Public Health最新文献

{"title":"Performance evaluation of Mexico's health system at the national and subnational level, 1990–2019: an analysis of the Health Access and Quality Index","authors":"","doi":"10.1016/j.puhe.2024.07.009","DOIUrl":"10.1016/j.puhe.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator.</p></div><div><h3>Study design</h3><p>A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO).</p></div><div><h3>Methods</h3><p>HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach.</p></div><div><h3>Results</h3><p>Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed.</p></div><div><h3>Conclusions</h3><p>The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624002956/pdfft?md5=071077eff3bc4d7adb671ce50ac97ea1&pid=1-s2.0-S0033350624002956-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is COVID-19 finally just a bad flu? Follow-up study comparing disease severity among COVID-19 and seasonal influenza hospital in-patients across pandemic waves in Ireland","authors":"","doi":"10.1016/j.puhe.2024.07.010","DOIUrl":"10.1016/j.puhe.2024.07.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Coronavirus disease 2019 (COVID-19) was a more severe illness than seasonal influenza in hospitalised cohorts during the early phase of the pandemic. This study's aim was to determine if COVID-19 severity, relative to seasonal influenza, evolved across subsequent disease waves.</p></div><div><h3>Study design</h3><p>Retrospective population-based cohort study.</p></div><div><h3>Methods</h3><p>COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes from the Irish national hospitalisation dataset. Descriptive comparative analysis of each group was carried out using Pearson's Chi-squared tests. Length of stay (LOS), intensive care unit (ICU) admission and in-hospital mortality were measured and compared using logistic regression analysis.</p></div><div><h3>Results</h3><p>Compared to influenza episodes, COVID-19 episodes for all ages and all waves combined, had a longer mean LOS (15.8 days, vs 11.4 days, <em>P</em> &lt; 0.001); were more likely to receive ICU care (OR 1.24 95% CI 1.15–1.33, <em>P</em> &lt; 0.001) and were more likely to die in hospital (OR 2.61, 95% CI 2.36-2-88). Despite the reduction in the proportion of patients with an intensive care unit (ICU) stay and dying in hospital in Wave 5 compared to the previous waves, the risk of having an ICU admission or dying in hospital remained higher in patients with COVID-19 in Wave 5 compared to those with influenza diagnosis.</p></div><div><h3>Conclusion</h3><p>While the severity of COVID-19 has reduced with successive pandemic waves, it remains a more severe disease than influenza. Despite changes in strain, population immunity, vaccination and treatment, policymakers and the public must continue to approach COVID-19 as more than ‘just a bad flu’.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in social inequalities in excess body weight and body dissatisfaction among adolescents in Barcelona, Spain, 2016–2021","authors":"","doi":"10.1016/j.puhe.2024.07.012","DOIUrl":"10.1016/j.puhe.2024.07.012","url":null,"abstract":"<div><h3>Objectives</h3><p>Adolescence is a crucial life stage that can lead to excess weight and body dissatisfaction. Social inequalities in these issues may have been exacerbated by the COVID-19 pandemic. We aimed to analyze the presence of socioeconomic inequalities and their changes in these inequalities stratified by sex in 13- to 19-year-olds in a large Mediterranean city (Barcelona, Spain).</p></div><div><h3>Study design</h3><p>Cross-sectional population-based study.</p></div><div><h3>Methods</h3><p>We used data from the 2016 and 2021 editions of the FRESC survey, which is a representative citywide survey that captures various aspects of adolescent health. Excess weight was determined by objective body mass index measurements. Body dissatisfaction was defined as the discrepancy between perceived and desired body shape. Socioeconomic status was divided into five pseudo-quintiles by using the Family Affluence Scale. We calculated the corresponding prevalence estimates and fitted robust Poisson regression models to estimate both simple and complex measures of inequality, including relative and absolute differences between the two survey years.</p></div><div><h3>Results</h3><p>The overall prevalence of excess weight increased from 25.3% [23.9–26.6] to 29.8% [28.2–31.4] between 2016 and 2021. Similarly, body dissatisfaction increased from 44.2% [42.6–45.8] to 60.4% [58.7–62]. Socioeconomic inequalities in excess weight significantly increased in girls (adjusted ratio of the relative index of inequalities = 1.72 [1.08; 2.74] but not in boys. No significant changes were detected in body dissatisfaction in either girls or boys.</p></div><div><h3>Conclusions</h3><p>Our findings highlight the presence of a sex-specific change in socioeconomic inequalities in adolescent well-being regarding excess weight and body dissatisfaction. These results underscore the need for local public policies to improve social equity in adolescent health.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deaths of despair-associated mortality rates globally: a 2000–2019 sex-specific disparities analysis","authors":"","doi":"10.1016/j.puhe.2024.07.015","DOIUrl":"10.1016/j.puhe.2024.07.015","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to explore sex-specific disparities in rates of deaths of despair across 183 countries from 2000 to 2019.</p></div><div><h3>Study design</h3><p>Secondary analysis of cross-sectional population-level data.</p></div><div><h3>Methods</h3><p>Data were obtained from the World Health Organization Health Inequality Data Repository. We analysed data on mortality due to alcohol, drug-use disorders, and self-harm (as a proxy for suicide). We calculated the average rate of deaths of despair by year and sex, trends in these rates, and cause-specific mortality trends. We then fitted mixed-effect generalised linear models to compare mortality rates by sex and country.</p></div><div><h3>Results</h3><p>Analyses revealed significant disparities by sex, with a 3.3-fold higher rate among men than among women globally (95% confidence interval: 3.1–3.5, <em>P</em> &lt; 0.001). There was a significant decline in deaths of despair globally and among both sexes during the assessed period (5% per 5 years). Lesotho, Belarus, the US, the Russian Federation, Guyana, and Slovenia ranked among the top 10 countries out of 183 with the highest mortality rates for both sexes. Canada, the Republic of Korea, Belgium, and Finland were countries with the highest mortality rates among women, whereas Ukraine, Lithuania, Mongolia, and Eswatini have the highest rates among men. In the US, 5-year mortality rates increased by 35% for women and 21% for men: drug-use mortality showed a significant increase over time, whereas suicide rates decreased for both sexes in the given country. Additionally, mortality rates from alcohol use decreased among women.</p></div><div><h3>Conclusions</h3><p>This global analysis shed light on health disparities by sex in deaths of despair, especially concerning trends in the US. It identified countries and groups in need of targeted mental health and substance-use programs. Moreover, the disparities by sex revealed in this analysis suggest that mental health and substance-use interventions and programs may need to be more attentive to sex and/or gender, such as inequitable social norms and restrictive forms of masculinities, which have been shown to be contributing factors to deaths of despair.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003044/pdfft?md5=8080ddf7c60cebf82ac579f85c076294&pid=1-s2.0-S0033350624003044-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global associations between the use of basic drinking water and sanitation services with diarrhoeal disease incidence in 200 countries and territories from 2000 to 2019","authors":"","doi":"10.1016/j.puhe.2024.07.004","DOIUrl":"10.1016/j.puhe.2024.07.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Globally, billions of people do not have access to safely managed drinking water and sanitation services. Interventions to improve drinking water, sanitation and hygiene could reduce the incidence of diarrhoea in low- and middle-income countries. This study aimed to investigate the association between these services and the incidence of diarrhoea.</p></div><div><h3>Study design</h3><p>Worldwide, ecological observational study, utilising cross-sectional data.</p></div><div><h3>Methods</h3><p>Data from the Global Burden of Disease Study 2019 and World Bank were used in this study. Diarrhoeal disease episodes were defined as three or more loose bowel movements within 24 h. Estimated Annual Percentage Change was used to quantify trends in disease incidence over a specific time interval. Quasi-Poisson Generalised Linear Model was introduced to analyse the influence of basic drinking water and sanitation services on the incidence of diarrhoea. Subgroup analyses were carried out to determine potential variations in the incidence of diarrhoeal diseases according to sex, age and sociodemographic index (SDI) region.</p></div><div><h3>Results</h3><p>Between 2000 and 2019, the incidence rate of global diarrhoea remained consistent, with regional variations linked to SDIs. A 1% increase in access to basic drinking water was associated with a 0.41% (95% confidence interval [CI], 0.33%–0.50%) increase in the age-standardised incidence rate of diarrhoea; meanwhile, a 1% increase in sanitation service usage was associated with a 0.47% (95% CI, 0.40%–0.54%) reduction in the age-standardised incidence rate of diarrhoea. The correlation differed across SDI regions. The use of safely managed drinking water was associated with a reduction in diarrhoeal disease rates, but the effect was non-significant in High SDI regions. Higher diarrhoeal disease incidence was seen in younger and older populations. Individuals in the age groups 55–59 years and 10–14 years showed the greatest association of water service usage with diarrhoea, while an increase in sanitation service usage was related to decreased diarrhoea rates in most age groups, excluding children aged 5–14 years.</p></div><div><h3>Conclusions</h3><p>Emphasising initiatives to enhance water quality, elevate the standards of drinking water safety management, and strengthening related infrastructure development in global health policies and development plans could have a positive impact on overall global health. Such comprehensive interventions have the potential to not only prevent waterborne diseases but also elevate the general health status of societies worldwide.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624002828/pdfft?md5=3d592df867f02cdefdf00f318d02de1f&pid=1-s2.0-S0033350624002828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of disease and costs for the Unified Health System in Brazil due to diseases whose alcohol consumption is a necessary cause: an ecological study","authors":"","doi":"10.1016/j.puhe.2024.06.038","DOIUrl":"10.1016/j.puhe.2024.06.038","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to quantify the health and economic impacts of alcohol consumption in Brazil for 2019.</p></div><div><h3>Study design</h3><p>Ecological study using secondary data sources.</p></div><div><h3>Methods</h3><p>We calculated the disease burden using estimates from the Global Burden of Disease study, which incorporated data from health surveys and hospital records. Costs were estimated based on direct expenses recorded in the Hospital and Outpatient Information System of the Unified Health System, with data by sex, age group, cause, and Federative Units.</p></div><div><h3>Results</h3><p>Alcohol consumption was a necessary cause for 30,355 deaths and approximately 1.69 million disability-adjusted life years in Brazil, representing 2.2% and 2.6% of the national totals, respectively. The impact was more pronounced among men, in the Northeast region and within the 40- to 64-year-old age group. The total costs attributed to these outcomes reached approximately Int$43.1 million, with hospital admissions accounting for 94.16% of these expenses.</p></div><div><h3>Conclusion</h3><p>In 2019, alcohol consumption had a significant impact on both the health of Brazilians and the expenses of the health system. As a preventable risk factor, alcohol consumption necessitates effective intersectoral strategies to mitigate its burden.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation indicators for access to cancer screening services: a scoping review","authors":"","doi":"10.1016/j.puhe.2024.07.003","DOIUrl":"10.1016/j.puhe.2024.07.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Access to health services has received increasing attention, and the International Agency for Research on Cancer (IARC) includes ‘availability’ as one of the indicators to evaluate cancer screening. Evaluating, monitoring, and decision-making on cancer screening depends on systematic quantitative evidence on access to cancer screening, but indicators are currently inconsistently, if they are reported at all. This can be improved by developing systematic indicators for evaluating and reporting access to cancer screening. This requires a thorough understanding of current indicators of access to cancer screening.</p></div><div><h3>Study design</h3><p>Scoping review.</p></div><div><h3>Methods</h3><p>We completed a scoping review of studies on access to cancer screening services from 2013 to 2022. The relevant indicators were extracted, quantified, and then matched to two widely used frameworks: a universal five-dimensional conceptual framework for access to healthcare (‘U5D’) and a cancer-specific framework/list on the availability/use of screening indicators endorsed by the IARC.</p></div><div><h3>Results</h3><p>A total of 331 studies on access to cancer screening services were included. Based on the U5D framework, publications from supply side reported approachability (number of publications = 16), acceptability (6), availability and accommodation (44), affordability (30), and appropriateness (11); among this process, 17 sub-indicators were identified. Correspondingly, publications from demand side reported ability to perceive (170), ability to seek (85), ability to reach (58), ability to pay (59), and ability to engage (2); 26 sub-indicators were identified. More macroscopically, the publications of the IARC-endorsed indicators reported availability of policies and guidelines for screening (13), type of screening provided (3), extent of population coverage and participation rates (76), and demographic/behavioural related considerations (167). By integrating the universal and cancer-specific frameworks, a new adapted framework was proposed.</p></div><div><h3>Conclusions</h3><p>This study identified and collated indicators for evaluating access to cancer screening services, and determined the gaps in the current application of various indicators. The findings are anticipated to facilitate further development of an evaluation indicator system for access to cancer screening services.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gambling as a precipitating factor in deaths by suicide in the National Violent Death Reporting System","authors":"","doi":"10.1016/j.puhe.2024.07.005","DOIUrl":"10.1016/j.puhe.2024.07.005","url":null,"abstract":"<div><h3>Objectives</h3><p>The public health burden of gambling remains difficult to estimate, given the lack of relevant, available data. Death by suicide, represents a substantial and quantifiable public health cost. The current study reviews data from the National Violent Death Reporting System to detect cases where gambling was identified as a meaningful contextual factor to a death by suicide.</p></div><div><h3>Study design</h3><p>This study is an exploratory content analysis.</p></div><div><h3>Methods</h3><p>We analysed narrative data from cases of death by suicide, collected from 2003 to 2020 recorded in the Restricted Access Data of the National Violent Death Reporting System. Gambling-related cases identified in our analysis were compared against all other cases on demographic characteristics, case characteristics, US state, and incident year. Chi-square tests of independence and the Wilcoxon ranked sum tests were used in bivariate comparisons.</p></div><div><h3>Results</h3><p>Overall, 1306 of 296 317 cases were classified as gambling-related. This represented 0.44% of total cases. Gambling-related classification was over-represented among those identified as Asian (7.0% vs 2.2%) and under-represented among those identified as Black or African American (4.0% vs 6.4%) compared with all other deaths by suicide. Gambling-related cases were also over-represented in cases where alcohol use was suspected (28.0% vs 21.2%), where there were significant financial problems (50.3% vs 8.6%), where there were intimate partner problems (31.5% vs 25.6%), and under-represented in cases where there was a previous mental health diagnosis (35.1% vs 38.8%). The rate of gambling-related cases in Nevada was approximately nine times greater than the rate in the overall sample (4.0% vs 0.44%).</p></div><div><h3>Conclusions</h3><p>Administrative data can be used to study the impacts of gambling on public health in the absence of quality representative survey data. However, these sources are still likely to underestimate the public health burden of gambling with current structures and procedures. Requiring intentional collection of gambling-related information in cases of suicide would be a significant step towards better quantifying the public health burden of gambling in the United States.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003335062400283X/pdfft?md5=6c7b92f35da71183f488f26184c09a80&pid=1-s2.0-S003335062400283X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and chronicity of child maltreatment in Germany: results from a representative sample","authors":"","doi":"10.1016/j.puhe.2024.06.019","DOIUrl":"10.1016/j.puhe.2024.06.019","url":null,"abstract":"<div><h3>Objectives</h3><p>Child maltreatment (CM) is a major risk factor across the lifespan. While research on CM and its consequences has risen strongly during the last decades, research is mainly focused on the prevalence of types of CM incidents. As valid prevalence rates on timing and chronicity of CM are lacking to date, we aimed to assess the timing of experienced CM by describing the age of onset, duration, and prevalence at each year of age for each CM subtype in a population-based sample.</p></div><div><h3>Study design</h3><p>Cross-sectional, observational study in a representative sample.</p></div><div><h3>Methods</h3><p>Using different sampling steps including a random route procedure, a probability sample of the German population above the age of 16, encompassing 2514 persons (50.6% female, mean age: 50.08 years) was generated. Participants were asked about sociodemographic information in a face-to-face interview, CM was assessed using the ICAST-R questionnaire.</p></div><div><h3>Results</h3><p>The earliest mean age of onset was seen in neglect with 8.07 (±3.07) years for boys and 7.90 (±2.96) years for girls, while the mean age of onset for sexual abuse was in adolescence with 13.65 (±3.86) years for boys and 13.91(±3.17) years for girls. The overall duration of CM was lowest for sexual abuse with 2.12 (±2.01) years for boys and 2.35 (±1.73) years for girls, the highest duration was seen for emotional abuse with 4.00 (±3.54) years for boys and 4.21 (±3.77) years for girls.</p></div><div><h3>Conclusions</h3><p>Our novel results provide important epidemiological information for prevention efforts.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for severe disease in pediatric respiratory syncytial virus infections","authors":"","doi":"10.1016/j.puhe.2024.06.023","DOIUrl":"10.1016/j.puhe.2024.06.023","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess factors associated with the risk of severe disease in children aged 5 years or younger with laboratory-confirmed respiratory syncytial virus (RSV) infection.</p></div><div><h3>Study design</h3><p>We conducted a nationwide retrospective cohort study in Mexico.</p></div><div><h3>Methods</h3><p>Eligible participants included children aged 5 years or younger with laboratory-confirmed RSV infection January 1, 2023, and May 15, 2024. We collected relevant clinical and epidemiological data. Risk ratios (RR) and 95% confidence intervals (CI) were employed to identify factors associated with the risk of severe disease, characterized by clinical and radiographic evidence of bronchiolitis or pneumonia requiring hospital admission.</p></div><div><h3>Results</h3><p>Data from 2022 children were analyzed and the overall risk of severe disease was 21.0% (<em>n</em> = 424/2022). In multiple generalized linear regression analysis, a personal history of immunosuppression (due to any cause) showed a protective effect (RR = 0.14, 95% CI 0.05–0.42, <span><math><mrow><mi>P</mi></mrow></math></span> = 0.001) against severe RSV disease, while an increased risk was documented for each additional day elapsed between the date of symptom onset and the date of seeking healthcare RR = 1.06, 95% CI 1.02–1.10, <span><math><mrow><mi>P</mi></mrow></math></span> = 0.004).</p></div><div><h3>Conclusion</h3><p>These findings provide insights into risk stratification and suggest specific directions for future research. This information informs the development of targeted intervention strategies to mitigate the impact of RSV infections in this vulnerable population.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}