Journal of Epidemiology and Global Health最新文献

Background: The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals.

Objectives: The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues.

Methods: A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05.

Results: Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024-0.276)), appearance (OR = 0.299, CI = 0.182-0.489), distance (OR = 0.264, CI = 0.099-0.705), water unavailability (OR = 0.477, CI = 0.297-0.765), and obligation to pay (OR = 0.351, CI = 0.185-0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children's stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing.

Conclusion: The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure.

Background: Since its resurgence in 2017, Yellow fever (YF) outbreaks have continued to occur in Nigeria despite routine immunization and the implementation of several reactive mass vaccinations. Nigeria, Africa's most populous endemic country, is considered a high-priority country for implementing the End Yellow fever Epidemics strategy.

Methods: This retrospective analysis described the epidemiological profile, trends, and factors associated with Yellow fever viral positivity in Nigeria. We conducted a multivariable binary logistic regression analysis to identify factors associated with YF viral positivity.

Results: Of 16,777 suspected cases, 8532(50.9%) had laboratory confirmation with an overall positivity rate of 6.9%(585). Predictors of YFV positivity were the Jos Plateau, Derived/Guinea Savanah, and the Freshwater/Lowland rainforest compared to the Sahel/Sudan Savannah; dry season compared to rainy season; the hot dry or humid compared to the temperate, dry cool/humid climatic zone; 2019, 2020, 2021, 2022, and 2023 epidemic years compared to compared to 2017; first, third, and fourth quarters compared to the second; male sex compared to female; age group > = 15 years compared to < 15 years; working in outdoor compared to indoor settings; having traveled within the last two weeks; being of unknown vaccination status compared to being vaccinated; and vomiting.

Conclusion: Ecological, climatic, and socio-demographic characteristics are drivers of YF outbreaks in Nigeria, and public health interventions need to target these factors to halt local epidemics and reduce the risk of international spread. Inadequate vaccination coverage alone may not account for the recurrent outbreaks of YF in Nigeria.

Background: Colorectal cancer (CRC) has become a significant global concern, presenting formidable challenges to healthcare systems and leading to substantial healthcare expenses. This study examines the projected prevalence and trends of CRC worldwide, encompassing 21 regions and 195 nations.

Methods: We employed an illness-death model (IDM) in order to forecast the anticipated prevalence of CRC by the year 2040. To accomplish this, we utilized data retrieved from the Global Health Data Exchange (GHDx) query tool spanning from 1990 to 2021. The primary objective of this study is to furnish sex-specific estimations encompassing various geographical regions.

Results: By 2040, the global age-standardized prevalence rate (ASPR) of CRC among the total population is projected to rise, reaching 145.82 per 100,000, which reflects an increase of 8.15%. East Asia is forecasted to have the highest ASPR at 330.17 per 100,000, representing a substantial rise of 94.81%. Notably, the most rapid percentage increase is projected in Andean Latin America, with an anticipated rise of 106.2%. In contrast, many countries, particularly in developed nations, are expected to see a decline in ASPR during this period. The United Arab Emirates is projected to experience the most significant decrease in ASPR, at -86.51%, while Mauritius is anticipated to have the largest increase in CRC prevalence rate, at 226.26%. Globally and regionally, the ASPR among males is expected to remain higher than that among females over the next 21 years.

Conclusions: The global prevalence of CRC is increasing, particularly in developing countries, while developed countries are anticipated to observe a declining trend. This highlights the significance of appropriately allocating resources and implementing effective preventive measures, especially in developing nations.

Background: Legionella infections are a major global health issue, yet there's limited research on their impact and trends. We aimed to systematically analyzed the long-term trends in Legionella spp. infection-associated diseases (LSIADs) burden from 1990 to 2021.

Methods: Age-standardized disability-adjusted life years (ASR-DALYs) and age-standardized death rates (ASDRs) of LSIADs from 1990 to 2021 were accessed from the Global Burden of Disease (GBD) 2021, which utilized the Bayesian hierarchical meta-regression tool and the Cause of Death Ensemble model to estimate these metrics. Trends in disease burden across age, sex, region, and Socio-Demographic Index (SDI) levels were estimated using annual percentage changes (EAPCs) and annual percentage changes (APCs).

Results: Globally, the ASR-DALYs and ASDRs for LSIADs in 2021 were 24.74 and 0.86 per 100,000, respectively, with the highest rates observed in regions with low SDI. From 1990 to 2021, while the overall burden of LSIADs showed a downward trend, the highest ASR-DALYs (101.85 per 100,000) and ASDRs (8.15 per 100,000) were observed in individuals over 70 years of age, accompanied by a corresponding increase in deaths (EAPCs = 0.17%, 95% CI: 0.09-0.26%). Furthermore, increases in ASR-DALYs and ASDRs for LSIADs were also noted among those aged 15-49 years (EAPCs = 0.43% and 0.57%, respectively) and those aged 50-69 years (EAPCs = 0.14% and 0.09%, respectively).

Conclusion: Higher disease burdens and increasing trends have been observed in specific age groups and regions, which require the implementation of water quality management plans, enhanced readiness of health facilities, and improved sanitation infrastructure.

Human papillomavirus (HPV), a common sexually transmitted infection, includes over 200 types, some linked to genital warts and various cancers, including cervical, anal, penile, and oropharyngeal cancers. In Saudi Arabia, an estimated 10.7 million women aged 15 years and older are at risk of HPV-related cervical cancer. This study assessed HPV prevalence, genotype distribution, awareness, and health behaviors among females in Jeddah, Saudi Arabia. Pap smear samples were collected from 106 women attending gynecology clinics at King Abdulaziz University Hospital and were analyzed using nested PCR and Sanger sequencing. Results showed a 15.1% HPV positivity rate, with genotypes of HPV 16, 6, and 58 identified. HPV 16 was the most prevalent (43.75%), particularly among women aged 35-44. In addition, over 60% of the participants were unaware of the link between HPV and cervical cancer, or the availability of vaccines, indicating significant knowledge gaps in the population. These findings underscore the urgent need for comprehensive HPV surveillance and targeted public health interventions in Saudi Arabia. This study emphasizes the importance of HPV vaccination programs, increased screening, and educational campaigns to address the high prevalence of high-risk genotypes, particularly HPV 16. Tailored strategies are crucial to reducing HPV-related health risks, especially for high-risk age groups and under-informed populations. The data provide a foundation for improving HPV prevention and reducing the burden of related diseases in the Saudi population.

Objective: This study investigates the key factors contributing to the dengue outbreak in Oman.

Methods: Data on climate (e.g., temperature, humidity, wind pace), population traits (e.g., populace density), and vector dynamics (e.g., mosquito density) within the Seeb district of Oman from 2022 to 2023 were gathered. The partial least squares structural equation modeling (PLS-SEM) was performed to study which variables affect dengue outbreaks.

Results: The results indicate that climatic factors significantly affect the dengue vector (β = -0.361, p < 0.001) but do not directly impact the dengue outbreak. Population characteristics, however, have a more substantial impact on dengue transmission, with a total effect (β = 0.231, p = 0.002) being relatively higher than that of the vector itself (total effect: β = 0.116, p < 0.001).

Conclusions: Even with ongoing vector intervention efforts, the study underscores the need to include innovative public health interventions when considering environmental and demographic factors. More advantageous surveillance and focused interventions in excessive-threat regions are essential to mitigate the effect of dengue in Oman.

Introduction: The COVID-19 pandemic overwhelmed health systems, resulting in a surge in excess deaths. This study clustered countries based on excess mortality to understand their response to the pandemic and the influence of various factors on excess mortality within each cluster.

Materials and methods: This ecological study is part of the COVID-19 MORtality (C-MOR) Consortium. Mortality data were gathered from 21 countries and were previously used to calculate weekly all-cause excess mortality. Thirty exposure variables were considered in five categories as factors potentially associated with excess mortality: population factors, health care resources, socioeconomic factors, air pollution, and COVID-19 policy. Estimation of Latent Class Linear Mixed Model (LCMM) was used to cluster countries based on response trajectory and Generalized Linear Mixture Model (GLMM) for each cluster was run separately.

Results: Using LCMM, two clusters were reached. Among 21 countries, Brazil, the USA, Georgia, and Poland were assigned to a separate cluster, with the mean of excess mortality z-score in 2020 and 2021 around 4.4, compared to 1.5 for all other countries assigned to the second cluster. In both clusters the population incidence of COVID-19 had the greatest positive relationship with excess mortality while interactions between the incidence of COVID-19, fully vaccinated people, and stringency index were negatively associated with excess mortality. Moreover, governmental variables (government revenue and government effectiveness) were the most protective against excess mortality.

Conclusion: This study highlighted that clustering countries based on excess mortality can provide insights to gain a broader understanding of countries' responses to the pandemic and their effectiveness.

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.

Background: Corneal pathologies are among the most common reversible sight-threatening diseases globally. As such, corneal tissue transplantation (keratoplasty) techniques are evolving over time depending on the prevalence of different pathologies in each geographical area. We aim to provide a baseline information on the common keratoplasty procedures performed in our area in relation to prevalent corneal pathologies and to analyze common corneal surgical practice trends in our area. Other types of corneal tissue sampling (superficial keratectomy and corneal biopsy) indicated for therapeutic and diagnostic purposes are also included.

Methods: This is a retrospective cohort study. All corneal tissue specimens, including those harvested for both therapeutic and diagnostic purposes, received for histopathological examination at our center over a period of 5 years were collected along with the respective demographic data, clinical diagnoses, and surgical indications. Descriptive analysis was used to elucidate important conclusions, and comparative analysis was used to highlight differences between different types of keratoplasty specimens in relation to the surgical indications.

Results: A total of 347 patients' corneal tissue specimens were included. Males accounted for 52.45%. Full-thickness corneal buttons were the most common (n = 172), followed by partial-thickness corneal specimens (n = 75), and Descemet's membrane and endothelium samples (n = 63). Top surgical indications for keratoplasty were keratoconus (n = 149), followed by bullous keratopathy (n = 61), failed previous keratoplasty (n = 47), corneal ulceration (n = 33) and corneal dystrophies (n = 22). Patients undergoing penetrating or lamellar keratoplasty were significantly younger (p < 0.001). Superficial keratectomy and corneal biopsy for keratitis were significantly more common among male patients (p = 0.041), while failed endothelial keratoplasty was observed more among females (p = 0.026).

Conclusion: Our findings highlight the evolving landscape of corneal transplantation and the importance of tailoring surgical approaches to address the specific needs and risk profiles in different populations. Keratoconus is a leading cause for corneal grafting and seems to constitute a major treatable and visually disabling disease in Saudi Arabia, thus may require further screening and genetic studies with consideration for preventive measures.

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.