Osong Public Health and Research Perspectives最新文献

Objectives: To examine how national innovation and policy configurations enabled vaccine development in Brazil, Cuba, India, and Iran, and to distil lessons for low- and middle-income country (LMIC) vaccine sovereignty.

Methods: Narrative review of peer-reviewed and grey literature (2020-2023), guided by a structured search and screening approach; synthesis mapped to national and sectoral innovation system perspectives and technology readiness levels.

Results: Cuba and Iran leveraged mission-oriented public research and development (R&D) and domestic platforms; India combined indigenous R&D with large-scale licensed manufacturing; Brazil's scientific capacity was constrained by fragmented governance and supply-chain dependence. Adaptive regulation (e.g., emergency use authorization/conditional approvals), targeted technology transfer, and South-South partnerships accelerated progress but raised longer-term questions about intellectual property (IP) control and economic sustainability.

Conclusion: Institutional coherence, strategic IP management, and regional manufacturing alliances are as critical as scientific capacity for LMIC vaccine self-reliance. Policy priorities include pre-negotiated tech-transfer frameworks, regulatory preparedness, and investment in public R&D linked to distributed manufacturing.

Objectives: This study measured the impact of prenatal intimate partner violence (p-IPV) on maternal mental health and suspected developmental delays (SDDs) in children at 6 months of age in central Vietnam.

Methods: Data were drawn from a community-based birth cohort of 285 mother-child dyads in Hue citycity, central Vietnam. The exposure factor was p-IPV, assessed using the revised conflict tactics scale (CTS2). Maternal mental health was measured with the patient health questionnaire-9. Child development at 6 months was screened using the Vietnamese version of the Ages and Stages Questionnaire, 3rd Edition (ASQ-3). Robust Poisson regression was used to estimate associations of p-IPV with maternal mental health and SDDs.

Results: Among the women, 18.9% reported experiencing p-IPV. SDDs were identified in 13% of the children, with communication delays being the most prevalent (10.9%). The association between p-IPV and SDDs remained significant after adjustment for confounders in multilevel models, with the highest relative risk (RR) observed in the fully adjusted model (RR, 2.43; 95% confidence interval [CI], 1.08-5.48). p-IPV exposure was significantly associated with postpartum depression in the crude and partially adjusted models, but this association became non-significant after full adjustment-most notably after accounting for prenatal depression, which remained a predictor of postpartum depression (RR, 1.15; 95% CI, 1.06-1.25).

Conclusion: p-IPV is significantly associated with increased risk of postpartum depression and developmental delays in early infancy. Integrating IPV screening and targeted interventions into prenatal care may contribute to improved developmental outcomes in children and better maternal health.

Background: This study aimed to strengthen the core capabilities of epidemiological investigation and response teams (ERTs) at the Korea Disease Control and Prevention Agency, drawing on lessons learned from the Middle East respiratory syndrome and coronavirus disease 2019 pandemics. The primary objectives were to facilitate rapid and accurate data collection and analysis, improve communication skills, and simulate real-world on-site responses.

Methods: The training program was developed using a scenario involving a novel infectious disease from the World Health Organization priority list entering a community. ERTs collected and analyzed epidemiological data and implemented control measures as they addressed the missions of the scenario. Improvement in competencies was assessed through self-evaluation surveys completed before and after training.

Results: A total of 49 participants, including disease control officers, epidemiological investigation officers, researchers, and administrative officials, attended the training. Participant satisfaction with the training was high, scoring 6.4 out of 7, and the improvement in competency was statistically significant (pre-training score, 5.2; post-training score, 6.2; p<0.001).

Conclusion: Scenario-based training can effectively enhance the capabilities of ERTs. Such training is essential, as emerging and re-emerging infectious diseases can exhibit unpredictable spread and potentially severe impacts. Therefore, developing diverse scenarios and conducting regular training sessions are necessary to improve the capacities of ERTs.

Background: The co-occurrence of tuberculosis (TB) and diabetes mellitus presents a significant global health challenge, marked by a bidirectional relationship. This study aims to evaluate the effectiveness of the tuberculosis predictive index (TPI) score, developed by Isfandiari et al., in predicting TB occurrence among individuals living with type 2 diabetes mellitus.

Methods: A case-control study was conducted using primary data collected through questionnaires administered to individuals with type 2 diabetes mellitus, with and without pulmonary TB, at the internal medicine outpatient clinic of Fatmawati General Hospital from June to August 2024. The study compared TPI scores between those with type 2 diabetes mellitus who had TB and those who did not.

Results: TPI scores were significantly associated with TB risk. Individuals with both type 2 diabetes mellitus and TB had a 6.8-fold higher risk (95% confidence interval [CI], 2.6-17.6; p<0.001) than those without TB. Further chi-square analysis identified three significant risk factors: individuals with type 2 diabetes mellitus exhibiting TB-like symptoms had a 13.3-fold increased TB risk (95% CI, 5.1-34.3; p<0.001); those with a body mass index below 18.5 kg/m² had a 3.3-fold higher risk (95% CI, 1.0-11.0; p=0.039); and those living in poorly ventilated homes (ventilation ≤10%) had a 3.2-fold higher risk (95% CI, 1.0-9.8; p=0.035).

Conclusion: This study demonstrates that individuals with type 2 diabetes mellitus who developed TB had significantly higher TPI scores, corresponding to a 6.8-fold increased risk compared to their counterparts without TB. The TPI score may serve as a valuable tool for predicting TB risk among populations living with type 2 diabetes mellitus.

Background: This study aimed to (1) assess healthcare workers' (HCWs) knowledge and attitudes toward mpox across 3 Gulf countries, and (2) examine factors influencing their acceptance of the mpox vaccine using the health belief model (HBM). This model evaluated perceptions related to susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. Additionally, the study explored the impact of prior coronavirus disease 2019 (COVID-19) vaccination history on mpox vaccine acceptance.

Methods: A cross-sectional study was conducted among 764 HCWs from the United Arab Emirates (UAE), Saudi Arabia, and Qatar. Data were collected through a structured online questionnaire based on HBM constructs. Logistic regression and structural equation modeling were employed to analyze predictors of vaccine acceptance.

Results: Knowledge levels varied across the countries, with the highest proportion of good knowledge reported in the UAE (59%). UAE HCWs also demonstrated higher perceived susceptibility, perceived benefits, and intention to vaccinate compared to those in Saudi Arabia and Qatar (p<0.001). Receiving 4 doses of the COVID-19 vaccine was associated with greater acceptance of the mpox vaccine. Among the HBM constructs, perceived benefits and self-efficacy were identified as the strongest predictors of vaccine acceptance. Perceived barriers, such as fear of side effects and concerns about vaccine safety, were more prominent among HCWs in Saudi Arabia and Qatar.

Conclusion: The HBM effectively explains the factors influencing mpox vaccine acceptance among Gulf HCWs. Targeted interventions that improve perceived benefits, reduce barriers, and improve self-efficacy may facilitate greater vaccine uptake and preparedness for emerging infectious diseases.

Background: The increasing prevalence of drug use in the Republic of Korea has emerged as a significant social concern. This study applied the extended theory of planned behavior to investigate the factors influencing intentions to use drugs among young adults (aged 20-30 years) in the Republic of Korea. The study integrated personal traits-specifically, impulsivity, sensation seeking, and self-efficacy-into 2 core theory of planned behavior constructs: attitudes and subjective norms. The principal aim was to improve the prediction of drug use intentions by incorporating these variables.

Methods: Data were obtained from the 2023 National Survey of Drug Harm Perception, which sampled 1,500 individuals aged 19 to 39 years. Hierarchical regression analysis was employed to assess the influence of psychological and social factors on intentions to use drugs.

Results: In the primary model, age emerged as a significant predictor of drug use intentions (R2 =0.01). The secondary model showed that positive attitudes toward drugs, subjective norms, and lower self-efficacy significantly increased drug use intentions (R2 =0.23). In the final tertiary model, the addition of sensation seeking and impulsivity further amplified these intentions (R2 =0.25).

Conclusion: The findings underscore the pivotal roles of attitudes, subjective norms, and selfefficacy in shaping intentions to use drugs. Sensation seeking and impulsivity were found to further elevate vulnerability. Effective prevention efforts must address both psychological traits and social influences. Future research should examine the long-term behavioral outcomes associated with these factors.

Background: This study developed deep neural network (DNN) models capable of accurately classifying major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI) after hospital discharge, across 3 follow-up intervals: 1, 6, and 12 months.

Methods: DNN models were constructed to predict post-discharge MACE across 4 categories. Multiple traditional machine learning models were implemented as controls to benchmark the performance of our DNN approach. All models were evaluated based on their ability to predict MACE occurrence during the specified follow-up periods.

Results: The DNN models demonstrated superior predictive performance over conventional machine learning methods, achieving high accuracies of 0.922, 0.884, and 0.913 for the 1-month, 6-month, and 12-month follow-up periods, respectively.

Conclusion: The high accuracy of our DNN models highlights their practical advantages for AMI diagnosis and guidance of follow-up treatment. These models can serve as valuable decision support tools, enabling clinicians to optimize the overall management of AMI patients and potentially enhance their hospitalization experience.

Background: Incorporating CD40 ligand (CD40L) into vaccine strategies has shown considerable potential for enhancing immune responses. In this study, we designed and formulated a CD40Lbased multi-epitope vaccine construct using immunoinformatics approaches, and compared it to a full-length CD40L-based vaccine construct.

Methods: The study commenced with the identification and screening of potential T-cell and B-cell epitopes derived from the CD40L protein, followed by the construction of a multi-epitope vaccine from these selected epitopes. We analyzed and validated the physicochemical and structural properties of the vaccine constructs. Further, we predicted disulfide bonds, performed protein-protein docking, and conducted molecular dynamics simulations to evaluate the constructs. Comparative analyses of the ligand-binding site localization were conducted using LigPlot. Additionally, simulation trajectories were analyzed using multiple descriptors, including root mean square deviations, radius of gyration, and root mean square fluctuations.

Results: Our findings indicated that the CD40L multi-epitope vaccine construct possessed favorable physicochemical properties and a validated structural profile. Immune simulation studies showed a stronger affinity of the multi-epitope construct for the CD40 receptor compared to the full-length CD40L construct.

Conclusion: Overall, the CD40L multi-epitope vaccine construct demonstrated greater potency in eliciting an effective immune response than the full-length CD40L construct. These results highlight a promising approach to vaccine design for the prevention or treatment of infections and cancers.