Journal of Epidemiology and Global Health最新文献

Background: In Madagascar, a sentinel surveillance system was set up in 18 hospitals since 2014 and was managed by the Ministry of Public Health and the Institut Pasteur de Madagascar. In order to improve the access to appropriate health care in Madagascar, the main clinical diagnoses in hospitalized patients were analyzed.

Methods: At hospitalization of a patient, each unit involved in the sentinel surveillance recorded the clinical diagnosis through an e-health platform. Data from September 2014 to July 2018 were analyzed. Morbidity and annual incidence of diseases according to ICD-10 were reported.

Results: A total of 140,789 inpatients information was recorded. The median age was 28.2 years (IQR: 18.3; 45.3). 21.6% of the children < 15 years suffered from communicable diseases. The hospital morbidity was 4.01% for malaria, 0.84% for tuberculosis, 0.09% for HIV/AIDS and 0.05% for plague. The hospital morbidity of non-communicable diseases was higher compared to communicable diseases with 7.8%, 7.1% and 3.1% for "Diseases of the circulatory system", "Injury, poisoning and certain other consequences of external causes" and "Mental and behavioural disorders", respectively. "Pregnancy, childbirth and puerperium" represented 20.5% of the hospitalized patients.

Conclusions: The e-health platform enabled continuous and standardized data collection. Communicable diseases affect mainly children < 15 years. Non-communicable diseases are on the rise and need more attention by national health authorities. A number of hospitalizations could be prevented by a better health care management at the community-based health care level and by implementation of a Universal Health Coverage (UHC) in Madagascar.

Background: Pediatric dermatoses are common and impact the quality of life. This study aimed to estimate the prevalence and characteristics of pediatric dermatoses among 1^ry and 2^ry school students in Egypt.

Methods: A Cross-sectional study was conducted on 23,203 1^ry and 2^ry school students of both sexes in eight governorates in Egypt between January 2023 and May 2023. A clinical examination for skin diseases was done, and a self-administered, author-designed questionnaire was given to children to complete with the assistance of their parents.

Results: The average age of students was 12.00 ± 3.33 years. Prevalence of skin diseases was 37.9%. Positive family history of skin disease (aOR 3.482, 95% CI: 2.871-4.222, p < 0.001), sanitary water disposal (aOR 3.846, 95% CI: 3.001-4.930, p < 0.001), residence (aOR 1.760, 95% CI: 1.657-1.870, p < 0.001), father's occupation and education (aOR 1.494, 95% CI: 1.334-1.672, p < 0.001 and aOR 1.349, 95% CI: 1.251-1.454, p < 0.001, respectively), and crowding index (aOR 1.469, 95% CI: 1.372-1.573, p < 0.001) were independent risk factors for exhibiting skin diseases.

Conclusion: A high prevalence of pediatric dermatosis was established with associated sociodemographic risk factors, so healthcare and education programs and services should be directed toward children with continuous supervision and periodic examination.

Purpose: Measles is a highly contagious but vaccine-preventable infectious disease. According to health authorities such as the ECDC (20240, urgent action is required to address the increasing spread of measles and insufficient vaccination coverage across the EU. The main objective of the present research is a comparative analysis of measles outbreak risk in two neighbouring countries with intensive economic relations and similar socio-economic challenges-Bulgaria and Romania. This research aims to deliver results on measles outbreak risk assessment in Bulgaria's neighbouring countries to gain broader insight on the potential threats faced regionally and globally.

Methods: Data from a 50-year period was collected on immunization coverage and demographic dynamics in Bulgaria and Romania. The main objective of the paper is the calculation of an annual Risk Index defined as the ratio of all susceptible individuals to the total population. A mathematical model is applied to estimate the immunization coverage and demographic parameters on an annual basis. This allows us to calculate with satisfactory precision the accumulation of susceptible persons tracing at least 20 years back in the history, needed for the calculation of an annual Risk Index.

Results: The Risk Index curves for measles outbreak in Bulgaria and Romania are calculated for the period 2000 to 2023. The Risk Index curve for Bulgaria reveals a concerning increase after 2015, with particularly alarming values projected for 2017 and later. The results of the Risk Index for Romania after 2016 are also concerning. In 2023, the Risk Index for Bulgaria hits 7.55%, whereas in Romania it hits 8.1%.

Conclusion: Comparing the findings from the Risk Index to the real data from measles outbreaks for two neighbouring countries-with similar socio-demographic challenges-shows that the Risk Index is a good indicator for risk of measles outbreak. It can help the health authorities to forecast potential measles outbreaks - alongside vaccination coverage, demographic factors should also be considered when monitoring public health.

Background: On October 8, 2022, Kampala, the capital city of Uganda, recorded its first Sudan virus disease (SVD) case. We described strategies utilized by Kampala Capital City Authority (KCCA) during SVD outbreak response in Kampala City from October 2022 - January 2023.

Methods: We reviewed daily situation reports submitted by KCCA incident management team to document strategies implemented throughout the SVD response. During SVD After Action Review (AAR), we convened consensus meetings with the Directorate of Public Health and Environment, incident management team, rapid response teams, and representatives from implementing partners. The AAR served as a structured platform for reflection and consensus-building through semi-structured group discussions among stakeholders. Findings were thematically synthesized to identify effective strategies and operational challenges encountered during SVD response in Kampala City.

Results: KCCA established an incident management system to coordinate the SVD response. Daily coordination meetings were held with rapid response teams and implementing partners to address emerging challenges. A centralized call and dispatch center served as the coordination hub for rapid response teams, facilitating timely verification of alerts and response to suspected SVD cases. Case investigation teams established epidemiological linkages among confirmed SVD cases and identified contacts for daily follow up. Designated ambulances were utilized to transport high-risk patients to isolation units, while confirmed cases were referred to Entebbe Ebola Treatment Unit. Infection prevention and control teams provided essential decontamination services and distributed IEC materials to affected health facilities and communities. KCCA also leveraged innovative strategies such as drones to disseminate public health messages, distributed placards with SVD symptoms and preventive measures, and actively engaged business communities, media outlets, and local leaders to enhance public awareness and risk communication.

Conclusion: KCCA's response to the 2022 Sudan virus disease outbreak demonstrated effectiveness of leveraging existing coordination structures, adapting surveillance tools, and engaging communities in a complex city setting. The integration of emergency preparedness efforts and contextualized approaches such as mobile phone tracking, closed-circuit television (CCTV) footage, school-based interventions, and drone utilization contributed to timely containment. These strategies demonstrate valuable best practices for strengthening emergency preparedness and response capacities in high-risk urban settings.

Since 2022, outbreaks of monkeypox (Mpox), which is caused by the monkeypox virus (MPXV), have been documented in more than 116 nations, making it a serious danger to world health. Despite being self-limiting in most cases, Mpox can lead to severe illness and even death, especially among high-risk populations like the LGBTQI + community. Hence, there is an urgent need for effective prevention and treatment strategies, with vaccination playing a crucial role. This paper explores the safety and efficacy of three key vaccines; ACAM2000, JYNNEOS, and LC16 that are repurposed from smallpox vaccines to combat Mpox. ACAM2000, a replication-competent vaccinia virus vaccine, has shown high effectiveness but is associated with serious adverse reactions, including myocarditis and progressive vaccinia. JYNNEOS, a modified vaccinia Ankara vaccine, offers a more favorable safety profile with fewer severe side effects, demonstrating 82% vaccine effectiveness in preventing Mpox. LC16, another smallpox vaccine, shows strong protective efficacy in animal models and excellent safety outcomes in human trials. Our assessment of the available primary data suggests that amongst the three candidates, JYNNEOS emerges as the most promising candidate for widespread use due to its strong effectiveness and superior safety profile. However, while Mpox vaccines provide robust protection, their varying safety profiles highlight the need for tailored vaccination strategies based on individual health factors. The authors therefore emphasize balancing vaccine efficacy with safety risks, particularly in vulnerable populations. Further research and surveillance are essential to optimize vaccination strategies and control Mpox outbreaks worldwide.

Background: To assess an overview of research trends, influential studies, and collaborative networks in pediatric acute respiratory distress syndrome (PARDS), identifying key contributions and insights for future research directions.

Methods: Web of Science Core Collection (WoSCC) database was used to conduct the bibliometric analysis. Bibliometric indicators such as publication counts, citation frequencies, authors, countries/regions, institutions and keyword occurrences were analyzed using VOSviewer and CiteSpace and R.

Results: The analysis included 419 publications from 2014 to 2024, with a total of 88,849 citations. These publications involved 22,141 authors affiliated with various institutions worldwide. the United States leading in research output, contributing 1,124 articles and 24,421 citations. Leading institutions included the University of Pennsylvania, the University of California System, and the Children's Hospital of Philadelphia. The most influential journals were Pediatric Critical Care Medicine and Critical Care Medicine. Yehya N, Thomas NJ, and Khemani RG are the most contributed authors. Keyword co-occurrence analysis revealed five major research clusters: neonatal outcomes, critical care strategies (e.g., mechanical ventilation and extracorporeal membrane oxygenation [ECMO]), inflammation and immune mechanisms, respiratory support interventions, and diagnostic tools like lung ultrasound. Emerging trends focused on inflammation, molecular mechanisms, and diagnostic advancements.

Conclusion: This study presents a bibliometric analysis of PARDS research, highlighting significant trends, influential studies, and collaborative networks. The findings provide valuable insights into the current state of research and future directions for advancements, emphasizing the need for continued investigation to improve clinical outcomes for children with ARDS.

Clinical trial number: Not applicable.

Background: It is a well-established fact that Alzheimer's Disease (AD) is a growing public health challenge worldwide, with increasing prevalence among older adults. Cardiometabolic multimorbidity (CMM) and various sociodemographic and lifestyle factors are acknowledged to influence AD risk. This study aimed to estimate the prevalence of AD and investigate its association with CMM and related sociodemographic and behavioral factors in older adults aged 60 years and above in Türkiye.

Method: This study was conducted using secondary data obtained from the Türkiye Health Survey, provided by the Turkish Statistical Institute (TÜİK). Data were derived from 4630 individuals (weighted sample of 11,331,239) aged 60 years and older. AD prevalence, CMM (hypertension, coronary heart disease, stroke, diabetes, hyperlipidemia), and relevant covariates were evaluated. Multivariable binary logistic regression models were used to identify independent predictors of AD.

Results: The overall prevalence of AD was 3.8% (95% CI: 3.6-4.9%), slightly higher in females (4.1%, 95% CI: 3.8-5.7%) than males (3.5%, 95% CI: 2.8-4.7%). AD was more common among individuals who were single/divorced (6.4%), had lower education (4.1%), presented with CMM (5.9%), or led sedentary lifestyles (4.9%). In the model adjusted for age, sex, educational status, and marital status, the presence of CMM was significantly associated with increased odds of AD (aOR = 2.081; 95% CI: 1.522-2.844). In the further adjusted model for BMI, tobacco use, alcohol use, and activity during the day, CMM remained a significant predictor of AD (aOR = 1.975, 95% CI: 1.446-2.698).

Conclusions: This large-scale study highlights a substantial burden of AD among older adults in Türkiye, strongly linked to CMM and modifiable social and behavioral factors. The findings of this study highlight the importance of integrated prevention strategies targeting vascular health, education, social support, and physical activity to reduce AD risk.