Journal of Epidemiology and Global Health最新文献

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.

Background: Echinococcus granulosus sensu lato, a hepatic cystic echinococcosis (CE), is a major public health concern in endemic regions, such as Yemen. Understanding their prevalence, computed tomography (CT) patterns, and socio-demographic characteristics is crucial for effective disease management.

Methods: This retrospective study analyzed the medical records of 835 patients diagnosed with hepatic CE cysts at Al-Thawra Modern General Hospital, Sana'a, Yemen, between 2004 and 2023. Data on patient demographics, CE cyst characteristics, WHO Informal Working Group on Echinococcosis (IWGE) classification, and radiological evidence suggestive of complications were collected from the CT reports and analyzed using SPSS version 26.

Results: The patients (66.47% female, median age 35 years) had 1,669 cysts, which were predominantly solitary (67%) and located in the right lobe (50.06%). The most common classifications were CE1 (38.56%) and CE3 (34.02%). The most common radiological finding suggestive of a complication was mass effect (38%). Other findings included intrabiliary rupture (4%) and intraperitoneal rupture (1.4%) with an annual mean of 44 cases.

Conclusions: The high prevalence, especially among young females, underscores the need for improved hygiene, standardized CT reporting for complex or preoperative cases, and a national registry to control this disease in Yemen.

Purpose: This study aims to describe the social-relational context of adolescents and young adults living with (AYALHIV) and without HIV (AYAHIV-) in the city of Beira (Mozambique) and to assess how it can impact their mental health.

Methods: A cross-sectional study with three-level assessment was conducted between July and August 2023. Socio-economic factors were assessed through an ad-hoc questionnaire, mental health through symptom Checklist-90 (SCL-90), and social-relational networks using social network analysis (SNA). SNA parameters included were: average degree centrality, closeness centrality, betweenness centrality, eigenvector centrality and transitivity. Robust linear regression model was used to assess association between SNA parameters and SCL-90 scores.

Results: AYAs involved were 352 (F: 50.7%) and 341 (96.9%) completed both sociogram and SCL-90. Average degree centrality was 1.44 (SD 0.77) for supportive networks (supSN) and 0.49 (SD 0.39) for stressful ones (strSN). The average degree centrality was higher in AYAHIV- compared to AYALHIV (0.009). Supportive edges occurred more often between the individual and their mother (65.1%), while stressful edges between one (24.3%) or two (18.8%) neighbourhood people. The supSN betweenness was 0.27 (SD 0.24) in females and was significantly lower compared to males (0.33, SD 0.27, p = 0.017). The mean score at the SCL-90 was 1.1 (SD 0.5). An increase in 1 SD of the average degree centrality of the supSN was associated with a decrease of 0.14 SD at the SCL-90 (p = 0.014). The SCL-90 score was significantly lower in males (p = 0.045) and in AYAs from the high socio-economic group (p = 0.009).

Conclusion: Two groups proved to be more vulnerable with regard to socio-relational networks, women and AYALHIV. Better interconnected social support networks were associated with better mental health (i.e. lower scores on the SCL-90). Improving support within the community is therefore important for achieving better mental well-being for all.

Background: Despite a high burden of injuries in low-income and middle-income countries (LMICs), a lack of empirical evidence on mechanism, location, and distribution of unintentional injuries requiring medical attention (hereafter injuries) hinders informed health system policy development.

Methods: Using individual-level data from nationally representative surveys conducted in LMICs between 2014-2019, we describe the weighted annual prevalence of non-fatal injuries, their mechanisms, environments in which they occur, and characteristics of people injured, in individuals aged 15-64 years. Multivariable logistic regression models were estimated to evaluate associations of injuries with individual-level characteristics.

Results: We included data on 47,747 participants from 12 LMICs in four WHO regions. The weighted prevalence of non-fatal injuries in the past year was 6.8% (95% CI: 6.3%-7.2%); men suffered a greater prevalence of injuries than women (8.3% [95% CI 7.6%-9.0%] vs. 5.4% [95% CI 5.0%-5.9%], respectively). In the multivariable logistic regression, the odds of having any injury were lower among females and married people and higher among individuals with some primary education. Prevalence of non-road traffic collision injuries was almost threefold that of road traffic collision (RTC) injuries: 5.6% (5.2%-6.0%) vs. 1.7% (1.5%-2.0%). When considering non-RTC injuries, falls were the most common mechanism (47.0%, 95% CI 44.0%-50.1%), and homes were the most common location (38.1%, 95% CI 34.9%-41.4%), followed by road (17.9%, 95% CI 15.7%-20.4%), and workplace (17.4%, 95% CI 15.2%-19.8%). The largest proportion (23.2%, [95% CI 20.6%-25.9%]) of non-RTC injuries happened to women at home.

Conclusion: Non-RTC injuries, in particular falls, predominate in this population. This highlights a neglected side of injuries, many of which happen at home to women, whereas global attention tends to focus on RTCs. Data on all mechanisms of injuries and care-seeking behaviour after injuries are required for health system planning.

Background: Climate change has emerged as a critical global health threat, with growing evidence linking environmental stressors such as heatwaves, air pollution, and temperature variability to adverse pregnancy and neonatal outcomes. However, the structure, evolution, and research hotspots within this interdisciplinary field remain insufficiently understood.

Methods: We conducted a bibliometric analysis of 1,393 English-language publications (2001-2024) retrieved from the Web of Science Core Collection (WoSCC) using a predefined search strategy. CiteSpace was used for knowledge mapping, including co-authorship, co-citation, keyword clustering, and temporal trend analyses.

Results: The number of publications increased markedly after 2017. The United States, China, and the United Kingdom were the most productive countries, with leading institutions including the University of California and Harvard University. Influential authors such as Basu R, Dadvand P, and Chersich MF shaped the field's development. High-frequency keywords included "climate change," "preterm birth," and "air pollution." Keyword clusters and citation bursts highlighted evolving themes such as oxidative stress, brown adipose tissue, and maternal thermoregulation.

Conclusions: This study provides a comprehensive visual and quantitative overview of the research landscape linking climate change with maternal and neonatal health. The findings highlight the growing interdisciplinarity of the field and underscore the need for future research to explore underlying biological mechanisms, prioritize vulnerable populations through equity-focused studies, and inform the development of targeted climate adaptation and mitigation strategies in low-resource settings. These insights can support evidence-based policymaking and guide resource allocation to safeguard maternal and child health amid a changing climate.

Over the past few decades, significant progress has been made in the global fight against HIV and AIDS, largely driven by international funding mechanisms such as the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund. These initiatives have been instrumental in expanding access to antiretroviral therapy (ART), implementing prevention programs, and strengthening healthcare infrastructure, particularly in Sub-Saharan Africa (SSA), a region disproportionately affected by HIV. Zimbabwe, in particular, has achieved remarkable success in combating the epidemic, recently meeting the UNAIDS 95-95-95 fast-track targets, a testament to sustained international support and national commitment. However, the recent suspension of foreign aid, including funding for HIV programs, threatens to undermine these gains. For Zimbabwe, a prolonged freeze could lead to a resurgence of new infections, an increase in AIDS-related mortality, and further strain on Zimbabwe's already fragile healthcare system. This commentary examines the potential consequences of the aid suspension on Zimbabwe's HIV and AIDS response and explores strategies to mitigate its impact.

Background: Presently, the associations between blood glucose management, systemic inflammation, and prognosis in the asthmatic population are still uncertain.

Method: This investigation included 2719 people with asthma from the National Health and Nutrition Examination Survey (NHANES). The linear regression, Cox proportional hazards regression, the Shapley Additive Explanations (SHAP) model, restricted cubic spline (RCS), survival area plot, and survival quantile plot were used to comprehensively evaluate the associations between fasting plasma glucose (FPG), hemoglobin A1c (HbAlc), the systemic inflammation, and the mortality in populations with asthma.

Results: The Cox regression model revealed a positive correlation between HbA1c (HR: 1.21, 95% CI: 1.04-1.42) and FPG (HR: 1.08, 95% CI: 1.02-1.15) and the risk of death in asthmatics, while diabetes (HR: 1.55, 95% CI: 1.07-2.23) also increased the death risk of asthma. The RCS, survival area plot, and survival quantile plot all corroborated the positive association between HbA1c, FPG, and the death risk in asthma patients. The SHAP model suggested that the top five key markers for predicting the mortality risk of asthmatic people were age, cardiovascular disease, cholesterol, systemic inflammatory index (SII), and FPG. This investigation also revealed a positive relationship between HbA1c and FPG as well as neutrophils, along with a positive association between FPG and the SII.

Conclusions: Higher blood glucose levels-reflected by both HbA1c and FPG-are independently associated with greater mortality risk in adults with asthma. And hyperglycemia is linked to systemic inflammation, optimizing blood glucose control may improve inflammatory status and long-term outcomes in this population.