Jinghui Sun, Yuanyuan Zhang, Suizan Zhou, Ying Song, Suping Zhang, Jie Zhu, Zhiyuan Zhu, Rui Wang, Hong Chen, Liling Chen, Haibing Yang, Jun Zhang, Eduardo Azziz-Baumgartner, W William Schluter
Pregnancy is associated with increased risk for severe illness and complications associated with influenza infection. Insufficient knowledge about the risk for influenza among pregnant women and their health care providers in China is an important barrier to increasing influenza vaccination coverage and treating influenza and its complications among pregnant women. Improved influenza incidence estimates might promote wider vaccine acceptance and higher vaccination coverage. In Suzhou, active population-based surveillance during October 2018-September 2023 estimated that the annual rate of hospitalization for acute respiratory or febrile illness (ARFI) among women who were pregnant or <2 weeks postpartum was 11.1 per 1,000 live births; the annual rate of laboratory-confirmed influenza-associated ARFI (influenza ARFI) hospitalization in this group was 2.1 per 1,000 live births. A majority of hospitalized pregnant or early postpartum patients with ARFI (82.6%; 2,588 of 3,133) or influenza ARFI (85.5%; 423 of 495) were admitted to obstetrics wards rather than respiratory medicine wards. Only one (0.03%) pregnant or postpartum ARFI patient had received influenza vaccination, and 31.3% of pregnant or postpartum women hospitalized for influenza ARFI received antiviral treatment; the lowest percentage of hospitalized women with influenza ARFI who received antiviral treatment was among women admitted to obstetrics and gynecology wards (29.6% and 23.1%, respectively), compared with 54.1% of those admitted to a respiratory medicine ward. These findings highlight the risk for influenza and its associated complications among pregnant and postpartum women, the low rates of influenza vaccination among pregnant women, and of antiviral treatment of women with ARFI admitted to obstetrics and gynecology wards. Increasing awareness of the prevalence of influenza ARFI among pregnant women, the use of empiric antiviral treatment for ARFI, and the infection control in obstetrics wards during influenza seasons might help reduce influenza-associated morbidity among pregnant and postpartum women.
{"title":"Laboratory-Confirmed Influenza Hospitalizations During Pregnancy or the Early Postpartum Period - Suzhou City, Jiangsu Province, China, 2018-2023.","authors":"Jinghui Sun, Yuanyuan Zhang, Suizan Zhou, Ying Song, Suping Zhang, Jie Zhu, Zhiyuan Zhu, Rui Wang, Hong Chen, Liling Chen, Haibing Yang, Jun Zhang, Eduardo Azziz-Baumgartner, W William Schluter","doi":"10.15585/mmwr.mm7343a1","DOIUrl":"10.15585/mmwr.mm7343a1","url":null,"abstract":"<p><p>Pregnancy is associated with increased risk for severe illness and complications associated with influenza infection. Insufficient knowledge about the risk for influenza among pregnant women and their health care providers in China is an important barrier to increasing influenza vaccination coverage and treating influenza and its complications among pregnant women. Improved influenza incidence estimates might promote wider vaccine acceptance and higher vaccination coverage. In Suzhou, active population-based surveillance during October 2018-September 2023 estimated that the annual rate of hospitalization for acute respiratory or febrile illness (ARFI) among women who were pregnant or <2 weeks postpartum was 11.1 per 1,000 live births; the annual rate of laboratory-confirmed influenza-associated ARFI (influenza ARFI) hospitalization in this group was 2.1 per 1,000 live births. A majority of hospitalized pregnant or early postpartum patients with ARFI (82.6%; 2,588 of 3,133) or influenza ARFI (85.5%; 423 of 495) were admitted to obstetrics wards rather than respiratory medicine wards. Only one (0.03%) pregnant or postpartum ARFI patient had received influenza vaccination, and 31.3% of pregnant or postpartum women hospitalized for influenza ARFI received antiviral treatment; the lowest percentage of hospitalized women with influenza ARFI who received antiviral treatment was among women admitted to obstetrics and gynecology wards (29.6% and 23.1%, respectively), compared with 54.1% of those admitted to a respiratory medicine ward. These findings highlight the risk for influenza and its associated complications among pregnant and postpartum women, the low rates of influenza vaccination among pregnant women, and of antiviral treatment of women with ARFI admitted to obstetrics and gynecology wards. Increasing awareness of the prevalence of influenza ARFI among pregnant women, the use of empiric antiviral treatment for ARFI, and the infection control in obstetrics wards during influenza seasons might help reduce influenza-associated morbidity among pregnant and postpartum women.</p>","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"73 43","pages":"958-964"},"PeriodicalIF":25.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"QuickStats: Percentage* of Adults Aged ≥18 Years Who Were in Families Having Problems Paying Medical Bills in the Past 12 Months,<sup>†</sup> by Disability Status<sup>§</sup> and Age Group - United States, 2023.","authors":"","doi":"10.15585/mmwr.mm7343a6","DOIUrl":"10.15585/mmwr.mm7343a6","url":null,"abstract":"","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"73 43","pages":"989"},"PeriodicalIF":25.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jason Zucker, Avrom S Caplan, Shauna H Gunaratne, Stephanie M Gallitano, John G Zampella, Caitlin Otto, Rachel Sally, Sudha Chaturvedi, Brittany O'Brien, Gabrielle C Todd, Priyanka Anand, Laura A S Quilter, Dallas J Smith, Tom Chiller, Shawn R Lockhart, Meghan Lyman, Preeti Pathela, Jeremy A W Gold
{"title":"Notes from the Field: Trichophyton mentagrophytes Genotype VII - New York City, April-July 2024.","authors":"Jason Zucker, Avrom S Caplan, Shauna H Gunaratne, Stephanie M Gallitano, John G Zampella, Caitlin Otto, Rachel Sally, Sudha Chaturvedi, Brittany O'Brien, Gabrielle C Todd, Priyanka Anand, Laura A S Quilter, Dallas J Smith, Tom Chiller, Shawn R Lockhart, Meghan Lyman, Preeti Pathela, Jeremy A W Gold","doi":"10.15585/mmwr.mm7343a5","DOIUrl":"10.15585/mmwr.mm7343a5","url":null,"abstract":"","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"73 43","pages":"985-988"},"PeriodicalIF":25.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Camille E Jones, M Carolina Danovaro-Holliday, George Mwinnyaa, Marta Gacic-Dobo, Lauren Francis, Jan Grevendonk, Yoann Nedelec, Aaron Wallace, Samir V Sodha, Ciara Sugerman
In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (IA2030), a 10-year strategy to reduce vaccine-preventable disease (VPD)-associated morbidity and mortality. IA2030 goals include improving equitable vaccination coverage, halving the number of unimmunized (zero-dose) children, and increasing the introduction of new and underutilized vaccines. The COVID-19 pandemic disrupted health systems worldwide, hindering years of childhood vaccination achievements and putting global public health goals at risk. This report presents trends in World Health Organization (WHO) and UNICEF routine vaccination coverage estimates through 2023 across the 194 WHO member countries. During 2022-2023, global coverage with the first and third doses of diphtheria-tetanus-pertussis-containing vaccine (DTPcv) (89% and 84%, respectively) and the first dose of measles-containing vaccine (83%) stagnated and remained lower than prepandemic levels. The 31 WHO member countries with fragile, conflict-affected, and vulnerable (FCV) settings include approximately one half of the world's 14.5 million children who did not receive the first DTPcv dose. The introduction of new and underutilized vaccines, such as a second MCV dose in the African Region, has improved countries' overall protection against VPDs. Accelerating country-specific routine immunization and catch-up vaccination programs to reach unvaccinated and incompletely vaccinated children, especially those living in FCV settings, is critical to reducing morbidity and mortality associated with VPDs.
{"title":"Routine Vaccination Coverage - Worldwide, 2023.","authors":"Camille E Jones, M Carolina Danovaro-Holliday, George Mwinnyaa, Marta Gacic-Dobo, Lauren Francis, Jan Grevendonk, Yoann Nedelec, Aaron Wallace, Samir V Sodha, Ciara Sugerman","doi":"10.15585/mmwr.mm7343a4","DOIUrl":"10.15585/mmwr.mm7343a4","url":null,"abstract":"<p><p>In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (IA2030), a 10-year strategy to reduce vaccine-preventable disease (VPD)-associated morbidity and mortality. IA2030 goals include improving equitable vaccination coverage, halving the number of unimmunized (zero-dose) children, and increasing the introduction of new and underutilized vaccines. The COVID-19 pandemic disrupted health systems worldwide, hindering years of childhood vaccination achievements and putting global public health goals at risk. This report presents trends in World Health Organization (WHO) and UNICEF routine vaccination coverage estimates through 2023 across the 194 WHO member countries. During 2022-2023, global coverage with the first and third doses of diphtheria-tetanus-pertussis-containing vaccine (DTPcv) (89% and 84%, respectively) and the first dose of measles-containing vaccine (83%) stagnated and remained lower than prepandemic levels. The 31 WHO member countries with fragile, conflict-affected, and vulnerable (FCV) settings include approximately one half of the world's 14.5 million children who did not receive the first DTPcv dose. The introduction of new and underutilized vaccines, such as a second MCV dose in the African Region, has improved countries' overall protection against VPDs. Accelerating country-specific routine immunization and catch-up vaccination programs to reach unvaccinated and incompletely vaccinated children, especially those living in FCV settings, is critical to reducing morbidity and mortality associated with VPDs.</p>","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"73 43","pages":"978-984"},"PeriodicalIF":25.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meredith Robinson, Jenny Crain, Brittany Kendall, Victoria Alexander, Elena Diskin, Dawn Saady, Corryn Hicks, Angela Myrick-West, Paige Bordwine, Denise Sockwell, Emily Craig, Amy Rubis, Lucy McNamara, Shalabh Sharma, Rebecca Howie, Daya Marasini, Henju Marjuki, Ana Colón
Invasive meningococcal disease (IMD) is a severe illness that can have devastating effects; outbreaks are uncommon in the United States. Vaccination is the preferred control measure for IMD outbreaks when a defined population at risk (e.g., college students or persons experiencing homelessness) can be identified. In August 2022, the Virginia Department of Health (VDH) began investigating an IMD outbreak in Virginia's Eastern Health Planning Region, prompted by the detection of four confirmed cases within 8 weeks. Clinical isolates available from three cases were characterized as Neisseria meningitidis serogroup Y, sequence type 1466. A subsequent statewide investigation identified 36 genetically related cases, including seven deaths (case fatality rate = 19.4%) as of March 1, 2024. A majority of patients (63.9%) were in an age group (30-60 years) not generally considered at increased risk for IMD; 78.0% were non-Hispanic Black or African American. No common exposures, affiliations, or risk factors were identified, and a defined population could not be identified for vaccination. VDH recommended quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccination of a subset of close contacts of patients based on IMD risk factors and age range similar to that of patients with identified cases. IMD outbreaks might affect populations without established IMD risk factors. Lack of a well-defined population at risk might prompt exploration of novel control strategies, such as selective vaccination of close contacts.
{"title":"Statewide Outbreak of Neisseria meningitidis Serogroup Y, Sequence Type 1466 - Virginia, 2022-2024.","authors":"Meredith Robinson, Jenny Crain, Brittany Kendall, Victoria Alexander, Elena Diskin, Dawn Saady, Corryn Hicks, Angela Myrick-West, Paige Bordwine, Denise Sockwell, Emily Craig, Amy Rubis, Lucy McNamara, Shalabh Sharma, Rebecca Howie, Daya Marasini, Henju Marjuki, Ana Colón","doi":"10.15585/mmwr.mm7343a3","DOIUrl":"10.15585/mmwr.mm7343a3","url":null,"abstract":"<p><p>Invasive meningococcal disease (IMD) is a severe illness that can have devastating effects; outbreaks are uncommon in the United States. Vaccination is the preferred control measure for IMD outbreaks when a defined population at risk (e.g., college students or persons experiencing homelessness) can be identified. In August 2022, the Virginia Department of Health (VDH) began investigating an IMD outbreak in Virginia's Eastern Health Planning Region, prompted by the detection of four confirmed cases within 8 weeks. Clinical isolates available from three cases were characterized as Neisseria meningitidis serogroup Y, sequence type 1466. A subsequent statewide investigation identified 36 genetically related cases, including seven deaths (case fatality rate = 19.4%) as of March 1, 2024. A majority of patients (63.9%) were in an age group (30-60 years) not generally considered at increased risk for IMD; 78.0% were non-Hispanic Black or African American. No common exposures, affiliations, or risk factors were identified, and a defined population could not be identified for vaccination. VDH recommended quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccination of a subset of close contacts of patients based on IMD risk factors and age range similar to that of patients with identified cases. IMD outbreaks might affect populations without established IMD risk factors. Lack of a well-defined population at risk might prompt exploration of novel control strategies, such as selective vaccination of close contacts.</p>","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"73 43","pages":"973-977"},"PeriodicalIF":25.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/s2468-2667(24)00226-3
Karen Lau, Robert Aldridge, Marie Norredam, George Frederick Mkoma, Mathura Kugan, Rosita Chia-Yin Lin, Ligia Kiss, Cathy Zimmerman, Sally Hargreaves
<h3>Background</h3>Migrant workers, a population of 170 million, often work in dangerous or unhealthy working environments and are likely to suffer workplace injuries and labour abuses. However, the risk of mortality in migrant workers compared with local workers is unknown. We aim to synthesise global evidence on migrant worker mortality risk and identify social determinants to inform health and safety protections for migrant workers.<h3>Methods</h3>We conducted a systematic review and meta-analysis of peer-reviewed literature to examine mortality outcomes among migrant workers and associated risk factors. We searched MEDLINE, Embase, PsycINFO, and Ovid Global Health for studies published between Jan 1, 2000, and Jan 17, 2023, reporting quantitative primary research in English. A broad definition of migrant worker was used, including any worker who is foreign-born (ie, international first-generation migrant workers), either in paid employment or self-employment. Internal migrants, second-generation migrants, and foreign health-care workers were excluded. The primary outcome was any reported mortality, including all-cause mortality, cause-specific mortality, suicide, homicide, and fatal occupational injury. We used meta-analysis to compare outcomes between migrant worker and local worker populations, and a random-effects model to calculate pooled estimates. We used narrative synthesis to develop a data-driven conceptual framework capturing the intersectional social determinants of mortality in migrant workers. The study protocol is registered on PROSPERO, CRD42023372893.<h3>Findings</h3>Of 11 495 identified records, 44 were included in the systematic review, of which 11 studies were pooled in meta-analyses. Data were from 16 countries, most of which were high-income countries, and included 44 338 migrant worker deaths, including migrants from the agriculture, construction, mining, and service industries. Compared with local workers, migrant workers had a higher risk of fatal occupational injury (pooled relative risk 1·71, 95% CI 1·22–2·38; eight studies; <em>I</em><sup>2</sup>=99·4%), and a lower risk of all-cause mortality (0·94, 0·88–0·99; three studies, <em>I</em><sup>2</sup>=90·7%). Migrant workers were more likely to die from external causes of death (such as falls or assaults) than internal causes of death (such as respiratory or digestive diseases) compared with local workers, with migrant workers also more likely to die from work-related homicides, especially in the retail and sex industries, with some evidence of higher suicide rates among female migrant workers compared with female local workers. Influential social determinants for poor fatality outcomes include migration-related factors (such as lower language proficiency, undocumented status, and long duration of stay) and labour-related factors (such as precarious employment, labour migration policies, and economic deregulation policies).<h3>Interpretation</h3>Migrant workers have a
{"title":"Workplace mortality risk and social determinants among migrant workers: a systematic review and meta-analysis","authors":"Karen Lau, Robert Aldridge, Marie Norredam, George Frederick Mkoma, Mathura Kugan, Rosita Chia-Yin Lin, Ligia Kiss, Cathy Zimmerman, Sally Hargreaves","doi":"10.1016/s2468-2667(24)00226-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00226-3","url":null,"abstract":"<h3>Background</h3>Migrant workers, a population of 170 million, often work in dangerous or unhealthy working environments and are likely to suffer workplace injuries and labour abuses. However, the risk of mortality in migrant workers compared with local workers is unknown. We aim to synthesise global evidence on migrant worker mortality risk and identify social determinants to inform health and safety protections for migrant workers.<h3>Methods</h3>We conducted a systematic review and meta-analysis of peer-reviewed literature to examine mortality outcomes among migrant workers and associated risk factors. We searched MEDLINE, Embase, PsycINFO, and Ovid Global Health for studies published between Jan 1, 2000, and Jan 17, 2023, reporting quantitative primary research in English. A broad definition of migrant worker was used, including any worker who is foreign-born (ie, international first-generation migrant workers), either in paid employment or self-employment. Internal migrants, second-generation migrants, and foreign health-care workers were excluded. The primary outcome was any reported mortality, including all-cause mortality, cause-specific mortality, suicide, homicide, and fatal occupational injury. We used meta-analysis to compare outcomes between migrant worker and local worker populations, and a random-effects model to calculate pooled estimates. We used narrative synthesis to develop a data-driven conceptual framework capturing the intersectional social determinants of mortality in migrant workers. The study protocol is registered on PROSPERO, CRD42023372893.<h3>Findings</h3>Of 11 495 identified records, 44 were included in the systematic review, of which 11 studies were pooled in meta-analyses. Data were from 16 countries, most of which were high-income countries, and included 44 338 migrant worker deaths, including migrants from the agriculture, construction, mining, and service industries. Compared with local workers, migrant workers had a higher risk of fatal occupational injury (pooled relative risk 1·71, 95% CI 1·22–2·38; eight studies; <em>I</em><sup>2</sup>=99·4%), and a lower risk of all-cause mortality (0·94, 0·88–0·99; three studies, <em>I</em><sup>2</sup>=90·7%). Migrant workers were more likely to die from external causes of death (such as falls or assaults) than internal causes of death (such as respiratory or digestive diseases) compared with local workers, with migrant workers also more likely to die from work-related homicides, especially in the retail and sex industries, with some evidence of higher suicide rates among female migrant workers compared with female local workers. Influential social determinants for poor fatality outcomes include migration-related factors (such as lower language proficiency, undocumented status, and long duration of stay) and labour-related factors (such as precarious employment, labour migration policies, and economic deregulation policies).<h3>Interpretation</h3>Migrant workers have a ","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"213 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/s2468-2667(24)00227-5
Monique Tan
Salt is consumed in excess in most countries, with global salt intake averaging at more than double the recommended maximum limit of 5 g per day. By raising blood pressure, excess salt intake is a major risk factor for cardiovascular disease, the leading cause of premature death and ill health worldwide. In 2013, all WHO Member States committed to a 30% reduction in average salt intake by 2025. However, as of 2023, none were on track to achieve it.1
{"title":"Mandatory salt targets: a key policy tool for global salt reduction efforts","authors":"Monique Tan","doi":"10.1016/s2468-2667(24)00227-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00227-5","url":null,"abstract":"Salt is consumed in excess in most countries, with global salt intake averaging at more than double the recommended maximum limit of 5 g per day. By raising blood pressure, excess salt intake is a major risk factor for cardiovascular disease, the leading cause of premature death and ill health worldwide. In 2013, all WHO Member States committed to a 30% reduction in average salt intake by 2025. However, as of 2023, none were on track to achieve it.<span><span><sup>1</sup></span></span>","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"15 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/s2468-2667(24)00222-6
Ruth F Hunter, Selin Akaraci, Ruoyu Wang, Rodrigo Reis, Pedro C Hallal, Sandy Pentland, Christopher Millett, Leandro Garcia, Jason Thompson, Kerry Nice, Belen Zapata-Diomedi, Esteban Moro
<h3>Background</h3>During the COVID-19 pandemic, changes were seen in city mobility patterns around the world, including in active transportation (walking, cycling, micromobility, and public transit use), creating a unique opportunity for global public health lessons and action. We aimed to analyse a global natural experiment exploring city mobility patterns during the pandemic and how they related to the implementation of COVID-19-related policies.<h3>Methods</h3>We obtained data from Apple's Mobility Trends Reports on city mobility indexes for 296 cities from Jan 13, 2020 to Feb 4, 2022. Mobility indexes represented the frequency of Apple Maps queries for driving, walking, and public transit journeys relative to a baseline value of 100 for the pre-pandemic period (defined as Jan 13, 2020). City mobility index trajectories were plotted with stratification by country income level, transportation-related city type, population density, and COVID-19 pandemic severity (SARS-CoV-2 infection rate). We also synthesised global pandemic policies and recovery actions that promoted or restricted city mobility and active transportation (walking, cycling and micromobility, and public transit) using the Shifting Streets dataset. Additionally, a natural experiment on a global scale evaluated the effects of new active transportation policies on walking and public transit use in cities around the world. We used multivariable regression with a difference-in-difference (DID) analysis to explore whether the implementation of walking or public transit promotion policies affected mobility indexes, comparing cities with and without implementation of these policies in the pre-intervention period (Jan 27 to April 12, 2020) and post-intervention period (April 13 to June 28, 2020).<h3>Findings</h3>Based on city mobility index trajectories, we observed an overall decline in mobility indexes for walking, driving, and public transit at the beginning of the pandemic, but these values began to increase in April, 2020. Cities with lower population densities generally had higher driving and walking indexes than cities with higher population density, while cities with higher population densities had higher public transit indexes. Cities with higher pandemic severity generally had higher driving and walking indexes than cities with lower pandemic severity, while cities with lower pandemic severity had higher public transit indexes than other cities. We identified 587 policies in the dataset that had known implementation dates and were relevant to active transportation, which included 305 policies on walking, 321 on cycling and micromobility, and 143 on public transit, across 230 cities within 33 countries (19 high-income, 11 middle-income, and three low-income countries). In the global natural experiment (including 39 cities), implementation of policy interventions promoting walking was significantly associated with a higher absolute value of the walking index (DID coefficient 20·6
{"title":"City mobility patterns during the COVID-19 pandemic: analysis of a global natural experiment","authors":"Ruth F Hunter, Selin Akaraci, Ruoyu Wang, Rodrigo Reis, Pedro C Hallal, Sandy Pentland, Christopher Millett, Leandro Garcia, Jason Thompson, Kerry Nice, Belen Zapata-Diomedi, Esteban Moro","doi":"10.1016/s2468-2667(24)00222-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00222-6","url":null,"abstract":"<h3>Background</h3>During the COVID-19 pandemic, changes were seen in city mobility patterns around the world, including in active transportation (walking, cycling, micromobility, and public transit use), creating a unique opportunity for global public health lessons and action. We aimed to analyse a global natural experiment exploring city mobility patterns during the pandemic and how they related to the implementation of COVID-19-related policies.<h3>Methods</h3>We obtained data from Apple's Mobility Trends Reports on city mobility indexes for 296 cities from Jan 13, 2020 to Feb 4, 2022. Mobility indexes represented the frequency of Apple Maps queries for driving, walking, and public transit journeys relative to a baseline value of 100 for the pre-pandemic period (defined as Jan 13, 2020). City mobility index trajectories were plotted with stratification by country income level, transportation-related city type, population density, and COVID-19 pandemic severity (SARS-CoV-2 infection rate). We also synthesised global pandemic policies and recovery actions that promoted or restricted city mobility and active transportation (walking, cycling and micromobility, and public transit) using the Shifting Streets dataset. Additionally, a natural experiment on a global scale evaluated the effects of new active transportation policies on walking and public transit use in cities around the world. We used multivariable regression with a difference-in-difference (DID) analysis to explore whether the implementation of walking or public transit promotion policies affected mobility indexes, comparing cities with and without implementation of these policies in the pre-intervention period (Jan 27 to April 12, 2020) and post-intervention period (April 13 to June 28, 2020).<h3>Findings</h3>Based on city mobility index trajectories, we observed an overall decline in mobility indexes for walking, driving, and public transit at the beginning of the pandemic, but these values began to increase in April, 2020. Cities with lower population densities generally had higher driving and walking indexes than cities with higher population density, while cities with higher population densities had higher public transit indexes. Cities with higher pandemic severity generally had higher driving and walking indexes than cities with lower pandemic severity, while cities with lower pandemic severity had higher public transit indexes than other cities. We identified 587 policies in the dataset that had known implementation dates and were relevant to active transportation, which included 305 policies on walking, 321 on cycling and micromobility, and 143 on public transit, across 230 cities within 33 countries (19 high-income, 11 middle-income, and three low-income countries). In the global natural experiment (including 39 cities), implementation of policy interventions promoting walking was significantly associated with a higher absolute value of the walking index (DID coefficient 20·6","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"7 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/s2468-2667(24)00221-4
Kathy Trieu, Liping Huang, Leopold N Aminde, Linda Cobiac, Daisy H Coyle, Mary Njeri Wanjau, Sudhir Raj Thout, Bruce Neal, Jason H Y Wu, Lennert Veerman, Matti Marklund, Rachita Gupta
Background
Excess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India.
Methods
We used a multiple cohort, proportional multistate, life table (Markov) model to estimate the health gains and cost effectiveness for adults if sodium content in packaged foods complied with the WHO benchmarks compared to the status quo. We used India-specific dietary surveys, food composition tables, foods sales data, and sodium content data from packaged food labels to estimate sodium intake before and after the intervention. Data on blood pressure, cardiovascular disease, and chronic kidney disease burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors study, and the effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to estimate net costs, and calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted at 3%.
Findings
In the first 10 years, compliance with the WHO sodium benchmarks was estimated to avert a mean of 0·3 (95% uncertainty interval [UI] 0·2–0·5) million deaths from cardiovascular diseases and chronic kidney disease, a mean of 1·7 (95% UI 1·0–2·4) million incident cardiovascular disease events, and 0·7 (0·4–1·0) million new chronic kidney disease cases, compared with current practice. Over 10 years, the intervention was projected to be cost saving (100·0% probability), generating 1·0 (0·6 to 1·4) billion HALYs and US$0·8 (95% UI 0·3 to 1·4) million in cost savings. Over the population lifetime, the intervention could prevent 4·2 (2·4–6·0) million deaths from cardiovascular diseases and chronic kidney disease, 14·0 (8·2–20·1) million incident cardiovascular disease events, and 4·8 (2·8–6·8) new chronic kidney disease cases, with an 84·2% probability of being cost-saving and 100·0% probability of being cost-effective.
Interpretation
Our modelling data suggest a high potential for compliance with WHO sodium benchmarks for packaged food being associated with substantial health gains and cost savings, making a strong case for India to mandate the implementation of the WHO sodium benchmarks, particularly as packaged food consumption continues to rise.
{"title":"Estimated health benefits, costs, and cost-effectiveness of implementing WHO's sodium benchmarks for packaged foods in India: a modelling study","authors":"Kathy Trieu, Liping Huang, Leopold N Aminde, Linda Cobiac, Daisy H Coyle, Mary Njeri Wanjau, Sudhir Raj Thout, Bruce Neal, Jason H Y Wu, Lennert Veerman, Matti Marklund, Rachita Gupta","doi":"10.1016/s2468-2667(24)00221-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00221-4","url":null,"abstract":"<h3>Background</h3>Excess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India.<h3>Methods</h3>We used a multiple cohort, proportional multistate, life table (Markov) model to estimate the health gains and cost effectiveness for adults if sodium content in packaged foods complied with the WHO benchmarks compared to the status quo. We used India-specific dietary surveys, food composition tables, foods sales data, and sodium content data from packaged food labels to estimate sodium intake before and after the intervention. Data on blood pressure, cardiovascular disease, and chronic kidney disease burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors study, and the effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to estimate net costs, and calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted at 3%.<h3>Findings</h3>In the first 10 years, compliance with the WHO sodium benchmarks was estimated to avert a mean of 0·3 (95% uncertainty interval [UI] 0·2–0·5) million deaths from cardiovascular diseases and chronic kidney disease, a mean of 1·7 (95% UI 1·0–2·4) million incident cardiovascular disease events, and 0·7 (0·4–1·0) million new chronic kidney disease cases, compared with current practice. Over 10 years, the intervention was projected to be cost saving (100·0% probability), generating 1·0 (0·6 to 1·4) billion HALYs and US$0·8 (95% UI 0·3 to 1·4) million in cost savings. Over the population lifetime, the intervention could prevent 4·2 (2·4–6·0) million deaths from cardiovascular diseases and chronic kidney disease, 14·0 (8·2–20·1) million incident cardiovascular disease events, and 4·8 (2·8–6·8) new chronic kidney disease cases, with an 84·2% probability of being cost-saving and 100·0% probability of being cost-effective.<h3>Interpretation</h3>Our modelling data suggest a high potential for compliance with WHO sodium benchmarks for packaged food being associated with substantial health gains and cost savings, making a strong case for India to mandate the implementation of the WHO sodium benchmarks, particularly as packaged food consumption continues to rise.<h3>Funding</h3>WHO Country Office India.","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"3 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/s2468-2667(24)00218-4
Jiangrong Wang, K Miriam Elfström, Joakim Dillner
<h3>Background</h3>Human papillomavirus (HPV)-based cervical screening is a globally recommended public health policy. Randomised clinical trials find superior performance of primary HPV-based screening compared with cytology for preventing cervical cancer. However, additional evidence from real-world public health policies is needed. In preplanned secondary analysis of a randomised health-care policy trial in Sweden we aimed to evaluate which policy provided better protection against invasive cervical cancer, after two full rounds of screening.<h3>Methods</h3>The organised cervical screening programme in the capital region of Sweden invited all women aged 30–64 years and eligible for screening to a randomised health-care policy trial of HPV-based versus cytology-based screening. During 2014–16, 395 725 eligible women were randomly assigned (non-concealed) to either policy and the invasive cervical cancer incidences over 8 years of follow-up were compared. Intention-to-screen analyses included all invited women and per-protocol analyses the women that attended baseline screening according to protocol. This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>, <span><span>NCT01511328</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>.<h3>Findings</h3>Women invited to HPV-based cervical screening had a 17% lower invasive cervical cancer risk compared with women invited to cytology (hazard ratio [HR] 0·83, 95% CI 0·70–0·98). Women participating in HPV-based screening had a 28% lower invasive cervical cancer risk compared with women participating with cytology (HR 0·72, 95% CI 0·54–0·95). Adverse events were a higher number of referrals to colposcopy with biopsy in the HPV policy (15 832 [7·5%] of 212 199 in intention to screen analyses and 9968 [9·0%] of 110 176 per protocol at baseline) than in the cytology policy (12 650 [6·9%] of 183 120 in intention to screen analyses, and 7179 [7·9%] of 90 821 per protocol at baseline). Women who were HPV-negative at baseline had invasive cervical cancer risks of 1·3 (95% CI 0·6–2·4) per 100 000 person-years, whereas the risk for women with normal cytology was 9·1 (6·7–11·8) per 100 000 person-years. HPV-positive women with negative cytology triage had invasive cervical cancer risks of 79·2 per 100 000 person-years and HPV 16 or HPV 18-positive women with negative cytology triage had risks of 318·2 per 100 000 person-years.<h3>Interpretation</h3>This randomised policy trial found HPV-based screening to be superior for preventing invasive cervical cancer in the real-world setting. A single baseline HPV-negative test was associated with a very
{"title":"Human papillomavirus-based cervical screening and long-term cervical cancer risk: a randomised health-care policy trial in Sweden","authors":"Jiangrong Wang, K Miriam Elfström, Joakim Dillner","doi":"10.1016/s2468-2667(24)00218-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00218-4","url":null,"abstract":"<h3>Background</h3>Human papillomavirus (HPV)-based cervical screening is a globally recommended public health policy. Randomised clinical trials find superior performance of primary HPV-based screening compared with cytology for preventing cervical cancer. However, additional evidence from real-world public health policies is needed. In preplanned secondary analysis of a randomised health-care policy trial in Sweden we aimed to evaluate which policy provided better protection against invasive cervical cancer, after two full rounds of screening.<h3>Methods</h3>The organised cervical screening programme in the capital region of Sweden invited all women aged 30–64 years and eligible for screening to a randomised health-care policy trial of HPV-based versus cytology-based screening. During 2014–16, 395 725 eligible women were randomly assigned (non-concealed) to either policy and the invasive cervical cancer incidences over 8 years of follow-up were compared. Intention-to-screen analyses included all invited women and per-protocol analyses the women that attended baseline screening according to protocol. This trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT01511328</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>.<h3>Findings</h3>Women invited to HPV-based cervical screening had a 17% lower invasive cervical cancer risk compared with women invited to cytology (hazard ratio [HR] 0·83, 95% CI 0·70–0·98). Women participating in HPV-based screening had a 28% lower invasive cervical cancer risk compared with women participating with cytology (HR 0·72, 95% CI 0·54–0·95). Adverse events were a higher number of referrals to colposcopy with biopsy in the HPV policy (15 832 [7·5%] of 212 199 in intention to screen analyses and 9968 [9·0%] of 110 176 per protocol at baseline) than in the cytology policy (12 650 [6·9%] of 183 120 in intention to screen analyses, and 7179 [7·9%] of 90 821 per protocol at baseline). Women who were HPV-negative at baseline had invasive cervical cancer risks of 1·3 (95% CI 0·6–2·4) per 100 000 person-years, whereas the risk for women with normal cytology was 9·1 (6·7–11·8) per 100 000 person-years. HPV-positive women with negative cytology triage had invasive cervical cancer risks of 79·2 per 100 000 person-years and HPV 16 or HPV 18-positive women with negative cytology triage had risks of 318·2 per 100 000 person-years.<h3>Interpretation</h3>This randomised policy trial found HPV-based screening to be superior for preventing invasive cervical cancer in the real-world setting. A single baseline HPV-negative test was associated with a very ","PeriodicalId":25,"journal":{"name":"ACS Sustainable Chemistry & Engineering","volume":"131 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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