Global Health Epidemiology and Genomics最新文献

Introduction: With growing recognition of the prolonged effects of COVID-19, there is an urgent need to understand its extended clinical and public health implications across diverse settings. Long-term consequences following SARS-CoV-2 infection remain insufficiently studied in Middle Eastern populations. This study aimed to assess the prevalence of persistent COVID-19 symptoms among Palestinian adults and to evaluate their associations with hospitalization and recovery duration.

Methods: This cross-sectional study was conducted on a randomized sample of 407 adult COVID-19 patients confirmed by the Palestinian Ministry of Health between November 25 and December 15, 2020. We used a standardized Arabic questionnaire to cover demographics, medical history, symptoms, complications, and physical activity. Data were gathered by phone interviews in October 2021. All data came from self-reports. With significance defined at p < 0.05, associations between the symptom duration, hospitalization, and recovery time were examined using descriptive statistics and chi-square tests.

Results: The study population had a mean age of 40 years; 54% were female, and 70.3% had no previous medical history. Common complaints were fatigue (64.9%), anosmia (61.9%), joint pain (52.6%), and headache (51.8%). Hospitalization was necessary in 7.6% of patients, while 5.9% required oxygen or intubation. Most patients (92.6%) recovered in 4 months. The persistence of chest pain (χ ², 16.225), shortness of breath (χ ², 13.257), and lethargy (χ ², 8.194) was significantly associated with hospitalization (p < 0.001). The persistence of the previously mentioned symptoms was significantly associated with the duration of recovery.

Conclusion: This study offers valuable insights into the long-term symptoms experienced by individuals recovering from COVID-19 in the West Bank. The findings carry implications for clinicians, public health authorities, and affected individuals, highlighting the importance of integrated care strategies and sustained support throughout the postacute phase of the disease.

Background: Transfusion-related infections are a severe threat to the safety of transfusing blood products internationally. Advances in screening procedures have not, nevertheless, rendered blood transfusion a risk-free procedure for transmitting infectious disease(s).

Objective: The objective of this study was to determine donors' histories that could influence the possibility of transfusion-related infections.

Methods: This was a cross-sectional study. Data for 108 donors were retrieved from donor medical records and donor screening forms. Variables were analyzed for their link with TRIs. The diagnosis of TRIs was established based on the results of a clinical examination and laboratory tests. Using descriptive statistics as well as chi-square tests and logistic regression, data were analyzed.

Results: Of the total donor sample, 13.9% of donor blood units were found to be infected with TTI and were therefore not transfused to the patients; in these cases, 4.6% had hepatitis B infections, whereas 3.7% had HIV infections and 5.6% had malaria infections. Past donor experience and risky behavior, which include intravenous drug use and other risky sexual practices, show a significant association between the increased risk of TRIs (p < 0.05). The odds of transfusion-transmitted infections among repeat donors as compared to first-time donors were marginally high (p=0.04). These independent risk factors for transfusion-related infections were hepatitis B and HIV.

Conclusion: The current study calls for a deliberate consideration of donor history, especially previous donation records, medical conditions, and high-risk behaviors, in the prevention of transfusion-related infections.

Background: Soil-transmitted helminth (STH) infection is a widespread problem globally, particularly in rural areas. In Ethiopia, the prevalence of STH infection is high. The prevalence of Ascaris lumbricoides and hookworm infections has not diminished in spite of the nation's strict STH prevention and control measures for decants. Additionally, variables linked to the high prevalence of A. lumbricoides and hookworm infections are not adequately addressed.

Objective: This study aimed to determine the prevalence and risk factors of STHs among students in the Fogera district, northwest Ethiopia.

Method: A cross-sectional study design was employed in two primary schools in the Fogera district in February-March 2023. The stool samples were collected from the students and examined using saline wet mount and double Kato-Katz technique. Data were entered and analyzed using SPSS Version 25. Descriptive statistics was used to compute the prevalence of STHs. Factors associated with hookworm and A. lumbricoides infections were analyzed by logistic regression. Variables with p < 0.05 in the multivariate logistic regression were considered significant.

Results: Among 463 schoolchildren, totally, the prevalence of STHs was 25.3%. The prevalence of A. lumbricoides and hookworm infections was 55 (11.9%) and 62 (13.4%), respectively. Mothers' lack of education (AOR = 24.99; 95% CI = 7.05-88.67; p < 0.001), fathers' lack of education (AOR = 3.03; 95% CI = 1.18-7.7; p = 0.021), school latrine nonusage at school (AOR = 4.53; 95% CI = 1.89-10.95; p < 0.001), untrimmed fingernails (AOR = 7.31; 95% CI = 2.57-20.81; p < 0.001), no handwashing after toilet use (AOR = 14.87; 95% CI = 3.97-55.75; p < 0.001), no handwashing before eating (AOR = 30.05; 95% CI = 11.05-81.74; p < 0.001), the absence of handwashing facility at home (AOR = 5.86; 95% CI = 2.19-15- 64; p < 0.001), and irregular wearing of shoes (AOR = 18.59; 95% CI = 6.89-50.13; p < 0.001) were significantly associated with STH infection.

Conclusion: The prevalence of A. lumbricoides was significant. Poor implementation of water, sanitation, and hygiene was a risk factor for A. lumbricoides and hookworm infection. Hence, health education on the transmission of STHs should be advocated to parents and schoolchildren.

Background: Alcohol use disorder (AUD) is a global public health issue, impacting individuals physiologically, socially, and mentally. Limited studies were conducted to explore associated factors in Nepal. This study aims to assess AUD prevalence and associated factors among people attending primary healthcare services in Rupandehi, Nepal.

Methods: An institutional-based cross-sectional study was conducted among 688 individuals attending primary healthcare facilities of Rupandehi district, Nepal, using multistage probability sampling technique. The study utilized validated AUD identification test (AUDIT) in its Nepali version for screening AUD. To assess relationships between dependent and independent variables, bivariate analysis was initially conducted. Variables that showed significant association with dependent variable having p value < 0.05 were then included in a multivariate logistic regression model to identify final associated factors.

Results: The prevalence of AUD was 30.8% (CI: 27.4-34.4). About 62.8% are in low risk, 26.7% higher risk, 5.1% harmful and hazardous, and 5.4% in alcohol dependence. Respondents aged ≥ 50 years (adjusted odds ratio [AOR] = 0.26, CI: 0.11-0.61), female (AOR = 0.14, CI: 0.07-0.28), non-Hindu (AOR = 0.05, CI: 0.01-0.43), ≥ SLC education (AOR = 0.16, CI: 0.08-0.31) were negatively associated with AUD. Whereas, Newar (AOR = 4.10, CI: 1.00-16.88), rural areas (AOR = 1.57, CI: 1.02-2.42), joint family (AOR = 1.58, CI: 1.05-2.37), daily wages (AOR = 3.57, CI: 1.10-11.56), food sufficiency of 6-9 months (AOR = 1.94, CI: 1.01-3.75), habit of alcohol (AOR = 8.46, CI: 5.28-13.55) friends' history of alcohol (AOR = 2.16, CI: 1.19-3.94) and intimate partners' history of alcohol (AOR = 2.16, CI: 1.30-3.75) were positively associated with AUD.

Conclusions: Nearly one-third of the respondents' experiences AUD, with factors including age, sex, ethnicity, residential status, religion, family type, education, occupation, food sufficiency from own land, personal alcohol habits, and social connections. Hence, this study recommends screening and treatment in primary healthcare, emphasizing government orientation for healthcare workers.

Oral health significantly impacts overall health, with increasing evidence linking poor oral health to adverse pregnancy outcomes. Periodontal disease, a chronic gum condition, is associated with preterm birth, low birth weight, and preeclampsia. Systemic inflammation and bacterial translocation are proposed mechanisms connecting periodontal disease to pregnancy complications. Maternal immune responses may be impaired, increasing systemic inflammation, and triggering preterm labor. In addition, oral bacteria may reach the uterus, causing localized inflammation and poor outcomes. Intervention trials show mixed results-some small studies report improved birth outcomes after periodontal treatment, while larger trials show no significant effect. These discrepancies highlight the need for further research on patient subgroups, disease categories, and treatment strategies. Prenatal care should emphasize preventive dental care, including regular checkups, good oral hygiene, and treatment of periodontal disease. Addressing oral health during pregnancy can improve outcomes for both mother and child. Future studies should explore the oral-systemic connection, host susceptibility, and effective interventions for at-risk individuals. Comprehensive oral health care during pregnancy offers the potential to reduce adverse outcomes and promote better maternal and fetal health.

Background: Breast cancer remains one of the major diseases affecting women in the world. Relative to high-income settings, women in low-income settings such as Africa are less likely to be diagnosed with breast cancer and are more likely to die when they are affected by the disease. Apart from the negative health consequences of breast cancer, it could also reduce the labour productivity (LP) of the affected persons, at both the micro- and macrolevels. Nonetheless, empirical evidence on LP effects of breast cancer are scant and mostly focused on the microlevel and, hence, do not provide broader insights into the productivity losses associated with the disease. This study, to the best of our knowledge, therefore, provides the first cross-country macrolevel empirical evidence of the effect of breast cancer (among women) on LP in Africa. Methods: The study uses data on 47 African countries spanning the period 1992-2021. Disability-Adjusted Life Years (DALYs) associated with breast cancer in women is used as the baseline measure of breast cancer, while Years Lived with Disability (YLDs) and deaths associated with the disease in women are used as robustness measures. The system Generalised Method of Moments (GMM) regression is used as the main estimation technique, while two other estimators are used for robustness purposes. Results: Our analysis reveals a negative statistically significant association between breast cancer DALYs and LP. Specifically, we find a percentage increase in breast cancer DALYs to be associated with a 0.27% and 0.87% fall in LP in the short- and long-run periods, respectively, at the 1% level of significance. The findings are robust using the other measures of breast cancer and different estimation techniques. Conclusion: There is a need to enhance measures towards breast cancer prevention and control in Africa such as timely diagnosis, all-inclusive management of breast cancer, health promotion geared towards early detection and the creation of dependable referral systems to significantly reduce its associated LP losses.

Purpose: Disparities in Global Cancer Care outcomes continue to grow between high- and low- and middle-income countries (LMICs). Specific competencies are required to provide effective oncologic care in low-resource settings. We assessed trainee interest and participation in global oncology and training activities at a major cancer center to determine support for future global oncology program development. Methods: An online survey was administered to trainees at MD Anderson Cancer Center in November 2020. Questions addressed interest in global health, prior experience, perceptions of mentorship and opportunities, career aspirations, and interest in participation in global oncology training. Results: Survey links were emailed to all trainees (n = 318) enrolled in oncology-related residency and fellowship training programs. Completed surveys were returned by 72 trainees (22.6%) spanning 17 programs. Thirty-three trainees expressed interest in global health, and 8 (24.2%) had previous or ongoing experience specific to global oncology. Seven (21.2%) indicated they had good access to global oncology faculty mentorship, while 26 (78.8%) indicated little to no access to mentorship. Thirty (90%) indicated that they wished to include global oncology activities in their future careers. More than half of the respondents indicated interest in participating in global oncology activities in training, including collaborative research projects with partners abroad, clinical work and education abroad, and global oncology grand rounds and journal clubs. Thirteen (39.4%) were interested in a global health track and 12 (36.4%) requested formalized coursework. Conclusions: We found significant interest in global health among trainees in oncology specialties at MD Anderson. As a result, the institution is implementing the Global Cancer Care Track for all trainees. The track includes a formalized curriculum, mentorship, research, and clinical opportunities to develop future leaders in global oncology with the goal of improving cancer care in low-resource settings.

Background: Type 2 diabetes mellitus (T2DM) links to oxidative stress in both its origin and progression. Vitamin E has the potential to be a highly effective therapeutic intervention in fighting against T2DM as it protects cells against oxidative stress. While some interventional studies have explored the effect of vitamin E on T2DM, there is a lack of cross-sectional studies globally, and none to our knowledge on the Bangladeshi population. Consequently, it is worthwhile to investigate the serum vitamin E levels in Bangladeshi T2DM patients. Methods: 94 T2DM patients and 30 healthy subjects were evaluated for their serum vitamin E concentration for a comparative cross-sectional study. Mean serum concentrations were compared between these two groups, as well as among different sex and age groups using independent sample t-test and one-way ANOVA, as appropriate. Results: The serum vitamin E concentration was significantly lower in T2DM patients (mean ± standard deviation: 8.97 ± 2.99 μg/mL) than in healthy subjects (13.13 ± 2.70 μg/mL), p < 0.001. Additionally, male T2DM patients had significantly higher serum vitamin E levels compared to those in female patients (9.73 ± 3.02 μg/mL in males vs. 7.74 ± 2.53 μg/mL in females; p=0.001). The study showed a significant fall in serum vitamin E concentration with increasing age in T2DM patients (≤ 30 years: 12.7 ± 1.05 μg/mL vs. 31-50 years: 11.06 ± 2.65 μg/mL vs. 51-70 years: 8 ± 2.04 μg/mL vs. 71-90 years: 6.05 ± 0.78 μg/mL; p < 0.001). Conclusion: Our findings suggest that lower serum vitamin E levels are significantly associated with T2DM, particularly among female and older patients, highlighting the potential relevance of antioxidant status in T2DM management.

Background: Folic acid supplementation during pregnancy is essential for preventing neural tube defects and other congenital anomalies. Despite global recommendations, supplementation remains suboptimal in many low- and middle-income countries, including Guatemala, where disparities persist across regions and populations. Objective: To investigate the association between the quality of antenatal care and folic acid supplementation among pregnant women in Guatemala. Design and Setting: This cross-sectional study used data from the 2014-2015 Encuesta Nacional de Salud Materno Infantil (ENSMI), part of the Demographic and Health Survey (DHS). A total of 9523 women aged 15-49 with children under two years were included. Folic acid supplementation was assessed through self-reported responses to survey questions. Multilevel logistic regression examined the association between antenatal care quality and folic acid supplementation, accounting for individual, household, and community-level factors. Results: Overall, 15.4% of women reported not taking folic acid during pregnancy. Lower folic acid supplementation was most notable among women who received no or inadequate antenatal care, indigenous women, and those living in socioeconomically disadvantaged communities. Women without antenatal care had 97% lower odds of folic acid supplementation compared with those with adequate care (OR = 0.03, 95% CI: 0.02-0.04, and p < 0.001), while intermediate care was associated with 41% lower odds (OR = 0.59, 95% CI: 0.47-0.74, and p < 0.001). Indigenous women had 26% lower odds of supplementation (OR = 0.74, 95% CI: 0.63-0.86, and p < 0.001), and women in communities with high levels of no media exposure had 33% lower odds of folic acid supplementation (OR = 0.67 and 95% CI: 0.53-0.84). Conclusions: Quality antenatal care plays a critical role in improving maternal nutrition behaviors. These findings underscore the need for targeted interventions, such as culturally tailored education, mass media campaigns, and improved access to antenatal careto increase folic acid supplementation among pregnant women in Guatemala.

Objectives: Oral cancer (OC) poses a growing health concern in Pakistan, emerging as the second-most diagnosed cancer in the country. The escalating incidence and mortality rates of OC place considerable strain on the health system. This study aims to delineate the factors contributing to the elevated incidence of OC in Pakistan. Methods: A hospital-based case-control study involving 688 participants above 18 years old was conducted. Participants were evaluated for reported OC risk factors. Results: Findings indicate a heightened susceptibility among men (71.5%) to develop OC in Pakistan. Factors contributing to OC include advancing age (AOR 1.12, 95% CI 1.13-1.18, p=0.001), low SES (61.4%), and limited education. Significant risk was associated with chewing tobacco (niswar) AOR 6.83, 95% CI 2.67-17.45, p=0.001), areca nut (AOR 4.99, 95% CI 1.51-16.45, p=0.001), and pan (AOR 7.90, 95% C1 3.19-19.59, p=0.001). Parental consanguinity increased OC incidence (AOR 4.72, 95% CI 1.12-4.14, p=0.02). Physical activity had no association with OC (AOR 0.41, 95% CI 0.23-0.75, p=0.004). Excessive sunlight exposure appeared to be associated with OC (AOR 0.15; 95% CI: 0.08-0.28, p-value: 0.001). At the same time, cigarette smoking and alcohol are not significant factors for the development of OC in Pakistan. Conclusion: The study underscores the elevated prevalence of OC among Pakistani men, attributable in part to lower literacy rates and inadequate access to healthcare facilities. The implementation of targeted prevention strategies informed by these epidemiological insights is essential for mitigating the burden of OC in the region.