Archives of Public Health最新文献

Background: Integrating HIV clinical records with population-based surveillance data allows the study of health care seeking behaviours, access to care, and predictors of patient outcomes. We implemented a graph-based record linkage algorithm to deduplicate and link HIV clinical and population-based surveillance records in an HIV-endemic setting in rural South Africa.

Methods: We linked four data sources to create the Africa Health Research Institute (AHRI) Unified Data Platform: AHRI's Health and Demographic Surveillance System (HDSS), AHRI Clinic and Hospital Information System (AHRILink), National Health Laboratory Service (NHLS), and Three Integrated Electronic Registers (TIER.Net) HIV care and treatment records. HDSS data were collected between January 1, 2000, and July 31, 2024, through repeated household surveys of over 140,000 individuals. Clinical and laboratory data were obtained for one hospital and 17 clinics in Hlabisa, KwaZulu-Natal, covering the HDSS surveillance area. We implemented a probabilistic record linkage algorithm trained and validated on a subset of records with national identity numbers. We assessed linkage accuracy, computed descriptive statistics for the linked database, and estimated the HIV care cascade for this population.

Results: A total of 986,832 records were successfully linked across the four databases, achieving a sensitivity of 92.7% and a positive predictive value of 96.5% (F-score=0.95). The average number of records (standard deviation (SD)) in TIER.Net, HDSS, AHRILink and NHLS were 1.18 (0.44),1.05 (0.23),1.13 (0.40), and 5.21 (4.24), respectively. The linked data indicated that 12,293 HDSS resident adults (≥15 years) were living with HIV at some point during the 2022 and 2024 surveillance rounds. Of these, 10,622 (86.4%) had ever sought HIV care in the public sector, of whom 10,492 (98.8%) had ever started ART and 7,065 (66.5%) were currently on ART, of whom 6,301 (89.2%) were virally suppressed(viral load<200 copies/mL).

Conclusion: HIV care and population surveillance records from four data sources were deduplicated and linked with high accuracy, revealing persistent gaps in retention in care and viral suppression in an HIV-endemic region in rural South Africa. The AHRI Unified Data Platform offers the potential to deepen our understanding of HIV epidemiology in a well-described population and to improve services for HIV.

Trial registration: Not applicable.

Background: Access to safe and clean drinking water is a key determinant of public health and well-being. This study explores the relationship between perceived unpleasant odor of tap water (as a proxy of water quality) and perception of health risks from tap water, in low- and middle-income areas of Mexico, emphasizing the role of perceptions shaped by sensory indicators such as taste, color, and odor. The connection between perceived unpleasant odor of tap water and perceived risk warrants attention as a public health concern, given its potential to influence consumer behavior, risk exposure, and trust in health-related products and services.

Methods: The analysis draws on household survey data collected through face-to-face interviews in Zapopan, Jalisco, Mexico, in October 2018, complemented with a review of existing literature. Statistical regression models were executed to assess the association between perceived water quality and perceived health risk from drinking tap water.

Results: The analysis shows that households perceiving an unpleasant odor in tap water had 29% higher odds of identifying it as a health risk (OR = 1.29), controlling for socioeconomic and demographic conditions.

Conclusions: The findings underscore the need for public health interventions that address both actual and perceived water quality. Integrated water policies should prioritize equity, strengthen community trust, and incorporate engagement strategies to mitigate health risks linked to water insecurity.

Background: Tobacco exposure remains the leading preventable cause of lung cancer. However, long-term trends in tobacco-related lung cancer premature mortality have been insufficiently studied in rural China. This study aimed to determine premature mortality burden due to lung cancer attributable to smoking and secondhand smoke (SHS) exposure in rural southwest China from 2013 to 2025.

Methods: Years of life lost (YLL) per 1,000 and mortality rate per 100,000 due to lung cancer were calculated from medical death certificates, while smoking and SHS exposure data were collected from three waves of cross-sectional interviews conducted in 2013, 2019, and 2025 among individuals aged ≥ 35 years in rural China. The population attributable fraction (PAF) was used to derive mortality and YLL due to lung cancer attributable to tobacco exposure.

Results: From 2013 to 2025, prevalence of smoking increased in men (75.56% vs. 81.12%, P < 0.01) but declined in women (2.34% vs. 1.40%, P < 0.01), while prevalence of exposure to SHS decreased significantly both in men (34.66% vs. 20.57%, P < 0.01) and women (44.12% vs. 28.24%, P < 0.01). The mortality and YLL rate of lung cancer rose significantly from 11.67 to 38.34 per 100,000 population and from 1.77 to 4.92 per 1,000 population, respectively. These increasing rates were also observed in both sexes, with the largest relative increase occurring among men. The age-standardized mortality and YLL rate of lung cancer attributable to both smoking and exposure to SHS increased consistently in men and women over the study period. Further, smoking contributed much more to mortality and YLL due to lung cancer than exposure to SHS in men, while the difference in contributions among women was less pronounced.

Conclusions: The premature mortality burden due to lung cancer attributable to smoking and SHS exposure has increased substantially in rural southwest China over the twelve-year study period. Future lung cancer prevention and management efforts should prioritize reducing smoking in men as well as strengthening protections against SHS exposure in women and other non-smoking populations.