Clinical Epidemiology and Global Health最新文献_第7页

External generalizability and internal accuracy of predictive models for perinatal mortality: a systematic review and meta-analysis 围产期死亡率预测模型的外部概括性和内部准确性：一项系统回顾和荟萃分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102227

Ziad El Falah , Abdelghafour Marfak , Mdaghri Alaoui Asmaa , Amal Thimou

Objective

To systematically review and meta-analyze predictive models for perinatal mortality, including stillbirths from 28 weeks gestation and early neonatal deaths within six days, focusing on calibration and discrimination metrics.

Methods

We conducted a comprehensive search across databases like PubMed and Scopus from inception to April 1, 2025, targeting observational studies that developed or validated predictive models for perinatal mortality reporting at least one discrimination metric, such as the Area Under the Curve (AUC) or C-statistic. Two reviewers independently screened studies and assessed bias using the PROBAST tool. Meta-analyses were performed utilizing a random-effects model with heterogeneity assessed via the I² statistic.

Results

Sixteen studies were included, representing 8 553 805 neonates. Eight studies focused on stillbirths, five on early neonatal deaths, and three on both. Pooled AUC estimates ranged from 0.78 to 0.86, with higher discrimination in internally validated models. Calibration was reported in 11 studies, but varied in quality, with one study rated high risk of bias.

Conclusion

This meta-analysis is the first to synthesize predictive models specific to stillbirths and early neonatal mortality. While internal performance metrics are promising, significant shortfalls in external validation and generalizability remain. Standardized methodologies and thorough external validations are crucial for reliable perinatal risk prediction.

PROSPERO registration number

CRD42025638383.

目的系统回顾和荟萃分析围产期死亡率的预测模型，包括28周妊娠死胎和6天内早期新生儿死亡，重点关注校准和判别指标。方法我们对PubMed和Scopus等数据库进行了全面的检索，检索时间为2025年4月1日，目标是建立或验证围产期死亡率预测模型的观察性研究，这些预测模型报告了至少一种歧视指标，如曲线下面积（AUC）或c统计量。两位审稿人使用PROBAST工具独立筛选研究并评估偏倚。meta分析采用随机效应模型，通过I2统计量评估异质性。结果纳入16项研究，共8 553 805例新生儿。8项研究关注死产，5项研究关注新生儿早期死亡，3项研究关注两者。汇总的AUC估计范围从0.78到0.86，在内部验证的模型中具有更高的歧视。11项研究报告了校准，但质量各不相同，其中一项研究被评为高偏倚风险。结论：该荟萃分析首次综合了死产和早期新生儿死亡率的预测模型。虽然内部性能度量很有希望，但在外部验证和推广方面仍然存在明显的不足。标准化的方法和彻底的外部验证对于可靠的围产期风险预测至关重要。普洛斯彼罗注册号crd42025638383。

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引用次数: 0

Quality of life and prevalence of prehypertension/hypertension among patients with diabetes mellitus: A cross-sectional study in a tertiary care hospital of Gandaki Province, Nepal 糖尿病患者的生活质量和高血压前期/高血压患病率：尼泊尔甘达基省一家三级医院的横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102209

Sushila Baral , Rajesh Kumar Yadav , Srijana Paudel , Yadunath Baral , Pawan Pandeya , Sweta Silwal , Santosh Poudel , Roshan Dhakal , Roshan Kumar Mahato

Problem considered

Diabetes mellitus and hypertension are interrelated conditions that significantly contribute to the burden of cardiovascular diseases. Despite increasing prevalence, healthcare efforts often remain focused on treatment rather than prevention or the broader impact on patients’ quality of life (QOL). As QOL is increasingly recognized as a vital health outcome in chronic disease management, this study aimed to assess the prevalence of prehypertension and hypertension, identify associated factors and evaluate QOL among patients with diabetes mellitus in Gandaki Province, Nepal.

Methods

A hospital-based, cross-sectional study was conducted among diabetic patients attending the medical ward of the Western Regional Hospital at Pokhara Academy of Health Sciences. Data were collected using structured questionnaires and analyzed using SPSS version 22 employing descriptive statistics, binary logistic regression and multiple logistic regression.

Results

The overall prevalence of prehypertension and hypertension among diabetes mellitus patients was 51.48 % (95 % CI: 46.27–56.67) including 4.1 % who were newly diagnosed. The mean QOL score was 59.29 ± 8.25 with the highest scores observed in the environmental domain (66.40 ± 10.10) followed by the psychological domain (61.92 ± 11.12). Multivariable analysis revealed that patients from joint families (AOR: 2.06; 95 % CI: 1.30–3.26), those not practicing yoga (AOR: 1.87; 95 % CI: 1.14–3.07) and those on diabetes medication for ≥5 years (AOR: 1.92; 95 % CI: 1.24–2.96) had significantly higher odds of developing prehypertension and hypertension.

Conclusions

Over half of diabetic patients had elevated blood pressure. Promoting early detection, lifestyle modifications, and regular follow-up is crucial to reduce cardiovascular risk and improve overall quality of life.

糖尿病和高血压是相互关联的疾病，对心血管疾病的负担有重要影响。尽管患病率越来越高，但医疗保健工作往往仍然侧重于治疗，而不是预防或对患者生活质量（QOL）的更广泛影响。由于生活质量越来越被认为是慢性疾病管理的重要健康结果，本研究旨在评估高血压前期和高血压的患病率，确定相关因素并评估尼泊尔Gandaki省糖尿病患者的生活质量。方法以博克拉卫生科学院西部地区医院内科病房的糖尿病患者为研究对象，进行以医院为基础的横断面研究。采用结构化问卷收集数据，使用SPSS 22进行统计分析，采用描述性统计、二元逻辑回归和多元逻辑回归。结果糖尿病患者高血压前期及高血压的总患病率为51.48% (95% CI: 46.27 ~ 56.67)，其中新诊断者占4.1%。平均生活质量得分为59.29±8.25分，其中环境领域得分最高（66.40±10.10分），其次是心理领域得分（61.92±11.12分）。多变量分析显示，来自联合家庭的患者（AOR: 2.06; 95% CI: 1.30-3.26）、不练习瑜伽的患者（AOR: 1.87; 95% CI: 1.14-3.07）和服用糖尿病药物≥5年的患者（AOR: 1.92; 95% CI: 1.24-2.96）发生高血压前期和高血压的几率显著增加。结论超过一半的糖尿病患者血压升高。促进早期发现、改变生活方式和定期随访对于降低心血管风险和提高整体生活质量至关重要。

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引用次数: 0

Household pollutants, housing condition and cataracts among older adults in India: A rural-urban perspective 家庭污染物、住房条件和印度老年人白内障：城乡视角

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102223

Priyotosh Laha , Paramita Majumdar , Aparajita Chattopadhyay

Problem considered

Cataracts are one of the leading causes of visual impairment accounting for 17.7 million globally and 80% of blindness in India. This study tries to capture various household environmental factors like type of fuel used, dampness, smoke emitting substances and rural-urban differentials in the prevalence of cataracts among older adults aged 60 years and above in India.

Methods

The study used data from the Longitudinal Ageing Study in India. The outcome variable for the study is ‘self-reported cataract’ and the explanatory variables range from socio-economic factors, health and exposure factors like exposure to smoke and dampness. Multivariable logistic regressions and Blinder-Oaxaca decompositions were used for the analysis.

Results

The study found that the prevalence of cataracts is higher in urban areas (30%) compared to rural areas (21%) where people use a variety of pollutants. The internal environment of the house comprising of dampness, smoke emitting substances (agarbatti and liquid vaporizer), and use of unclean fuel increase the risk of cataracts. Health risk factors linked to urban lifestyle such as diabetes and hypertension, use of substances like liquid vaporizers, and pucca houses widen the urban-rural gap in cataract prevalence.

Conclusion

Urban areas are at an advantage over rural areas in terms of awareness and healthcare support to combat cataracts, but compromised household environment can augment the growth of cataracts among older urban adults. This study highlights the need for local-needs-based policies to combat this silent pandemic of cataracts in India.

白内障是导致视力损害的主要原因之一，全球有1770万人患有白内障，占印度失明人数的80%。这项研究试图捕捉各种家庭环境因素，如使用的燃料类型、湿度、烟雾排放物质以及印度60岁及以上老年人白内障患病率的城乡差异。方法本研究使用了印度纵向老龄化研究的数据。这项研究的结果变量是“自我报告的白内障”，解释变量包括社会经济因素、健康和暴露因素，如暴露于烟雾和潮湿中。采用多变量logistic回归和Blinder-Oaxaca分解进行分析。结果研究发现，白内障的患病率在城市地区（30%）高于农村地区（21%），农村地区人们使用各种污染物。房子的内部环境包括潮湿，冒烟的物质（香槟酒和液体汽化器），以及使用不清洁的燃料，增加了白内障的风险。与城市生活方式有关的健康风险因素，如糖尿病和高血压，使用液体蒸发器等物质，以及pucca房屋，扩大了白内障患病率的城乡差距。结论城市地区在白内障防治意识和卫生保健支持方面优于农村地区，但不良的家庭环境可促进城市老年人白内障的生长。这项研究强调需要制定基于当地需求的政策，以对抗印度这种无声的白内障大流行。

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引用次数: 0

Epidemiology, etiology and risk factors of culture confirmed, nosocomial late onset neonatal sepsis in Western Mexico 流行病学，病因学和危险因素培养证实，医院晚发新生儿败血症在墨西哥西部

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102220

Matthijs Christiaan Boom , Juan Carlos Lona-Reyes , Mirjam M. van Weissenbruch , Tessa de Baat , Lucía Miramontes-Buiza , Larissa María Gómez-Ruiz

Problem considered

Neonatal sepsis is an urgent global problem, as it is one of the leading causes of neonatal mortality and morbidity worldwide. The objectives of this study are to determine the rate of late onset sepsis (LOS) in a large university hospital in Mexico, to investigate what pathogens are causing LOS and in particular what part of them are not adequately covered by initial empiric treatment, and to objectify risk factors for LOS.

Methods

A retrospective case control study was performed in Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” (HCGJIM) from October 2021 to April 2023. Each episode of culture proven LOS was included as a case. For each case a control was matched based on gestational age ± 7 days and birthweight ± 200 g.

Results

LOS rate was 16.95 per 1000 newborns. 30.4 % of the pathogens causing LOS were not adequately covered by initial empiric treatment. Multivariable analysis revealed that central venous catheters (OR 3.65, 95 %CI 1.60–8.31, p = 0.002), total parenteral nutrition (OR 2.44, 95 %CI 1.32–4.49, p = 0.004), mechanical ventilation (OR 2.34, 95 %CI 1.31–4.20, p = 0.004) and surgery (OR 5.51, 95 %CI 2.60–11.72, p < 0.001) were independently associated with LOS.

Conclusion

This study demonstrates that HCGJIM has a high LOS rate with a large number of bacteria that are not adequately covered by initial empiric treatment. Additionally, this article affirms several risk factors for LOS, highlighting the importance of improvement of neonatal care in order to lower the rate of LOS.

新生儿败血症是一个紧迫的全球性问题，因为它是全世界新生儿死亡和发病的主要原因之一。本研究的目的是确定墨西哥一家大型大学医院的晚发型脓毒症（LOS）发生率，调查导致LOS的病原体，特别是其中哪些病原体未被最初的经验性治疗充分覆盖，并客观化LOS的危险因素。方法于2021年10月至2023年4月在瓜达拉哈拉民用医院Juan I. Menchaca博士（HCGJIM）进行回顾性病例对照研究。每一集经文化证明的LOS被列为一个案例。每例患者根据胎龄±7天和出生体重±200 g匹配对照组。结果新生儿死亡率为16.95 / 1000。30.4%引起LOS的病原菌未得到充分的初始经验性治疗。多变量分析显示，中心静脉导管（OR 3.65, 95% CI 1.60-8.31, p = 0.002）、全肠外营养（OR 2.44, 95% CI 1.32-4.49, p = 0.004）、机械通气（OR 2.34, 95% CI 1.31-4.20, p = 0.004）和手术（OR 5.51, 95% CI 2.60-11.72, p < 0.001）与LOS独立相关。结论本研究表明HCGJIM具有较高的LOS率，且大量细菌未被初始经验性处理充分覆盖。此外，这篇文章肯定了几个危险因素的LOS，强调了改善新生儿护理的重要性，以降低LOS的发生率。

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引用次数: 0

Corrigendum to “Seroprevalence and sociodemographic determinants of HBsAg and Anti-HBC in Malaysia's nationwide population” [Clinic Epidemiol Glob Health 35 (2025) 102152] “马来西亚全国人口HBsAg和Anti-HBC的血清流行率和社会人口学决定因素”的勘误表[临床流行病学全球健康35 (2025)102152]

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102213

Nurfatehar Ramly , Eida Nurhadzira Muhammad , Filza Noor Asari , Mohd Hatta Abdul Mutalip , Muhammad Faiz Mohd Hisham , Hasmah Haris , Zhuo Lin Chong

引用次数: 0

Anaemia in pregnancy across Tanzania: A comprehensive review of prevalence, risk factors, and birth outcomes 坦桑尼亚妊娠贫血：流行率、危险因素和出生结果的全面审查

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102219

Magnus Michael Sichalwe , Dolness Erick Charles , Regnald Raymond Kimaro , Abdul Basit , Grace Tavengana , Manas Ranjan Behera

Problem considered

Anaemia in pregnancy is a significant public health issue in Tanzania, linked to poor maternal and neonatal outcomes. Despite numerous regional studies, a comprehensive synthesis is needed. This study examined the prevalence, associated factors, and perinatal outcomes of anaemia among pregnant women in Tanzania.

Methods

A comprehensive literature search was conducted across Medline, EMBASE, PubMed, CINAHL, Web of Science, Scopus, PsycINFO, Science Direct, and grey literature sources, including manual searches for unpublished theses and dissertations from January 2010 to May 2025. Eligible studies reported prevalence and/or associated factors. Two independent reviewers screened, extracted data, and assessed study quality using PRISMA guidelines and the Modified Newcastle-Ottawa Scale. Findings were synthesised narratively through thematic grouping and interpretation.

Results

Twelve studies met the inclusion criteria, reporting anaemia prevalence from 20 % to 83.5 %, with a pooled estimate of 51.5 % (95 % CI: 43.1 %–61.6 %). Fourteen risk factors were identified, including low income, limited education, poor diet, younger age, short pregnancy intervals, multigravidity, advanced gestation, and infections (malaria, HIV). Nine protective factors emerged, such as higher education, food security, good knowledge and attitudes, employment, adequate ANC, and proximity to health facilities. Anaemia was also linked to low birth weight and preterm birth.

Conclusion

Anaemia in pregnancy remains prevalent in Tanzania, driven by socioeconomic, nutritional, and health factors. Targeted efforts to improve maternal nutrition, education, and ANC use are vital to reduce its impact on pregnancy outcomes.

怀孕期间贫血是坦桑尼亚的一个重大公共卫生问题，与孕产妇和新生儿预后不良有关。尽管进行了许多区域研究，但仍需要全面综合。本研究调查了坦桑尼亚孕妇贫血的患病率、相关因素和围产期结局。方法通过Medline、EMBASE、PubMed、CINAHL、Web of Science、Scopus、PsycINFO、Science Direct和灰色文献源对2010年1月至2025年5月期间未发表的论文和学位论文进行综合文献检索。符合条件的研究报告了患病率和/或相关因素。两名独立审稿人筛选、提取数据，并使用PRISMA指南和修改后的纽卡斯尔-渥太华量表评估研究质量。通过专题分组和解释，以叙述的方式综合了研究结果。结果12项研究符合纳入标准，报告的贫血患病率从20%到83.5%不等，合并估计为51.5% （95% CI: 43.1% - 61.6%）。确定了14个危险因素，包括低收入、受教育程度有限、饮食不良、年龄较小、妊娠间隔短、多胎、妊娠晚期和感染（疟疾、艾滋病毒）。出现了9个保护性因素，如高等教育、粮食安全、良好的知识和态度、就业、充足的非农业生产和靠近卫生设施。贫血也与低出生体重和早产有关。结论受社会经济、营养和健康因素的影响，妊娠期贫血在坦桑尼亚仍然普遍存在。有针对性地努力改善孕产妇营养、教育和ANC的使用，对于减少其对妊娠结局的影响至关重要。

{"title":"Anaemia in pregnancy across Tanzania: A comprehensive review of prevalence, risk factors, and birth outcomes","authors":"Magnus Michael Sichalwe , Dolness Erick Charles , Regnald Raymond Kimaro , Abdul Basit , Grace Tavengana , Manas Ranjan Behera","doi":"10.1016/j.cegh.2025.102219","DOIUrl":"10.1016/j.cegh.2025.102219","url":null,"abstract":"<div><h3>Problem considered</h3><div>Anaemia in pregnancy is a significant public health issue in Tanzania, linked to poor maternal and neonatal outcomes. Despite numerous regional studies, a comprehensive synthesis is needed. This study examined the prevalence, associated factors, and perinatal outcomes of anaemia among pregnant women in Tanzania.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across Medline, EMBASE, PubMed, CINAHL, Web of Science, Scopus, PsycINFO, Science Direct, and grey literature sources, including manual searches for unpublished theses and dissertations from January 2010 to May 2025. Eligible studies reported prevalence and/or associated factors. Two independent reviewers screened, extracted data, and assessed study quality using PRISMA guidelines and the Modified Newcastle-Ottawa Scale. Findings were synthesised narratively through thematic grouping and interpretation.</div></div><div><h3>Results</h3><div>Twelve studies met the inclusion criteria, reporting anaemia prevalence from 20 % to 83.5 %, with a pooled estimate of 51.5 % (95 % CI: 43.1 %–61.6 %). Fourteen risk factors were identified, including low income, limited education, poor diet, younger age, short pregnancy intervals, multigravidity, advanced gestation, and infections (malaria, HIV). Nine protective factors emerged, such as higher education, food security, good knowledge and attitudes, employment, adequate ANC, and proximity to health facilities. Anaemia was also linked to low birth weight and preterm birth.</div></div><div><h3>Conclusion</h3><div>Anaemia in pregnancy remains prevalent in Tanzania, driven by socioeconomic, nutritional, and health factors. Targeted efforts to improve maternal nutrition, education, and ANC use are vital to reduce its impact on pregnancy outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102219"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416290","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

Prevalence and determinants of symptomatic sexually transmitted infections among youth in pastoralist community refugee camps, in Somali region eastern Ethiopia: Multivariable regression analysis 埃塞俄比亚东部索马里地区牧民社区难民营青年中有症状性传播感染的患病率和决定因素：多变量回归分析

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102214

Mustafe said Mohamed , Tesfaye Assebe Yadeta , Aboma Motuma

Problem considered

Sexually transmitted infections(STIs) is a major public health problem among vulnerable youth in refugee settings. However, there is paucity of information on the burden of STIs among youth in Refugee Camps in Ethiopia. Therefore, this study aimed to assess symptomatic STIs and associated factors among youth in pastoralist refugee camp Eastern Ethiopia.

Methods

A cross-sectional study was conducted in January 2024 among 387 youth randomly selected from the pastoralist community at Kebri-Beyah refugee camp. Data was collected through face-to-face interviews using a WHO pre-tested structured questionnaire. The data was entered into Epi-data and analyzed using SPSS. A bivariable logistic regression model was used to identify potential variables for multivariable logistic regression at a P value < 0.25. In multivariable analysis a p-value <0.05 were considered statistically significant association with STIs.

Results

The mean age of the participants was 19.9 years. The majority (60.3 %) of the participants were between 20 and 24 years. The prevalence of symptomatic STIs among youth in refugee camp was 20 % (95 % CI = 16.1, 23.9). History of previous STIs [AOR = 3.22; 95 % CI: 1.21, 8.53], engaging in risky sexual behaviors [AOR = 4.81; 95 % CI: 2.36, 9.81], and poor knowledge of STIs [AOR = 2.65; 1.90, 4.94] were statistically significant associated with STIs.

Conclusion

A study revealed that 20 % of youths in a refugee camp had STIs. Risk factors such as previous STIs, engaging in risky sexual behaviors, and poor knowledge were identified. Therefore, health care providers should promote safer sexual practices in refugee camp.

性传播感染是难民环境中弱势青年面临的一个主要公共卫生问题。然而，关于埃塞俄比亚难民营中青年的性传播感染负担的信息缺乏。因此，本研究旨在评估埃塞俄比亚东部牧民难民营青年的症状性传播感染及其相关因素。方法于2024年1月在kebrii - beyah难民营随机抽取387名青年进行横断面研究。使用世卫组织预先测试的结构化问卷，通过面对面访谈收集数据。数据录入Epi-data，用SPSS软件进行分析。采用双变量logistic回归模型识别多变量logistic回归的潜在变量，P值为<； 0.25。在多变量分析中，p值<；0.05被认为与性传播感染有统计学意义。结果参与者平均年龄为19.9岁。大多数（60.3%）的参与者年龄在20至24岁之间。难民营青年中有症状性传播感染的患病率为20% （95% CI = 16.1, 23.9）。既往性传播感染史[AOR = 3.22；95% CI: 1.21, 8.53]，从事危险性行为[AOR = 4.81；95% CI: 2.36, 9.81]，性传播感染知识贫乏[AOR = 2.65；1.90, 4.94]与性传播感染的相关性有统计学意义。一项研究显示，难民营中20%的青少年患有性传播感染。风险因素，如先前的性传播感染，从事危险的性行为，以及缺乏知识。因此，卫生保健提供者应在难民营中提倡更安全的性行为。

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引用次数: 0

Differential outcomes of tuberculosis hospitalizations in Ecuador: Lower pediatric mortality compared with adults 厄瓜多尔肺结核住院治疗的不同结果：与成人相比，儿童死亡率较低

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102228

German Josuet Lapo-Talledo , María José Jaramillo Montaño , Carlos Rafael Arteaga Reyes , Carlos Andrés Parrales Cevallos , Alberto Dario Díaz Parra , Gerardo Antonio Granja Carrión , Adriana Elizabeth Salazar Monar , Johanna Lizbeth Aguirre Palacios

Problem considered

This study aimed to assess tuberculosis hospitalizations and in‐hospital mortality in Ecuador (2015–2023), while identifying factors associated with mortality.

Methods

We conducted a cross-sectional study using the Statistical Registry of Hospital Beds and Discharges of the Ecuadorian National Institute of Statistics and Censuses (INEC). Cases with International Classification of Diseases 10th Revision (ICD-10) codes A15–A19 were included. Hospitalization and mortality rates were estimated by year and province. Univariable and multivariable logistic regression models were used to identify factors associated with mortality.

Results

17,724 tuberculosis hospitalizations were analyzed, 2955 (16.67 %) were pediatric patients, 14,769 (83.33 %) were adults. Adults showed higher proportion of deaths (10.31 %) than children (1.83 %). Tuberculosis of lung was the most frequent type in both children and adults (n = 11,284; 63.67 %). Guayas, Napo, and Santo Domingo provinces had the highest hospitalizations and mortality rates; Napo showing highest hospitalization rate among children. Although severe forms disproportionately affected pediatric mortality, pediatric ages showed lower death probabilities compared to adults. Notably, when analyzing only pediatric cases, children under 15 years showed lower probabilities of death compared to those aged 15–19 years. During 2020, hospitalization rates declined, with subsequent rebound in 2022–2023.

Conclusion

Adults bear significantly higher tuberculosis burden than children. However, severe tuberculosis forms showed higher impact on pediatric mortality, underscoring the need for improved protocols for children. Nevertheless, protective effects in ages under 15 years, might reflect benefits of Ecuador's mandatory neonatal BCG vaccination and prioritized pediatric care, although persistent underdiagnosis challenges in children might also shape the observed patterns.

本研究旨在评估厄瓜多尔（2015-2023）的结核病住院率和住院死亡率，同时确定与死亡率相关的因素。方法：我们利用厄瓜多尔国家统计和人口普查研究所（INEC）的医院床位和出院统计登记处进行了一项横断面研究。纳入国际疾病分类第十版（ICD-10）编码A15-A19的病例。住院率和死亡率按年份和省份进行了估计。使用单变量和多变量logistic回归模型来确定与死亡率相关的因素。结果共分析17724例结核病住院患者，其中儿童2955例（16.67%），成人14769例（83.33%）。成人死亡比例（10.31%）高于儿童（1.83%）。在儿童和成人中，肺结核是最常见的类型（n = 11,284; 63.67%）。瓜亚斯、纳波和圣多明各省的住院率和死亡率最高；纳波的儿童住院率最高。尽管严重形式对儿童死亡率的影响不成比例，但与成年人相比，儿童年龄显示出较低的死亡概率。值得注意的是，在仅分析儿科病例时，15岁以下儿童的死亡概率低于15 - 19岁儿童。2020年期间，住院率下降，随后在2022-2023年出现反弹。结论成人结核病负担明显高于儿童。然而，严重结核病对儿童死亡率的影响更大，这强调了改进儿童方案的必要性。尽管如此，对15岁以下儿童的保护作用可能反映了厄瓜多尔强制性新生儿卡介苗接种和优先儿科护理的益处，尽管儿童持续的诊断不足挑战也可能影响观察到的模式。

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引用次数: 0

Influence of maternal and socioeconomic factors as determinants of low birth weight among hospital delivery mothers of rural West Bengal, India 产妇和社会经济因素作为印度西孟加拉邦农村医院分娩母亲低出生体重决定因素的影响

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102225

Somnath Sau , Pritam Pal , Alo Dey , Sagarika Pahari , Esa Chakraborty , Kankan Kumar Maity , Dipak Kumar Tamili , Amitava Pal , Balaram Das

Background and aims

The multidimensional risk factors of low birth weight (LBW) remain a major public health concern globally and are often linked to neonatal morbidity and mortality. This study aimed to identify the key factors associated with low birth weight (LBW) among mothers delivering in rural hospitals in West Bengal, India.

Methods

A cross-sectional study was conducted from August 2024 to February 2025 in a rural hospital using a structured questionnaire. Data from 1136 participants were analyzed using multivariable logistic regression through SPSS version 24.

Results

The prevalence of LBW was 21.3 % (n = 242). Significant risk factors identified included low socioeconomic status (BPL/AAY vs APL cardholders) [AOR 1.46, CI 1.06–2.01] and environmental factors (household cooking) [AOR 0.43, CI 0.19–0.65; AOR 0.35, CI 0.23–0.78] and (indoor air pollution) [AOR 2.35, CI 1.39–3.97]. Optimal birth intervals, adequate weight gain, ≥4 ANC visits, and receiving dietary advice reduced LBW, whereas abortion increased the risk of LBW.

Conclusions

The study concludes that LBW is significantly influenced by multiple clinical and socioeconomic factors. Key determinants include inadequate maternal weight gain, fewer ANC visits, short birth intervals, poor dietary advice, and indoor air pollution from biomass fuels. Effective interventions targeting maternal health, antenatal care, nutrition, and household environment are essential to reduce LBW risk and improve newborn outcomes.

背景和目的低出生体重（LBW）的多维风险因素仍然是全球关注的一个主要公共卫生问题，通常与新生儿发病率和死亡率有关。本研究旨在确定在印度西孟加拉邦农村医院分娩的母亲低出生体重（LBW）相关的关键因素。方法于2024年8月至2025年2月在某农村医院采用结构化问卷进行横断面研究。通过SPSS version 24对1136名参与者的数据进行多变量logistic回归分析。结果LBW患病率为21.3% （n = 242）。确定的重要危险因素包括低社会经济地位（BPL/AAY vs APL持卡人）[AOR 1.46, CI 1.06-2.01]和环境因素（家庭烹饪）[AOR 0.43, CI 0.19-0.65；（室内空气污染）[AOR 2.35, CI 1.39 ~ 3.97]。最佳生育间隔、适当的体重增加、≥4次ANC就诊和接受饮食建议可降低LBW，而流产可增加LBW的风险。结论LBW受多种临床和社会经济因素的显著影响。主要决定因素包括产妇体重增加不足、产前检查次数较少、分娩间隔短、饮食建议不佳以及生物质燃料造成的室内空气污染。针对孕产妇保健、产前保健、营养和家庭环境的有效干预措施对于降低低体重儿风险和改善新生儿结局至关重要。

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引用次数: 0

Low uptake of follow-up care for children with pneumonia compounded by suboptimal drug regimen adherence in Northwest Ethiopia: Longitudinal follow-up study 埃塞俄比亚西北部肺炎患儿随访治疗的低吸收率和药物治疗依从性不佳：纵向随访研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health

Pub Date : 2025-11-01 DOI: 10.1016/j.cegh.2025.102230

Abebaw Addis Gelagay , Telake Azale , Lemma Derseh Gezie , Zemene Tigabu , Kassahun Alemu

Problem considered

The integrated management of newborn and childhood illnesses guideline recommends follow-up care for children with pneumonia on the second day after initial treatment. However, evidence on follow-up care utilization and its determinants is limited. Therefore, this study aimed to investigate follow-up care utilization, associated factors, and adherence to the treatment regimen.

Methods

A prospective follow-up study was conducted in northwest Ethiopia from March to July 2023 among 818 under-five children with pneumonia who were treated as outpatients. Two-stage sampling was employed. Data were collected using validated questionnaires. Descriptive and multilevel binary logistic regression analyses were performed.

Results

Only one-third, 259 (31.7 %, 95 % CI: 28.6, 34.9), of caregivers of children with pneumonia sought follow-up care. Of these, 213 (82.2 %) children received the correct treatment regimen. Factors associated with follow-up care utilization included receiving treatment from healthcare providers who counseled caregivers on when to return immediately (AOR: 1.9, 95 % CI: 1.2, 3.0), from facilities with internal quality assessment (AOR: 2.8, 95 % CI: 1.3, 6.1), those located nearest to the community (AOR: 2.9, 95 % CI: 1.8, 4.9), and those providing better quality of service (AOR: 4.1, 95 % CI: 1.4, 11.8).

Conclusion

Low utilization of follow-up care for children with pneumonia represents a critical gap in the continuum of care. This issue is further compounded by suboptimal adherence to medication regimens. Follow-up care utilization for childhood pneumonia is influenced by the interplay of individual and facility-specific factors. The study findings imply that improving process quality can increase follow-up care utilization.

新生儿和儿童疾病综合管理指南建议在初始治疗后第二天对肺炎患儿进行随访。然而，关于后续护理利用及其决定因素的证据是有限的。因此，本研究旨在调查随访护理的使用情况、相关因素和治疗方案的依从性。方法对2023年3月至7月在埃塞俄比亚西北部门诊就诊的818例5岁以下肺炎患儿进行前瞻性随访研究。采用两阶段抽样。使用有效的问卷收集数据。进行描述性和多水平二元逻辑回归分析。结果只有三分之一（259人，31.7%,95% CI: 28.6, 34.9）的肺炎患儿护理人员寻求随访。其中，213名（82.2%）儿童接受了正确的治疗方案。与随访护理利用相关的因素包括接受医疗保健提供者的治疗，这些医疗保健提供者建议护理人员何时立即返回（AOR: 1.9, 95% CI: 1.2, 3.0），从具有内部质量评估的机构接受治疗（AOR: 2.8, 95% CI: 1.3, 6.1），离社区最近的机构（AOR: 2.9, 95% CI: 1.8, 4.9），以及提供更好服务质量的机构（AOR: 4.1, 95% CI: 1.4, 11.8）。结论肺炎患儿随访护理使用率低是持续护理的一个重要缺口。对药物治疗方案的不理想依从性进一步加剧了这一问题。儿童肺炎的随访护理利用受到个体和机构特定因素的相互作用的影响。研究结果表明，改善过程质量可以提高随访护理的利用率。

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