Clinical Epidemiology and Global Health最新文献

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IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

Occupational prevalence with agricultural machinery related injuries among rice farmers in Bang Rakam district, Phitsanulok Province, Thailand 泰国平世洛省Bang Rakam地区稻农中农业机械相关伤害的职业流行率

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 DOI: 10.1016/j.cegh.2025.102285

Chavinthorn Maiyapakdee , Saowanee Norkaew , Nontiya Homkham , Theerayut Baubhom , Katiya Ivanovitch , Teeraphun Kaewdok

Problem considered

Accidents are among the major occupational health hazards, and agricultural machinery is a significant cause of musculoskeletal injuries, including cuts, sprains, and strains, among agriculturists in Thailand. Due to the lack of information in the farmer accident database, this cross-sectional study investigated the prevalence of agricultural machinery-related injuries among rice farmers in Thailand's Bang Rakam District of Phitsanulok Province.

Methods

Data were collected via in-person interviews with 294 rice farmers who used agricultural machinery at any stage of farming activities during the 2023 crop year. The questionnaire consisted of three sections: (1) general information about the farmers, (2) details of their work equipment and practices, and (3) information about injuries sustained during work.

Results

All participants reported experiencing work-related injuries. The machinery most associated with injuries was the walking tractor (41.8 %) followed by the harvesting machine (13.3 %). The most frequently injured body parts were the back and torso (21.8 %), legs, and knees (19.0 %), and hands and fingers (17.3 %). Land preparation activities accounted for the highest proportion of injuries (56.1 %) followed by pesticide application (31.6 %).

Conclusion

This study highlights the prevalence of work-related musculoskeletal injuries among rice farmers, reflecting significant occupational health concerns in Thailand. The findings suggest a need to redesign agricultural machinery, particularly tractors, to enhance safety. Additionally, interventions and safety guidelines should be developed and implemented to prevent occupational accidents in the agricultural sector.

事故是主要的职业健康危害之一，农业机械是泰国农业工人肌肉骨骼损伤的重要原因，包括割伤、扭伤和拉伤。由于农民事故数据库中缺乏信息，本横断面研究调查了泰国彭世洛省Bang Rakam地区稻农中与农业机械相关的伤害发生率。方法通过对294名在2023作物年期间在农业活动的任何阶段使用农业机械的稻农进行面对面访谈，收集数据。问卷包括三个部分：(1)农民的一般情况，(2)他们的工作设备和操作的细节，(3)在工作中受伤的信息。结果所有参与者都报告有工伤经历。与伤害相关最多的机械是手扶拖拉机（41.8%），其次是收获机械（13.3%）。最常受伤的身体部位是背部和躯干（21.8%），腿和膝盖（19.0%），手和手指（17.3%）。整理土地活动造成的伤害比例最高（56.1%），其次是施用农药（31.6%）。结论：本研究强调了水稻农民中与工作相关的肌肉骨骼损伤的患病率，反映了泰国重要的职业健康问题。研究结果表明，需要重新设计农业机械，特别是拖拉机，以提高安全性。此外，应制定和执行干预措施和安全准则，以防止农业部门的职业事故。

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引用次数: 0

Spatiotemporal evolution of dengue hotspots in Kuantan, Malaysia: A decade-long geospatial analysis for adaptive vector control 马来西亚关丹登革热热点的时空演变：自适应媒介控制的十年地理空间分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 DOI: 10.1016/j.cegh.2025.102273

Zulkifli Abdul Hadi , Agus Naba , Ahmad Mohiddin Mohd Ngesom , Nazri Che Dom

Problem considered

Dengue continues to pose a major public health burden in Malaysia, particularly in rapidly urbanising districts where shifting land-use patterns influence transmission dynamics. Despite increasing case numbers, evidence on long-term hotspot trajectories at the district scale remains limited. This study examined a decade of dengue transmission in Kuantan District, Malaysia by integrating detailed land-use characteristics with epidemiological and population data to identify persistent, emerging, and expanding hotspots.

Methods

A retrospective spatiotemporal analysis was conducted using laboratory-confirmed dengue cases reported from 2014 to 2023. Case data were geocoded and aggregated at the sub-district level. Residential, commercial, industrial, and green-area land-use layers were standardised and spatially overlaid with dengue incidence rates to quantify their contribution to hotspot formation. Annual incidence rates were calculated to provide a precise measure of disease intensity across sub-districts. A multi-stage geospatial framework comprising Kernel Density Estimation, Space–Time Cube modelling, Mann–Kendall trend analysis, Emerging Hotspot Analysis, and Local Moran's I was applied to evaluate hotspot intensity, persistence, and spatial evolution.

Results

A total of 38,412 dengue cases were documented, with an average annual incidence of 386.5 cases per 100,000 population. Major peaks occurred in 2019 (624.5 per 100,000; 6213 cases) and 2022 (578.2 per 100,000; 5876 cases). Persistent hotspots increased from five in 2016 to nine in 2023, primarily within high-density residential and mixed-commercial zones identified through the land-use overlay analysis. Transitional hotspots frequently emerged in peri-urban areas undergoing rapid land-use change before stabilizing. Local Moran's I showed significant High–High clusters in the urban core (Moran's I = 0.41, p < 0.01).

Conclusion

Dengue transmission in Kuantan has become increasingly entrenched, driven by urban density, mixed land-use development, and peri-urban expansion. Proactive, land-use-informed hotspot surveillance is essential for strengthening targeted dengue control.

登革热在马来西亚继续构成重大公共卫生负担，特别是在快速城市化的地区，不断变化的土地利用模式影响着传播动态。尽管病例数不断增加，但在地区范围内关于长期热点轨迹的证据仍然有限。本研究通过将详细的土地利用特征与流行病学和人口数据相结合，调查了马来西亚关丹地区十年来登革热传播的情况，以确定持续存在的、新出现的和正在扩大的热点。方法对2014 - 2023年登革热病例进行回顾性时空分析。病例数据在分区一级进行地理编码和汇总。将住宅、商业、工业和绿地土地利用层标准化，并在空间上叠加登革热发病率，以量化其对热点形成的贡献。计算了年发病率，以提供对各区疾病强度的精确衡量。采用核密度估计、时空立方体建模、Mann-Kendall趋势分析、新兴热点分析和局部Moran’s I等多阶段地理空间框架对热点强度、持久性和空间演化进行了评价。结果共报告登革热病例38412例，年平均发病率为386.5例/ 10万人。主要高峰发生在2019年（624.5 / 10万，6213例）和2022年（578.2 / 10万，5876例）。持续热点从2016年的5个增加到2023年的9个，主要在高密度住宅和混合商业区内，通过土地利用覆盖分析确定。在土地利用快速变化趋于稳定的城郊地区，频繁出现过渡性热点。当地Moran's I在城市核心显示出显著的High-High集群（Moran's I = 0.41, p < 0.01）。结论受城市密度、混合土地利用开发和城郊扩张等因素的影响，登革热在关丹的传播日益根深蒂固。积极主动、了解土地利用情况的热点监测对于加强有针对性的登革热控制至关重要。

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引用次数: 0

Low dose corticosteroid for a longer duration at an early phase: A potentially optimal dosage regimen for the management of ARDS 早期使用较长时间的低剂量皮质类固醇：治疗ARDS的潜在最佳剂量方案

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 DOI: 10.1016/j.cegh.2025.102282

Muhammed Rashid , Sreedharan Nair , Pooja Gopal Poojari , Vishal Shanbhag , Raviraja V. Acharya , Sohil Khan , Girish Thunga

Problem considered

Disparities exist within both clinical practice and literature regarding the use of corticosteroids in management of acute respiratory distress syndrome (ARDS). Given the absence of definitive evidence from a singular research approach, we adopted a mixed method approach design to address this clinical question.

Methods

We employed a sequential exploratory mixed methods approach. Initially, we conducted a retrospective analysis, which was complemented by a comprehensive literature review to identify the best treatment approaches in literature and practice. Subsequently, a semi-structured qualitative interview was conducted to gain insights into perception and experience of the physicians involved in ARDS management. Finally, a meta-inference was applied to synthesize the evidence to propose a corticosteroid regimen for ARDS, considering the patient etiology, dosage, duration, and timing of administration.

Results

The retrospective evidence (nearly thousand patient data from five years) indicates that, low dose corticosteroid for a longer duration of treatment observed to have a significantly better recovery rate than other strategies. The literature (overview of meta-analyses, clinical guidelines and RCTs), and qualitative (among 9 physicians) evidence strengthened this by supporting the use of low dose corticosteroid (1–2 mg/kg) at the early phase (24–72 h), for a longer duration (minimum 10 days) to have better clinical outcome without safety concerns. Additionally, this provides more insights on ARDS epidemiology, management, efficacy, cost and safety.

Conclusion

Low-dose corticosteroids for a longer duration of treatment administered at an early phase can be considered a potentially optimal corticosteroid regimen for ARDS which needs to be clinically validated in future.

考虑的问题：关于使用皮质类固醇治疗急性呼吸窘迫综合征（ARDS）的临床实践和文献存在差异。鉴于单一研究方法缺乏明确证据，我们采用混合方法方法设计来解决这一临床问题。方法采用顺序探索性混合方法。首先，我们进行了回顾性分析，并辅以全面的文献综述，以确定文献和实践中的最佳治疗方法。随后，进行了半结构化定性访谈，以深入了解参与ARDS管理的医生的看法和经验。最后，综合考虑患者病因、剂量、持续时间和给药时间的综合证据，提出了治疗ARDS的皮质类固醇方案。结果回顾性研究（近五年来近千例患者资料）表明，低剂量皮质类固醇治疗时间较长，其治愈率明显优于其他治疗策略。文献（荟萃分析概述、临床指南和随机对照试验）和定性证据（在9名医生中）通过支持在早期（24-72小时）使用低剂量皮质类固醇（1-2 mg/kg），持续时间较长（至少10天）以获得更好的临床结果而没有安全性问题，加强了这一点。此外，这为ARDS流行病学、管理、疗效、成本和安全性提供了更多的见解。结论早期给予较长时间的低剂量皮质类固醇治疗可能是治疗ARDS的最佳方案，有待于进一步的临床验证。

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IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01

引用次数: 0

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