Clinical Epidemiology and Global Health最新文献_第5页

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

Vitamin D normative values by age, sex, and supplement use 维生素D按年龄、性别和补充剂使用的标准值

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-02 DOI: 10.1016/j.cegh.2025.102251

Man Hung , Eric S. Hon , Amir Mohajeri , Sharon Vu , Samantha Lee , Martin S. Lipsky

Problem considered

Vitamin D levels vary by age, sex, lifestyle, and supplement use. Establishing normative values for Vitamin D within these populations is crucial to advancing global health and reducing the disease burden. This study aimed to establish age-, sex-, and supplementation-specific normative values for serum 25-hydroxyvitamin D2 [25(OH)D2], 25-hydroxyvitamin D3 [25(OH)D3], and total Vitamin D using nationally representative United States data from the NHANES 2017–2018 cycle.

Methods

A cross-sectional analysis was conducted using data from 3668 NHANES participants aged 1 year and older. Serum 25(OH)D2, 25(OH)D3, and total Vitamin D levels were measured. Participants were stratified by age, sex, and supplement use. Percentile distributions were calculated to provide reference values for subgroups.

Results

25(OH)D3 was the primary contributor to total Vitamin D levels across all demographics. Adults 51 years and older displayed higher upper percentiles for 25(OH)D3 and total Vitamin D. Males exhibited higher levels than females, especially in younger age groups. Among non-supplement users, Vitamin D levels at the 5th percentile were above 20 nmol/L across all ages, suggesting adequate levels from natural sources, such as sunlight and diet.

Conclusion

This study established normative values for Vitamin D across demographic groups, emphasizing the importance of age- and sex-specific values in clinical evaluations. These findings highlight that many individuals obtain Vitamin D naturally, reinforcing the global relevance of environmental and nutritional health strategies. These normative values can inform clinical and public health assessments and help to refine Vitamin D guidelines and support worldwide efforts toward optimal population health.

维生素D水平因年龄、性别、生活方式和补充剂的使用而异。在这些人群中确立维生素D的标准价值对于促进全球健康和减轻疾病负担至关重要。本研究旨在利用美国NHANES 2017-2018周期具有全国代表性的数据，建立血清25-羟维生素D2 [25(OH)D2]、25-羟维生素D3 [25(OH)D3]和总维生素D的年龄、性别和补充剂特异性规范值。方法对3668名年龄在1岁及以上的NHANES参与者的数据进行横断面分析。测定血清25(OH)D2、25(OH)D3和总维生素D水平。参与者按年龄、性别和补充剂使用情况分层。计算百分位数分布，为亚组提供参考值。结果25(OH)D3是所有人口统计数据中总维生素D水平的主要贡献者。51岁及以上的成年人25(OH)D3和总维生素d的百分位数较高，男性的水平高于女性，尤其是在年轻年龄组。在未服用补充剂的人群中，所有年龄段的第5百分位数的维生素D水平都高于20毫摩尔/升，这表明自然来源（如阳光和饮食）的维生素D水平足够。结论：本研究建立了不同人群维生素D的标准值，强调了临床评估中年龄和性别特异性值的重要性。这些发现突出表明，许多人可以自然获取维生素D，从而加强了环境和营养健康战略的全球相关性。这些标准值可以为临床和公共卫生评估提供信息，有助于完善维生素D指南，并支持全世界为实现最佳人口健康所做的努力。

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引用次数: 0

Perception of Human Papilloma Virus infection and acceptance of its testing among women of reproductive age in a low-resource setting, Ghana 加纳，资源匮乏地区育龄妇女对人乳头瘤病毒感染的认识和接受检测

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-12-01 DOI: 10.1016/j.cegh.2025.102254

Rejoice Fletcher, Evelyn Asamoah Ampofo, Caroline Dinam Badzi, Janet Aba Saah

Problem considered

Human Papillomavirus (HPV) infection is a significant public health concern globally, particularly among young women. Globally, 662, 000 cervical cancer cases were reported. In Ghana, the prevalence of HPV infection among females was 2, 797. Yet there is limited understanding of the perception of HPV infection and acceptance of its testing among women of reproductive age especially those in New Takoradi as evidenced by poor uptake of the test. This study aimed to investigate the perception of HPV infection and its testing among women of reproductive age in New Takoradi, Western Region of Ghana.

Methods

Using a quantitative cross-sectional design, 323 women aged 18–49 years were surveyed. Descriptive statistics was used to analyse the data.

Results

Majority of the respondents (70.6 %) were aged 18–30 years, had completed senior high school (SHS) (43.3 %) and single (61 %). A third of participants (30 %) perceived HPV to affect only promiscuous women, curable (53.6 %) and causes infertility (81.7 %). Whereas two-thirds (66.3 %) of participants were willing to undergo HPV testing in the next 6 months, majority (80.5 %) were willing to do so out of fear of contracting the disease.

Conclusion

The study's findings highlighted the importance of education and awareness campaigns to promote HPV testing among women of reproductive age in Ghana and similar contexts.

人乳头瘤病毒（HPV）感染是全球范围内一个重要的公共卫生问题，尤其是在年轻女性中。全球共有662,000宗子宫颈癌个案。在加纳，女性感染HPV的流行率为2797。然而，育龄妇女，特别是新塔科拉迪的育龄妇女，对HPV感染的认知和对其检测的接受程度的了解有限，这一点从检测的接受程度较低可见一斑。本研究旨在调查加纳西部地区新塔科拉迪育龄妇女对HPV感染的认识及其检测。方法采用定量横断面设计，对323名年龄在18 ~ 49岁的女性进行调查。采用描述性统计方法对数据进行分析。结果调查对象的年龄以18-30岁为主（70.6%），高中毕业（43.3%），单身（61%）。三分之一的参与者（30%）认为HPV只影响滥交妇女，可治愈（53.6%）并导致不孕（81.7%）。尽管三分之二（66.3%）的参与者愿意在未来6个月内接受HPV检测，但大多数（80.5%）的参与者愿意这样做是因为害怕感染这种疾病。该研究的发现强调了教育和宣传运动在加纳和类似环境中促进育龄妇女进行HPV检测的重要性。

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引用次数: 0

“Developing an integrated model for anemia prevention in prospective brides: A qualitative exploration of multisectoral collaboration in bengkulu city of Indonesia” “在准新娘中发展预防贫血的综合模式：印度尼西亚明古鲁市多部门合作的定性探索”

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-28 DOI: 10.1016/j.cegh.2025.102252

Afrina Mizawati , Nursyirwan Effendi , Delmi Sulastri , Rozi Sastra Purna

Problem considered

Anemia among women of reproductive age, particularly prospective brides, remains a significant public health concern in Indonesia. Despite national programs, preventive efforts are often fragmented and lack structured education, family engagement, and cross-sector collaboration. This study aimed to explore determinants of anemia prevention practices to inform the development of the Anemia-Free Integrated Network Approach (AFRINA).

Methods

This descriptive qualitative study employed in-depth interviews and focus group discussions with 71 informant (24 prospective brides and 47 supporting stakeholders), including midwives, health officials, and community leaders, purposively and snowball recruited to ensure diverse perspectives. Data collection was conducted between September and December 2024. Semi-structured interview guides explored knowledge, screening practices, supplementation adherence, and intersectoral collaboration. Data were analyzed using thematic analysis to identify barriers, enablers, and opportunities related to anemia prevention.

Results

The analysis revealed five major themes related to premarital anemia prevention: limited exposure to anemia information; superficial understanding of anemia risks; inconsistent and unenforced screening policies; poor adherence to iron supplementation; and weak coordination and shared responsibility across health, religious, and community sectors. These themes directly informed the development of the AFRINA Framework, which emphasizes structured education, early intervention, strengthened supplementation adherence, multisectoral collaboration, and coordinated referral pathways.

Conclusions

Anemia prevention among prospective brides requires a holistic approach that integrates digital health communication, family engagement, and cross-sector policy implementation. The findings from this qualitative phase serve as a foundation for developing a targeted intervention model tailored to local needs.

在印度尼西亚，育龄妇女，特别是准新娘的贫血仍然是一个重大的公共卫生问题。尽管有国家规划，但预防工作往往是零散的，缺乏有组织的教育、家庭参与和跨部门合作。本研究旨在探讨贫血预防实践的决定因素，为无贫血综合网络方法（AFRINA）的发展提供信息。方法本描述性定性研究采用深入访谈和焦点小组讨论的方式，对71名信息提供者（24名准新娘和47名支持利益相关者），包括助产士、卫生官员和社区领导人进行了有目的的和滚雪球式的招募，以确保多样化的观点。数据收集于2024年9月至12月进行。半结构化访谈指南探讨了知识、筛选实践、补充依从性和部门间合作。使用专题分析对数据进行分析，以确定与预防贫血有关的障碍、促进因素和机会。结果分析揭示了与婚前预防贫血相关的五大主题：对贫血信息的接触有限；对贫血风险的肤浅认识；筛查政策不一致且未强制执行；不坚持补铁；卫生、宗教和社区部门之间的协调和共同责任薄弱。这些主题直接影响了AFRINA框架的发展，该框架强调结构化教育、早期干预、加强补充依从性、多部门合作和协调转诊途径。结论准新娘预防贫血需要综合数字健康沟通、家庭参与和跨部门政策实施的整体方法。这一定性阶段的研究结果为制定适合当地需求的针对性干预模式奠定了基础。

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引用次数: 0

Examining the model of social determinants affecting the health of referring women to the center of health with the World Health Organization model approach: a path analysis 用世界卫生组织模式方法审查影响妇女转诊到保健中心的健康的社会决定因素模式：路径分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-28 DOI: 10.1016/j.cegh.2025.102243

Parisa Shojaei

Problem considered

The goal of this study was testing the communication model of the social determinants effective on healthcare in women referred to the healthcare centers based on the WHO's approach: pathway analysis.

Methods

This analytical cross-sectional study was conducted on 700 women referred to a public healthcare center in northwest Tehran. Data were collected using Keyes's Social Well-Being Questionnaire (KSWBQ), which measures five dimensions of social health. Based on the conceptual framework of the World Health Organization's model of social determinants of health, path analysis was applied to investigate the structural relationships between socioeconomic variables and women's social health. Statistical analyses were performed using SPSS version 27 and LISREL 8.8.

Results

In the first model with the outcome variable being the Keyes social well-being score, the most meaningful direct positive effect in social acceptance (β = 0.22) and social solidarity (β = 0.15) is the age variable. In social participation (β = 0.79), social coherence (β = 0.79) and social prosperity (β = 0.83), income has the most direct effect. From the indirect effective factors, occupation was the most effective in all the social well-being dimensions except for social prosperity.

Conclusion

Effective determinants of women's social well-being should be considered by governments in order to further advance the health of women, families and finally the society.

考虑的问题本研究的目的是测试社会决定因素的沟通模式有效的妇女转诊到医疗保健中心基于世界卫生组织的方法：途径分析。方法对德黑兰西北部一家公共保健中心的700名妇女进行了横断面分析研究。数据收集使用凯斯的社会健康问卷（KSWBQ），测量社会健康的五个维度。基于世界卫生组织健康的社会决定因素模型的概念框架，应用路径分析来调查社会经济变量与妇女社会健康之间的结构关系。采用SPSS version 27和LISREL 8.8进行统计学分析。结果在以Keyes社会幸福感得分为结果变量的第一个模型中，年龄变量对社会接受度（β = 0.22）和社会团结度（β = 0.15）的直接正向影响最显著。在社会参与（β = 0.79）、社会凝聚力（β = 0.79）和社会繁荣（β = 0.83）中，收入的影响最为直接。从间接影响因素来看，除社会繁荣外，职业在所有社会福利维度中最有效。结论政府应考虑妇女社会福利的有效决定因素，以进一步促进妇女、家庭和社会的健康。

{"title":"Examining the model of social determinants affecting the health of referring women to the center of health with the World Health Organization model approach: a path analysis","authors":"Parisa Shojaei","doi":"10.1016/j.cegh.2025.102243","DOIUrl":"10.1016/j.cegh.2025.102243","url":null,"abstract":"<div><h3>Problem considered</h3><div>The goal of this study was testing the communication model of the social determinants effective on healthcare in women referred to the healthcare centers based on the WHO's approach: pathway analysis.</div></div><div><h3>Methods</h3><div>This analytical cross-sectional study was conducted on 700 women referred to a public healthcare center in northwest Tehran. Data were collected using Keyes's Social Well-Being Questionnaire (KSWBQ), which measures five dimensions of social health. Based on the conceptual framework of the World Health Organization's model of social determinants of health, path analysis was applied to investigate the structural relationships between socioeconomic variables and women's social health. Statistical analyses were performed using SPSS version 27 and LISREL 8.8.</div></div><div><h3>Results</h3><div>In the first model with the outcome variable being the Keyes social well-being score, the most meaningful direct positive effect in social acceptance (β = 0.22) and social solidarity (β = 0.15) is the age variable. In social participation (β = 0.79), social coherence (β = 0.79) and social prosperity (β = 0.83), income has the most direct effect. From the indirect effective factors, occupation was the most effective in all the social well-being dimensions except for social prosperity.</div></div><div><h3>Conclusion</h3><div>Effective determinants of women's social well-being should be considered by governments in order to further advance the health of women, families and finally the society.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102243"},"PeriodicalIF":1.7,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684887","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

Underrepresentation of Africa in HIV cure research: A systematic review of the literature from 2010 to 2022 非洲在艾滋病治疗研究中的代表性不足：2010年至2022年文献的系统回顾

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-28 DOI: 10.1016/j.cegh.2025.102250

Evelyn Y. Bonney , James O. Aboagye , Helena Lamptey , Anthony T. Boateng , Christopher Z-Yen Abana , Bernard A. Logonia , Angela Hardi , George B. Kyei

Problem considered

Over the past decade, there has been a significant increase in research aimed at finding a cure or achieving long-term remission for HIV. However, the extent to which this research includes Africa—the continent with the highest HIV burden—remains unclear. To address this, we conducted a systematic review of the literature to assess Africa's contributions to HIV cure research.

Methods

We reviewed original HIV cure-related research published from January 1, 2010, to December 31, 2022, in Embase.com and Web of Science. Our search terms, ‘HIV cure(s)’ and ‘research,’ along with their synonyms like HIV latency, persistence, and reactivation, covered all languages and geographic locations. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

Of 1077 studies reviewed, 614 (57 %) were performed in North America, followed by Europe (24.3 %), Asia (17.2 %), and Australia 5.2 %). Africa contributed only 31 studies (2.9 %). Of the 31 African studies, Southern Africa accounted for 67.7 %, followed by Eastern Africa (19.4 %) and Western Africa (12.9 %). No cure-related studies were performed in Northern and Central African institutions. African contributions across the different types of studies were 18 (3.7 %) for ex vivo, 8 (10.7 %) for social science and epidemiological, 3 (3.3 %) for clinical trials, 4 (0.8 %) for basic science, and zero for animal studies. The NIH funded the majority of all cure-related studies.

Conclusions

This systematic review shows that African patients and scientists are contributing little to HIV cure research, and urgent measures are needed to remedy the disparity.

考虑到的问题在过去的十年里，针对寻找HIV的治疗方法或实现长期缓解的研究显著增加。然而，这项研究在多大程度上包括了艾滋病毒负担最高的非洲大陆，这一点仍不清楚。为了解决这个问题，我们对文献进行了系统回顾，以评估非洲对艾滋病治疗研究的贡献。方法回顾2010年1月1日至2022年12月31日发表在Embase.com和Web of Science上的HIV治疗相关的原始研究。我们的搜索词“HIV治愈”和“研究”，以及它们的同义词“HIV潜伏期”、“持久性”和“再激活”，涵盖了所有语言和地理位置。该研究遵循了系统评价和荟萃分析的首选报告项目（PRISMA）指南。在1077项研究中，614项（57%）在北美进行，其次是欧洲（24.3%），亚洲（17.2%）和澳大利亚（5.2%）。非洲只贡献了31项研究（2.9%）。在31项非洲研究中，南部非洲占67.7%，其次是东非（19.4%）和西非（12.9%）。在北部和中部非洲的机构中没有进行与治疗相关的研究。在不同类型的研究中，非洲对离体研究的贡献为18篇（3.7%），对社会科学和流行病学的贡献为8篇（10.7%），对临床试验的贡献为3篇（3.3%），对基础科学的贡献为4篇（0.8%），对动物研究的贡献为零。美国国立卫生研究院资助了大多数与治疗相关的研究。结论本系统综述表明，非洲患者和科学家对艾滋病治疗研究的贡献很小，需要采取紧急措施弥补这种差距。

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引用次数: 0

Disrupted gut microbial profiles in Vietnamese children under 5 years of age with community-acquired pneumonia 越南5岁以下社区获得性肺炎儿童肠道微生物谱紊乱

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-26 DOI: 10.1016/j.cegh.2025.102247

Nghi Huu Chung , Van Hung Pham , Thien-Phuc Nguyen Hoang , Trinh Thi Phuong Ha , Phuong Bich Thi Do , Chuyen Quoc Vo , Nguyen Thanh Nhu , Tuan Anh Nguyen

Problem considered

Pneumonia remains a major cause of morbidity and mortality in children under five years. Emerging evidence highlights the critical role of the gut-lung axis in respiratory diseases; however, data on gut microbial alterations in pediatric community-acquired pneumonia (CAP) are scarce, especially in Southeast Asia.

Methods

We conducted a cross-sectional study involving 78 Vietnamese children aged 2 months to 5 years, including 30 patients with CAP and 48 healthy controls (HC). Stool samples were collected prior to antibiotic administration and analyzed by 16S rRNA gene sequencing, targeting the V3–V4 region. Gut microbial diversity (alpha and beta) and taxonomic composition were compared between the groups. Linear discriminant analysis effect size (LEfSe) was performed.

Results

Children with CAP exhibited significantly reduced microbial richness (Chao1, ACE, observed features, all p < 0.001) but preserved evenness along with distinct community structures (PERMANOVA, p = 0.001). CAP was associated with the enrichment of potentially pathogenic genera (Escherichia, Shigella, Eggerthella) and the depletion of butyrate-producing taxa (Ruminococcus and Coprobacillus). These alterations may impair mucosal immunity by disrupting the gut–lung axis.

Conclusion

Vietnamese children with CAP display marked gut microbiota dysbiosis, with reduced richness and an imbalance favoring pro-inflammatory taxa. These results support the pivotal role of the gut-lung axis in the pathogenesis of pediatric pneumonia and suggest that microbiota-targeted interventions may hold promise for prevention and adjunctive treatment strategies.

肺炎仍然是5岁以下儿童发病和死亡的主要原因。新出现的证据强调了肠-肺轴在呼吸系统疾病中的关键作用；然而，关于儿童社区获得性肺炎（CAP）肠道微生物变化的数据很少，特别是在东南亚。方法对78名年龄在2个月至5岁的越南儿童进行横断面研究，其中30例CAP患者和48例健康对照（HC）。在给药前收集粪便样本，针对V3-V4区进行16S rRNA基因测序分析。比较各组肠道微生物多样性（α和β）和分类组成。进行线性判别分析效应量（LEfSe）。结果CAP患儿微生物丰富度显著降低（Chao1， ACE，观察特征，均p <； 0.001），但群落结构保持均匀（PERMANOVA, p = 0.001）。CAP与潜在致病性属（埃希氏菌、志贺氏菌、蛋菌）的富集和产丁酸菌群（瘤胃球菌和副杆菌）的消耗有关。这些改变可能通过破坏肠-肺轴而损害粘膜免疫。结论越南CAP患儿表现出明显的肠道菌群失调，菌群丰富度降低，促炎菌群失衡。这些结果支持了肠-肺轴在儿童肺炎发病机制中的关键作用，并表明以微生物群为目标的干预措施可能有助于预防和辅助治疗策略。

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引用次数: 0

Assessing lung cancer screening knowledge, attitude, and perceived barriers among high-risk individuals in Jordan: A cross-sectional study 评估约旦高危人群的肺癌筛查知识、态度和感知障碍：一项横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-26 DOI: 10.1016/j.cegh.2025.102249

Sanaa K. Bardaweel , Suha A. AlMuhaissen , Mays Abu Ajamieh , Sana AlNajjar , Hashem AlJarrah

Problem considered

Lung cancer (LC) is a leading cause of cancer-related mortality globally. Early detection through low-dose computed tomography (LDCT) significantly improves prognosis, yet public awareness and screening uptake remain low, particularly in Jordan. This study aims to assess the knowledge, attitudes, and perceived barriers toward LC screening among high-risk individuals in Jordan.

Methods

A cross-sectional study was conducted among 470 high-risk participants, primarily long-term smokers. A validated questionnaire assessed knowledge of LC risk factors, symptoms, and screening methods; attitudes toward early detection; and perceived barriers. Descriptive statistics, bivariate analyses, and multivariate linear regression were used to examine associations between sociodemographic factors and outcome scores.

Results

Participants demonstrated moderate knowledge (mean = 9 ± 5 out of 20), with high awareness of general LC risk factors but limited knowledge of LDCT (25.7 %). Over 90 % supported early detection, yet 27.4 % held fatalistic beliefs. Key barriers included lack of knowledge (86.2 %), unawareness of procedures (84.5 %), time constraints (61.7 %), and fear of diagnosis (54.5 %). Knowledge and attitudes were significantly associated with education, income, employment status, and family history of LC. Multivariate analysis confirmed sociodemographic factors and willingness to screen as strong predictors of engagement.

Conclusion

Despite positive attitudes, there are significant gaps in knowledge and several perceived barriers to LC screening among high-risk individuals. Targeted educational interventions, greater physician involvement, and culturally tailored outreach are crucial to improving screening uptake in this population.

肺癌（LC）是全球癌症相关死亡的主要原因。通过低剂量计算机断层扫描（LDCT）进行早期检测可显著改善预后，但公众意识和筛查接受度仍然很低，特别是在约旦。本研究旨在评估约旦高危人群对LC筛查的知识、态度和感知障碍。方法对470名高风险参与者进行横断面研究，主要是长期吸烟者。一份有效的问卷评估了对LC危险因素、症状和筛查方法的了解；对早期发现的态度；以及感知障碍。使用描述性统计、双变量分析和多变量线性回归来检查社会人口因素与结局评分之间的关系。结果参与者表现出中等程度的知识（平均= 9±5 / 20），对一般LC危险因素有较高的认识，但对LDCT的知识有限（25.7%）。超过90%的人支持早期发现，但27.4%的人持宿命论信仰。主要障碍包括缺乏知识（86.2%）、不了解程序（84.5%）、时间限制（61.7%）和害怕诊断（54.5%）。知识和态度与教育程度、收入、就业状况和家族史显著相关。多变量分析证实，社会人口因素和筛选意愿是参与的有力预测因素。结论尽管态度积极，但高危人群对LC筛查的认识和认知障碍仍存在显著差距。有针对性的教育干预，更多的医生参与，和文化量身定制的外展是至关重要的，以提高筛查在这一人群的吸收。

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引用次数: 0

The association between oxidative balance score and human papillomavirus infection in women: A cross-sectional study from NHANES 氧化平衡评分与女性人乳头瘤病毒感染之间的关系：来自NHANES的横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-24 DOI: 10.1016/j.cegh.2025.102244

Ziyi Cheng, Fan Yang, Jing Zhang, Yun Bai, Xiuli Zheng, Yongjun Wang

Background

Understanding the dietary and lifestyle factors associated with human papillomavirus (HPV) infection is of public health significance. The combined effects of an antioxidant diet and lifestyle on HPV infection remain unclear. We aim to investigate the association between oxidative balance score (OBS) and HPV infection in women.

Methods

We conducted a cross-sectional study involving 8204 female participants from the National Health and Nutrition Examination Survey (NHANES) 2003–2016. Sixteen dietary and four lifestyle components were used to calculate the OBS. Multivariable logistic regression was used to analyze the association between OBS and HPV infection. Restricted cubic splines were used to examine the dose-response relationship.

Results

Among the included participants, 3620 (44.1 %) had an HPV infection. The risk of HPV infection decreased with higher OBS, from 52.6 % in the lowest quintile of OBS (Q1) to 37.0 % in the highest quintile of OBS (Q5). After multivariable adjustment, the ORs (95 % CIs) for Q2-Q5 of OBS were 0.93 (0.74–1.17), 0.81 (0.64–1.01), 0.73 (0.59–0.90), and 0.70 (0.57–0.85), respectively, compared with the Q1 group. OBS was also negatively associated with the risk of multiple HPV infections. There was a linear dose-response relationship between OBS and HPV infection (P for nonlinearity = 0.855).

Conclusions

An antioxidative lifestyle is associated with a lower prevalence of genital HPV infection in women. Future prospective studies are needed to validate the effect of OBS on the risk of incident and persistent infection with HPV.

背景了解与人乳头瘤病毒（HPV）感染相关的饮食和生活方式因素具有重要的公共卫生意义。抗氧化饮食和生活方式对HPV感染的综合影响尚不清楚。我们的目的是研究氧化平衡评分（OBS）和女性HPV感染之间的关系。方法对2003-2016年全国健康与营养检查调查（NHANES）的8204名女性参与者进行横断面研究。16种饮食成分和4种生活方式成分被用来计算OBS。采用多变量logistic回归分析OBS与HPV感染的关系。用限制三次样条曲线来检验剂量-反应关系。结果在纳入的参与者中，有3620人（44.1%）感染HPV。HPV感染的风险随着OBS的增加而降低，从OBS最低五分位数（Q1）的52.6%降至OBS最高五分位数（Q5）的37.0%。多变量调整后，与Q1组相比，Q2-Q5 OBS的or （95% ci）分别为0.93（0.74-1.17）、0.81（0.64-1.01）、0.73（0.59-0.90）和0.70（0.57-0.85）。OBS也与多重HPV感染的风险呈负相关。OBS与HPV感染呈线性剂量-反应关系（非线性P = 0.855）。结论抗氧化的生活方式与女性生殖器HPV感染率较低有关。未来的前瞻性研究需要验证OBS对HPV偶发和持续感染风险的影响。

{"title":"The association between oxidative balance score and human papillomavirus infection in women: A cross-sectional study from NHANES","authors":"Ziyi Cheng, Fan Yang, Jing Zhang, Yun Bai, Xiuli Zheng, Yongjun Wang","doi":"10.1016/j.cegh.2025.102244","DOIUrl":"10.1016/j.cegh.2025.102244","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the dietary and lifestyle factors associated with human papillomavirus (HPV) infection is of public health significance. The combined effects of an antioxidant diet and lifestyle on HPV infection remain unclear. We aim to investigate the association between oxidative balance score (OBS) and HPV infection in women.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study involving 8204 female participants from the National Health and Nutrition Examination Survey (NHANES) 2003–2016. Sixteen dietary and four lifestyle components were used to calculate the OBS. Multivariable logistic regression was used to analyze the association between OBS and HPV infection. Restricted cubic splines were used to examine the dose-response relationship.</div></div><div><h3>Results</h3><div>Among the included participants, 3620 (44.1 %) had an HPV infection. The risk of HPV infection decreased with higher OBS, from 52.6 % in the lowest quintile of OBS (Q1) to 37.0 % in the highest quintile of OBS (Q5). After multivariable adjustment, the ORs (95 % CIs) for Q2-Q5 of OBS were 0.93 (0.74–1.17), 0.81 (0.64–1.01), 0.73 (0.59–0.90), and 0.70 (0.57–0.85), respectively, compared with the Q1 group. OBS was also negatively associated with the risk of multiple HPV infections. There was a linear dose-response relationship between OBS and HPV infection (<em>P</em> for nonlinearity = 0.855).</div></div><div><h3>Conclusions</h3><div>An antioxidative lifestyle is associated with a lower prevalence of genital HPV infection in women. Future prospective studies are needed to validate the effect of OBS on the risk of incident and persistent infection with HPV.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102244"},"PeriodicalIF":1.7,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616849","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

Impacts of the Covid-19 pandemic on the detection and diagnosis of Tuberculosis: Analysis of scientific evidence Covid-19大流行对结核病检测和诊断的影响：科学证据分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-21 DOI: 10.1016/j.cegh.2025.102234

Ezequiel Almeida Barros , Marcelino Santos Neto , Cicero N. Lemos Felicio Agostinho , Lívia Maia Pascoal , Marcio F. Moura de Araújo , Roberto Wagner Júnior Freire de Freitas , Perpétua do Socorro Silva Costa , Ana C. Pereira de Jesus Costa

Objective

To analyze, based on global scientific evidence, the impacts of the COVID-19 pandemic on the detection and diagnosis of tuberculosis.

Methods

This is an integrative literature review conducted between January and May 2025, using the databases SciVerse Scopus, MEDLINE, SCIELO, PubMed®, SCIENCE DIRECT, and LILACS. The descriptors used were: “Tuberculosis,” “COVID-19,” and “Diagnosis,” considering the time frame from 2020 to 2025. Data were collected using Rayyan software and extracted using a specific instrument. The selected studies were assessed for level of evidence and methodological rigor. After categorization, data were synthesized into a table for descriptive analysis.

Results

The COVID-19 pandemic created considerable obstacles for the diagnosis and management of tuberculosis, compromising the capacity of health systems to perform crucial disease control measures. The reallocation of personnel, supplies, and funding—alongside movement restrictions, fear of contamination, and socioeconomic repercussions—interfered with essential actions such as identifying individuals with respiratory symptoms, tracking contacts, and monitoring treatment adherence. In Brazil, impacts were observed in the incidence, mortality, and treatment abandonment rates. In other countries, such as Mexico, the Russian Federation, Spain, and Zambia, a decrease in TB detection rates was also reported, along with reduced treatment success and inadequate supervision. Studies conducted in Turkey, Indonesia, China, Peru, and India reported significant delays in diagnosis and treatment initiation. These delays were more pronounced in regions with higher COVID-19 incidence, structural limitations in health systems, and low-income areas. Conclusions: The pandemic negatively affected TB detection in different global settings, highlighting the need for coordinated efforts to restore care and surveillance pathways.

目的基于全球科学证据，分析2019冠状病毒病疫情对结核病检测和诊断的影响。方法：这是一项于2025年1月至5月进行的综合文献综述，使用SciVerse Scopus、MEDLINE、SCIELO、PubMed®、SCIENCE DIRECT和LILACS数据库。考虑到2020年至2025年的时间框架，使用的描述词是：“结核病”、“COVID-19”和“诊断”。使用Rayyan软件收集数据，并使用特定仪器提取数据。对所选研究的证据水平和方法严谨性进行了评估。分类后，将数据综合成表进行描述性分析。结果2019冠状病毒病大流行对结核病的诊断和管理造成了相当大的障碍，损害了卫生系统执行关键疾病控制措施的能力。人员、物资和资金的重新分配——以及行动限制、对污染的恐惧和社会经济影响——干扰了基本行动，如识别有呼吸道症状的个体、追踪接触者和监测治疗依从性。在巴西，观察到在发病率、死亡率和治疗放弃率方面的影响。在其他国家，如墨西哥、俄罗斯联邦、西班牙和赞比亚，也报告结核病检出率下降，同时治疗成功率下降，监督不足。在土耳其、印度尼西亚、中国、秘鲁和印度进行的研究报告了诊断和开始治疗的重大延误。在COVID-19发病率较高、卫生系统存在结构性限制的地区和低收入地区，这种延误更为明显。结论：大流行对全球不同地区的结核病检测产生了负面影响，突出表明需要协调努力，恢复护理和监测途径。

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引用次数: 0