Epidemiologic Reviews最新文献

People with disability experience health inequities and mostly live in low- and middle-income countries (LMIC), as this is where most of the world's population resides. Despite this, existing evidence on health equity for people with disability mostly comes from high-income settings. Monitoring and evaluation of health equity is crucial for countries to address and track progress towards goals, such as the highest attainable standard of health for people with disability. This scoping review aimed to summarise the available literature on approaches and indicators used in LMIC to compare health-related outcomes between people with and without disability. We included peer-reviewed articles published between 2008 and 2024 that compared health-related outcomes between people with and without disability. We identified 59 eligible studies, from a broad range of LMIC. Disability indicators varied, with most studies using one of multiple Washington Group (WG) sets to enable disaggregation of data by disability status. Survey data was most frequently used, with only two studies using administrative data. A wide range of health-related outcomes were explored, with themes of maternal and child health, and human immunodeficiency virus (HIV)-related outcomes emerging as key areas of focus. Disparities were consistently found, with almost all included studies finding poorer outcomes for people with compared to people without disability. There was a noticeable lack of action taken to improve future policy or monitoring and evaluation or to enact real and meaningful change in health equity for people with disability.

HPV-induced oropharyngeal cancer (HPV-OPC), caused by persistent infection with high-risk types such as HPV16 and HPV18, poses a significant global health challenge. Its epidemiological research focuses on prevention, detection, distribution, and disease incidence, revealing an increasing OPC burden related to HPV exposure. This study aims to identify research hotspots and trends in HPV-OPC epidemiology, highlighting the role of epidemiology in guiding prevention and control strategies. A bibliometric analysis of 960 articles (1987-2025) from WOSCC, SCOPUS, and PMC was performed, using Python to assess collaborations across countries, institutions, and individuals, as well as literature citation, research timelines, and clustering. Results show a substantial rise in publications, especially from 2013 to 2025, with the US and China as leading contributors and notable work from researchers like Sturgis Erich M and Li Guojun. Research primarily focuses on HPV vaccination, screening, attributable fraction, and incidence prediction, though challenges such as data quality, vaccination efficacy, limited resource, and modeling limitations. Future directions include improving data reliability, promoting early and direct vaccination, strengthening international funding, and integrating multiple models. This bibliometric study provides valuable insights into research hotspots and future directions in HPV-OPC, offering researchers and clinicians an overview of current situations and future developments in HPV-OPC epidemiology, potentially improving HPV vaccination and screening strategies and promoting preventive and diagnostic approaches to reduce OPC incidence.

Loneliness and social isolation are emerging public health concerns among young adults, yet the role of community and societal factors remains poorly understood. Existing research has predominantly focused on individual or interpersonal determinants. This systematic review synthesised observational evidence on community- and societal-level factors associated with loneliness and social isolation among young adults aged 18-30 years. Five databases were searched for observational studies examining place-based community or societal exposures and loneliness or social isolation outcomes. Thirteen eligible studies were identified, and a structured narrative synthesis was undertaken. The exposure variables explored were diverse. Neighbourhood characteristics (including trust, safety, and atmosphere), community participation, cultural and societal norms, and structural conditions demonstrated consistent associations with loneliness. Higher neighbourhood cohesion, safety and belonging were protective, whereas neighbourhood disorder, minority status, perceived discrimination and individualistic cultural orientations were associated with greater loneliness. Evidence for social isolation was sparse and methodologically heterogeneous, though area-level disadvantage and remoteness showed emerging relevance. Most studies were cross-sectional in design, and the way that loneliness and social isolation were measured across studies was heterogenous. Community and societal determinants meaningfully shape young adults' experiences of loneliness, but evidence for social isolation remains limited. Findings highlight the need for longitudinal research, improved consistency in the use of measurement tools, further examination of moderators between individual factors and community influences, which will all contribute to the development of multi-level public health strategies addressing structural and neighbourhood conditions.

Persistent inequities in the social determinants of health contribute to poor health outcomes among people with disability. People with disability are more likely to live in unaffordable housing, which is associated with increased risk of chronic conditions and poor mental health. However, there is limited research on how housing affordability impacts health in this priority population. We undertook a scoping review to evaluate existing evidence on the health impacts of living in unaffordable housing for people with disability. Peer-reviewed literature published in English between 2004 and 2024 was considered. MEDLINE, SocIndex and Web of Science were searched to identify studies examining possible links between housing affordability and any health outcome, in a population of people with disability. Two independent reviewers performed study screening and data extraction. Of the 1386 studies identified initially, three met the eligibility criteria. The included studies focused on individuals with acquired, psychiatric, or military-related disability. Each study provided evidence suggesting that unaffordable housing negatively impacted mental health in people with disability. Substantial methodological and conceptual heterogeneity limited direct comparison or synthesis. This review highlights a critical knowledge gap in the relationship between housing affordability and health for people with disability, limiting the development of evidence-informed policy and intervention. People with disability have a fundamental right to access affordable, appropriate housing, as well as the right to the highest attainable standard of health. High-quality, targeted research using consistent definitions of disability and housing affordability, as well as validated health outcome measures, is needed to inform future policy.

Hepatitis E virus (HEV) infection can progress to chronic hepatitis in immunosuppressed individuals. The seroprevalence of hepatitis E among people living with human immunodeficiency virus (HIV) remains controversial. This systematic review and meta-analysis aimed to estimate the pooled global seroprevalence of hepatitis E among people living with HIV. This study followed the PRISMA guidelines and was registered in PROSPERO. Searches were conducted in PubMed, Embase, and Web of Science databases. The seroprevalence of hepatitis E (anti-HEV IgG) among people living with HIV was estimated by meta-analysis using the random-effects model. Subgroup meta-analyses were performed for each continent. A total of 88 studies from all continents were included, most originated from Europe (48.9%). The pooled seroprevalence of hepatitis E was 16.0% (95% CI: 13.0-18.0; I2 = 97.7%). Subgroup analyses revealed seroprevalence rates of 12.0% in Europe, 24.0% in Asia, 19.0% in Africa, and 11.0% in the Americas, and a notably high prevalence observed in low-income countries (37.0%). Sensitivity analyses restricted to studies with sample sizes >200 and risk of bias score ≥ 7 showed seroprevalence estimates of 18.0% and 15.0%, respectively. In conclusion, this meta-analysis demonstrates a pooled global seroprevalence of hepatitis E of 16.0% among people living with HIV, ranging from 11.0% to 24.0% across the continents.

Chronic pain is the leading cause of disability worldwide and chronic neuropathic pain (NP) disproportionately affects individuals with unmet healthcare needs, especially those facing health inequities. This scoping review addressed three research questions: (1) What are the characteristics and outcomes of cognitive behavioral therapy (CBT), mindfulness, and meditative-based intervention studies, designed to manage NP? (2) Are these intervention studies including participants from populations experiencing h2ealth inequities? (3) Are the interventions customized to meet the needs of people experiencing health inequities? Ten databases were searched for studies focused on the search terms cognitive behavioral therapy, CBT, mindfulness meditation, and neuropathic pain. In total, 1732 abstracts were screened and a total of 24 articles from 22 original studies were included. The primary characteristics of the studies showed that 99% of participants had NP attributable to diabetes, cancer, or spinal cord injury. Outcomes were consistent with previous reviews, demonstrating promise for CBT, mindfulness, and meditative-based therapies in relieving NP. However, demographics were poorly reported, and with little diversity among participants. Individuals from groups experiencing health inequities were largely unrepresented. While 55% of studies tailored intervention materials and provided content to support long-term practice, few included long-term follow-ups to evaluate sustained impact. In general, research on this topic has fallen short in including and addressing the needs of people experiencing health inequities. Future research should prioritize broader participant inclusion criteria, involve individuals with lived experience in intervention design and delivery, and conduct long-term follow-ups to enhance the accessibility, relevance, and sustainability of NP interventions.

High-density lipoprotein (HDL) is a highly heterogeneous lipoprotein with multiple physiological functions. However, observational studies present conflicting evidence regarding its association with various diseases. This review systematically summarizes evidence from Mendelian randomization (MR) studies to investigate the causal relationships between HDL-related biomarkers and a wide spectrum of disease outcomes. We systematically searched multiple databases up to November 2024. The causal relationship between HDL and 158 diseases was studied. Findings reveal that the role of HDL is highly disease-specific. Genetically predicted higher HDL levels are protective against most circulatory and digestive system diseases. Conversely, however, they are associated with an increased risk of certain conditions, including breast cancer, intracerebral hemorrhage, and age-related macular degeneration. The MR analyses revealed inconsistent and sometimes conflicting findings for several disease outcomes, notably Alzheimer's disease. This review underscores the context-dependent nature of HDL's effects, which may be driven by factors like HDL particle heterogeneity and functional transformation into a pro-inflammatory state. Future research should move beyond concentration-based metrics to focus on HDL functionality and precise subtyping to fully understand its role in disease etiology.

The large number of people infected by SARS-CoV-2 necessitates estimation of the future health care burdens. We updated a systematic review examining associations between SARS-CoV-2 infection and incidence of new diagnoses and exacerbations of chronic conditions. Updated searches were run September 4, 2024, in the MEDLINE and Embase databases for observational studies with a control group, adjustment by sex and comorbid conditions, and reporting age-stratified data for 1 or more chronic condition category (n = 12) or condition type (n = 46) of interest. Two human reviewers screened 50% of titles and abstracts, then DistillerAI acted as second reviewer. Two human reviewers assessed full texts of relevant studies for eligibility based on a priori criteria. One reviewer extracted data and assessed risk of bias using the JBI cohort studies checklist; a second reviewer verified results data and risk-of-bias assessments. Pooled hazard ratios (HRs) were estimated with inverse-variance weighting. Using the Grading of Recommendations, Assessment, Development, and Evaluation approach, 2 reviewers assessed certainty in conclusions of little to no association (ie, HR = 0.75-1.25), small to moderate association (ie, HR = 0.51-0.74 or 1.26-1.99), or large association (ie, HR ≤ 0.50 or ≥ 2.00). We identified 46 new studies and brought forward 23 studies from the original review. After SARS-CoV-2 infection, there is probably increased risk of new diagnoses for several chronic conditions, especially in adults. Most findings are based on data from earlier pandemic periods; their relevance to contemporary populations is uncertain due to differences in vaccination rates and circulating variants of concern. PROSPERO registration identifier CRD42024585278.

Hysterectomy is the most frequently performed nonobstetric surgery in women. Women with disabilities face barriers to reproductive health care, and little is known about their hysterectomy risk. The objective of this systematic review was to compare hysterectomy risk among women with and without disabilities. We searched the MEDLINE, Embase, PsycInfo, and CINAHL Plus databases from inception to May 2024 using validated search strategies. We included peer-reviewed observational studies that compared hysterectomy in women with physical, sensory, cognitive, and intellectual or developmental disabilities with those without disabilities. Study characteristics and data were extracted using a standardized form; the Newcastle-Ottawa Scale (NOS) was used for quality assessment. Study findings were summarized narratively following Synthesis Without Meta-analysis guidelines. The search yielded 3686 unique records, of which 5 met our criteria. These included 1 retrospective cohort and 4 cross-sectional studies, which were conducted in the United States (n = 3), Canada (n = 1), and South Korea (n = 1), and ranged in size from 881 to 42 842 participants. Evidence from 4 studies indicated hysterectomy frequency was higher among women with disabilities (range: 6.1% to 22.8%) compared with those without disabilities (range: 2.2% to 18.6%). Three studies suggested the disparity in hysterectomy was greatest among premenopausal women. Quality assessment scores on the NOS ranged from 0 to 8 (median, 3), with limitations mostly related to measurement of the exposure and outcome. The limited research on this topic points to the need for more studies on hysterectomy among women with disabilities, given historical reproductive injustices faced by this population.

Administrative data, including electronic health record (EHR) and claims data, are increasingly used to generate real-world evidence for epidemiologic research. Unlike clinical trials, which assess baseline conditions at the initial visit, observational studies using these data must define an appropriate lookback period to identify baseline characteristics. However, no established guidelines exist on the optimal length of lookback periods by clinical outcome. We conducted a scoping review, with a lens on methodological studies, to assess the frequency and variability of lookback periods used in epidemiologic studies. We searched PubMed for studies that employed lookback periods using EHR, claims data, or international registries. Our search yielded 262 studies spanning a broad range of clinical outcomes. We found that lookback periods varied significantly, ranging from 12 hours to 39 years, depending on the clinical outcome. The most common clinical areas included pharmacology, cardiovascular disease, cancer, and healthcare utilization. Our review underscores the need for tailored lookback periods based on the clinical context and suggests that a one-size-fits-all approach may be inadequate. Future research should focus on the impact of lookback periods on less-studied outcomes. This review provides a resource for researchers to make informed decisions on the appropriate lookback periods in epidemiologic studies utilizing administrative data.