Nepal Journal of Epidemiology最新文献

Background: Among Indian adolescent girl's anemia remains a major public health concern due to rapid growth, menstrual blood loss, and nutritional deficiencies. This systematic review and meta-analysis aim to assess the prevalence and severity of anemia among Indian adolescent girls.

Methods: This review (2004-2024) integrated data from 32 studies (14,053 persons) from PubMed, Embase, and Scopus, adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)/ Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Observational studies with the prevalence of anemia in Indian adolescent girls based on WHO criteria were included. The data was pooled using a random-effects model, and subgroup analyses were conducted by Indian region. Heterogeneity was assessed using the I² statistic.

Results: The pooled anemia prevalence was 65% (95% CI: 54%-74%), showed notable regional variations. The burden was highest in East India (81%; 39%-97%), then North India (65%), West India (61%), and South India (52%). The mean hemoglobin levels varied by region, ranging from 10.24 g/dL in the East to 11.20 g/dL in the South. Mild anemia (29%) and moderate anemia (25%) were more common than severe anemia (1%). The substantial heterogeneity (I²=98.7%) indicated differences in socioeconomic status, diet, and healthcare access.

Conclusion: Anemia affects disproportionate number of Indian adolescents' girls, particularly in the country's east, which highlights the need for context-specific interventions. The initiatives must be linked to national programs like Anemia Mukt Bharat to ensure equitable progress towards India's public health objectives and to avoid long-term health and developmental consequences.

Background: Air pollution and particularly the fine particulate matter (PM2.5) is a major environmental risk factor of cardiovascular diseases (CVD). Millions of untimely deaths every year have been reported because of it. The epidemiological literature has linked long-term exposure to PM2.5 and mortality rates of CVDs. This meta-analysis aims to synthesize the estimates of long-term PM2.5 exposure and CVDs.

Methods: Based on the PRISMA guidelines, PubMed, Embase, Web of Science, and Scopus were searched up to October 2025. Random-effects model was used to pool HRs, and the heterogeneity was measured with the help of I².

Results: Four studies were included in this meta-analysis. There was an increased risk of CVD with higher exposure to PM2.5 on a long-term basis (pooled HR=1.22, 95% CI: 1.06-1.41; p=0.006; I²=96%). Cardiovascular mortality did not show any significant association with PM2.5 exposure (pooled HR=1.00, 95% CI: 0.71-1.41; p=0.98; I²=29%). No significant difference was found between the PM2.5 exposure and ischemic heart disease (IHD) (pooled HR=1.65, 95% CI: 0.90-3.00; p=0.10; I²=95%). The same pattern was noted between the PM2.5 exposure and stroke (pooled HR=1.61, 95% CI: 0.96-2.68; p=0.07; I²=74%).

Conclusion: The PM2.5 exposure is associated with high CVD in the long term. Results reveal the significance of establishing strict air-drome quality standards and targeted interventions to mitigate the risks in the areas of issues. More integrated studies are required to support our findings and fill the knowledge gap.

Background: Arthritis affects millions of people worldwide; however, its mismanagement remains a growing global challenge, resulting in reduced quality of life (QoL) and disability. Digital health (DH), including smartphones, could be the key to solving this problem. Specific evidence-based reviews on the use of DH in this context are lacking. This systematic review aimed to explore the effect of DH on medication adherence (MA) among arthritis patients, thus improving their QoL.

Methods: A literature search was conducted on PubMed, Cochrane, TRIP, and Google Scholar using the keywords digital health, medication adherence, and arthritis. All randomized controlled trials (RCT) published between 2006 and 2024 were assessed for eligibility.

Result: The literature search yielded 12,671 results with 882 duplicates. The review included 8 RCTs that addressed rheumatoid arthritis (n=5), gout (n=2), and juvenile idiopathic arthritis (n=1), with a total sample size of 2449 patients, among whom 66% were males. Digital interventions used include calls, texts, videos, and online counselling. Study outcomes were classified as positive (DH increased MA), no significant difference, and negative (DH failed to show an effect on MA) in 62.5%, 25%, and 12.5% of the studies, respectively.

Conclusion: It is concluded that 62.5% of the RCTs showed significant contributions of digital health tools in arthritis management, mainly by enhancing medication adherence and thus improving patients' QoL. Owing to their availability, simplicity, and immediacy, digital health tools demonstrate their potential as reliable interventions for supporting arthritis patients.