Journal of Epidemiology and Global Health最新文献

Perceptions of healthcare personnel and institutions substantially impact healthcare behaviors. In the US, minority experiences with racist events like the Tuskegee study, alongside everyday experiences of marginalization and discrimination, drive medical mistrust in populations that are already burdened with health inequalities. However, the concept of medical mistrust is rarely applied outside of industrialized contexts. Histories of colonialism, underfunded healthcare institutions, and the enormous cultural and ethnolinguistic diversity present in low- and middle-income countries (LMICs) make medical mistrust a likely contributor to health behavior in these contexts. In the era of COVID-19 and emergent malaria vaccines, there is an urgent need to mitigate factors leading to medical mistrust, which impedes interest in novel vaccines. Doing so requires substantial investment in research that examines the causes of medical mistrust across diverse communities, develops methodological tools that can effectively measure medical mistrust across diverse cultural and ethno-linguistic contexts, and applies this data to policy and public health messaging. This commentary highlights the role of medical mistrust in vaccination and argues for its utility in addressing vaccine decision-making in LMICs.

An effective disease surveillance system can detect outbreaks of emerging zoonotic diseases early and allow the system to respond immediately and control the epidemic. Gujarat is a western Indian state with a population of more than 65 million humans and 26 million livestock, and it has the respective surveillance systems under the Department of Health & Family Welfare for humans and the Department of Animal Husbandry for animals. A veterinarian is placed on establishing cross-sectoral collaborations between these systems, but the joint collaborative activities and their effect on the early warning response are least understood. This provides an opportunity to conduct a secondary policy content analysis study using the One Health Surveillance Matrix (OHSM). The aim of this study was to evaluate the level of collaboration among human-animal disease surveillance systems for zoonotic disease in Gujarat, India. This study findings highlight a few gaps in the human health surveillance system, such as data sharing, sampling, outreach to decision-makers, and external communication, while the animal health surveillance system exhibits deficiencies in the data dissemination to decision-makers, management and storage of data analysis, interpretation of data, and external communication as per the OHSM evaluation. Despite major differences, there is a possibility of developing the One Health Surveillance system in Gujarat, India which is profoundly documented in this study.

At the end of 2022 and in the following months, an increase in the incidence of Streptococcus pyogenes infections was observed in many European countries that was simultaneously accompanying to enhance of invasive infections (iGAS). We have showed a risen trend of S. pyogenes infections among preschoolers after the pandemic event. A thorough epidemiological investigation of both paediatric and adult samples positive for S. pyogenes indicate a more complex scenario leading to need of important improvement in surveillance programs.

Introduction: Diarrhoeagenic Escherichia coli (DEC) persistently challenges public health in Africa, contributing substantially to the diarrhoeal disease burden. This systematic review and meta-analysis illuminate the distribution and antimicrobial resistance (AMR) patterns of DEC pathotypes across the continent.

Methods: The review selectively focused on pathotype-specific studies reporting prevalence and/or AMR of human-derived DEC pathotypes from African nations, excluding data from extra-intestinal, animal, and environmental sources and studies focused on drug and mechanism experiments. Pertinent studies were retrieved from SCOPUS, PubMed, and EBSCOhost, processed with Covidence, and screened in alignment with PRISMA guidelines.

Results: The reviewed studies were predominantly hospital-based (80%) and paediatric-focused (91%), with a meagre 4.4% documenting DEC outbreaks. Seven DEC pathotypes were discerned, with Enteroaggregative E. coli (EAEC) being notably prevalent (43%, 95% CI 30-55%) and Enteroinvasive E. coli (EIEC) least prevalent (24%, 95% CI 17-32%). Identified non-susceptibilities were noted against essential antibiotics including ciprofloxacin, ceftriaxone, and ampicillin, while instances of carbapenem and Extended-Spectrum ß-Lactamase (ESBL) resistance were scarce.

Conclusion: Despite sporadic data on DEC prevalence and AMR in Africa, particularly in community settings, a palpable gap remains in real-time outbreak surveillance and comprehensive data documentation. Augmenting surveillance and embracing advancements in molecular/genomic characterisation techniques are crucial to precisely discerning DEC's actual impact and resistance continuum in Africa.

Background: Managing postoperative setting, regarding pain and anxiety after cesarean delivery is crucial for the mother's recovery, her emotional well-being, mother-infant bonding and initiating breastfeeding. Although some research have suggested that aromatherapy with lavender essential oil can be effective in reducing pain and anxiety in various medical settings, the efficacy of lavender aromatherapy in the postoperative setting after cesarean delivery is less well-studied. We aimed to assess the effectiveness of lavender essential oil therapy in the management of pain and anxiety after cesarean delivery.

Methods: This was a monocentric randomized controlled double-blind trial conducted over a period of five months during 2023. A hundred women undergoing c-sections under spinal anesthesia were enrolled and randomly assigned; using block randomization of 4 items per block with allocation ratio 1:1, into two groups: The aromatherapy group (receiving inhaled Lavender essential oil) versus the placebo group (receiving distilled water instead). The primary outcomes were pain (at rest and after mobilization) and anxiety levels and after the intervention. This trial was registered on clinical-trials.org (NCT06387849).

Results: A total of 100 women were included (50 women in each group aromatherapy and the placebo group). The two groups were comparable regarding baseline characteristics and pre-intervention parameters with no statistically significant difference. After the intervention, the pain at rest (38,76 ± 22,9 vs. 23,84 ± 18,01; p < 0.001), the pain after mobilization (60,28 ± 23,72 vs. 40,12 ± 22,18; p < 0.001), and degree of anxiety (46,76 ± 6,59 vs. 44,3 ± 5,17; p = 0.03) were all significantly lower in the aromatherapy group. No adverse effects were reported by participants in both groups.

Conclusion: Aromatherapy using Lavender essential oil is effective in reducing pain and anxiety after cesarean delivery without adverse effects.

Objective: The anti-COVID vaccination campaign has led to a significant increase in the demand for allergology consultations in patients considered at risk of reaction to anti-COVID-19 vaccines. This study aims to describe the experience of the vaccination campaign held in Piedmont (Italy) which developed a new service of Allergy Call Center (ACC) thus providing for the screening and management of allergy high-risk patients during pandemic.

Study design: A retrospective analysis was performed on all patients considered at high risk for the development of allergic reactions who were referred by the Immunology and Allergy Unit of Azienda Ospedaliera Ordine Mauriziano in Turin, Italy, between December 2020 and December 2022 and also on ACC consultations.

Methods: During the COVID-19 pandemic, Piedmont Region instituted the ACC, active from May 10th, 2021 to December 31st 2022, to allow vaccinating doctors to require a telephonic consultation for patients who were considered at high risk for the development of allergic reactions. If further diagnostic evaluations were required, the ACC scheduled a visit with a Consultant of the Unit to better assess the clinical situation of the patient. Furthermore, patients referred by General Practitioners, Occupational Doctors and other consultants were also evaluated by the Unit when required.

Results: During the operational period the ACC received a total of 15,865 calls and referred only 336 patients to the unit (27.4% of the total referrals), while General Practitioners referred 499 patients (40.8%), Occupational Doctors referred 61 patients (4.9%), and other consultants referred 326 patients (26.6%).

Conclusions: Evaluation and management of a large volume of requests seemed to be facilitated by a proactive framework for screening patients at high risk for allergic reactions as the ones referred by our ACC. This approach led to a prominent decrease in allergological visits to our tertiary care Centre, reducing the waiting times and providing additional support for both patients and healthcare providers, thus allowing the vaccinations to be more easily handled.

Background: Peripheral artery disease (PAD) is a global health concern associated with arterial narrowing or blockage, leading to significant morbidity and mortality. The aim of this study is to assess the disease burden and trends in mortality utilizing nationwide administrative health data.

Methods: This retrospective study utilized data from the Unified National Electronic Healthcare System (UNEHS) from 2014 to 2021. Patients meeting PAD criteria were included, with demographic and clinical data analyzed. Cox regression and Competing Risk Analysis assessed mortality risks.

Results: Between 2014 and 2021, 19,507 individuals were hospitalized due to PAD, with 8,332 (43%) being women and 11,175 (57%) men. The incidence of PAD increased markedly over the observation period, rising from 79 individuals per million population (PMP) in 2014 to 309 PMP in 2021. Concurrent heart failure (HF), acute myocardial infarction (AMI), diabetes, and essential hypertension were prevalent in 50%, 27%, 27%, and 26% of the PAD patients, respectively. Competing Risk Analysis showed a subdistribution hazard ratio (SHR) of 6.53 [95% CI: 4.65-9.19] for individuals over 80 years. Heart failure was associated with lower all-cause HR [0.80, 95% CI: 0.76-0.86, p < 0.001] but higher SHR [1.30, 95% CI: 1.18-1.44, p < 0.001]. Comorbidities such as heart failure, stroke, and acute myocardial infarction significantly increased mortality risks, while essential hypertension was associated with lower risk of death.

Conclusion: The significant rise in the incidence rate of PAD underscores the growing burden of the disease, highlighting the urgent need for targeted preventive and management strategies in Kazakhstan.

Background and objectives: Coronavirus disease 2019 (COVID-19) is associated with various manifestations even after infection resolution. This study aimed to assess the prevalence of post-COVID-19 fatigue and its predictors.

Methods: We conducted a nationwide cross-sectional study among Polymerase Chain Reaction test confirmed COVID-19 cases in Saudi Arabia from July 2021 to February 2022. We collected data through telephonic interviews covering socio-demographics, comorbidities, body mass index, smoking, illness severity, and COVID-19 vaccination status. We assessed fatigue using Fatigue Severity Scale while depression was assessed using Patient Health Questionnaire-2. Logistic regression was employed to analyze the relationship between post-COVID-19 fatigue and depression.

Results: The analysis included 361 participants with a mean age of 37 ± 10.5 years, among whom 43% were female. Approximately 10% had comorbidities, and 21% were current smokers. Nearly two-thirds (68%) of the participants reported mild illness. The prevalence of perceived fatigue was 22.7%, while fatigue measured by the Fatigue Severity Scale was 14.4%. The multivariable logistic regression model revealed that COVID-19 severity and depression were significant predictors of post-COVID-19 fatigue; adjusted odds ratio 1.87 (95% CI: 1.10 to 3.18) and 14.3 (95% CI: 4.55 to 45.0), respectively.

Conclusion: Our findings suggest a higher prevalence of perceived fatigue compared to that measured by the Fatigue Severity Scale, underscoring the importance of using a valid assessment tool for fatigue among COVID-19 patients to ensure proper management. The significant association between post-COVID-19 fatigue and depression highlights the need for psychological assessment of COVID-19 patients to enhance their post-infection quality of life.

Background: In Malawi approximately, 88.3% people living with HIV are aware of their HIV status. Significant gaps are among men aged 15-34 years; only 72% know their HIV status. To reach men, Jhpiego, in collaboration with the Ministry of Health (MOH), implemented the Men's Mobile Wellness Clinic (MMWC) at workplace settings in Blantyre, Malawi between October 2019 and March 2020.

Methods: We conducted a descriptive qualitative study to understand motivators and barriers to MMWC service uptake by employees and employers. Primary data was drawn from in-depth telephone interviews from four study populations: employers who accepted or declined to host the MMWC at their worksite, and employees who accessed or did not access the services. We performed a thematic analysis using Nvivo 12 software to identify patterns and themes across the dataset.

Findings: Main reasons given for using the service among male employees were a desire to know their health status, availability of free health services at the workplace, and good quality services offered by MMWC staff, and support from their supervisor. Men who did not access services stated reasons such as work-clinic scheduling conflicts, lack of adequate promotion of the service, and miscommunication on the criteria about who should attend the MMWC. Employers who accepted to host the MMWC stated convenience and employee's rights to know their health status. Those who declined either stated that employees did not want the services or COVID-19 preventive measures by the MOH between October 2019 and March 2020 restricted participation.

Conclusion: This study underscores the potential utility of MMWC services including HIV testing among men. The desire to know their health status, availability of free MMWC services at the workplace, good quality services offered by MMWC staff, and the endorsement of MMWC by supervisors were main motivators to access the MMWC services. Sensitizing supervisors and employees about the benefits of the MMWC services, strengthening demand creation, and clarifying eligibility are important to facilitate MMWC uptake among men in Malawi.

Toxoplasmosis is one of the most common parasites affecting humans in diverse populations caused by T. gondii. This study aims to systematically review and analyze the prevalence of T. gondii infection among various population categories in Saudi Arabia. Our search was done in five databases: PubMed, Scopus, Cochrane Library, Embase, and Web of Science to find the relevant studies from inception to November 2023. The pooled prevalence of toxoplasmosis among the total population living in Saudi Arabia was estimated using a random-effect meta-analysis approach, and Comprehensive Meta-Analysis software was utilized for this analysis. Our study included 30 case-control and retrospective studies published from 1994 to 2023 involving 20,699 patients from different regions in the Kingdom of Saudi Arabia. Various cities were included, such as Al-Ahsa, Najran, Riyadh, Arar, Mecca, al Khobar, Mushait, Tabuk, jazan, Hail City, Almadinah Almunawwarah, AL-Ahsa, and Abha; 27 reported outcomes related to IgG seroprevalence, revealing an overall toxoplasmosis prevalence of 27.5% in Saudi Arabia. Fifteen studies that measured IgM seroprevalence found an overall toxoplasmosis prevalence of 2.2%. Specifically for pregnant women, IgG seroprevalence was 28%. Among different age categories, the highest toxoplasmosis prevalence was observed in the group aged 31-45 years, reaching 32.5%, while the lowest prevalence was in the 10-20 years category at 19.3%. Regarding gravidity, the grand multi-gravida group exhibited the highest prevalence at 32.9%, with an upper limit of 47.8%. Furthermore, individuals who consumed freshwater demonstrated a higher incidence than those drinking bottled water, with respective prevalence rates of 33.5% and 29.4%. In conclusion, the prevalence of toxoplasmosis in Saudi Arabia is lower than the global average, with significant variations across different age groups, water sources, and dietary habits. Targeted educational programs and public health interventions are essential to raise awareness and reduce the risk of T. gondii infection. Future research should focus on improving study quality and exploring the broader implications of toxoplasmosis on public health in Saudi Arabia.