Pub Date : 2025-06-01Epub Date: 2025-05-02DOI: 10.1016/j.gloepi.2025.100203
Julie E. Goodman , Denali Boon , Robyn L. Prueitt
O'Brien et al. [6] reported on the patterns and reliability of self-reported talc use in the Sister Study, a US-based prospective cohort study of women aged 35–74 who had a sister with a history of breast cancer. They found that among certain groups of women, reported use of talc was different at baseline and follow-up. O'Brien et al. [7] evaluated the association between talc and ovarian cancer in this cohort and conducted a quantitative bias analysis (QBA), reporting evidence for differential recall of talc use at baseline and follow-up, which likely increased the magnitude of risk estimates based on recall at follow-up. Additional analyses (e.g., using distributions of recall bias rather than fixed point estimates) may allow for a more complete characterization of the potential impact of recall bias, including a better characterization of the uncertainty around the bias-corrected effect estimates. Future analyses that evaluate recall and other biases more comprehensively, particularly with respect to more fully addressing uncertainty, will contribute to a better understanding of the magnitude of the impact of differential recall on estimated risks.
{"title":"Talc, ovarian cancer, and recall bias in the sister study","authors":"Julie E. Goodman , Denali Boon , Robyn L. Prueitt","doi":"10.1016/j.gloepi.2025.100203","DOIUrl":"10.1016/j.gloepi.2025.100203","url":null,"abstract":"<div><div>O'Brien et al. [<span><span>6</span></span>] reported on the patterns and reliability of self-reported talc use in the Sister Study, a US-based prospective cohort study of women aged 35–74 who had a sister with a history of breast cancer. They found that among certain groups of women, reported use of talc was different at baseline and follow-up. O'Brien et al. [<span><span>7</span></span>] evaluated the association between talc and ovarian cancer in this cohort and conducted a quantitative bias analysis (QBA), reporting evidence for differential recall of talc use at baseline and follow-up, which likely increased the magnitude of risk estimates based on recall at follow-up. Additional analyses (e.g., using distributions of recall bias rather than fixed point estimates) may allow for a more complete characterization of the potential impact of recall bias, including a better characterization of the uncertainty around the bias-corrected effect estimates. Future analyses that evaluate recall and other biases more comprehensively, particularly with respect to more fully addressing uncertainty, will contribute to a better understanding of the magnitude of the impact of differential recall on estimated risks.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905947","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}
Pub Date : 2025-06-01Epub Date: 2025-05-07DOI: 10.1016/j.gloepi.2025.100206
Louis Anthony Cox Jr.
How can causal models be used to quantify the fractions of risk associated with environmental and occupational exposures that would be prevented by reducing exposures by different amounts? This paper provides a constructive answer. It introduces three key metrics — Interventional Probability of Causation (IPoC), Causal Assigned Shares (CAS), and Preventable Risk Fraction (PRF) curves — to help overcome the limitations of traditional association-based metrics, such as Population Attributable Fractions (PAFs), which are sometimes misused to answer interventional causal questions. The tools introduced here provide scenario-specific, individual-level predictions of risk reductions grounded in mechanistic causality rather than associations. Using case studies of benzene exposure and acute myeloid leukemia (AML), smoking and lung cancer, and blood lead levels and mortality, we demonstrate how PRF curves quantify the potential risk-reduction benefits caused by exposure reductions at both the individual and population levels, even under uncertainty or heterogeneity. Monte Carlo simulations capture inter-individual variability, and scenario analyses identify practical thresholds where additional exposure reductions yield minimal added benefit. These methods can provide evidence-based assessments of how specific exposure reductions affect risk. By shifting the focus from attribution to prevention of harm, this framework can potentially advance risk assessment, policy development, and legal decision-making. It offers a simple, easily visualized, transparent, and scientifically rigorous approach to identifying causally effective interventions and quantifying risk-reduction benefits.
{"title":"Calculating preventable risk fractions for exposure-reducing interventions","authors":"Louis Anthony Cox Jr.","doi":"10.1016/j.gloepi.2025.100206","DOIUrl":"10.1016/j.gloepi.2025.100206","url":null,"abstract":"<div><div>How can causal models be used to quantify the fractions of risk associated with environmental and occupational exposures that would be prevented by reducing exposures by different amounts? This paper provides a constructive answer. It introduces three key metrics — Interventional Probability of Causation (IPoC), Causal Assigned Shares (CAS), and Preventable Risk Fraction (PRF) curves — to help overcome the limitations of traditional association-based metrics, such as Population Attributable Fractions (PAFs), which are sometimes misused to answer interventional causal questions. The tools introduced here provide scenario-specific, individual-level predictions of risk reductions grounded in mechanistic causality rather than associations. Using case studies of benzene exposure and acute myeloid leukemia (AML), smoking and lung cancer, and blood lead levels and mortality, we demonstrate how PRF curves quantify the potential risk-reduction benefits caused by exposure reductions at both the individual and population levels, even under uncertainty or heterogeneity. Monte Carlo simulations capture inter-individual variability, and scenario analyses identify practical thresholds where additional exposure reductions yield minimal added benefit. These methods can provide evidence-based assessments of how specific exposure reductions affect risk. By shifting the focus from attribution to prevention of harm, this framework can potentially advance risk assessment, policy development, and legal decision-making. It offers a simple, easily visualized, transparent, and scientifically rigorous approach to identifying causally effective interventions and quantifying risk-reduction benefits.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106091","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}
Pub Date : 2025-06-01Epub Date: 2025-02-08DOI: 10.1016/j.gloepi.2025.100188
Lilianne Samad, J.E. Reed
It is common to see mass media headlines about health-related topics in traditional and online news outlets, as well as on social media platforms. What a consumer might not realize is that often these headlines are a distillation of results reported in epidemiologic publications. Journalists make decisions about what information to include and exclude, hopefully without compromising the main conclusions. In this exercise, sixty-three media articles that summarized one peer-reviewed journal publication (Zhang et al., 2021) describing results from a cohort study on coffee and tea consumption and risk of stroke and dementia were compared to determine the consistency of details among them. The most heterogeneity was observed in whether articles compared results with other literature. There was some variation in inclusion of a measure of frequency within the study population, and in details describing measurement of exposure. However, most of the articles were consistent in either including or excluding other methodological details in the main text. The results of the present comparison have implications for readers, researchers, and journalists. Readers must know that media summaries of peer reviewed studies are just that – summaries. It is likely that some information from the original source is not represented by the article, and that additional information might be necessary to craft an informed opinion on a given topic.
在传统和在线新闻媒体以及社交媒体平台上，经常看到有关健康主题的大众媒体头条。消费者可能没有意识到的是，这些标题通常是流行病学出版物报道的结果的精华。记者们会在不影响主要结论的前提下，决定哪些信息应该包括，哪些信息应该排除。在这个练习中，63篇媒体文章总结了一篇同行评议的期刊出版物（Zhang et al., 2021），描述了一项关于咖啡和茶消费与中风和痴呆风险的队列研究的结果，并进行了比较，以确定其中细节的一致性。在文章是否与其他文献比较结果时，观察到最大的异质性。在纳入研究人群的频率测量和描述暴露测量的细节方面存在一些差异。但是，大多数条款在包括或排除正文中的其他方法细节方面是一致的。目前比较的结果对读者、研究人员和记者都有启示意义。读者必须知道，媒体对同行评议研究的总结只是总结而已。很可能来自原始来源的一些信息没有在文章中表现出来，并且可能需要额外的信息来形成对给定主题的知情意见。
{"title":"All are not created equal: Method descriptions in an epidemiology publication differ among media summaries – A case study comparison","authors":"Lilianne Samad, J.E. Reed","doi":"10.1016/j.gloepi.2025.100188","DOIUrl":"10.1016/j.gloepi.2025.100188","url":null,"abstract":"<div><div>It is common to see mass media headlines about health-related topics in traditional and online news outlets, as well as on social media platforms. What a consumer might not realize is that often these headlines are a distillation of results reported in epidemiologic publications. Journalists make decisions about what information to include and exclude, hopefully without compromising the main conclusions. In this exercise, sixty-three media articles that summarized one peer-reviewed journal publication (Zhang et al., 2021) describing results from a cohort study on coffee and tea consumption and risk of stroke and dementia were compared to determine the consistency of details among them. The most heterogeneity was observed in whether articles compared results with other literature. There was some variation in inclusion of a measure of frequency within the study population, and in details describing measurement of exposure. However, most of the articles were consistent in either including or excluding other methodological details in the main text. The results of the present comparison have implications for readers, researchers, and journalists. Readers must know that media summaries of peer reviewed studies are just that – summaries. It is likely that some information from the original source is not represented by the article, and that additional information might be necessary to craft an informed opinion on a given topic.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420221","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}
Pub Date : 2025-06-01Epub Date: 2025-03-22DOI: 10.1016/j.gloepi.2025.100198
Pierluigi Francesco Salvo , Valentina Iannone , Francesca Lombardi , Arturo Ciccullo , Francesco Lamanna , Rosa Anna Passerotto , Gianmaria Baldin , Rebecca Jo Steiner , Andrea Carbone , Valentina Massaroni , Simona Di Giambenedetto , Alberto Borghetti
Background
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.
Objectives
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.
Study design
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.
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.
Results
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 >50 cp/mL before enrollment date (versus <50 aOR 4.56, 95 % CI 1.01–20.46). A reduced odds was correlated with >3 vaccine doses (versus <3 or not vaccinated aOR 0.08, 95 % CI 0.02–0.24).
Conclusion
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.
HIV感染者感染SARS-CoV-2的危险因素以及HIV与SARS-CoV-2之间的真正关系尚不完全清楚。目的本研究的目的是确定PLWH治疗中感染SARS-CoV-2的独立危险因素，揭示PLWH治疗中感染SARS-CoV-2的潜在危险因素。研究设计从意大利杰梅利大学基金会（Fondazione Policlinico Universitario a . gemelli IRCCS）传染病门诊诊所招募plwh，并在随访期间通过问卷随机采访，以确定他们是否在2020年3月至2022年6月期间经历过SARS-CoV-2感染。对于每一名报告有SARS-CoV-2病史的参与者（病例），选择两名未报告感染COVID-19的PLWH（对照组）；PLWH对SARS-CoV-2的潜在暴露时间相似。共选取PLWH 220例：72例，对照组148例。没有人患上严重的Covid-19疾病，只有一名参与者需要住院治疗。结果共纳入PLWH 220例，其中病例72例，对照组148例。除了使用抗逆转录病毒治疗方案和入组日期前最后一次HIV-RNA浓度不同，病例和对照组的特征相似。通过调整后的多变量logistic回归，近年来SARS-CoV-2感染的估计几率更高（2022年比2020年aOR 20.74, 95% CI 5.26-81.8），在入组日期前最后一次HIV-RNA为50 cp/mL的PLWH中（50 aOR 4.56, 95% CI 1.01-20.46）。降低的比值与接种3剂疫苗相关（与未接种3剂或未接种相关：or 0.08, 95% CI 0.02-0.24）。在该队列中，SARS-CoV-2感染的几率随着时间的推移而增加，可能是由于封锁措施和SARS-CoV-2循环变体的变化。可检测的病毒载量与感染风险增加有关，这突出了在大流行期间监测艾滋病毒rna的重要性。
{"title":"Estimating risk of acquiring SARS-COV2 infection in treatment-experienced PLWH: A case-control study","authors":"Pierluigi Francesco Salvo , Valentina Iannone , Francesca Lombardi , Arturo Ciccullo , Francesco Lamanna , Rosa Anna Passerotto , Gianmaria Baldin , Rebecca Jo Steiner , Andrea Carbone , Valentina Massaroni , Simona Di Giambenedetto , 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 >50 cp/mL before enrollment date (versus <50 aOR 4.56, 95 % CI 1.01–20.46). A reduced odds was correlated with >3 vaccine doses (versus <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":"2025-06-01","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}
Pub Date : 2025-06-01Epub Date: 2025-03-06DOI: 10.1016/j.gloepi.2025.100192
Agustín Ramiro Miranda , Paula Eugenia Barral , Ana Veronica Scotta , Mariela Valentina Cortez , Elio Andrés Soria
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.
{"title":"An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots","authors":"Agustín Ramiro Miranda , Paula Eugenia Barral , Ana Veronica Scotta , Mariela Valentina Cortez , 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":"2025-06-01","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}
Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease.
Methods
A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review.
Results
Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit.
Conclusions
This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.
目的儿童多系统炎症综合征（multi - system inflammatory syndrome of childhood, MIS-C）是新发现的与COVID-19相关的儿童疾病。目的是描述74例诊断为这种疾病的患者的临床病程。方法对约旦5家主要医院进行多中心回顾性研究。收集了确诊感染SARS-CoV-2的住院儿童或与确诊病例密切接触的儿童的数据。共有74例患者被诊断为misc。临床，实验室，放射学和治疗资料收集回顾性图表审查。结果患者出现发热、腹痛、缺氧等症状。心脏方面的发现较少，不包括冠状动脉的发现。治疗主要是皮质类固醇和IVIG。本组病例均无死亡，但发生严重疾病，部分患者被送入儿科重症监护病房。结论本研究描述了约旦misc病例的流行病学、临床过程、处理和结局。这一发现与全球其他地区的情况一致。表现的严重程度有很大的差别。腹痛多见，部分患儿被误诊为外科急腹症。
{"title":"Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, clinical characteristics: A multi-center observational study from Jordan","authors":"Marwan Shalabi , Salam Ghanem , Iyad Al-Ammouri , Amirah Daher , Enas Al-zayadneh , Alaa Alsmadi , Mais Ayyoub , Samah Abughanam , Mariam Jabr , Montaha Al-Iede","doi":"10.1016/j.gloepi.2025.100185","DOIUrl":"10.1016/j.gloepi.2025.100185","url":null,"abstract":"<div><h3>Objective</h3><div>Multisystem inflammatory syndrome of childhood (MIS-C) is a newly recognized entity associated with COVID-19 in children. The objective was to describe the clinical course for 74 patients diagnosed with this disease.</div></div><div><h3>Methods</h3><div>A multicenter retrospective study including 5 major hospitals in Jordan was conducted. Data from children admitted with confirmed SARS-CoV-2 infection or were in close contact with confirmed cases were collected. Total of 74 patients were diagnosed with MIS-C. Clinical, laboratory, radiological and therapeutic data were collected by retrospective chart review.</div></div><div><h3>Results</h3><div>Fever, abdominal pain, hypoxia and other manifestation occurred. Cardiac findings were less common and did not include coronary findings. Treatments were mainly Corticosteroids and IVIG. No mortality was found in this series but serious disease occurred and some patients were admitted to Pediatric Intensive Care Unit.</div></div><div><h3>Conclusions</h3><div>This study described the epidemiology, clinical course, management, and outcome of MIS-C cases in Jordan. The findings were consistent with what has been described from other regions globally. There was a wide spectrum in the severity of presentation. Abdominal pain was more prevalent and some children were misdiagnosed as surgical acute abdomen.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157041","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}
We aimed to compare access to diagnostics, treatment, rehabilitation, and outcome in women and men with stroke.
Methods
In this observational study we used routinely-collected, aggregate health data from all patients admitted with a stroke in the Capital Region and Region Zealand, Denmark from May 2016 until October 2022.
Results
Among 28,855 stroke patients (55 % men, 45 % women), women were older (53 % women vs. 47 % men with age > 75 years). Overall, women had reduced access to: magnetic resonance imaging (MRI; 40 % vs. 43 %, CI 95 %: 1.06–1.16), computer tomography (CT)-angiography (25 % vs. 28 %, CI95%: 1.07–1.19), carotid ultrasound (48 % vs. 52 %, CI95%: 1.12–1.23), thrombolysis (16 % vs. 18 %, CI95%: 1.13–1.28), and neuropsychological assessment (9 % vs. 16 %, CI95%: 1.70–1.97). Home discharge rates were lower for women (45 % vs. 47 %, CI95%: 1.04–1.15), while in-hospital mortality was higher (8 % vs. 6 %, CI95%: 0.59–0.71). For patients >75 years, women had less access to MRI (34 % vs. 35 %, CI95%: 1–1.16), carotid ultrasound (46 % vs. 51 %, CI95%: 1.13–1.30), thrombolysis (15 % vs. 16 %, CI95%: 1.02–1.24), and neuropsychological assessment (2 % vs. 4 %, CI95%: 1.60–2.42). Women's in-hospital mortality remained higher also in patients >75 years (12 % vs. 8 %, CI95%: 0.62–0.79).
Conclusions
Women had reduced access to testing, treatment, and rehabilitation across all age groups and stroke types. This disparity was most notable in interventions not included in the national quality assessment program.
{"title":"Comparison of access to stroke diagnostics, treatment, rehabilitation, and outcome between men and women","authors":"Josefine Grundtvig , Katrine Sværke , Mathilde Preskou , Louisa Marguerite Christensen , Thorsten Steiner , Hanne Christensen","doi":"10.1016/j.gloepi.2025.100201","DOIUrl":"10.1016/j.gloepi.2025.100201","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to compare access to diagnostics, treatment, rehabilitation, and outcome in women and men with stroke.</div></div><div><h3>Methods</h3><div>In this observational study we used routinely-collected, aggregate health data from all patients admitted with a stroke in the Capital Region and Region Zealand, Denmark from May 2016 until October 2022.</div></div><div><h3>Results</h3><div>Among 28,855 stroke patients (55 % men, 45 % women), women were older (53 % women vs. 47 % men with age > 75 years). Overall, women had reduced access to: magnetic resonance imaging (MRI; 40 % vs. 43 %, CI 95 %: 1.06–1.16), computer tomography (CT)-angiography (25 % vs. 28 %, CI95%: 1.07–1.19), carotid ultrasound (48 % vs. 52 %, CI95%: 1.12–1.23), thrombolysis (16 % vs. 18 %, CI95%: 1.13–1.28), and neuropsychological assessment (9 % vs. 16 %, CI95%: 1.70–1.97). Home discharge rates were lower for women (45 % vs. 47 %, CI95%: 1.04–1.15), while in-hospital mortality was higher (8 % vs. 6 %, CI95%: 0.59–0.71). For patients >75 years, women had less access to MRI (34 % vs. 35 %, CI95%: 1–1.16), carotid ultrasound (46 % vs. 51 %, CI95%: 1.13–1.30), thrombolysis (15 % vs. 16 %, CI95%: 1.02–1.24), and neuropsychological assessment (2 % vs. 4 %, CI95%: 1.60–2.42). Women's in-hospital mortality remained higher also in patients >75 years (12 % vs. 8 %, CI95%: 0.62–0.79).</div></div><div><h3>Conclusions</h3><div>Women had reduced access to testing, treatment, and rehabilitation across all age groups and stroke types. This disparity was most notable in interventions not included in the national quality assessment program.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900122","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}
Tuberculosis (TB) continues to be a significant public health issue, especially in developing nations like Ethiopia. The country aims to reach a 90 % treatment success rate for TB by 2025. However, there is a considerable lack of recent data on treatment outcomes in the region. Current data on treatment outcomes and their determinants are crucial for guiding early interventions and aligning efforts with national goals and the End TB Strategy. Understanding the current state of TB treatment outcomes and influencing factors is vital for implementing effective interventions and measuring progress toward the target.
Methods
A four-year retrospective study (2019–2022) was conducted. From 323 patient files, 312 were eligible to be included in the final analysis, resulting in a response rate of 96.6 %. Data collection utilized a structured checklist, and analysis was performed with STATA version 18. The Mann-Kendall trend test was used to detect trends in TB incidence. Multicollinearity was checked using variance inflation factors (VIFs). A logistic regression model identified determinants of treatment outcomes.
Results
The study revealed that 84.94 % of participants achieved favorable treatment outcomes, while 15.06 % had unfavorable outcomes. A decreasing trend in unfavorable outcomes was noted, from 18.84 % in 2019 to 10.71 % in 2022 (Kendall's tau (τ) = −0.0686). Determinants of unfavorable outcomes included older age (AOR: 3.59, 95 % CI: 1.23–10.56), HIV positivity (AOR: 5.43, 95 % CI: 1.65–10.83), and smear-negative pulmonary TB (AOR: 3.82, 95 % CI: 1.39–10.45).
Conclusion
The overall treatment success rate of 84.94 % is below the global target of >90 % for 2025. Tailored treatment strategies for older patients and those co-infected with HIV are recommended. Additionally, improving TB diagnostic capabilities is essential for early intervention and achieving better outcomes.
{"title":"Trends, prevalence, and determinants of unfavorable tuberculosis treatment outcomes among adult patients in Northeast Ethiopia: The race to achieve a 90 % treatment success rate by 2025","authors":"Tegene Atamenta Kitaw , Amsalu Baylie , Addisu Getie , Ribka Nigatu Haile","doi":"10.1016/j.gloepi.2025.100189","DOIUrl":"10.1016/j.gloepi.2025.100189","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) continues to be a significant public health issue, especially in developing nations like Ethiopia. The country aims to reach a 90 % treatment success rate for TB by 2025. However, there is a considerable lack of recent data on treatment outcomes in the region. Current data on treatment outcomes and their determinants are crucial for guiding early interventions and aligning efforts with national goals and the End TB Strategy. Understanding the current state of TB treatment outcomes and influencing factors is vital for implementing effective interventions and measuring progress toward the target.</div></div><div><h3>Methods</h3><div>A four-year retrospective study (2019–2022) was conducted. From 323 patient files, 312 were eligible to be included in the final analysis, resulting in a response rate of 96.6 %. Data collection utilized a structured checklist, and analysis was performed with STATA version 18. The Mann-Kendall trend test was used to detect trends in TB incidence. Multicollinearity was checked using variance inflation factors (VIFs). A logistic regression model identified determinants of treatment outcomes.</div></div><div><h3>Results</h3><div>The study revealed that 84.94 % of participants achieved favorable treatment outcomes, while 15.06 % had unfavorable outcomes. A decreasing trend in unfavorable outcomes was noted, from 18.84 % in 2019 to 10.71 % in 2022 (Kendall's tau (τ) = −0.0686). Determinants of unfavorable outcomes included older age (AOR: 3.59, 95 % CI: 1.23–10.56), HIV positivity (AOR: 5.43, 95 % CI: 1.65–10.83), and smear-negative pulmonary TB (AOR: 3.82, 95 % CI: 1.39–10.45).</div></div><div><h3>Conclusion</h3><div>The overall treatment success rate of 84.94 % is below the global target of >90 % for 2025. Tailored treatment strategies for older patients and those co-infected with HIV are recommended. Additionally, improving TB diagnostic capabilities is essential for early intervention and achieving better outcomes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429699","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}
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.
Methods
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.
Results
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).
Conclusion
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.
{"title":"Reproductive health services utilization and associated factors among university youth students in Ethiopia: A mixed-methods study","authors":"Tsiyon Birhanu Wube , Solomon Gebremichael Asgedom , Dawit Gebregziabher Abrha , 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":"2025-06-01","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}
Pub Date : 2025-06-01Epub Date: 2024-12-10DOI: 10.1016/j.gloepi.2024.100177
Pieter Streicher , Alex Broadbent , Joel Hellewell
During the Covid-19 pandemic, the best-performing modelling groups were not always the best-resourced. This paper seeks to understand and learn from notable predictions in two reports by the UK's Scientific Advisory Group for Emergencies (SAGE). In July 2021, SAGE reported that, after the upcoming lifting of restrictions (“Freedom Day”) cases would “almost certainly remain extremely high for the rest of the summer” and that hospitalisations per day would peak between 100 and 10,000. Cases were not “extremely high” and began to decline, while hospitalisations initially lay outside (above) SAGE's confidence bounds, and only came within the expected range when the upper and lower bound moved so far apart as no longer to be useful for policy or planning purposes. The second episode occurred in December 2021, when SAGE projected 600–6000 deaths per day at peak in the scenario where restrictions remained as they were (referred to as “Plan B"). In the event, restrictions did not change, and deaths peaked at 202, well below the lower bound, even though this spanned one order of magnitude. We argue that the fundamental problem was over-reliance on mechanistic approaches to disease modelling, and that a methodologically pluralist approach would have helped. We consider various ways this could have been done, including evaluating past performance and considering data from elsewhere. We show how the South African Covid-19 Modelling Consortium performed better by learning from experience and using multiple methods. We conclude in favour of methodological pluralism in infectious disease modelling, echoing calls for methodological pluralism in recent literature on causal inference.
{"title":"The need for methodological pluralism in epidemiological modelling","authors":"Pieter Streicher , Alex Broadbent , Joel Hellewell","doi":"10.1016/j.gloepi.2024.100177","DOIUrl":"10.1016/j.gloepi.2024.100177","url":null,"abstract":"<div><div>During the Covid-19 pandemic, the best-performing modelling groups were not always the best-resourced. This paper seeks to understand and learn from notable predictions in two reports by the UK's Scientific Advisory Group for Emergencies (SAGE). In July 2021, SAGE reported that, after the upcoming lifting of restrictions (“Freedom Day”) cases would “almost certainly remain extremely high for the rest of the summer” and that hospitalisations per day would peak between 100 and 10,000. Cases were not “extremely high” and began to decline, while hospitalisations initially lay outside (above) SAGE's confidence bounds, and only came within the expected range when the upper and lower bound moved so far apart as no longer to be useful for policy or planning purposes. The second episode occurred in December 2021, when SAGE projected 600–6000 deaths per day at peak in the scenario where restrictions remained as they were (referred to as “Plan B\"). In the event, restrictions did not change, and deaths peaked at 202, well below the lower bound, even though this spanned one order of magnitude. We argue that the fundamental problem was over-reliance on mechanistic approaches to disease modelling, and that a methodologically pluralist approach would have helped. We consider various ways this could have been done, including evaluating past performance and considering data from elsewhere. We show how the South African Covid-19 Modelling Consortium performed better by learning from experience and using multiple methods. We conclude in favour of methodological pluralism in infectious disease modelling, echoing calls for methodological pluralism in recent literature on causal inference.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013008","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}
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