Journal of Epidemiology and Global Health最新文献

Chikungunya is a febrile illness caused by an arbovirus transmitted by Aedes spp. mosquitoes, which are abundant worldwide and can easily establish new habitats. With urbanization and climate change, the vector has spread to new areas. Chikungunya has caused multiple outbreaks worldwide in most continents. Molecular evidence suggests that a single mutation in the chikungunya virus can influence vector specificity, enhancing its potential to cause explosive outbreaks. The infection commonly presents with a triad of fever, rash, and arthritis. The latter symptom occurs in more than 90% of sufferers and may persist for many months to years, causing significant morbidity. Currently, no antiviral therapy is available, and management is primarily supportive. Several cases of Chikungunya acquired through international travel have been reported. Travel-associated viremic cases can drive introduction and local transmission in new geographical areas where the mosquito vector is abundant. Awareness of the disease among both travelers and healthcare providers remains poor. A global one health approach, with strengthened public health policies, enhanced surveillance, and travel-related prevention, is currently the most effective way to curb the reemerging threat of the disease. Two vaccines are currently available and are durable for at least 2 years; though they lack efficacy data, they have both been approved. First, VLA1553, trade-named IXCHIQ, is a live-attenuated vaccine with nearly 99% seroprotection; however, it has many safety concerns, including Chikungunya-like illness (CLI), and has recently been paused for use in persons older than 60 years. Second, PXVX0317, trade-named Vimkunya, is a virus-like particle with nearly 98% seroprotection, but it does not cause CLI. Both vaccines are currently recommended for travelers visiting areas with a CDC-declared outbreak.

Background: Chronic pancreatitis (CP) is a progressive inflammatory condition with regional differences in prevalence and etiology. Though alcohol and smoking are primarily the risk factors in Western populations, CP resulted from alcohol is rare in Saudi Arabia due to cultural differences. Our study aim to characterize the Etiology, clinical presentation, and complications of CP in Saudi Arabian adults who are minimally alcohol exposure.

Methods: Our retrospective research highlights on patients who are 14 years of age and older that diagnosed with CP, who are treated at King Fahad Medical City from the timeline of 2013 until 2024. The Demographics, clinical presentations, laboratory, radiological and comorbidity data were obtained from the electronic records of KFMC then analysed by SPSS version 27 program. Our study is approved ethically by the KFMC Research Center, and we ensure all participants' data remained anonymous.

Results: We identified 117 CP patients (65% female, 95.7% Saudi) with a median age of 42 years and median disease duration of 4 years. Smoking was reported in 40.2% of cases. The predominant symptom was right upper quadrant pain (80.3%), followed by fever (12%), jaundice (11.1%), and pruritus (10.3%). Median laboratory values included amylase 74 U/L, lipase 39.4 U/L, calcium 2.36 mmol/L, triglycerides 1.35 mmol/L, and IgG4 0.847 g/L. Frequent complications included pancreatic leak/fistula (46.2%), pseudocysts (27.4%), bile duct obstruction (26.5%), and pancreatic carcinoma (13.7%). New-onset diabetes and duodenal obstruction each occurred in 9.5%, while metabolic bone disease and autoimmune hepatitis were rare (0.9%).

Conclusion: In Saudi Arabia, CP often occurs without alcohol consumption, but with smoking emerging as a potential risk factor. Despite this non-alcoholic profile, the risk of serious complications, including pancreatic cancer, remains high. Multicentric studies are needed to clarify risk factors and optimize the management.

Background: Malaria remains one of the most pressing public health challenges in Sub-Saharan Africa (SSA), which continues to shoulder over 90% of the global burden of malaria cases and deaths. Despite major investments in control and treatment, the region faces persistent transmission heterogeneity, with pockets of low but sustained incidence that often fuel larger seasonal outbreaks. Each year, during the hot and dry season, multiple low-transmission hotspots-ranging from 3 to 150 cases per 10,000 person-weeks-emerge in many peri-urban and rural-urban fringe zones in western SSA. These hotspots frequently precede widespread outbreaks that occur with the onset of the rainy season. While intensive malaria control programs have reduced incidence in many high-transmission areas, the persistence of such low-transmission hotspots throughout the dry months remains poorly understood.

Methods: In this study, we focus on Ouagadougou, the capital of Burkina Faso, where malaria incidence demonstrates striking spatiotemporal patterns. We hypothesize that seasonal rural-urban migration of labourers-driven largely by agricultural and economic cycles-plays a pivotal role in sustaining dry-season transmission, seeding subsequent rainy-season epidemics. To examine this hypothesis, we develop a data-driven malaria model and analyze with statistical inference methods to compare the impacts of seasonal, regular, and permanent migration patterns, using empirical incidence and mobility data.

Results: Our analysis indicates that seasonal migration most accurately explains the low-transmission endemicity in dry months and their amplification into widespread rainy-season outbreaks. High seasonal migration maintained a low but persistent level of transmission, preventing local fade-out, and significantly intensified transmission once favourable ecological conditions returned during the rains. These findings demonstrate how cyclical patterns of human mobility can drive malaria persistence even in periods otherwise unsuitable for transmission.

Conclusion: These findings highlight the importance of incorporating human mobility, particularly seasonal labour migration, into malaria transmission models and control strategies. From a global health perspective, accounting for mobility-driven persistence mechanisms can strengthen malaria elimination programs across Sub-Saharan Africa, where seasonal migration is widespread. By integrating migration dynamics into intervention planning, policymakers can better anticipate epidemic risk and target resources to vulnerable communities, thereby moving closer to the long-term goal of malaria elimination.