Journal of Epidemiology and Global Health最新文献

Survivors of COVID-19 are susceptible to diminished health-related quality of life (HRQoL) and adverse psychological health, which may be exacerbated by their experiences of fear and the impact of the pandemic itself. This study aims to identify distinct fear and impact patterns related to the COVID-19 pandemic among survivors through latent profile analysis (LPA) and examine the associations of fear and impact patterns with post-traumatic stress symptoms (PTSS) and HRQoL. A total of 5,890 Vietnamese COVID-19 survivors completed the COVID-19 Impact Battery- Disability Scale (CIB-D), the Fear of COVID-19 Scale (FCoV-19 S), the Impact of Event Scale-Revised for PTSS, and the 36-Item Short Form Survey (SF-36) for HRQoL. Four distinct groups of fear and impact were identified: "Fearful and highly impacted" (26.8%), "moderately impacted yet not fearful" (22.9%), "less impacted and less fearful" (18.6%), and "mildly impacted and neutral" (31.7%). Survivors who were "less impacted and less fearful" exhibited significantly higher HRQoL scores (regression coefficient, B: 10.9; 95% confidence interval (CI): 10.0 - 11.7), both in terms of physical (B: 12.0; 95%CI: 11.1 - 12.9) and mental health (B: 19.4; 95%CI: 9.6 - 11.1), and lower PTSS levels (B: -24.5; 95%CI: -25.8 - -23.3) compared to those who were "highly impacted and fearful". It is imperative to acknowledge the intricate association between fear, impact, and mental health to comprehensively address the diverse needs of this distinct population post-COVID-19. These findings provide insights for designing interventions and support mechanisms for COVID-19 survivors.

Background: Pandemic zoonotic RNA virus infections have continued to threaten humans and animals worldwide. The objective of this review was to highlight the epidemiology and socioeconomic impacts of pandemic zoonotic RNA virus infections that occurred between 1997 and 2021.

Methods: Literature search was done from Web of Science, PubMed, Google Scholar and Scopus databases, cumulative case fatalities of individual viral infection calculated, and geographic coverage of the pandemics were shown by maps.

Results: Seven major pandemic zoonotic RNA virus infections occurred from 1997 to 2021 and were presented in three groups: The first group consists of highly pathogenic avian influenza (HPAI-H5N1) and swine-origin influenza (H1N1) viruses with cumulative fatality rates of 53.5% and 0.5% in humans, respectively. Moreover, HPAI-H5N1 infection caused 90-100% death in poultry and economic losses of >$10 billion worldwide. Similarly, H1N1 caused a serious infection in swine and economic losses of 0.5-1.5% of the Gross Domestic Product (GDP) of the affected countries. The second group consists of severe acute respiratory syndrome-associated coronavirus infection (SARS-CoV), Middle East Respiratory Syndrome (MERS-CoV) and Coronavirus disease 2019 (COVID-19) with case fatalities of 9.6%, 34.3% and 2.0%, respectively in humans; but this group only caused mild infections in animals. The third group consists of Ebola and Zika virus infections with case fatalities of 39.5% and 0.02%, respectively in humans but causing only mild infections in animals.

Conclusion: Similar infections are expected in the near future, and hence strict implementation of conventional biosecurity-based measures and development of efficacious vaccines would help minimize the impacts of the next pandemic infection.

Background: Despite continued efforts to manage and control Tuberculosis (TB) in China, it remains a major health concern. Bone tuberculosis (Bone-TB), a common form of extrapulmonary tuberculosis, still adds considerably to the global TB case load. Diagnosing Bone-TB is often difficult as its symptoms can be similar to other bone or joint diseases, which leads to delayed detection and treatment. Currently, comprehensive reports on the epidemiological aspects of Bone-TB in China are scarce.

Methods: This retrospective study analyzed demographic and clinical data from 2,191 patients diagnosed with Bone-TB in Southwest China between January 2011 and September 2023.This study fully reveals the characteristics of Bone-TB in Southwest China.

Results: The overall trend of bone tuberculosis was a slow rise. Among 2191 patients, males, farmers, aged 42-68 years, and people with HIV and diabetes are the priority groups for the prevention and treatment of Bone-TB. The majority of the infected spines (1556/2191) were located in the thoracic vertebra (759/2191) and lumbar vertebra (715/2191). Forty-nine (2.24%) patients had drug-resistant TB (DR-TB). Forty-five (2.05%) died during the treatment. The total and actual hospitalization. Costs amounted to $3,837.10 and $1,914.35 (p < 0.01). Patients with DR-TB incurred the highest costs, amounting to $4,968.37. Cervical TB, with a prevalence of 5 patients (6.10%), exhibited the highest rates of catastrophic expenditures.

Conclusions: From 2011 to 2023, the yearly occurrence of Bone-TB in southwestern China exhibited a rising pattern, marked by notable distinctions in terms of gender, age, and regional variations, indicating localized clustering characteristics.

Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in controlling HIV. Poor medication adherence may lead to higher disease mortality, increased HIV spread, and transmission of drug-resistant strains. Identifying the specific factors that contribute to suboptimal medication adherence in people with HIV is crucial for developing effective, personalized interventions.

Methods: This study conducted a cross-sectional analysis by enrolling individuals over 18 years of age with HIV at a single clinic in Taipei, Taiwan, from December 2018 to November 2020. Participants completed a questionnaire that collected demographic data, recreational drug use, comorbidities, and history of sexually transmitted infections (STIs). The Medication Adherence Report Scale (MARS-5) was utilized to assess treatment adherence. A multiple logistic regression model was applied to identify the factors influencing adherence.

Results: A total of 831 PWH were included in the analysis. After controlling for demographics, comorbidities, and recreational drug use, independent risk factors associated with poor adherence among PWH include the presence of a depressive disorder (AOR:2·887, 95% CI:1·461-5·703, p = 0·002), a history of acquired gonorrhea (AOR:2·026, 95% CI:1·079 - 3·803, p = 0·028), methamphetamine use within past three months (AOR:2·073, 95% CI:1·172-3·665, p = 0·012), HIV-1 RNA ≥ 40 copies/ml (AOR:5·221, 95% CI:2·976-9·157, p < 0·001) and younger age (AOR:0·959, 95% CI:0·932-0·988, p = 0·006).

Conclusions: To enhance HIV treatment adherence, targeted efforts are essential for PWH who are young, have used methamphetamine in the past three months, are experiencing depressive disorders, or have previously acquired gonorrhea.

Purpose: To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements.

Methods: In this prospective study conducted at a medical center in southern Taiwan from January 1, 2020, to December 31, 2021, 1636 participants aged 40-75 years without prior ASCVD events were enrolled. Carotid flow velocity was obtained through duplex ultrasonography. ASCVD risk was categorized into two groups according to the 2022 USPSTF guidelines for primary prevention. We analyzed associations between flow indices and ASCVD risk using logistic regression and generalized additive models (GAMs).

Results: The end diastolic velocity (EDV) of common carotid artery (CCA) and the peak systolic velocity (PSV) of internal carotid artery (ICA) were inversely and nonlinearly associated with cardiovascular event risk. Multivariate logistic regression analysis with ROC curves revealed that the optimal speed for the EDV of CCA was approximately 23.75 cm/s, and the optimal PSV and EDV of ICA were approximately 81.75 cm/s and 26.75 cm/s, respectively. The GAMs showed U-shaped relationships between elevated ASCVD risk and blood flow velocity in the carotid arteries, with inflection points of approximately 82 cm/s in the PSV of ICA and near 25 cm/s in the EDV of CCA. Both methods revealed similar results.

Conclusions: The EDVs and PSVs of the CCA and ICA are associated with the development of cardiovascular events. Optimal velocity ranges were identified; however, further hemodynamic investigations are warranted.

Background: The gut microbiota, comprising billions of microorganisms, plays a pivotal role in health and disease. This study aims to investigate the effect of sepsis on gut microbiome of neonates admitted to the Neonatal Intensive Care Unit.

Methods: A prospective cohort study was carried out in the NICU of tertiary care hospital in Karnataka, India, from January 2021 to September 2023. Preterm neonates with birth weight < 1500 g and gestational age < 37 weeks were recruited, excluding those with congenital gastrointestinal anomalies, necrotizing enterocolitis, or blood culture-negative infections. The study population was divided into three groups: healthy neonates (Group A), neonates with drug-sensitive GNB sepsis (Group B), and neonates with pan drug-resistant GNB sepsis (Group C). Stool samples were collected aseptically, snapped in liquid nitrogen, and stored at -80⁰C for extraction of DNA and microbiome analysis.

Results: The gut microbiota of healthy neonates (Group A) was dominated by Proteobacteria (24.04%), Actinobacteria (27.13%), Firmicutes (12.74%), and Bacteroidetes (3%). Predominant genera included Bifidobacterium (55.17%), Enterobacter (12.55%), Enterococcus (50.69%), Streptococcus (7.92%), and Bacteroides (3.58%).Groups B and C, the microbiota exhibited higher Proteobacteria abundance (57.16% and 66.58%, respectively) and reduced diversity of beneficial bacteria. Notably, the presence of sepsis was associated with an increase in pathogenic bacteria and a decrease in beneficial commensal bacteria.

Conclusion: Neonates with sepsis exhibited significant gut microbiome dysbiosis, characterized by increased Proteobacteria and reduced beneficial bacteria diversity. These findings highlight the potential of microbiome profiling as a diagnostic tool and underscore the importance of gut microbiota modulation in managing neonatal sepsis.

Background: Klebsiella pneumoniae is a common opportunistic pathogen in humans, often associated with both virulence and antimicrobial resistance (AMR) phenotypes. K. pneumoniae have a highly plastic genome and can act as a vehicle for disseminating genetic information. Aiming to assess the impact of the human-animal-environment interface on AMR dissemination in K. pneumoniae we sampled and genome sequenced organisms from a range of environments and compared their genetic composition.

Methods: Representative K. pneumoniae isolated from clinical specimens (n = 59), livestock samples (n = 71), and hospital sewage samples (n = 16) during a two-year surveillance study were subjected to whole genome sequencing. We compared the taxonomic and genomic distribution of K. pneumoniae, AMR gene abundance, virulence gene composition, and mobile genetic elements between the three sources.

Results: The K. pneumoniae isolates originating from livestock were clonally distinct from those derived from clinical/hospital effluent samples. Notably, the clinical and hospital sewage isolates typically possessed a greater number of resistance/virulence genes than those from animals. Overall, we observed a limited overlap of K. pneumoniae clones, AMR genes, virulence determinants, and plasmids between the different settings.

Conclusion: In this setting, the spread of XDR and hypervirulent clones of K. pneumoniae appears to be restricted to humans with no obvious association with non-clinical sources. Emergent clones of K. pneumoniae carrying both resistance and virulence determinants are likely to have emerged in hospital settings rather than in animal or natural environments. These data challenge the current view of AMR transmission in K. pneumoniae in a One-Health context.

Background: COVID-19 vaccination has become a pivotal global strategy in managing the pandemic. Despite COVID-19 no longer being classified as a Public Health Emergency of International Concern, the virus continues affecting people worldwide. This study aimed to evaluate risk factors and vaccine effectiveness on COVID-19-related hospital admissions, intensive care unit (ICU) admission and mortality within the Andalusian population throughout the pandemic.

Methods: From March 2020 to April 2022, 671,229 individuals, out of 9,283,485 with electronic health records in Andalusia, experienced SARS-CoV-2 infection and were included in the analysis. Data on demographics, medical history, vaccine administration, and hospitalization records were collected. Associations between medical history, COVID-19 vaccines, and COVID-19 outcomes were assessed.

Results: Our study identified 48,196 hospital admissions, 5,057 ICU admissions, and 11,289 deaths linked to COVID-19. Age, male sex, and chronic diseases were identified as risk factors, while the COVID-19 vaccine demonstrated protective effects, although with reduced effectiveness during the omicron variant period. However, the risk for these outcomes increased over time after receiving the last vaccine dose, particularly after six months, especially among those aged 60 or older.

Conclusion: The global health challenge of COVID-19 persists, marked by emerging variants with higher virulence and severity, particularly among the unvaccinated and those beyond six months post-vaccination, especially those aged 60 and above. These findings highlight the need for robust surveillance systems targeting new variants and administering booster doses, particularly for individuals aged 60 or older with underlying health conditions, to mitigate the global burden of COVID-19.

Not receiving a DPT-containing vaccine in early childhood indicates an absence of routine immunization, which puts children at an elevated risk of mortality, morbidity, and worse human development over the life course. We estimated the percentage of children 12-35 months who did not receive a dose of DPT-containing vaccine (termed zero-dose children) using household surveys from 81 low- and middle-income countries conducted between 2014 and 2023. For 68 countries with more than one survey (with the earlier survey conducted 2000-2013), we estimated the average annual percentage point change in prevalence of zero-dose children between the earliest and latest surveys. We also explored the association of zero-dose prevalence with postneonatal and child mortality, health expenditure, and Gavi-eligibility. Overall, 16% of children in our pooled sample had not received a dose of DPT-containing vaccine. There was a 0.8% point decline in zero-dose prevalence per year on average across the period studied. A single percentage point average annual decline in zero-dose prevalence was associated with an average annual decrease of 1.4 deaths in the postneonatal and childhood period per 1000 live births. Gavi-eligible countries had a much faster decline in zero-dose prevalence than other countries. Large gains have been made in reducing the percentage of children who did not receive a DPT-containing vaccine. Efforts to reduce the number of zero-dose children should focus on countries with high prevalence to achieve the Immunization Agenda 2030. Healthcare spending could be prioritized so that the prevalence of zero-dose children is reduced.