Clinical Epidemiology and Global Health最新文献

Depression and influencing factors among pregnant women living in central Viet Nam: A mixed-methods study 越南中部孕妇抑郁及其影响因素：一项混合方法研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-19 DOI: 10.1016/j.cegh.2025.102268

Minh Ho , Tung Viet Le , Ly Thi-Ly Tran , Huong Thanh Nguyen

Problem considered

Antenatal depression can create social and economic pressures for families and communities. Pregnant women with antenatal depression may struggle to maintain employment, manage household responsibilities, and provide a stable environment for the fetus. Assessing the prevalence of antenatal depression and its influencing factors provides necessary information to develop support programs for pregnant women and their families.

Methods

A mixed-method study design was employed. Quantitative information assessed signs of depression using the Edinburgh Postnatal Depression scale among 312 pregnant women residing in Da Nang City. Qualitative information was gathered through in-depth interviews with 8 participants, including representatives of healthcare managers and staff, and focus group discussions with pregnant women exhibiting and not exhibiting signs of depression. Quantitative data were analysed using descriptive statistics and univariate logistic regression, while qualitative data were recorded, transcribed, and thematically analysed.

Results

The study found 28.2 % prevalence of antenatal depression. Qualitative analysis revealed positive influencing factors including: marital status (married/living with partner), planned pregnancy, support from husband's family, good relationship with husband, and having social support; Negative influencing factors included: advanced maternal age, low educational attainment, previous pregnancy complications, fetal abnormalities, having two or more children, poor relationship with mother-in-law, preference for male offspring within the family, experiencing mental and physical violence from the husband, and the support from service providers is inadequate.

Conclusions

Depression symptoms are prevalent among pregnant women, so it's important for healthcare professionals to understand the risk factors for depression in pregnant women.

产前抑郁症会给家庭和社区带来社会和经济压力。患有产前抑郁症的孕妇可能难以维持工作，承担家庭责任，并为胎儿提供稳定的环境。评估产前抑郁症的患病率及其影响因素为制定孕妇及其家庭的支持计划提供了必要的信息。方法采用混合方法设计。定量信息采用爱丁堡产后抑郁量表评估了居住在岘港市的312名孕妇的抑郁症状。通过对8名参与者（包括医疗保健管理人员和工作人员的代表）的深入访谈，以及与表现出和没有表现出抑郁迹象的孕妇进行焦点小组讨论，收集了定性信息。定量数据采用描述性统计和单变量逻辑回归进行分析，而定性数据则进行记录、转录和主题分析。结果产前抑郁患病率为28.2%。定性分析显示，积极影响因素包括：婚姻状况（已婚/同居）、有计划怀孕、丈夫家庭支持、与丈夫关系良好、有社会支持；负面影响因素包括：产妇高龄、受教育程度低、以前的妊娠并发症、胎儿畸形、有两个或两个以上子女、与婆婆关系差、家庭中偏爱男性后代、遭受丈夫的精神和身体暴力以及服务提供者的支持不足。结论孕妇抑郁症状普遍存在，因此了解孕妇抑郁的危险因素对医护人员来说非常重要。

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引用次数: 0

Health literacy, medication adherence, and diabetes complications in Morocco: A cross-sectional study 摩洛哥的健康素养、药物依从性和糖尿病并发症：一项横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-18 DOI: 10.1016/j.cegh.2025.102263

Sanaa Mohammi , Nada Bennani Mechita , Leila Lafdili , Majdouline Obtel , Rachid Razine

Background

Diabetes is a major public health challenge in Morocco. Health literacy (HL) and medication adherence are central to self-management and complication prevention, yet evidence from primary care is limited.

Objective

To assess functional, communicative, and critical HL among adults with diabetes in Marrakech primary care, and examine their associations with medication adherence and self-reported complications.

Methods

A cross-sectional survey was conducted among 333 adults with type 1 or type 2 diabetes attending urban and rural primary healthcare facilities. HL was assessed using the French Functional, Communicative, and Critical Health Literacy (FCCHL) scale, and adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8). Sociodemographic and clinical data were collected through interviewer-administered questionnaires. Non-parametric tests, Spearman correlations, and multivariable linear regression examined factors associated with HL, adherence, and complications.

Results

Overall HL was moderate (median FCCHL 49, IQR 45–54), with critical literacy the least developed. HL did not differ by age or diabetes type but varied by education, occupation, and insurance. Three-quarters of participants had low or moderate adherence, which correlated positively with functional and critical literacy and negatively with communicative literacy. Diabetes complications were frequent (43.5 %) but showed only weak links with HL.

Conclusion

HL domains were differentially associated with adherence, with critical literacy showing the strongest relationship. Education and social position were key predictors of HL, whereas clinical characteristics contributed little. Primary care interventions should target functional and critical HL and adapt communication to patients’ sociodemographic profiles, while longitudinal studies clarify causal pathways linking HL, adherence, and complications.

糖尿病是摩洛哥面临的一项重大公共卫生挑战。健康素养（HL）和药物依从性是自我管理和并发症预防的核心，但来自初级保健的证据有限。目的评估马拉喀什初级保健中成年糖尿病患者的功能性、交流性和危重性HL，并检查其与药物依从性和自我报告的并发症的关系。方法对333例在城市和农村初级卫生保健机构就诊的成人1型或2型糖尿病患者进行横断面调查。使用法语功能、交际和关键健康素养（FCCHL）量表评估HL，使用8项Morisky药物依从性量表（MMAS-8）评估依从性。通过访谈者填写的问卷收集社会人口学和临床数据。非参数检验、Spearman相关性和多变量线性回归检验了与HL、依从性和并发症相关的因素。结果总体HL为中等水平（FCCHL中位数为49，IQR为45-54），关键读写能力最不发达。HL不因年龄或糖尿病类型而异，但因教育、职业和保险而异。四分之三的参与者有低或中等程度的依从性，这与功能性和批判性素养呈正相关，与交际素养负相关。糖尿病并发症发生率较高（43.5%），但与HL的相关性较弱。结论hl域与依从性存在差异，其中批判性读写能力的相关性最强。教育程度和社会地位是影响HL发生的主要因素，而临床特征影响较小。初级保健干预应针对功能性和关键型HL，并使沟通适应患者的社会人口特征，同时纵向研究阐明HL、依从性和并发症之间的因果关系。

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引用次数: 0

Descriptive epidemiology of one of the most common complications in patients living with diabetes in Mauritius: the diabetic foot 毛里求斯糖尿病患者最常见的并发症之一：糖尿病足的描述流行病学

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-17 DOI: 10.1016/j.cegh.2025.102265

Luqman Nisa , Thibaut Gelle , Concheta Tchibozo , Shaad Toofanee , Damien Steciuk , Andy Sadien , Parveen Pokun , Sabeena Dowlut , Farid Boumediene

Problem considered

Diabetic foot and lower-limb complications are a leading cause of disability and healthcare burden in patients with diabetes, particularly in low- and middle-income countries. Mauritius has one of the highest diabetes prevalence rates worldwide, yet data on diabetic foot and lower-limb outcomes in real-world clinical settings remain scarce. This study aimed to describe the characteristics and treatment outcomes of patients receiving diabetic foot care in a specialised center.

Methods

A retrospective observational study was conducted over 26 months (January 2021–March 2023) at a diabetic foot care center in Mauritius. Adults with diabetes requiring wound care were included. Data were extracted from clinical records. Outcomes were classified as successful or unsuccessful wound healing. Multivariable logistic regression identified factors independently associated with healing success.

Results

Among 198 patients (2407 consultations), the median age was 65.0 years (IQR 57.0–71.8) and 59.1 % were male. Arteriopathy and neuropathy were present in 38.8 % and 39.5 %, respectively. The most common wound sites were toes (30.3 %) and foot (21.1 %). Overall, 68.2 % of patients achieved successful healing. Independent predictors of success included having 3–10 visits (adjusted odds ratio [aOR] 3.1; 95 % CI 1.3–7.6; p = 0.01), while arteriopathy was associated with failure (aOR 0.3; 95 % CI 0.1–0.6; p < 0.001).

Conclusion

Moderate follow-up (3–10 visits) was associated with better wound healing, while arteriopathy impaired outcomes. These findings support the need for structured diabetic foot care pathways in Mauritius, promoting early intervention and timely referral to specialist care.

糖尿病足和下肢并发症是糖尿病患者残疾和医疗负担的主要原因，特别是在低收入和中等收入国家。毛里求斯是世界上糖尿病患病率最高的国家之一，但在现实世界的临床环境中，关于糖尿病足和下肢结局的数据仍然很少。本研究旨在描述在专门中心接受糖尿病足护理的患者的特征和治疗结果。方法在毛里求斯一家糖尿病足护理中心进行回顾性观察性研究，为期26个月（2021年1月- 2023年3月）。需要伤口护理的成人糖尿病患者也包括在内。数据从临床记录中提取。结果分为成功或不成功的伤口愈合。多变量逻辑回归确定了与治疗成功独立相关的因素。结果198例患者2407次就诊，中位年龄65.0岁（IQR 57.0 ~ 71.8），男性占59.1%。动脉病变和神经病变分别占38.8%和39.5%。最常见的伤口部位是脚趾（30.3%）和足部（21.1%）。总体而言，68.2%的患者成功治愈。成功的独立预测因子包括3-10次就诊（调整比值比[aOR] 3.1; 95% CI 1.3-7.6; p = 0.01），而动脉病变与失败相关（aOR为0.3;95% CI 0.1-0.6; p < 0.001）。结论中度随访（3-10次）患者伤口愈合较好，动脉病变患者预后较差。这些发现支持毛里求斯有必要建立结构化的糖尿病足护理途径，促进早期干预和及时转诊到专科护理。

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引用次数: 0

Effectiveness of mHealth interventions for improving diabetes management outcomes in patients with type 2 diabetes: A cluster randomized crossover trial in Western Rajasthan 移动健康干预改善2型糖尿病患者糖尿病管理结果的有效性：拉贾斯坦邦西部的一项随机交叉试验

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-17 DOI: 10.1016/j.cegh.2025.102264

Ramesh Kumar Huda, Jayvardhan Singh, Pankaj Kumar, Laxmikant Mandhana, Manoj Kumar, Ramesh Kumar Sangwan, Bontha V. Babu

Problem considered

Type 2 diabetes (T2DM) poses a major public health challenge in India, particularly in Western Rajasthan, where access to consistent diabetes care is limited. Despite national programs, management gaps persist. mHealth interventions offer scalable, low-cost solutions, but evidence from Indian primary care settings remains limited.

Methods

This cluster-randomized crossover trial was conducted between January and November 2024 across two urban Primary Health Centres (PHCs) in Jodhpur, Rajasthan. One PHC (n = 140) received an mHealth intervention (SMS and Android app reminders) with usual care, while the other (n = 140) received usual care alone. The primary outcome was the change in HbA1c, quality of life, and other health outcomes at 6 months, analyzed using paired and independent t-tests.

Results

Finding shows, the intervention group showed significant improvements: mean HbA1c decreased from 9.23 % to 8.33 % (p < 0.001), BMI from 27.25 to 26.74 kg/m² (p < 0.05), systolic BP from 138 to 132 mmHg (p < 0.01), diastolic BP from 86 to 84 mmHg (p < 0.05), and quality of life improved (p = 0.001). The control group demonstrated a significant reduction in mean HbA1c (8.96 %–7.70 %, p < 0.001), but no improvement in anthropometric measures, and a significant decline in quality of life (p = 0.001).

Conclusions

The study concluded that mHealth intervention significantly improved glycemic control, blood pressure, waist circumference, and quality of life, highlighting its potential as an effective tool for diabetes self-management in resource-limited settings.

2型糖尿病（T2DM）在印度构成了一个重大的公共卫生挑战，特别是在拉贾斯坦邦西部，那里获得持续的糖尿病治疗的机会有限。尽管有国家规划，管理差距依然存在。移动医疗干预措施提供了可扩展的低成本解决方案，但来自印度初级保健机构的证据仍然有限。方法本群随机交叉试验于2024年1月至11月在拉贾斯坦邦焦特布尔的两个城市初级卫生中心（PHCs）进行。一名初级保健医生（n = 140）接受移动健康干预（短信和Android应用程序提醒）和常规护理，而另一名（n = 140）单独接受常规护理。主要结局是6个月时HbA1c、生活质量和其他健康结局的变化，使用配对和独立t检验进行分析。结果干预组患者的平均HbA1c从9.23%降至8.33% (p < 0.001)， BMI从27.25降至26.74 kg/m2 (p < 0.05)，收缩压从138降至132 mmHg (p < 0.01)，舒张压从86降至84 mmHg (p < 0.05)，生活质量得到改善（p = 0.001）。对照组的平均HbA1c显著降低（8.96% - 7.70%,p < 0.001），但人体测量没有改善，生活质量显著下降（p = 0.001）。该研究得出结论，移动健康干预显著改善了血糖控制、血压、腰围和生活质量，突出了其作为资源有限环境下糖尿病自我管理的有效工具的潜力。

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引用次数: 0

Burden of reproductive cancers in India: Insights from population-based cancer registries 印度生殖癌症的负担：基于人口的癌症登记的见解

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-16 DOI: 10.1016/j.cegh.2025.102261

Ranjan Kumar Prusty , Varun Kumar Kashyap , Mahadev Bhise , Shahina Begum , Sharyu Mhamane , Anupama Chauhan

Problem considered

Reproductive cancers (RCs) are a major component of India's non-communicable disease burden, with significant gender and regional disparities. Despite being largely preventable, early detection and access to care remain limited, and comprehensive national-level incidence data are scarce. The present study aims to provide an overview of the epidemiology of RCs in India, including their magnitude and patterns, based on data from population-based cancer registries.

Methods

Cancer incidence data from 37 Population-Based Cancer Registries (PBCRs) in India, covering the years 2012–2017, were analysed. RC cases were identified using ICD-10 codes. Age-standardized incidence rates (ASRs), age-specific rates, and lifetime cumulative risks were computed and disaggregated by sex and region.

Results

Among 436,223 total cancer cases, 61,190 (14.0 %) were RCs—15,091 in males (6.9 %) and 46,099 in females (21.3 %). In females, cervical cancer accounted for 48.8 % of RCs, followed by ovarian (28.7 %) and endometrial (15.5 %) cancers. In males, prostate cancer comprised 78.8 % of RC cases. The burden peaked between the ages of 40 and 59 years in both sexes. In India, the lifetime cumulative risk was 1 in 34 for females and 1 in 68 for males, with higher risks observed in northern and southern regions of India.

Conclusion

The burden of RCs in India is disproportionately higher among females, with marked regional disparities. Strengthening early detection programmes and leveraging Health and Wellness Centres under Ayushman Bharat are critical strategies. Region-specific, gender-sensitive approaches, coupled with ongoing surveillance and a multisectoral policy focus, are essential to improve outcomes and mitigate the psychosocial impacts of RCs.

生殖癌症是印度非传染性疾病负担的一个主要组成部分，存在显著的性别和地区差异。尽管这些疾病在很大程度上是可以预防的，但早期发现和获得护理的机会仍然有限，而且缺乏全面的国家级发病率数据。本研究旨在根据基于人群的癌症登记处的数据，概述印度RCs的流行病学，包括其规模和模式。方法分析印度37个基于人口的癌症登记处（pbcr） 2012-2017年的癌症发病率数据。使用ICD-10代码确定RC病例。计算年龄标准化发病率（ASRs）、年龄特异性发病率和终生累积风险，并按性别和地区分类。结果436223例肿瘤患者中，rcs 61190例（14.0%），男性15091例（6.9%），女性46099例（21.3%）。在女性中，宫颈癌占RCs的48.8%，其次是卵巢癌（28.7%）和子宫内膜癌（15.5%）。在男性中，前列腺癌占78.8%。无论男女，这种负担在40岁到59岁之间达到高峰。在印度，女性的终生累积风险为34分之一，男性为68分之一，印度北部和南部地区的风险更高。结论印度女性RCs负担高，且地区差异明显。加强早期发现方案和利用Ayushman Bharat下的保健和保健中心是关键战略。针对特定区域、对性别问题有敏感认识的方法，加上持续监测和多部门政策重点，对于改善结果和减轻rc的社会心理影响至关重要。

{"title":"Burden of reproductive cancers in India: Insights from population-based cancer registries","authors":"Ranjan Kumar Prusty , Varun Kumar Kashyap , Mahadev Bhise , Shahina Begum , Sharyu Mhamane , Anupama Chauhan","doi":"10.1016/j.cegh.2025.102261","DOIUrl":"10.1016/j.cegh.2025.102261","url":null,"abstract":"<div><h3>Problem considered</h3><div>Reproductive cancers (RCs) are a major component of India's non-communicable disease burden, with significant gender and regional disparities. Despite being largely preventable, early detection and access to care remain limited, and comprehensive national-level incidence data are scarce. The present study aims to provide an overview of the epidemiology of RCs in India, including their magnitude and patterns, based on data from population-based cancer registries.</div></div><div><h3>Methods</h3><div>Cancer incidence data from 37 Population-Based Cancer Registries (PBCRs) in India, covering the years 2012–2017, were analysed. RC cases were identified using ICD-10 codes. Age-standardized incidence rates (ASRs), age-specific rates, and lifetime cumulative risks were computed and disaggregated by sex and region.</div></div><div><h3>Results</h3><div>Among 436,223 total cancer cases, 61,190 (14.0 %) were RCs—15,091 in males (6.9 %) and 46,099 in females (21.3 %). In females, cervical cancer accounted for 48.8 % of RCs, followed by ovarian (28.7 %) and endometrial (15.5 %) cancers. In males, prostate cancer comprised 78.8 % of RC cases. The burden peaked between the ages of 40 and 59 years in both sexes. In India, the lifetime cumulative risk was 1 in 34 for females and 1 in 68 for males, with higher risks observed in northern and southern regions of India.</div></div><div><h3>Conclusion</h3><div>The burden of RCs in India is disproportionately higher among females, with marked regional disparities. Strengthening early detection programmes and leveraging Health and Wellness Centres under Ayushman Bharat are critical strategies. Region-specific, gender-sensitive approaches, coupled with ongoing surveillance and a multisectoral policy focus, are essential to improve outcomes and mitigate the psychosocial impacts of RCs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102261"},"PeriodicalIF":1.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790472","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}

引用次数: 0

Burden of anemia in inflammatory bowel disease: A systematic review and meta-analysis 炎症性肠病的贫血负担：一项系统综述和荟萃分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-15 DOI: 10.1016/j.cegh.2025.102262

Rupa Tharu , Savitesh Kushwaha , Rachana Srivastava , Vaneet Jearth , Nitin Kaushal , Anupam Kumar Singh , Shweta Khandelwal , Poonam Khanna

Problem considered

Inflammatory bowel disease (IBD) is a chronic immune-mediated condition of the gastrointestinal system. Anemia is one of the most prevalent extraintestinal manifestations of IBD. This study assessed the global prevalence of anemia in patients with IBD.

Methods

A systematic review and meta-analysis were conducted following PRISMA guidelines to estimate the prevalence of anemia in IBD across world from year 2015–2024. The literature search was conducted in PubMed, Web of Science, Scopus, and Embase. The inclusion and exclusion criteria were pre-defined. The data on prevalence of anemia were extracted and Random effect pooled prevalence with 95 % CI was estimated for overall IBD and separately for Crohn's disease and ulcerative colitis. The subgroup was also defined among types of anemia, age groups, country, study site and study designs.

Results

The Search identified 791 records and 47 publications with a sample population of 138577 unique IBD cases from 22 countries and 5 continents were included in the prevalence estimation. The prevalence of anemia among overall IBD populations was 36.9 % (95 % CI:31.1–42.9), the prevalence of iron deficiency anemia (IDA) was 32.2 % (95 % CI:25.6–39.1), and the prevalence anemia of chronic disease (ACD) was 8.1 % (95 % CI:5.8–10.7). The country wise analysis shows highest prevalence of anemia in Bulgaria, for IDA highest prevalence was in Poland and ACD was highest in India.

Conclusions

Anemia is a common and variable complication of IBD globally. Its prevalence differs significantly by anemia subtype and geographic region, highlighting a substantial and complex burden.

炎症性肠病（IBD）是一种慢性免疫介导的胃肠道疾病。贫血是IBD最常见的肠外表现之一。本研究评估了IBD患者贫血的全球患病率。方法根据PRISMA指南进行系统回顾和荟萃分析，以估计2015-2024年全球IBD患者贫血的患病率。文献检索在PubMed、Web of Science、Scopus和Embase中进行。预先定义了纳入和排除标准。提取有关贫血患病率的数据，并对总体IBD和克罗恩病和溃疡性结肠炎的随机效应汇总患病率进行95% CI估计。该亚组还根据贫血类型、年龄组、国家、研究地点和研究设计进行了定义。结果共检索到来自5大洲22个国家的138577例IBD病例样本，共791份记录和47份出版物纳入患病率估算。总体IBD人群中贫血的患病率为36.9% (95% CI: 31.1-42.9)，缺铁性贫血（IDA）患病率为32.2% (95% CI: 25.6-39.1)，慢性疾病贫血（ACD）患病率为8.1% （95% CI: 5.8-10.7）。国别分析显示，保加利亚的贫血患病率最高，国际开发协会的贫血患病率最高的是波兰，亚行的贫血患病率最高的是印度。结论贫血是全球IBD常见且多变的并发症。其患病率因贫血亚型和地理区域的不同而有显著差异，突出了一个巨大而复杂的负担。

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引用次数: 0

A qualitative analysis of climate change-related perceptions among a sample of the Egyptian population: A youth participatory action research 在埃及人口样本中对气候变化相关观念的定性分析：青年参与性行动研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-04 DOI: 10.1016/j.cegh.2025.102257

Samah Saleh , Ihab Abdel-Aziz Gebreel , Salah hassan AL Hanafy , Ahmed Tawfik Bayad , Sherry Medhat Ayad , Shaimaa Baher Abdel-aziz , Abdelhamid Mohamed El Shabrawy

Problem considered

Climate change-related perceptions and communication are important factors influencing people's support for climate change policies and individual behavior. The purpose of this Youth-Led PAR is to involve young people in framing the discussion about climate change, identifying knowledge, perception about CC and its effects.

Methods

This is an exploratory population-based study that was implemented in partnership with the Egyptian Ministry of Environment (MOE) and UINCEF/Egypt Country Office (ECO) during the period from June 2023 to December 2023. A qualitative investigative approach was chosen for this study's methodology including 90 focus group discussions and 180 in-depth interviews in 10 governorates including a purposive sample of 1082 respondents.

Results

The interview questions elicited responses related to five thematic areas: young people's awareness, attitudes and beliefs; lessons learned, mitigation strategies, barriers against contribution; Roles and responsibilities for the implementation strategies; Advocacy campaigns and raising awareness. The findings revealed that young people perceive climate change as a global warming phenomenon. The majority realized that the situation would be worse, children, adolescents and young people are the most affected due to spreading diseases, emerging new organisms, increasing in mental health problems.

Conclusions

Generate evidence and assessing youth's understanding related to climate change impact on health is a critical issue. The study results can provide the foundation to develop community-based awareness campaigns, draw attention to the causes, indicators, and broad hazards of CC, advocate for the urgent need to support strict governmental policies and the development of future environmental impact reducing strategies.

与气候变化相关的认知和沟通是影响人们对气候变化政策和个人行为支持的重要因素。青年领导的PAR的目的是让年轻人参与关于气候变化的讨论，确定关于气候变化及其影响的知识和看法。方法：这是一项基于人群的探索性研究，于2023年6月至2023年12月期间与埃及环境部（MOE）和联合国儿童基金会/埃及国家办事处（ECO）合作实施。本研究的方法选择了定性调查方法，包括在10个省进行90次焦点小组讨论和180次深度访谈，其中包括1082名受访者的有目的样本。结果访谈问题引出的回答涉及5个主题领域：年轻人的意识、态度和信念；经验教训、缓解战略、阻碍捐款的障碍；实施策略的角色和责任；宣传活动和提高认识。调查结果显示，年轻人认为气候变化是一种全球变暖现象。大多数人认识到情况会更糟，儿童、青少年和年轻人受疾病传播、新生物体出现和精神健康问题增加的影响最大。结论生成证据并评估青年对气候变化对健康影响的理解是一个关键问题。研究结果可为开展以社区为基础的宣传活动提供基础，引起人们对CC的原因、指标和广泛危害的关注，倡导迫切需要支持严格的政府政策和制定未来的减少环境影响战略。

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引用次数: 0

Predicting severity in spotted fever in India: A retrospective cohort study 预测印度斑疹热严重程度：一项回顾性队列研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-03 DOI: 10.1016/j.cegh.2025.102255

Nitin Gupta , Praveen Kumar Tirlangi , Rachana Bhat , S. Chaithra , Mohammad Arham Parvez , V. Shashidhar , Seema Shetty , Muralidhar Varma , K.E. Vandana , Prithvishree Ravindra

Problem considered

Spotted fever, a neglected rickettsial illness in India, can present with life-threatening complications, yet early predictors of severity remain poorly defined.

Methods

We conducted a retrospective cohort study of 117 adult patients with spotted fever admitted to a tertiary care centre in Karnataka, India (2017–2024). Spotted fever was diagnosed based on a positive Weil-Felix test (OX-2 and/or OX-19) with exclusion of other common tropical infections. Severe disease was defined as the presence of oxygen requirement, vasopressor use, dialysis, or altered sensorium. Clinical and laboratory variables were compared between severe and non-severe groups, and multivariable logistic regression identified independent predictors.

Results

Severe disease occurred in 31.6 % (37/117). On multivariable analysis, shorter duration of illness at presentation to the hospital was independently associated with severe disease [aOR 0.70 (95 % CI: 0.57–0.86)], while higher serum creatinine also predicted severity [aOR 1.29 (95 % CI: 1.00–1.66)]. Lower serum albumin showed a strong association with severe disease [aOR 0.16 (95 % CI: 0.07–0.37)]. Although platelet count demonstrated an inverse trend, the association did not reach statistical significance [aOR 0.92 (95 % CI: 0.83–1.03)]. The model showed good calibration (Hosmer–Lemeshow p = 0.128) and an overall accuracy of 77.7 %.

Conclusion

In spotted fever, simple and accessible markers, shorter illness duration, renal dysfunction, and hypoalbuminemia, can help predict severity and guide early referral, especially in resource-limited settings. These findings merit validation in prospective cohorts.

在印度，斑疹热是一种被忽视的立克次体疾病，可导致危及生命的并发症，但其严重程度的早期预测指标仍不明确。方法对2017-2024年印度卡纳塔克邦一家三级医疗中心收治的117例成人斑疹热患者进行回顾性队列研究。在排除其他常见热带感染的情况下，根据韦尔-费利克斯试验阳性（OX-2和/或OX-19）诊断为斑疹热。严重的疾病被定义为存在氧气需求、血管加压剂的使用、透析或感觉改变。比较重症组和非重症组的临床和实验室变量，并用多变量logistic回归确定独立预测因子。结果重症占31.6%（37/117）。在多变量分析中，入院时病程较短与疾病严重程度独立相关[aOR 0.70 (95% CI: 0.57-0.86)]，而较高的血清肌酐也预测疾病严重程度[aOR 1.29 (95% CI: 1.00-1.66)]。较低的血清白蛋白与严重疾病密切相关[aOR 0.16 (95% CI: 0.07-0.37)]。虽然血小板计数呈负相关，但相关性不具有统计学意义[aOR 0.92 (95% CI: 0.83-1.03)]。该模型具有良好的校正效果（Hosmer-Lemeshow p = 0.128），总体精度为77.7%。结论在斑疹热中，简单易行的标志物、较短的病程、肾功能不全和低白蛋白血症可帮助预测病情严重程度并指导早期转诊，特别是在资源有限的地区。这些发现值得在前瞻性队列中得到验证。

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引用次数: 0

Comparative analysis of HPV prevalence and genotype distribution in patients with base of tongue, cervical, and tonsillar squamous cell carcinomas: Indications of a shift in HPV genotype patterns 舌底、宫颈和扁桃体鳞状细胞癌患者的HPV患病率和基因型分布的比较分析：HPV基因型模式转变的指征

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-02 DOI: 10.1016/j.cegh.2025.102248

Reham M. Alahmad

Problem considered

Human Papillomavirus (HPV) is a significant etiological factor in several cancers, including cervical and head and neck squamous cell carcinoma (HNSCC). While HPV-16 is the most commonly reported genotype globally, emerging evidence indicates regional variations in genotype distribution. In Saudi Arabia, data on HPV genotypes in these cancers remain limited. This study investigated the prevalence and genotype distribution of high-risk HPV (HR-HPV) in base of tongue squamous cell carcinoma (BOTSCC), cervical squamous cell carcinoma (CSCC), and tonsillar squamous cell carcinoma (TSCC), and to evaluate implications for HPV vaccine coverage.

Methods

A total of 97 patients (11 BOTSCC, 70 CSCC, and 16 TSCC) were tested for the presence and genotypes of HR-HPV using molecular methods. The distribution of HR-HPV genotypes, single and multiple infections, was assessed, and genotypes were compared to the coverage provided by the nine-valent HPV vaccine.

Results

In patients with base of tongue squamous cell carcinoma (BOTSCC), HPV DNA was detected in all cases, with HPV-35 being the most prevalent genotype (90 %), followed by HPV-16 (63 %) and HPV-45 (9 %). Notably, 81.8 % of BOTSCC patients exhibited multiple HPV infections, predominantly dual infections. Among cervical squamous cell carcinoma (CSCC) cases, HPV-35 was again the most frequently detected genotype (84 %), followed by HPV-16 (68 %) and HPV-18 (54 %), while HPV-33 was not observed. In tonsillar squamous cell carcinoma (TSCC), 81.3 % of patients tested positive for.

Conclusion

The predominance of HPV-35 over HPV-16 in CSCC and HNSCC highlights a unique regional pattern and a gap in current vaccine coverage. The detection of non-vaccine genotypes supports the need for regional surveillance and potential expansion of vaccine targets to improve protection against HPV-related cancers in Saudi Arabia.

人乳头瘤病毒（HPV）是几种癌症的重要病因，包括宫颈癌和头颈部鳞状细胞癌（HNSCC）。虽然HPV-16是全球最常见的基因型，但新出现的证据表明基因型分布存在区域差异。在沙特阿拉伯，这些癌症中HPV基因型的数据仍然有限。本研究调查了高危型HPV （HR-HPV）在舌鳞癌（BOTSCC）、宫颈鳞癌（CSCC）和扁桃体鳞癌（TSCC）基底的患病率和基因型分布，并评估HPV疫苗覆盖率的影响。方法采用分子方法对97例患者（11例BOTSCC、70例CSCC、16例TSCC）进行HR-HPV基因型检测。评估了单次和多次感染的HR-HPV基因型分布，并将基因型与九价HPV疫苗提供的覆盖率进行了比较。结果舌底鳞状细胞癌（BOTSCC）患者均检出HPV DNA，其中HPV-35基因型最多（90%），其次是HPV-16（63%）和HPV-45（9%）。值得注意的是，81.8%的BOTSCC患者表现为多发HPV感染，主要是双重感染。在宫颈鳞状细胞癌（CSCC）病例中，HPV-35再次是最常检测到的基因型（84%），其次是HPV-16（68%）和HPV-18(54%)，而HPV-33未被观察到。在扁桃体鳞状细胞癌（TSCC）中，81.3%的患者检测呈阳性。结论HPV-35比HPV-16在CSCC和HNSCC中的优势突出了一种独特的区域模式和目前疫苗覆盖率的差距。非疫苗基因型的检测支持了区域监测的必要性和扩大疫苗靶点的潜力，以改善对沙特阿拉伯人乳头瘤病毒相关癌症的保护。

{"title":"Comparative analysis of HPV prevalence and genotype distribution in patients with base of tongue, cervical, and tonsillar squamous cell carcinomas: Indications of a shift in HPV genotype patterns","authors":"Reham M. Alahmad","doi":"10.1016/j.cegh.2025.102248","DOIUrl":"10.1016/j.cegh.2025.102248","url":null,"abstract":"<div><h3>Problem considered</h3><div>Human Papillomavirus (HPV) is a significant etiological factor in several cancers, including cervical and head and neck squamous cell carcinoma (HNSCC). While HPV-16 is the most commonly reported genotype globally, emerging evidence indicates regional variations in genotype distribution. In Saudi Arabia, data on HPV genotypes in these cancers remain limited. This study investigated the prevalence and genotype distribution of high-risk HPV (HR-HPV) in base of tongue squamous cell carcinoma (BOTSCC), cervical squamous cell carcinoma (CSCC), and tonsillar squamous cell carcinoma (TSCC), and to evaluate implications for HPV vaccine coverage.</div></div><div><h3>Methods</h3><div>A total of 97 patients (11 BOTSCC, 70 CSCC, and 16 TSCC) were tested for the presence and genotypes of HR-HPV using molecular methods. The distribution of HR-HPV genotypes, single and multiple infections, was assessed, and genotypes were compared to the coverage provided by the nine-valent HPV vaccine.</div></div><div><h3>Results</h3><div>In patients with base of tongue squamous cell carcinoma (BOTSCC), HPV DNA was detected in all cases, with HPV-35 being the most prevalent genotype (90 %), followed by HPV-16 (63 %) and HPV-45 (9 %). Notably, 81.8 % of BOTSCC patients exhibited multiple HPV infections, predominantly dual infections. Among cervical squamous cell carcinoma (CSCC) cases, HPV-35 was again the most frequently detected genotype (84 %), followed by HPV-16 (68 %) and HPV-18 (54 %), while HPV-33 was not observed. In tonsillar squamous cell carcinoma (TSCC), 81.3 % of patients tested positive for.</div></div><div><h3>Conclusion</h3><div>The predominance of HPV-35 over HPV-16 in CSCC and HNSCC highlights a unique regional pattern and a gap in current vaccine coverage. The detection of non-vaccine genotypes supports the need for regional surveillance and potential expansion of vaccine targets to improve protection against HPV-related cancers in Saudi Arabia.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102248"},"PeriodicalIF":1.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685518","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}

引用次数: 0

Unveiling the hidden burden of malnutrition in tuberculosis: A multifaceted evaluation using malnutrition universal screening tool and patient-generated subjective global assessment 揭示结核病中营养不良的隐性负担：利用营养不良普遍筛查工具和患者主观全球评估进行多方面评估

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-02 DOI: 10.1016/j.cegh.2025.102253

Priyanka Guha , Meenakshi Abbagouni , Maturu Ashok , Rajat Kumar Mishra , Tukaram Kendre , Gulshan Singh Rana , Abhik Sen , Krishna Pandey , Sameer Dhingra

Problem considered

Tuberculosis (TB) remains a significant public health burden, especially in resource-limited countries. Malnutrition is a significant concern among TB patients, exacerbating symptoms and impeding recovery. Despite this, standardised nutritional screening remains underutilised in TB care programs. Accurate and routine nutritional assessment is essential to guide timely interventions and improve treatment outcomes among TB patients. This study aimed to assess malnutrition risk in TB patients using MUST and PG-SGA, evaluate disagreement between screening tools, and determine the limitations of Body Mass Index (BMI) based assessments.

Methods

A cross-sectional study was conducted among 194 adult TB patients receiving anti-TB therapy in Bihar, India. Nutritional risk was evaluated using MUST and PG-SGA, along with demographic, clinical, and anthropometric data. Statistical analyses included ANOVA, Bonferroni post hoc tests, chi-square tests, and Cohen's kappa to assess agreement between tools.

Results

The study revealed a high prevalence of malnutrition risk, with MUST detecting 74.2 % and PG-SGA detecting 88.1 % of the overall population. Underweight patients were disproportionately affected, with MUST identifying 96.5 % and PG-SGA identifying 88.3 % as high-risk. This study emphasises the limitations of BMI alone in assessing malnutrition risk and reveals near-random agreement (κ = 0.010, p < 0.001), suggesting BMI alone inadequately captures malnutrition risk in TB patients.

Conclusion

This study highlights a critical gap in malnutrition screening for TB patients, with MUST and PG-SGA detecting high but discordant risk levels. Given PG-SGA's higher sensitivity, policymakers in resource-limited settings should consider integrating it into TB programs for early nutritional intervention, while further research validates optimal screening approaches.

结核病仍然是一个重大的公共卫生负担，特别是在资源有限的国家。营养不良是结核病患者的一个重大问题，它会加剧症状并阻碍康复。尽管如此，标准化营养筛查在结核病治疗规划中仍未得到充分利用。准确和常规的营养评估对于指导及时干预和改善结核病患者的治疗结果至关重要。本研究旨在利用MUST和PG-SGA评估结核病患者的营养不良风险，评估筛查工具之间的差异，并确定基于体重指数（BMI）评估的局限性。方法对印度比哈尔邦194例接受抗结核治疗的成年结核病患者进行横断面研究。营养风险评估使用MUST和PG-SGA，以及人口统计学、临床和人体测量数据。统计分析包括方差分析、Bonferroni事后检验、卡方检验和Cohen kappa来评估工具之间的一致性。结果该研究显示营养不良风险的患病率较高，MUST检出率为74.2%，PG-SGA检出率为88.1%。体重过轻的患者受到不成比例的影响，其中必须确定96.5%，PG-SGA确定88.3%为高危患者。这项研究强调了单独使用BMI来评估营养不良风险的局限性，并揭示了近乎随机的一致性（κ = 0.010, p < 0.001），表明单独使用BMI不能充分反映结核病患者的营养不良风险。结论本研究突出了结核病患者营养不良筛查的关键差距，MUST和PG-SGA检测出高但不一致的风险水平。鉴于PG-SGA具有更高的敏感性，资源有限国家的政策制定者应考虑将其纳入结核病规划，用于早期营养干预，同时进一步研究验证最佳筛查方法。

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引用次数: 0