific mammogram abnormalities such as masses (P = 0.262), or microcalcifications (P = 0.421). Ultrasonography was performed for all patients, with abnormalities detected in only one patient who was diagnosed with Paget's disease of the nipple. Masses, with or without parenchymal changes, were the predominant feature in 88.3% of cases.</p><p><strong>Conclusion: </strong>The imaging findings in breast cancer cases typically involve masses with suspicious features, irregular shape, and spiculated margins on mammograms, and irregular shape with microlobulated or angular margins on ultrasound. MRI features commonly include masses with irregular shape and heterogeneous enhancement. The luminal B subtype was identified as the most prevalent pathological feature, characterized by a high proliferative index (Ki-67%).</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-02-01DOI: 10.1007/s44197-024-00188-7
Ying Liu
The prevention and treatment of leprosy is a public health and social issue of global concern. China has become the first country in the world to put forward a proposal on the elimination of the harm caused by leprosy. This paper briefly introduces the status of the spread of leprosy in China, and systematically reviews the evolution of policies and measures at different stages of the disease in China, from the serious epidemic of leprosy to the control of the infection, to the basic elimination, and to the elimination of the hazards. On this basis, five main lessons learned from the control and elimination of leprosy in China were also summarized. These provide the basis for promoting the complete global elimination of leprosy and preventing its re-transmission, thereby benefiting all those who still suffer from the scourge of leprosy.
{"title":"Policy Evolution and Lessons Learned from China's Efforts to Eliminate Leprosy.","authors":"Ying Liu","doi":"10.1007/s44197-024-00188-7","DOIUrl":"10.1007/s44197-024-00188-7","url":null,"abstract":"<p><p>The prevention and treatment of leprosy is a public health and social issue of global concern. China has become the first country in the world to put forward a proposal on the elimination of the harm caused by leprosy. This paper briefly introduces the status of the spread of leprosy in China, and systematically reviews the evolution of policies and measures at different stages of the disease in China, from the serious epidemic of leprosy to the control of the infection, to the basic elimination, and to the elimination of the hazards. On this basis, five main lessons learned from the control and elimination of leprosy in China were also summarized. These provide the basis for promoting the complete global elimination of leprosy and preventing its re-transmission, thereby benefiting all those who still suffer from the scourge of leprosy.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-02-05DOI: 10.1007/s44197-023-00185-2
Kurubaran Ganasegeran, Mohd Rizal Abdul Manaf, Nazarudin Safian, Lance A Waller, Feisul Idzwan Mustapha, Khairul Nizam Abdul Maulud, Muhammad Faid Mohd Rizal
Accurate assessments of epidemiological associations between health outcomes and routinely observed proximal and distal determinants of health are fundamental for the execution of effective public health interventions and policies. Methods to couple big public health data with modern statistical techniques offer greater granularity for describing and understanding data quality, disease distributions, and potential predictive connections between population-level indicators with areal-based health outcomes. This study applied clustering techniques to explore patterns of diabetes burden correlated with local socio-economic inequalities in Malaysia, with a goal of better understanding the factors influencing the collation of these clusters. Through multi-modal secondary data sources, district-wise diabetes crude rates from 271,553 individuals with diabetes sampled from 914 primary care clinics throughout Malaysia were computed. Unsupervised machine learning methods using hierarchical clustering to a set of 144 administrative districts was applied. Differences in characteristics of the areas were evaluated using multivariate non-parametric test statistics. Five statistically significant clusters were identified, each reflecting different levels of diabetes burden at the local level, each with contrasting patterns observed under the influence of population-level characteristics. The hierarchical clustering analysis that grouped local diabetes areas with varying socio-economic, demographic, and geographic characteristics offer opportunities to local public health to implement targeted interventions in an attempt to control the local diabetes burden.
{"title":"How Socio-economic Inequalities Cluster People with Diabetes in Malaysia: Geographic Evaluation of Area Disparities Using a Non-parameterized Unsupervised Learning Method.","authors":"Kurubaran Ganasegeran, Mohd Rizal Abdul Manaf, Nazarudin Safian, Lance A Waller, Feisul Idzwan Mustapha, Khairul Nizam Abdul Maulud, Muhammad Faid Mohd Rizal","doi":"10.1007/s44197-023-00185-2","DOIUrl":"10.1007/s44197-023-00185-2","url":null,"abstract":"<p><p>Accurate assessments of epidemiological associations between health outcomes and routinely observed proximal and distal determinants of health are fundamental for the execution of effective public health interventions and policies. Methods to couple big public health data with modern statistical techniques offer greater granularity for describing and understanding data quality, disease distributions, and potential predictive connections between population-level indicators with areal-based health outcomes. This study applied clustering techniques to explore patterns of diabetes burden correlated with local socio-economic inequalities in Malaysia, with a goal of better understanding the factors influencing the collation of these clusters. Through multi-modal secondary data sources, district-wise diabetes crude rates from 271,553 individuals with diabetes sampled from 914 primary care clinics throughout Malaysia were computed. Unsupervised machine learning methods using hierarchical clustering to a set of 144 administrative districts was applied. Differences in characteristics of the areas were evaluated using multivariate non-parametric test statistics. Five statistically significant clusters were identified, each reflecting different levels of diabetes burden at the local level, each with contrasting patterns observed under the influence of population-level characteristics. The hierarchical clustering analysis that grouped local diabetes areas with varying socio-economic, demographic, and geographic characteristics offer opportunities to local public health to implement targeted interventions in an attempt to control the local diabetes burden.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}