Clinical Epidemiology and Global Health最新文献_第6页

Factors associated with lymphatic filariasis in Indonesia 印度尼西亚与淋巴丝虫病相关的因素

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1016/j.cegh.2025.102277

Sinta Dewi Lestyoningrum , Adistha Eka Noveyani , Debri Rizki Faisal , Wahyu Pudji Nugraheni , Syarifah Nuraini , Indah Pawitaningtyas , Linta Meyla Putri

Problem considered

Lymphatic filariasis (LF) remains a significant public health issue in Indonesia despite global progress and national elimination efforts. This study aimed to comprehensively assess the influence of socioeconomic characteristics, preventive behaviors, and housing environmental factors on the risk of LF among Indonesian adults.

Methods

This cross-sectional study used the 2023 Indonesia Health Survey to examine associations between socioeconomic factors, protective behaviors, housing characteristics, and lymphatic filariasis (LF) among 570,618 adults. Associations with LF were analyzed using multivariable logistic regression, with results reported as adjusted odds ratios (AORs) and 95 % confidence intervals.

Results

The prevalence of LF was 0.14 %. Socio-demographic characteristics (age, sex, education, wealth index, and residence) were not statistically associated with LF risk. However, regular use of mosquito repellents (sprays, coils, electric devices) was significantly associated with a 25 % reduction in LF risk (AOR 0.75, 95 % CI: 0.59–0.95). Living in houses with non-permanent roofing (AOR 1.49, 95 % CI: 0.97–2.28) and without ceilings (AOR 1.20, 95 % CI: 0.93–1.54) showed increased, though non-significant, odds of LF occurrence.

Conclusion

LF risk in Indonesia is not distinguished by socioeconomic status but is more strongly determined by consistent adoption of protective behaviors and housing quality. Universal access to mosquito repellents and targeted improvement in housing infrastructure should be prioritized as equitable and effective LF control strategies.

考虑的问题淋巴丝虫病（LF）在印度尼西亚仍然是一个重大的公共卫生问题，尽管全球取得了进展，国家也在努力消除。本研究旨在综合评估印尼成人社会经济特征、预防行为和居住环境因素对LF风险的影响。方法：本横断面研究使用2023年印度尼西亚健康调查来检查570,618名成年人的社会经济因素、保护行为、住房特征和淋巴丝虫病（LF）之间的关系。使用多变量逻辑回归分析与LF的关联，结果报告为调整优势比（AORs）和95%置信区间。结果LF患病率为0.14%。社会人口特征（年龄、性别、教育程度、财富指数和居住地）与LF风险无统计学关联。然而，经常使用驱蚊剂（喷雾剂、蚊香、电子装置）与LF风险降低25%显著相关（AOR 0.75, 95% CI: 0.59-0.95）。生活在非永久性屋顶（AOR 1.49, 95% CI: 0.97-2.28）和没有天花板（AOR 1.20, 95% CI: 0.93-1.54）的房屋中，尽管不显著，但LF发生的几率增加。结论印度尼西亚的lf风险不受社会经济地位的影响，而更大程度上取决于是否采取保护行为和住房质量。普及驱蚊剂和有针对性地改善住房基础设施应作为公平和有效的疟疾控制战略予以优先考虑。

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引用次数: 0

A qualitative assessment of Community and stakeholders' perception towards Malaria elimination in Gujarat focusing behavior of community 社区和利益相关者对古吉拉特邦消除疟疾认知的定性评估，重点关注社区行为

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 Epub Date: 2025-12-20 DOI: 10.1016/j.cegh.2025.102267

Niraj Pandit , Arpita Patel , Manju Rahi , Sachin Sharma , Nirmal Jyoti Jyotsana , Yagna Pandit

Problem considered

In the last couple of years, the incidence and prevalence of malaria in Gujarat have declined as compared to Indian data. India's goal is to end malaria by the year 2030, for which community behavior is vital apart from other logistics and treatment management. This qualitative study conducted with aim to determine the perceptions of community towards malaria.

Methods

The qualitative assessment was conducted in the two districts of Gujarat during September 2022 and November 2022. Data were collected through Focus Group discussions (FGDs), in-depth interviews (IDIs), and key informant interviews (KIIs) with the help of a qualitative guide. Data were analyzed through thematic framework.

Results

64 interviews consisting of 12 FGDs were carried out, combining the use of FGDs, KIIs, and IDIs. Review of community perception regarding malaria elimination was conducted and it was observed that they had sufficient knowledge regarding symptoms and diagnosis and their practices of the same were seen. Supportive presence of community in prevention and control measures to the government action was observed. The key gaps were seen on sustained social and behaviour change communication, human resources management, malaria among migratory population and poor interdepartmental coordination.

Conclusion

The stakeholders in this study expressed their optimism regarding the progress towards eliminating malaria in Gujarat, but at a slower pace. The areas which required to improve like diagnosis coverage among migratory population and compliance with treatment regimens. The identified gaps can be targeted like sustainable funding for BCC, manpower management and malaria in migratory population.

在过去几年中，与印度的数据相比，古吉拉特邦的疟疾发病率和流行率有所下降。印度的目标是到2030年消灭疟疾，为此，除了其他后勤和治疗管理之外，社区行为至关重要。这项定性研究的目的是确定社区对疟疾的看法。方法于2022年9月和2022年11月在古吉拉特邦两个区进行定性评价。在定性指南的帮助下，通过焦点小组讨论（fgd）、深度访谈（IDIs）和关键信息提供者访谈（KIIs）收集数据。通过专题框架对数据进行分析。结果共进行了64次访谈，包括12个fdd，并结合了fdd、kii和idi的使用。对社区对消除疟疾的看法进行了审查，观察到他们对症状和诊断有足够的了解，并观察到他们的做法。观察到社区在预防和控制措施方面对政府行动的支持。主要的差距体现在持续的社会和行为改变沟通、人力资源管理、移徙人口中的疟疾和部门间协调不力。本研究的利益相关者对古吉拉特邦消除疟疾的进展表示乐观，但速度较慢。需要改进的领域包括移徙人口的诊断覆盖率和治疗方案的遵守情况。可以针对已确定的差距，例如为BCC提供可持续资金、人力管理和移徙人口的疟疾。

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引用次数: 0

Tranexamic acid in bleeding management of advanced cancer in palliative care: A systematic review 氨甲环酸在姑息治疗中晚期癌症出血管理中的应用：系统综述

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 Epub Date: 2025-12-27 DOI: 10.1016/j.cegh.2025.102274

Ian Huang , Dion Ravinder Theodeus Subroto , Felicia Nathania Kosasih , Stephen Tjandra , Darien Alfa Cipta

Problem considered

Bleeding complications in patients with advanced cancer receiving palliative care pose a significant clinical challenge. Tranexamic acid (TXA) has been explored as a potential therapeutic option for bleeding control. This review aimed to summarize the evidence on TXA, with a primary focus on the efficacy and safety profile of TXA in addressing bleeding issues in advanced cancer patients within palliative care.

Methods

A systematic literature search using relevant keywords was conducted in medical databases, including PubMed, EBSCO, Google Scholar and Cochrane Central Library, from inception to September 14th, 2023. Randomized controlled trials (RCTs), observational studies, and case series or case reports that evaluated the use of TXA in advanced cancer patients for bleeding management in palliative care settings were included.

Results

A total of eleven studies were included, comprising one observational study, one non-randomized study, six case reports, and three case series. Among the advanced cancer patients, the majority (87 %) had solid tumors. The overall success rate for bleeding cessation was 91.3 %, with a median of 3 days (ranging 15 min to 30 days) to achieve complete bleeding cessation. All routes of TXA administration with varying dosages were documented, including subcutaneous (46.5 %), oral (23.3 %), intravenous (18.6 %), and topical (11.6 %). Thromboembolic events were observed in 4.3 % of patients. No RCTs were identified during our search.

Conclusion

Tranexamic acid appears to be an effective and well-tolerated option for managing bleeding in advanced cancer patients receiving palliative care. Further research is needed to establish optimal dosing regimens and confirm its safety.

接受姑息治疗的晚期癌症患者的出血并发症是一个重大的临床挑战。氨甲环酸（TXA）已被探索作为一种潜在的治疗选择出血控制。本综述旨在总结有关TXA的证据，主要关注TXA在姑息治疗中解决晚期癌症患者出血问题的有效性和安全性。方法采用相关关键词系统检索PubMed、EBSCO、谷歌Scholar、Cochrane Central Library等医学数据库自成立至2023年9月14日的相关文献。随机对照试验（rct）、观察性研究、病例系列或病例报告评估了在姑息治疗环境中使用TXA治疗晚期癌症患者出血的情况。结果共纳入11项研究，包括1项观察性研究、1项非随机研究、6例病例报告和3个病例系列。在晚期癌症患者中，大多数（87%）存在实体瘤。止血的总成功率为91.3%，中位数为3天（15分钟至30天）达到完全止血。所有不同剂量的TXA给药途径均被记录在案，包括皮下给药（46.5%）、口服给药（23.3%）、静脉给药（18.6%）和局部给药（11.6%）。4.3%的患者发生血栓栓塞事件。在我们的搜索中没有发现随机对照试验。结论氨甲环酸是一种治疗晚期癌症姑息治疗患者出血的有效且耐受性良好的选择。需要进一步研究以确定最佳给药方案并确认其安全性。

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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 : 2026-01-01 Epub 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。

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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 : 2026-01-01 Epub 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。

{"title":"Assessing lung cancer screening knowledge, attitude, and perceived barriers among high-risk individuals in Jordan: A cross-sectional study","authors":"Sanaa K. Bardaweel , Suha A. AlMuhaissen , Mays Abu Ajamieh , Sana AlNajjar , Hashem AlJarrah","doi":"10.1016/j.cegh.2025.102249","DOIUrl":"10.1016/j.cegh.2025.102249","url":null,"abstract":"<div><h3>Problem considered</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102249"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616772","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

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 : 2026-01-01 Epub 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

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 : 2026-01-01 Epub 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

Determinants of medication knowledge using DFIT% score in indian geriatric population: A cross-sectional study 印度老年人群中使用DFIT%评分的药物知识决定因素：一项横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.cegh.2025.102232

Sneha Gowthaman , Mohammed Fayaz Sadiqbasha , Padma Priya Rangachapam Mani , Varun Sundaramoorthy , Dhandapani Chidambaram

Problem

Assessing medication knowledge in older adults is critical for managing chronic diseases, yet existing tools are often impractical or lack specificity. This study evaluates a composite score (DFIT%) assessing knowledge of Dose, Frequency, Indication, and Time of administration.

Methods

A cross-sectional study was conducted among 202 geriatric patients (≥65 years) to determine the association between DFIT% and patient characteristics were analyzed using bivariate tests and logistic regression.

Results

DFIT% was strongly associated with cognitive status; patients without impairment scored significantly higher (67.1 % vs 43.5 %, p < 0.0001). A higher DFIT% score was associated with lower odds of polypharmacy (OR = 0.984, p = 0.018) and recent medication changes (OR = 0.986, p = 0.043). Ability to read English was also statistically associated with (OR = 1.020, p = 0.041) DFIT% score. No significant associations were found with hospitalization or disease duration.

Conclusion

The DFIT% score is a practical tool that identifies specific medication knowledge deficits, which are significant to cognitive function and treatment complexity. It can help target interventions to improve medication safety in geriatric populations.

评估老年人的用药知识对于管理慢性病至关重要，然而现有的工具往往不切实际或缺乏特异性。本研究采用综合评分（DFIT%）评估剂量、频率、适应症和给药时间的知识。方法对202例≥65岁的老年患者进行横断面研究，采用双变量检验和logistic回归分析DFIT%与患者特征的相关性。结果dfit %与认知状态密切相关；无损伤患者得分明显更高（67.1% vs 43.5%, p < 0.0001）。DFIT%评分越高，多药的几率越低（OR = 0.984, p = 0.018），近期用药改变的几率越低（OR = 0.986, p = 0.043）。英语阅读能力与DFIT%得分也有统计学相关性（OR = 1.020, p = 0.041）。未发现与住院或病程有显著关联。结论DFIT%评分是识别特定药物知识缺陷的实用工具，对认知功能和治疗复杂性具有重要意义。它可以帮助有针对性的干预措施，以改善老年人群的用药安全。

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引用次数: 0

Evaluating the effectiveness of pilot hypertension program on hypertension prevention, treatment and control: Insights from Amhara region 评价高血压预防、治疗和控制试点项目的有效性：来自阿姆哈拉地区的见解

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2026-01-01 Epub Date: 2025-12-19 DOI: 10.1016/j.cegh.2025.102269

Abiyie Demelash Gashe , Dawit Zenebe , Aman Yesuf Endries

Problems considered

To improve hypertension control, Ethiopia has been piloting a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained. This study aimed to determine the effectiveness of a pilot hypertension program in hypertension prevention, treatment and control in the Amhara region of Ethiopia.

Methods

A parallel evaluation design guided by the CDC's Framework for Public Health Program Evaluation was conducted at four pilot and four non-pilot health facilities in Ethiopia's Amhara region. Data were collected using a checklist and a structured questionnaire. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95 % confidence intervals, and p < 0.05.

Results

Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91 %, 95 % CI: 87.8–93.5 %) than in non-pilot facilities (74.4 %, 95 % CI: 71.2–79.7 %). Hypertension detection rates were also significantly higher in pilot facilities (19.9 %, 95 % CI: 16.2–24.0 %) compared to non-pilot facilities (14.9 %, 95 % CI: 11.7–18.6 %). BP control was achieved in 51.8 % of patients in pilot and 42.4 % in non-pilot facilities (χ² = 10.823; p < 0.001). The mean performance across the three domains was higher in pilot facilities (76.1 %) compared to non-pilot facilities (51.2 %) (t = 2.125; p = 0.042)

Conclusion

The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, evidence base treatment and integration into community level care.

考虑到的问题为了改善高血压控制，埃塞俄比亚在初级卫生保健机构试行了一项高血压计划，其有效性尚未确定。本研究旨在确定埃塞俄比亚阿姆哈拉地区高血压预防、治疗和控制试点项目的有效性。方法在埃塞俄比亚阿姆哈拉地区的4个试点和4个非试点卫生设施中，以疾控中心公共卫生规划评估框架为指导，进行平行评估设计。使用检查表和结构化问卷收集数据。数据分析采用SPSS 25.0版本。采用卡方检验、t检验、95%置信区间和p <； 0.05进行统计学比较。结果试点机构的机会性血压（BP）筛查率（91%,95% CI: 87.8 ~ 93.5%）显著高于非试点机构（74.4%,95% CI: 71.2 ~ 79.7%）。试点设施的高血压检出率（19.9%,95% CI: 16.2 - 24.0%）也显著高于非试点设施（14.9%,95% CI: 11.7 - 18.6%）。试点医院51.8%的患者血压得到控制，非试点医院42.4%的患者血压得到控制（χ2 = 10.823; p < 0.001）。三个领域的平均绩效在试点设施（76.1%）高于非试点设施（51.2%）（t = 2.125; p = 0.042）结论在阿姆哈拉地区开展的高血压防治试点项目取得了良好的效果。这些结果支持将试点组成部分扩大到全国规划，如高血压管理的结构化方法、循证治疗和纳入社区一级护理。

{"title":"Evaluating the effectiveness of pilot hypertension program on hypertension prevention, treatment and control: Insights from Amhara region","authors":"Abiyie Demelash Gashe , Dawit Zenebe , Aman Yesuf Endries","doi":"10.1016/j.cegh.2025.102269","DOIUrl":"10.1016/j.cegh.2025.102269","url":null,"abstract":"<div><h3>Problems considered</h3><div>To improve hypertension control, Ethiopia has been piloting a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained. This study aimed to determine the effectiveness of a pilot hypertension program in hypertension prevention, treatment and control in the Amhara region of Ethiopia.</div></div><div><h3>Methods</h3><div>A parallel evaluation design guided by the CDC's Framework for Public Health Program Evaluation was conducted at four pilot and four non-pilot health facilities in Ethiopia's Amhara region. Data were collected using a checklist and a structured questionnaire. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95 % confidence intervals, and p < 0.05.</div></div><div><h3>Results</h3><div>Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91 %, 95 % CI: 87.8–93.5 %) than in non-pilot facilities (74.4 %, 95 % CI: 71.2–79.7 %). Hypertension detection rates were also significantly higher in pilot facilities (19.9 %, 95 % CI: 16.2–24.0 %) compared to non-pilot facilities (14.9 %, 95 % CI: 11.7–18.6 %). BP control was achieved in 51.8 % of patients in pilot and 42.4 % in non-pilot facilities (χ<sup>2</sup> = 10.823; p < 0.001). The mean performance across the three domains was higher in pilot facilities (76.1 %) compared to non-pilot facilities (51.2 %) (t = 2.125; p = 0.042)</div></div><div><h3>Conclusion</h3><div>The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, evidence base treatment and integration into community level care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102269"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839875","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 : 2026-01-01 Epub 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