Global Epidemiology最新文献

{"title":"Resurgence in focus: Covid-19 dynamics and optimal control frameworks","authors":"Evans O. Omorogie ,&nbsp;Kolade M. Owolabi ,&nbsp;Bola T. Olabode ,&nbsp;Tunde T. Yusuf ,&nbsp;Edson Pindza","doi":"10.1016/j.gloepi.2025.100200","DOIUrl":"10.1016/j.gloepi.2025.100200","url":null,"abstract":"<div><div>The resurgence of Covid-19, accompanied by various variants of the virus, highlights the fact that Covid-19 is still present within the population. The study proposed a Covid-19 dynamical model for analyzing the effect of vaccination and the continuous use of non-medical interventions for addressing Covid-19 transmission dynamics. The Lyaponov function and Jacobian matrix techniques were used to analyze the stability of the model's equilibria. The model was transformed into a problem of optimal control with time-dependent variables, aimed at managing efforts to prevent the spread of Covid-19. Numerical assessments were deployed to assess the effect of vaccination and the continuous use of non-medical intervention strategies to mitigate the spread of Covid-19. The global sensitivity analysis of the model was used to detect the key parameters influencing the behavior of the model. In addition, numerical results showed a significant decrease in the basic reproduction rate <span><math><mfenced><msub><mi>ℛ</mi><mn>0</mn></msub></mfenced></math></span> when implementing <span><math><mi>σ</mi></math></span> and <span><math><mi>ξ</mi></math></span>, either separately or together. The optimal control results suggested that the control measures should be consistently enforced without any relaxation.</div><div>2010 Mathematics Subject Classification: 92D30, 93C95, 49 N90, 34H05, 37 N25.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of stroke epidemiology in Vietnam: Insights from GBD 1990–2019 and RES-Q 2017–2023","authors":"Minh Cong Tran ,&nbsp;Lara Prisco ,&nbsp;Phuong Minh Pham ,&nbsp;Huy Quoc Phan ,&nbsp;Mario Ganau ,&nbsp;Nhat Pham ,&nbsp;Linh Huyen Truong ,&nbsp;Proochista Ariana ,&nbsp;Phuong Viet Dao ,&nbsp;Dung Tien Nguyen ,&nbsp;Chi Van Nguyen ,&nbsp;Hoa Thi Truong ,&nbsp;Thang Huy Nguyen ,&nbsp;Jeyaraj Pandian ,&nbsp;Ton Duy Mai ,&nbsp;Andrew Farmery","doi":"10.1016/j.gloepi.2025.100199","DOIUrl":"10.1016/j.gloepi.2025.100199","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a significant health burden in Vietnam, with substantial impacts on mortality, morbidity, and healthcare resources. An up-to-date report on stroke epidemiology and associated risk factors in Vietnam was missing.</div></div><div><h3>Method</h3><div>We analyzed the data published in the Global Burden of Disease (GBD) 2019, in combination with the first-time analysis of the Registry of Stroke Care Quality Improvement (RES-Q) initiative in Vietnam from 2017 to 2023.</div></div><div><h3>Findings</h3><div>Comparative analysis globally revealed that Vietnam had one of the highest stroke incidence and prevalence rates in Southeast Asia and ranked 4th in stroke mortality among 11 neighbouring countries. In the RES-Q dataset, 95,696 patients (77 %) were ischemic stroke, 23,203 (18 %) were intracerebral haemorrhage, and 2816 (2 %) were subarachnoid haemorrhage. In GBD 2019, stroke was the leading cause of death among cardiovascular diseases in Vietnam, accounting for 135,999 fatalities. The incidence of stroke was 222 (95 % UIs 206–242) per 100,000 population, with a prevalence of 1541 (1430-1679) per 100,000. Results align with the report from the RES-Q dataset in two megacities of Vietnam: Hanoi (incidence rate of 168.9, prevalence rate of 1182.2) and Ho Chi Minh City (incidence rate of 207.1, prevalence rate of 1221.8). Key risk factors for stroke mortality are high systolic blood pressure (79,000 deaths), unhealthy dietary (43,000 deaths), high fasting plasma glucose (35,000 deaths), and air pollution (33,000 deaths). Incidence is lower in rural Vietnam, but availability and quality of care are higher in megacities.</div></div><div><h3>Interpretation</h3><div>The results promote a further understanding of stroke and risk factors for the Vietnamese population and suggest prevention and treatment strategies for the Vietnamese government, including facility and capacity improvement and applications of advanced technologies.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating risk of acquiring SARS-COV2 infection in treatment-experienced PLWH: A case-control study","authors":"Pierluigi Francesco Salvo ,&nbsp;Valentina Iannone ,&nbsp;Francesca Lombardi ,&nbsp;Arturo Ciccullo ,&nbsp;Francesco Lamanna ,&nbsp;Rosa Anna Passerotto ,&nbsp;Gianmaria Baldin ,&nbsp;Rebecca Jo Steiner ,&nbsp;Andrea Carbone ,&nbsp;Valentina Massaroni ,&nbsp;Simona Di Giambenedetto ,&nbsp;Alberto Borghetti","doi":"10.1016/j.gloepi.2025.100198","DOIUrl":"10.1016/j.gloepi.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Risk factors for acquiring SARS-CoV-2 infection in people living with HIV (PLWH) and the true relationship between HIV and SARS CoV-2, are still not fully understood.</div></div><div><h3>Objectives</h3><div>The aim of this study was to identify the independent risk factors for SARS-CoV-2 acquisition in treatment experienced PLWH, shedding light on potential risk factors associated with SARS CoV-2 infection in PLWH undergoing treatment.</div></div><div><h3>Study design</h3><div>PLWH were recruited from the Infectious Diseases Outpatient Clinic of Fondazione Policlinico Universitario A.Gemelli IRCCS in Italy and randomly interviewed via a questionnaire during their follow-up visits to determine if they had experienced a SARS-CoV-2 infection between March 2020 and June 2022.</div><div>For each participant with reported history of SARS-CoV-2 (cases), two PLWH with no declared COVID-19 infection were selected (controls); PLWH had a similar potential exposure time to SARS-CoV-2. A total 220 PLWH were selected: 72 cases and 148 controls. None developed severe Covid-19 disease and only one participant required hospitalization.</div></div><div><h3>Results</h3><div>Overall, 220 PLWH were enrolled: 72 cases and 148 controls. Characteristics of cases and controls were similar, except for the ART regimen used and the last HIV-RNA concentration before the enrollment date. By an adjusted multivariable logistic regression, the estimated odds of SARS-CoV-2 infection was higher in more recent years (2022 versus 2020 aOR 20.74, 95 % CI 5.26–81.8) and in PLWH with last HIV-RNA &gt;50 cp/mL before enrollment date (versus &lt;50 aOR 4.56, 95 % CI 1.01–20.46). A reduced odds was correlated with &gt;3 vaccine doses (versus &lt;3 or not vaccinated aOR 0.08, 95 % CI 0.02–0.24).</div></div><div><h3>Conclusion</h3><div>In this cohort, the odds of SARS-CoV-2 acquisition increased over time, probably due to change in lock-down measures and in SARS-CoV-2 circulating variants.Detectable viral load was associated with increased risk of infection, highlighting the importance of HIV-RNA monitoring during pandemics.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox: Characterization and clinical outcomes of patients in Colombian healthcare institutions","authors":"Carlos Arturo Álvarez-Moreno ,&nbsp;Ludovic Reveiz ,&nbsp;Claudia Aristizabal ,&nbsp;Jesús Quevedo ,&nbsp;María Lucia Mesa Rubio ,&nbsp;Leonardo Arévalo-Mora ,&nbsp;Julián Felipe Porras Villamil ,&nbsp;Monica Padilla ,&nbsp;Juan Carlos Alzate-Angel ,&nbsp;Jamie Rylance ,&nbsp;Kurbonov Firdavs ,&nbsp;Ilich de la Hoz ,&nbsp;Sandra Liliana Valderrama-Beltran ,&nbsp;Santiago Arboleda ,&nbsp;Otto Sussmann ,&nbsp;Javier Andrade ,&nbsp;Carolina Murillo Velásquez ,&nbsp;Estefania García ,&nbsp;Ximena Galindo ,&nbsp;Daniela Martínez ,&nbsp;Antoine Chaillon","doi":"10.1016/j.gloepi.2025.100197","DOIUrl":"10.1016/j.gloepi.2025.100197","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2022, the world experienced a monkeypox outbreak caused by the Clade IIb strain of the virus. While this outbreak had widespread effects, more information is needed on mpox's specific impact in Colombia, particularly regarding how it is managed, its burden, and its epidemiology. This research seeks to examine the medical context, clinical presentation, and health outcomes of individuals diagnosed with mpox infection, with a particular focus on those with HIV in Colombia.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted in fourteen Health institutions in Colombia based on computerized clinical records from Jan 2022 to Dec 2023. Clinical and epidemiological characteristics were collected from diagnosis until discharge (or death). Participants in the study were diagnosed through molecular methods (PCR) and their clinical evolution was tracked through hospital and/or outpatient medical records. Registered variables were based on the mpox 2023 Case Report Form (2023 - CRF) proposed by the World Health Organization.</div></div><div><h3>Results</h3><div>One thousand four hundred thirteen (1413, 97.2 % male) individuals, including 2.6 % identified as healthcare workers, were included in this study. The majority (54 %, 764/1413 individuals) were persons living with HIV (PWH) and almost one-third of them (30.1 %, <em>n</em> = 284) of participants had concomitant sexually transmitted diseases and HIV, with syphilis being the most prevalent (20.4 %), followed by <em>Neisseria gonorrhoeae</em> (16.4 %). Complications were infrequent, with cellulitis being the most common, and no individuals received mpox-specific treatment or vaccination. Although all individuals had skin lesions distributed across various body regions, differences were noted in lesion distribution among women. Those living with HIV showed higher emergency department attendance and reported having known mpox contacts. While complications were rare, with cellulitis being the most common, women living with HIV showed a higher rate of emergency room visits and known mpox contacts. Although not statistically significant, gastrointestinal, musculoskeletal, psychological, respiratory, and STI symptoms, including syphilis and urethritis, were more common in the virologically non-suppressed HIV group. At the same time, proctitis was more prevalent in the suppressed group. No significant differences were found based on CD4 count, using 200 cells/mm³ in PWH.</div></div><div><h3>Conclusion</h3><div>Over half of the participants were people living with HIV (PWH), with a significant presence of STIs like syphilis. While skin lesions and complications varied, no significant differences were linked to CD4 count or viral load suppression. Mpox symptomatology was not significantly associated with unsuppressed viral loads or low CD4 levels, highlighting the need for further research.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and Associated Factors of Congenital Anomalies Among Neonates in 14 Yemeni Governorates 2021–2023: A Case: Control Study","authors":"Hiam Al-Atnah ,&nbsp;Anas Al-Qubati ,&nbsp;Amir Addin Al-Hashedi ,&nbsp;Muath Al-Saidy ,&nbsp;Saleh Al-Shawish ,&nbsp;Moamer M. Badi ,&nbsp;Najeeb Al-Qubati ,&nbsp;Yasser Ghaleb ,&nbsp;Maha Al-Muntaser","doi":"10.1016/j.gloepi.2025.100196","DOIUrl":"10.1016/j.gloepi.2025.100196","url":null,"abstract":"<div><h3>Background</h3><div>Long-term disability and a reduced quality of life are often associated with congenital anomalies (CAs), which present as structural, functional, or metabolic defects. This study provides a comprehensive view of neonatal congenital anomalies in 14 Yemeni governorates, a significant but often overlooked public health concern. The current study aimed to determine the patterns and associated factors of congenital anomalies in 14 Yemeni governorates between 2021 and 2023.</div></div><div><h3>Methods</h3><div>An unmatched case-control 1:2 design was conducted using secondary data collected from various health facilities across 14 Yemeni governorates during 2021–2023. Sample size was calculated and data was analyzed using Epi Info version 7.2, with 612 neonates with documented diagnosis of congenital anomalies and 1224 healthy neonates. Binary and multiple logistic regression were used to identify factors associated with congenital anomalies, alongside the chi-square test.</div></div><div><h3>Results</h3><div>The majority of the congenital anomalies identified were located in Al Hudaydah (34 %), Ibb (17.2 %), and Sana'a (13.1 %). Most were isolated 518 (84.64 %), whereas 94 (15.36 %) were multiple. The predominant system was the nervous system (33.9 %), followed by the skeletal system (14.8 %) and orofacial anomalies (10.6 %). Furthermore, strong associations were found with positive consanguinity (OR = 28.82), low socioeconomic status (OR = 10.70), maternal age ≥ 35 years old (OR = 7.66), stress (OR = 4.95), acute diseases (OR = 3.56), gestational age &lt; 37 weeks (OR = 3.32), maternal age &lt; 20 years old (OR = 2.32), positive family history (OR = 1.74), low birth weight (OR = 1.27), grand-multiparity (OR = 0.71) and male sex (OR = 0.10).</div></div><div><h3>Interpretation</h3><div>This broad research identified significant patterns, maternal and neonatal associations, and protective variables for congenital anomalies. These results can help inform national interventions and policies for prevention and improving neonatal care.</div></div><div><h3>Funding</h3><div>This study was self-funded by the authors and did not receive any external funding or any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characteristics of tobacco use among adults in Kazakhstan: A cross-sectional National Survey","authors":"Anel Ibrayeva ,&nbsp;Marat Shoranov ,&nbsp;Rassulbek Aipov ,&nbsp;Adil Katarbayev ,&nbsp;Shynar Tanabayeva ,&nbsp;Ildar Fakhradiyev","doi":"10.1016/j.gloepi.2025.100194","DOIUrl":"10.1016/j.gloepi.2025.100194","url":null,"abstract":"<div><h3>Background</h3><div>Smoking remains a major public health concern worldwide, contributing significantly to morbidity and mortality. Despite the implementation of tobacco control measures, smoking prevalence in Kazakhstan remains high. This study aims to assess the prevalence, demographic characteristics, and regional variations in smoking habits among adults in Kazakhstan.</div></div><div><h3>Methods</h3><div>A cross-sectional national survey was conducted from October 2021 to May 2022, covering all 17 regions of Kazakhstan. A total of 6720 adults aged 18–69 years participated, selected using a weighted multistage cluster sampling method. Data were collected through structured interviews based on the WHO STEPwise approach. Smoking status, tobacco consumption patterns, and smoking cessation attempts were analyzed. The results were reported as means with 95 % confidence intervals (CI).</div></div><div><h3>Findings</h3><div>The overall smoking prevalence was 19.1 %. Smoking was significantly more common among men (30.3 %) than women (7.9 %). The highest smoking prevalence was observed in the 30–44 age group (44.2 %) and among private-sector employees (53.2 %). Regional differences were notable, with the lowest smoking prevalence in Atyrau (9.2 %) and the highest in Pavlodar (30.4 %). Among current smokers, 89.1 % smoked daily, with an average of 11.8 cigarettes per day (95 % CI: 11.4–12.2). Only 36.7 % of smokers who visited healthcare professionals in the past year received advice to quit. Additionally, 42.8 % attempted to quit smoking in the past 12 months. Passive smoking exposure was common, with 26.8 % of women and 22.3 % of men exposed at home, and 30.2 % of men and 14.4 % of women exposed at work. The prevalence of smokeless tobacco use was low (1 %).</div></div><div><h3>Interpretation</h3><div>Smoking remains prevalent among adults in Kazakhstan, with significant differences by gender, age, occupation, and region. The high prevalence of daily smoking and the low frequency of smoking cessation advice from healthcare professionals indicate the need for stronger tobacco control policies, targeted public health campaigns, and enhanced smoking cessation support programs. These findings provide a basis for future research and policy-making efforts aimed at reducing tobacco consumption and its associated health risks.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots","authors":"Agustín Ramiro Miranda ,&nbsp;Paula Eugenia Barral ,&nbsp;Ana Veronica Scotta ,&nbsp;Mariela Valentina Cortez ,&nbsp;Elio Andrés Soria","doi":"10.1016/j.gloepi.2025.100192","DOIUrl":"10.1016/j.gloepi.2025.100192","url":null,"abstract":"<div><div>Breastfeeding is the most cost-effective intervention for reducing infant morbidity and mortality, offering benefits for infants and mothers. Despite extensive promotion, global adherence remains below 50 %, resulting in significant clinical, economic, and environmental impacts. Thus, this overview of reviews aims to synthesize barriers and facilitators of breastfeeding, analyze research trends, and identify gaps to guide future research. A comprehensive literature search was conducted, including systematic reviews that examine these factors. The search covered seven electronic data repositories. The methodological quality was assessed using the Risk of Bias in Systematic Reviews tool. Bibliometric analysis focused on identifying top journals, authors, and countries, assessing their impact, and exploring trends over time. Findings were classified and analyzed thematically through line-by-line coding, theme description, and analytical formulation. A total of 123 reviews were included, mostly of high quality and published in top journals. Key trends comprised a growing focus on psychosocial and cultural factors, increased representation from low- and middle-income countries, and improved methodological rigor. However, geographical representation remains biased towards high-income countries, and some breastfeeding outcomes need further exploration. Thematic analysis revealed four categories: Therapeutic and care interventions; Support networks and education; Maternal-infant health issues; and Societal and environmental context. In conclusion, this overview of reviews identifies barriers and facilitators of breastfeeding and emphasizes the need for more inclusive research and tailored support. Addressing gaps in evidence for enhancing healthcare systems and policies can improve breastfeeding practices and outcomes worldwide.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive health services utilization and associated factors among university youth students in Ethiopia: A mixed-methods study","authors":"Tsiyon Birhanu Wube ,&nbsp;Solomon Gebremichael Asgedom ,&nbsp;Dawit Gebregziabher Abrha ,&nbsp;Lielt Gebreselassie Gebrekirstos","doi":"10.1016/j.gloepi.2025.100195","DOIUrl":"10.1016/j.gloepi.2025.100195","url":null,"abstract":"<div><h3>Background</h3><div>Reproductive health services utilization among youth university students is essential for their sexual and reproductive well-being. Despite growing awareness, students often face barriers—cultural, social, and economic—that limit their access to these services. Understanding service utilization patterns and associated factors is crucial for addressing unmet needs, such as limited access to family planning, maternal care, and sexual health services, as well as the lack of resources and awareness, which affect the quality of care and access to services. The study investigated the utilization of the services among youth university students, aiming to provide insights for targeted interventions and enhanced service delivery.</div></div><div><h3>Methods</h3><div>We conducted an institutional-based cross-sectional study with 768 youth university students, using a mixed-methods approach. Participants were selected via a multistage sampling technique. Data were collected through a self-administered questionnaire, supplemented by key informant interviews and in-depth interviews. Quantitative analysis was performed using SPSS version 25, and qualitative data were transcribed and analyzed narratively through content analysis. Logistic regression was employed to identify associations with service utilization.</div></div><div><h3>Results</h3><div>The study found that the prevalence of adequate reproductive health service utilization rate was 42.5 % (95 % CI: 38.81 % - 46.20 %), which is comparable to similar studies conducted in other low- and middle-income countries. Key factors included open discussions about reproductive health (AOR = 4.1, 95 % CI: 2.14–7.16), positive attitudes towards services (AOR = 6.03, 95 % CI: 3.72–9.75), and perceived HIV risk (AOR = 4.32, 95 % CI: 2.39–7.77).</div></div><div><h3>Conclusion</h3><div>Utilization of reproductive health services is relatively low, with only 42.5 % reporting usage. Key factors influencing utilization include open discussions, positive attitudes towards services, and perceived HIV risk. Addressing barriers through inclusive, youth-friendly interventions such as peer education programs could significantly improve outcomes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-varying confounders in association between general and central obesity and coronary heart disease: Longitudinal targeted maximum likelihood estimation on atherosclerosis risk in communities study","authors":"Hossein Mozafar Saadati PhD ,&nbsp;Niloufar Taherpour MSc ,&nbsp;Seyed Saeed Hashemi Nazari MD, MPH, PhD","doi":"10.1016/j.gloepi.2025.100193","DOIUrl":"10.1016/j.gloepi.2025.100193","url":null,"abstract":"<div><h3>Aim</h3><div>This study examines the association between general and central obesity and the risk of cardiovascular diseases, utilizing the Targeted Maximum Likelihood Estimator (TMLE) method to account for time-varying covariates and also we compares the findings with those derived from conventional regression methods in the Atherosclerosis Risk in Communities (ARIC) cohort study.</div></div><div><h3>Methods</h3><div>We considered 15,792 participants 45–75 years of age registered in the Atherosclerosis Risk in Communities study, visit 1 and followed to visit 4. General obesity defined as body mass index and central obesity defined as Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), Body Shape Index (BSI) and Body Roundness Index (BRI). The effect of obesity on Coronary Heart Disease (CHD) was estimated and compared by Longitudinal Targeted Maximum Likelihood Estimation (LTMLE) and generalized linear model.</div></div><div><h3>Results</h3><div>The effects of BMI, adjusted for baseline and time-varying confounders, was 1.15 (95 %CI =1.00, 1.34). About the gender groups, the effect of BMI for males and females was 1.17 (95 %CI =0.97,1.40) and 1.19 (95 %CI =0.94,1.52), respectively. Considering age groups, the effect of BMI was 1.21 (95 %CI =0.95, 1.53) and 1.13 (95 %CI = 0.93, 1.36) for age ≤ 54 years and age &gt; 54 years, respectively. With regards to central obesity, the BSI and WC were shown the strongest effects, respectively. Among females and age group≤54 years, WHtR was associated with a higher incidence of CHD.</div></div><div><h3>Conclusions</h3><div>According to the results, the appropriate index for obesity varies based on gender and age. Knowledge about this difference will help to experts to implement appropriate interventions.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of adult asthma within the Hungarian population between 2009 and 2019 – A retrospective financial database analysis","authors":"B. Sánta ,&nbsp;A. Keglevich ,&nbsp;T. Kovács ,&nbsp;B. Engi ,&nbsp;A. Südi ,&nbsp;E. Noémi ,&nbsp;L. Tamási","doi":"10.1016/j.gloepi.2025.100191","DOIUrl":"10.1016/j.gloepi.2025.100191","url":null,"abstract":"<div><h3>Background</h3><div>Asthma is the most common chronic obstructive respiratory disease and is a considerable burden on the patients, caregivers and healthcare providers. However, data on epidemiology, healthcare expenditures, inhalation medication usage and comorbidities are scarce on a country-wide level.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on the Hungarian National Health Insurance Fund's financial database. All patients who had filled at least one prescription for asthma maintenance therapy between 2009-’19 had been enrolled. Prevalence for each year was assessed, based on prescriptions filled for asthma annually. Incidence was assessed only for 2011–’19. Frequency of exacerbations and their costs were calculated.</div></div><div><h3>Results</h3><div>Through the study period 439,977 patients filled at least one prescription for asthma maintenance therapy. The number of patients having at least one prescription in 12 months increased by 20.34 % (from 132,292 to 159,225 patients). Between 2011–’19 an average of 20,742.1 new patients used asthma maintenance medications. Between 2009 and ‘19 an average of 4308 patients were hospitalized due to asthma, on an average 5129 times. Healthcare expenditure on hospitalizations and outpatient treatment of asthmatics increased by 28.05 %.</div></div><div><h3>Conclusion</h3><div>Through our study period a substantial increase in patient numbers and overall expenditure was seen. Number and frequency of exacerbations however decreased over the years.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}