Pub Date : 2024-08-30DOI: 10.1101/2024.08.29.24312816
K. Cusimano, P. Freeman, A. Pettican, A. J. Brinkley
Stemming from a complex picture of compositional, contextual and wider determinants, health inequalities are presented at the level in which people reside (i.e., their place). Examples of this exist within Essex, England, where despite seeming affluence, pockets of high multiple deprivation exist. Programmes delivered across the system representing each place may provide a solution to these complex challenges. For this reason, Epping Forest District Council commissioned the evaluation of a programme representing two place-based projects within their district (i.e., Limes Farm and Oakwood Hill). This paper provides the evaluation protocol for this programme. Broadly, the evaluation seeks to investigate the design, implementation, mechanisms and effectiveness of both projects. Our evaluation is underpinned by the Medical Research Council (MRC) guidelines for the design, evaluation and implementation for complex interventions, and takes inspiration from a realist approach. We aim to understand where each project works, who does the projects work for, what impact do the projects have, and how and why does the projects work. This will be achieved through a mixed-methods approach which utilises a cohort study, ripple-effects mapping, focus groups, and secondary data analysis. Quantitative data will be analysed using descriptive, general linear and multi- level models, while qualitative data will be understood using visualisation (ripple-effects maps) and reflexive thematic analysis. Data will be triangulated to create programme theory configurations, which explain the outcomes which stemming from the programme, and how these are shaped by mechanisms within a given context. We anticipate our novel and robust approach to contribute to policy surrounding the adoption and implementation of place-based approaches.
{"title":"Can Place-Based Modifications Make a Difference to Local Health Inequalities in Urban Essex: An Evaluation Protocol","authors":"K. Cusimano, P. Freeman, A. Pettican, A. J. Brinkley","doi":"10.1101/2024.08.29.24312816","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312816","url":null,"abstract":"Stemming from a complex picture of compositional, contextual and wider determinants, health inequalities are presented at the level in which people reside (i.e., their place). Examples of this exist within Essex, England, where despite seeming affluence, pockets of high multiple deprivation exist. Programmes delivered across the system representing each place may provide a solution to these complex challenges. For this reason, Epping Forest District Council commissioned the evaluation of a programme representing two place-based projects within their district (i.e., Limes Farm and Oakwood Hill). This paper provides the evaluation protocol for this programme. Broadly, the evaluation seeks to investigate the design, implementation, mechanisms and effectiveness of both projects. Our evaluation is underpinned by the Medical Research Council (MRC) guidelines for the design, evaluation and implementation for complex interventions, and takes inspiration from a realist approach. We aim to understand <em>where</em> each project works, <em>who</em> does the projects work for, <em>what</em> impact do the projects have, and <em>how</em> and <em>why</em> does the projects work. This will be achieved through a mixed-methods approach which utilises a cohort study, ripple-effects mapping, focus groups, and secondary data analysis. Quantitative data will be analysed using descriptive, general linear and multi- level models, while qualitative data will be understood using visualisation (ripple-effects maps) and reflexive thematic analysis. Data will be triangulated to create programme theory configurations, which explain the outcomes which stemming from the programme, and how these are shaped by mechanisms within a given context. We anticipate our novel and robust approach to contribute to policy surrounding the adoption and implementation of place-based approaches.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225041","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}
Pub Date : 2024-08-30DOI: 10.1101/2024.08.28.24312682
Khadijat Adeleye, Tosin Tomiwa, Yaa Adoma Kwapong, Ellen Boakye, Oluwalonimi Adebowale, Brenda Owusu, Ruth-Alma Turkson-Ocran, Yvonne Commodore-Mensah, Oluwabunmi Ogungbe
Background Cardiometabolic conditions are among the leading causes of maternal mortality in the US. The American Heart Association (AHA) Life’s Essential 8TM (LE8) provides an actionable summary measure for assessing cardiovascular health.
{"title":"Race and Ethnicity Disparities in the Life’s Essential 8 Ever-Pregnant Adults in the United States: The National Health and Nutrition Examination Survey 2011-2020","authors":"Khadijat Adeleye, Tosin Tomiwa, Yaa Adoma Kwapong, Ellen Boakye, Oluwalonimi Adebowale, Brenda Owusu, Ruth-Alma Turkson-Ocran, Yvonne Commodore-Mensah, Oluwabunmi Ogungbe","doi":"10.1101/2024.08.28.24312682","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312682","url":null,"abstract":"<strong>Background</strong> Cardiometabolic conditions are among the leading causes of maternal mortality in the US. The American Heart Association (AHA) <em>Life’s Essential 8</em><sup>TM</sup> (LE8) provides an actionable summary measure for assessing cardiovascular health.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193494","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}
Pub Date : 2024-08-30DOI: 10.1101/2024.08.29.24312788
Trang N. D. Pham, Long B. Hoang, Diem V. B Dao, Thao T. Dang, Van T. Nguyen, Duc H. Le, Thai N. Truong, Toan T. Le, Bao Q. Duong, Tram T. Trinh, Hang V. Dao, Doan Y Dao
Background Vietnam faces a significant burden of hepatitis B virus (HBV) with around 10% of the population living with HBV and up to 80% unaware of their infection status. This study implemented a strategy using point-of-care rapid testing (POC-RT) for early HBV detection and linkage to care in primary care settings. The EPIS frameworks guided implementation, assessing barriers, enablers, feasibility, and acceptability.
{"title":"Expanding Hepatitis B Screening with Point-of-Care Rapid Testing in Primary Care: An Implementation Science Study","authors":"Trang N. D. Pham, Long B. Hoang, Diem V. B Dao, Thao T. Dang, Van T. Nguyen, Duc H. Le, Thai N. Truong, Toan T. Le, Bao Q. Duong, Tram T. Trinh, Hang V. Dao, Doan Y Dao","doi":"10.1101/2024.08.29.24312788","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312788","url":null,"abstract":"<strong>Background</strong> Vietnam faces a significant burden of hepatitis B virus (HBV) with around 10% of the population living with HBV and up to 80% unaware of their infection status. This study implemented a strategy using point-of-care rapid testing (POC-RT) for early HBV detection and linkage to care in primary care settings. The EPIS frameworks guided implementation, assessing barriers, enablers, feasibility, and acceptability.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193496","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}
Pub Date : 2024-08-29DOI: 10.1101/2024.08.29.24312773
Moses Mkosha, Brown Ngenda, Mukumbuta Nawa
Introduction Indoor Residual Spraying (IRS) is a crucial intervention for malaria control, yet its acceptability in urban areas remains understudied, particularly in Luwingu District, Zambia. This research aimed to estimate acceptance of IRS and identify the factors associated with its acceptability in an urban setting of this area that has holoendemic transmission of malaria.
{"title":"Factors Associated with Acceptance of Indoor Residual Spraying (IRS) among Residents of Luwingu District, Northern Province of Zambia","authors":"Moses Mkosha, Brown Ngenda, Mukumbuta Nawa","doi":"10.1101/2024.08.29.24312773","DOIUrl":"https://doi.org/10.1101/2024.08.29.24312773","url":null,"abstract":"<strong>Introduction</strong> Indoor Residual Spraying (IRS) is a crucial intervention for malaria control, yet its acceptability in urban areas remains understudied, particularly in Luwingu District, Zambia. This research aimed to estimate acceptance of IRS and identify the factors associated with its acceptability in an urban setting of this area that has holoendemic transmission of malaria.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193499","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}
Pub Date : 2024-08-29DOI: 10.1101/2024.08.28.24312750
Ayed A. Shati, Hasan S. Alamri, Abdulaziz M. Al-Garni, Syed E. Mahmood, Awad S. Alsamghan
Background Healthcare providers can use these virtual platforms for delivering medical advice and prescriptions of medications to patients. This study was aimed to explore the patient’s experiences and level of satisfaction regarding virtual health care received during the COVID-19 pandemic. This study also assessed the before and during lockdown sleep quality in these participants.
{"title":"Patients’ Experience and Satisfaction towards Virtual Health Care during the COVID-19 Pandemic in Southern Region of Saudi Arabia","authors":"Ayed A. Shati, Hasan S. Alamri, Abdulaziz M. Al-Garni, Syed E. Mahmood, Awad S. Alsamghan","doi":"10.1101/2024.08.28.24312750","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312750","url":null,"abstract":"<strong>Background</strong> Healthcare providers can use these virtual platforms for delivering medical advice and prescriptions of medications to patients. This study was aimed to explore the patient’s experiences and level of satisfaction regarding virtual health care received during the COVID-19 pandemic. This study also assessed the before and during lockdown sleep quality in these participants.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193497","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}
Pub Date : 2024-08-28DOI: 10.1101/2024.08.28.24312702
Christine Wagenlechner, Ralph Wendt, Berthold Reichardt, Michael Mildner, Julia Mascherbauer, Clemens Aigner, Johann Auer, Hendrik Jan Ankersmit, Alexandra Graf
Background: Recent literature gives different results on morbidity and mortality after COVID-19 as compared to Influenza hospitalized children and results of large, population based studies are scant. In this population-based study in Austria, we evaluated and compared the short- and long-term outcomes after COVID-19 or Influenza hospitalization and associations with their baseline drug profile. Methods: Individual data were provided on children ≤ 18 years hospitalized with COVID-19 in the years 2020 and 2021 or Influenza in 2016 to 2021 as well as on age-, sex- and region-matched controls from the Austrian Health Insurance Funds. The primary outcome was time to hospital discharge. Secondary outcomes were in-hospital death, all-cause mortality and readmission to hospital due to any reason. The median follow-up time was 430 days (IQR: 245-552) in the COVID-19 and 1221 days (IQR: 881-1599) in the Influenza group. Results: 1063 children were hospitalized due to COVID-19 and 2781 children due to Influenza in the study period. Children hospitalized due to COVID-19 or Influenza were more likely to have a larger disease burden as compared to the general population. Influenza hospitalized patients were observed to be generally younger and a larger percentage of polypharmacy than those with COVID-19. No significant difference in the time to hospital discharge was found between cohorts (HR: 1.22 [95%-CI: 0.97-1.55], p=0.093). The risk for readmission was significantly higher for Influenza (HR: 1.23 [95%-CI: 1.03-1.47], p=0.021). In-hospital mortality (0.94% vs. 0.22%, p=0.004) and long-term mortality (p=0.009) was significantly larger in COVID-19 patients. One-year mortality after hospitalization was estimated with 1.13% (CI: 0.49-1.77) in the COVID and 0.32% (CI: 0.11-0.53) in the Influenza group. Conclusion: A general picture of COVID-19 being a milder disease compared to Influenza may not be drawn. No significant difference for time to hospital discharge was observed between cohorts but the risk of readmission was significantly larger in the Influenza group. Death rates of COVID-19 hospitalized children seem to be higher, however, the low number of severe events may limit the findings.
{"title":"Short- and Long-term Outcomes of children hospitalized with COVID-19 or Influenza: results of the AUTCOV study","authors":"Christine Wagenlechner, Ralph Wendt, Berthold Reichardt, Michael Mildner, Julia Mascherbauer, Clemens Aigner, Johann Auer, Hendrik Jan Ankersmit, Alexandra Graf","doi":"10.1101/2024.08.28.24312702","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312702","url":null,"abstract":"Background:\u0000Recent literature gives different results on morbidity and mortality after COVID-19 as compared to Influenza hospitalized children and results of large, population based studies are scant. In this population-based study in Austria, we evaluated and compared the short- and long-term outcomes after COVID-19 or Influenza hospitalization and associations with their baseline drug profile.\u0000Methods:\u0000Individual data were provided on children ≤ 18 years hospitalized with COVID-19 in the years 2020 and 2021 or Influenza in 2016 to 2021 as well as on age-, sex- and region-matched controls from the Austrian Health Insurance Funds. The primary outcome was time to hospital discharge. Secondary outcomes were in-hospital death, all-cause mortality and readmission to hospital due to any reason. The median follow-up time was 430 days (IQR: 245-552) in the COVID-19 and 1221 days (IQR: 881-1599) in the Influenza group. Results:\u00001063 children were hospitalized due to COVID-19 and 2781 children due to Influenza in the study period. Children hospitalized due to COVID-19 or Influenza were more likely to have a larger disease burden as compared to the general population. Influenza hospitalized patients were observed to be generally younger and a larger percentage of polypharmacy than those with COVID-19. No significant difference in the time to hospital discharge was found between cohorts (HR: 1.22 [95%-CI: 0.97-1.55], p=0.093). The risk for readmission was significantly higher for Influenza (HR: 1.23 [95%-CI: 1.03-1.47], p=0.021). In-hospital mortality (0.94% vs. 0.22%, p=0.004) and long-term mortality (p=0.009) was significantly larger in COVID-19 patients. One-year mortality after hospitalization was estimated with 1.13% (CI: 0.49-1.77) in the COVID and 0.32% (CI: 0.11-0.53) in the Influenza group. Conclusion:\u0000A general picture of COVID-19 being a milder disease compared to Influenza may not be drawn. No significant difference for time to hospital discharge was observed between cohorts but the risk of readmission was significantly larger in the Influenza group. Death rates of COVID-19 hospitalized children seem to be higher, however, the low number of severe events may limit the findings.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193498","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}
Pub Date : 2024-08-28DOI: 10.1101/2024.08.28.24312721
Mercedes Sobers, Vajini Atukorale, Dane Mauer-Vakil, Kainat Bashir, Mariame O Ouedraogo, Christoffer Dharma, Anushka Ataullahjan, Shaza A Fadel, Sara Allin
Objectives: This study examined how six Canadian provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebec) adapted guidelines from the National Advisory Committee on Immunization to prioritize COVID-19 vaccines equitably for five key populations at high risk: Black communities; First Nations, Inuit, and Métis populations; non-medical essential workers; individuals experiencing homelessness; and individuals with disabilities. The objective was to compare timelines, justifications, and contextual factors that influenced provincial prioritization for early vaccine access. Methods: A mixed-methods approach was used to investigate how provinces operationalized equity in their vaccine rollout plans. Environmental scans (December 2020 – May 2021) gathered data on prioritization and distribution from provincial reports and media articles. Key informant interviews (December 2021 – April 2022) with provincial experts provided context on decision-making and justifications for prioritizing key populations. Data analysis employed the “Reach” component of the RE-AIM framework, with qualitative analysis of interviews following an interpretive descriptive approach. Results: Provinces used age-, risk-, and health status-based approaches to select priority populations. While all provinces consulted the National Advisory Committee on Immunization guidelines and various ethical frameworks to guide their decisions, deviations occurred due to local contexts. First Nations, Inuit, and Métis populations were prioritized earliest in all provinces, while Black communities received the least prioritization. Key subgroups, such as urban First Nations, Inuit, and Métis, unsheltered homeless individuals, and homebound disabled persons, were often overlooked. Factors that emerged as key drivers of priority population selection were data availability, population size, and geography. Conclusions: This study fills gaps in the literature by highlighting key contextual factors unique to each province that drove provincial justifications for their prioritization decisions. We provide several examples of the importance of data availability and early community-led partnerships when designing a successful mass vaccination rollout.
{"title":"An Equity-Focused Comprehensive Analysis of COVID-19 Vaccine Rollout and Prioritization Strategies Across Six Canadian Provinces: Addressing the Needs of Vulnerable and High-Risk Populations","authors":"Mercedes Sobers, Vajini Atukorale, Dane Mauer-Vakil, Kainat Bashir, Mariame O Ouedraogo, Christoffer Dharma, Anushka Ataullahjan, Shaza A Fadel, Sara Allin","doi":"10.1101/2024.08.28.24312721","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312721","url":null,"abstract":"Objectives: This study examined how six Canadian provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebec) adapted guidelines from the National Advisory Committee on Immunization to prioritize COVID-19 vaccines equitably for five key populations at high risk: Black communities; First Nations, Inuit, and Métis populations; non-medical essential workers; individuals experiencing homelessness; and individuals with disabilities. The objective was to compare timelines, justifications, and contextual factors that influenced provincial prioritization for early vaccine access. Methods: A mixed-methods approach was used to investigate how provinces operationalized equity in their vaccine rollout plans. Environmental scans (December 2020 – May 2021) gathered data on prioritization and distribution from provincial reports and media articles. Key informant interviews (December 2021 – April 2022) with provincial experts provided context on decision-making and justifications for prioritizing key populations. Data analysis employed the “Reach” component of the RE-AIM framework, with qualitative analysis of interviews following an interpretive descriptive approach. Results: Provinces used age-, risk-, and health status-based approaches to select priority populations. While all provinces consulted the National Advisory Committee on Immunization guidelines and various ethical frameworks to guide their decisions, deviations occurred due to local contexts. First Nations, Inuit, and Métis populations were prioritized earliest in all provinces, while Black communities received the least prioritization. Key subgroups, such as urban First Nations, Inuit, and Métis, unsheltered homeless individuals, and homebound disabled persons, were often overlooked. Factors that emerged as key drivers of priority population selection were data availability, population size, and geography. Conclusions: This study fills gaps in the literature by highlighting key contextual factors unique to each province that drove provincial justifications for their prioritization decisions. We provide several examples of the importance of data availability and early community-led partnerships when designing a successful mass vaccination rollout.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227678","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}
Pub Date : 2024-08-28DOI: 10.1101/2024.08.28.24312714
Raja Singh, Rima Dada, Arthur L Frank
There has been a steep increase in incidence of complex life style diseases. An unhealthy diet, alcohol consumption, tobacco consumption and high stress levels are major contributory factors. While action may be directed at dealing with all these points by various mechanisms, the issue of resolving unhealthy diets in schools, and the compliance of its related legal framework is discussed in this paper. In 2020, the Indian food regulatory organisation passed a regulation assuring school children are provided food that meets the standards of safety and a balanced diet. To this end, there has been consideration making sure foods with high trans/saturated fat and with added sodium and sugar do not form part of the diet of school children. All exposures to such foods, direct or indirect, have been prohibited and schools have been made accountable together with other local agencies. To understand compliance with this regulation, information from 49 public-run schools in a district of India's capital New Delhi were collected and reported. The implementation and compliance status in these schools has been dismal with 24% being, for example, the maximum compliance for a single factor related to implementation of Eat Right Campus campaign and similar or lower levels of compliance for other factors related to advertisement of unhealthy foods. The status of implementation and compliance of the food regulations for schools can inform policy and future actions required in this area. The creation of laws regarding regulation of schools must be followed by thorough implementation in order to deal with issues of rising global childhood obesity and other clinical manifestations (in the form of other lifestyle diseases) of unhealthy diets among children now and during adulthood.
{"title":"Study of Compliance of Law on Healthy and Balanced Diets by Schools in a District of New Delhi, India","authors":"Raja Singh, Rima Dada, Arthur L Frank","doi":"10.1101/2024.08.28.24312714","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312714","url":null,"abstract":"There has been a steep increase in incidence of complex life style diseases. An unhealthy diet, alcohol consumption, tobacco consumption and high stress levels are major contributory factors. While action may be directed at dealing with all these points by various mechanisms, the issue of resolving unhealthy diets in schools, and the compliance of its related legal framework is discussed in this paper. In 2020, the Indian food regulatory organisation passed a regulation assuring school children are provided food that meets the standards of safety and a balanced diet. To this end, there has been consideration making sure foods with high trans/saturated fat and with added sodium and sugar do not form part of the diet of school children. All exposures to such foods, direct or indirect, have been prohibited and schools have been made accountable together with other local agencies. To understand compliance with this regulation, information from 49 public-run schools in a district of India's capital New Delhi were collected and reported. The implementation and compliance status in these schools has been dismal with 24% being, for example, the maximum compliance for a single factor related to implementation of Eat Right Campus campaign and similar or lower levels of compliance for other factors related to advertisement of unhealthy foods. The status of implementation and compliance of the food regulations for schools can inform policy and future actions required in this area. The creation of laws regarding regulation of schools must be followed by thorough implementation in order to deal with issues of rising global childhood obesity and other clinical manifestations (in the form of other lifestyle diseases) of unhealthy diets among children now and during adulthood.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193517","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}
Pub Date : 2024-08-26DOI: 10.1101/2024.08.26.24303680
Sen Claudine Henriette Ngomtcho, Blaise Mboringong Akenji, Roland Ndip, Andrew S Azman, Yanick Carolle Tayimetha, Etienne Guenou, Sylvain Engamba, Marie Claire Assoumou Okomo, Justin Lessler, Shirlee Wohl
Seventh pandemic Vibrio cholerae was first identified in Cameroon in 1971, causing several sporadic disease clusters with few cases. More recent years have seen larger cholera outbreaks, but the mechanism behind these periodic outbreaks is poorly understood, and it is unclear the degree to which antibiotic resistant strains contribute to disease burden and spread. We used whole genome sequencing to characterize 14 V. cholerae isolates from the 2020 and 2021-2023 cholera epidemics in Cameroon. All these isolates belonged to the T12 lineage, and most showed the same antimicrobial resistance (AMR) pattern regardless of year. This suggests that cholera outbreaks in Cameroon are, at least in part, a continuation of the outbreaks previously reported in 2018 and as far back as 2012. This finding has important implications for cholera management since it suggests the ongoing presence of pathogenic cholera even in years with few reported cases. Similarly, the AMR results suggest the need for new treatment approaches, as resistance to many common antibiotics was found even within our limited sample set. As such, whole genome sequencing should be implemented in low-income countries such as Cameroon to improve disease surveillance and to detect and predict pathogen antibiotic resistance profiles.
{"title":"Continued T12 transmission and shared antibiotic resistance during 2018-2023 Vibrio cholerae outbreaks in Cameroon","authors":"Sen Claudine Henriette Ngomtcho, Blaise Mboringong Akenji, Roland Ndip, Andrew S Azman, Yanick Carolle Tayimetha, Etienne Guenou, Sylvain Engamba, Marie Claire Assoumou Okomo, Justin Lessler, Shirlee Wohl","doi":"10.1101/2024.08.26.24303680","DOIUrl":"https://doi.org/10.1101/2024.08.26.24303680","url":null,"abstract":"Seventh pandemic Vibrio cholerae was first identified in Cameroon in 1971, causing several sporadic disease clusters with few cases. More recent years have seen larger cholera outbreaks, but the mechanism behind these periodic outbreaks is poorly understood, and it is unclear the degree to which antibiotic resistant strains contribute to disease burden and spread. We used whole genome sequencing to characterize 14 V. cholerae isolates from the 2020 and 2021-2023 cholera epidemics in Cameroon. All these isolates belonged to the T12 lineage, and most showed the same antimicrobial resistance (AMR) pattern regardless of year. This suggests that cholera outbreaks in Cameroon are, at least in part, a continuation of the outbreaks previously reported in 2018 and as far back as 2012. This finding has important implications for cholera management since it suggests the ongoing presence of pathogenic cholera even in years with few reported cases. Similarly, the AMR results suggest the need for new treatment approaches, as resistance to many common antibiotics was found even within our limited sample set. As such, whole genome sequencing should be implemented in low-income countries such as Cameroon to improve disease surveillance and to detect and predict pathogen antibiotic resistance profiles.","PeriodicalId":501276,"journal":{"name":"medRxiv - Public and Global Health","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224881","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}
Pub Date : 2024-08-26DOI: 10.1101/2024.08.26.24312234
Marina Watowich, Audrey M Arner, Selina Wang, Echwa John, John C Kahumbu, Patricia Kinyua, Anjelina Lopurudoi, Francis Lotukoi, Charles M Mwai, Benjamin Muhoya, Boniface Mukoma, Kar Lye Tam Tam, Tan Bee Ting A/P Tan Boon Huat, Michael Gurven, Yvonne AL Lim, Dino Martins, Sospeter Njeru, Ng Kee Seong, Vivek V Venkataraman, Ian J Wallace, Julien F Ayroles, Thomas S Kraft, Amanda J Lea
Background: Many subsistence-level and Indigenous societies around the world are rapidly experiencing urbanization, nutrition transition, and integration into market-economies, resulting in marked increases in cardiometabolic diseases. Determining the most potent and generalized drivers of changing health is essential for identifying vulnerable communities and creating effective policies to combat increased chronic disease risk across socio-environmental contexts. However, comparative tests of how different lifestyle features affect the health of populations undergoing lifestyle transitions remain rare, and require comparable, integrated anthropological and health data collected in diverse contexts. Methods: We developed nine scales to quantify different facets of lifestyle (e.g., urban infrastructure, market-integration, acculturation) in two Indigenous, transitioning subsistence populations currently undergoing rapid change in very different ecological and sociopolitical contexts: Turkana pastoralists of northwest Kenya (n = 3,692) and Orang Asli mixed subsistence groups of Peninsular Malaysia (n = 688). We tested the extent to which these lifestyle scales predicted 16 measures of cardiometabolic health and compared the generalizability of each scale across the two populations. We used factor analysis to decompose comprehensive lifestyle data into salient axes without supervision, sensitivity analyses to understand which components of the multidimensional scales were most important, and sex-stratified analyses to understand how facets of lifestyle variation differentially impacted cardiometabolic health among males and females. Findings: Cardiometabolic health was best predicted by measures that quantified urban infrastructure and market-derived material wealth compared to metrics encompassing diet, mobility, or acculturation, and these results were highly consistent across both populations and sexes. Factor analysis results were also highly consistent between the Turkana and Orang Asli and revealed that lifestyle variation decomposes into two distinct axes-the built environment and diet-which change at different paces and have different relationships with health. Interpretation: Our analysis of comparable data from Indigenous peoples in East Africa and Southeast Asia revealed a surprising amount of generalizability: in both contexts, measures of local infrastructure and built environment are consistently more predictive of cardiometabolic health than other facets of lifestyle that are seemingly more proximate to health, such as diet. We hypothesize that this is because the built environment impacts unmeasured proximate drivers like physical activity, increased stress, and broader access to market goods, and serves as a proxy for the duration of time that communities have been market-integrated.
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