Journal of epidemiology and population health最新文献

Background: The French healthcare system has been affected by the COVID-19 pandemic in 2020, including cancer care.

Methods: In order to evaluate the impact of this pandemic on cancer incidence, the Isere Departmental Cancer Registry compared the actual 2020 incidence of melanoma, breast, colorectal, prostate and lung cancers with the expected 2020 incidence based on data collected by the Registry between 2015 and 2019, taking into account periods of lockdown and reopening. When available, cancer stages and/or prognostic scores were recorded.

Results: During the period of initial confinement, a 54%, 50% and 36,8% drop in incidence was observed for breast, prostate and colorectal cancer respectively. Although their annual incidence remained stable, a worsening trend emerged as a decline in the number of low stages/scores at diagnosis in favour of higher stages/scores towards the end of 2020. In contrast, a significant 17,8% drop was observed in annual incidence of melanoma, particularly for Breslow scores < 1 (-27,4%). However, this trend was noticeable before the lockdown, as well as the 14% reduction in the incidence of lung cancer in women, but not in men.

Conclusion: The incidence of certain cancers was caught up over the year but the COVID-19 pandemic seems to be associated with a change in their severity at diagnosis throughout 2020. The downward trends in female lung cancer and melanoma incidence point to complex underlying phenomena. Further analysis is still needed to assess the global impact of the COVID-19 pandemic on cancer incidence.

Objectives: Research on psychological distress in African students is scarce. This study aimed at exploring the epidemiology (prevalence and correlates) of depressive symptoms among undergraduate health sciences students at the University of Parakou (Benin).

Methods: We conducted a cross-sectional survey from June to July 2022 at the University of Parakou, the second-largest university in the Republic of Benin. Depressive symptoms were assessed using the Patient Health Questionnaire depression scale (PHQ-9). Information on several independent factors was collected and their associations with depressive symptoms were investigated using logistic regression models.

Results: Data from 560 students were analyzed (mean age: 21.3± 2.3 years, 60 % were male, and 50.4 % were registered in the first year of study). The overall prevalence of depressive symptoms was 39.1 % [95 % CI: 35.2 %-43.1 %]. Moderate and severe depressive symptoms were observed in 15.3 % and 1.8 % of participants, respectively. In the multivariable model, being aged 21-23 (adjusted Odds Ratio=1.8, p-value: 0.007), a female (aOR=1.5, p-value: 0.050), a medical student (aOR=2.9, p-value: <0.001), a public health student (aOR=3.6, p-value: <0.001), belonging to households with higher incomes (aOR= 2.4, p<0.001), and experiencing stress (aOR=1.5, p-value: 0.048) independently increased the probability of having depressive symptoms. However, having support from close relatives (aOR= 0.5, p-value: 0.026) was associated with a lower probability of depressive symptoms.

Conclusions: Our findings revealed a high prevalence of depressive symptoms among undergraduate health science students. Given the correlates identified, actions to promote coping skills in stress and encourage more parental support may be real avenues likely to help reduce the frequency and consequences of depressive symptoms.

Background: Armed conflict in the eastern Democratic Republic of Congo (DRC) has significantly increased the incidence of sexual violence against women. Victims who manage to access health care within 72 h of experiencing rape can receive critical preventive care to mitigate the consequences of such violence. Despite this, a disproportionately small number of victims are able to obtain medical care within this crucial time frame. This study aimed to identify both individual and contextual factors that influence the likelihood of accessing post-rape care within 72 h in the eastern DRC.

Methods: This retrospective cohort study utilized patient records from Panzi Hospital along with contextual data provided by the South Kivu Provincial Ministry of Health. It encompassed rape victims residing in South Kivu province who sought post-rape care between 2014 and 2019. To identify individual and contextual factors influencing timely access to care (within 72 h), multilevel logistic regression analysis was employed.

Results: The study included a total of 4,048 women, with 30 % being under 18 years old and 40 % married. Around 13 % accessed care within 72 h of rape. Multivariate analysis revealed that timely access to care (within 72 h) was negatively influenced by factors such as the isolation of the victim's health zone of residence (aOR = 0.29 [0.14-0.63], p = 0.002), the distance between the home health zone and the hospital (aOR = 0.75 [0.54-0.99], p = 0.041), instances of rape occurring in 2015 or earlier (aOR = 0.44 [0.34-0.57], p < 0.001), and referrals to the hospital from other health facilities or organizations (aOR = 0.78 [0.61-1.00], p = 0.049). Conversely, being single was positively associated with access to care within this critical period (aOR = 1.29 [1.03-1.61], p = 0.024). Furthermore, statistical trends indicate that the presence of Panzi partner NGOs in the victim's health zone might facilitate access to care (aOR = 1.33 [0.99-1.80], p = 0.057), highlighting an area of interest, while being internally displaced at the time of rape was associated with a trend towards reduced access to care (aOR = 0.78 [0.59-1.02], p = 0.068), underscoring the need for further research and targeted interventions.

Conclusion: To enhance access to post-rape care, our study highlights the need for strengthened collaboration with all partnering organizations and focused efforts on raising awareness, particularly among married women and their husbands. Enhancing security measures, constructing or upgrading roads to better connect major cities with currently inaccessible or isolated areas, bolstering the efforts of both local and international NGOs, and offering comprehensive reproductive health services to internally displaced women and those residing in the victims' health zones, are crucial steps toward ensuring access to post-rape care within the critical 72-hour window.

Objective: This systematic review aimed to identify ICD-10 based validated algorithms for chronic conditions using health administrative data.

Methods: A comprehensive systematic literature search using Ovid MEDLINE, Embase, PsycINFO, Web of Science and CINAHL was performed to identify studies, published between 1983 and May 2023, on validated algorithms for chronic conditions using administrative health data. Two reviewers independently screened titles and abstracts and reviewed full text of selected studies to complete data extraction. A third reviewer resolved conflicts arising at the screening or study selection stages. The primary outcome was validated studies of ICD-10 based algorithms with both sensitivity and PPV of ≥70 %. Studies with either sensitivity or PPV <70 % were included as secondary outcomes.

Results: Overall, the search identified 1686 studies of which 54 met the inclusion criteria. Combining a previously published literature search, a total of 61 studies were included for data extraction. The study identified 40 chronic conditions with high validity and 22 conditions with moderate validity. The validated algorithms were based on administrative data from different countries including Canada, USA, Australia, Japan, France, South Korea, and Taiwan. The algorithms identified included several types of cancers, cardiovascular conditions, kidney diseases, gastrointestinal disorders, and peripheral vascular diseases, amongst others.

Conclusion: With ICD-10 prominently used across the world, this up-to-date systematic review can prove to be a helpful resource for research and surveillance initiatives using administrative health data for identifying chronic conditions.

Introduction: Rapid reviews (RRs) offer a less rigorous and methodical approach to the process of reviewing literature in comparison to systematic reviews (SRs), which are currently a gold standard.

Materials and methods: Three different, expedited strategies of the review process were designed in the different scopes, already reviewed in Cochrane's SRs. Then, the results of our literature searches and the study selection process were compared to the ones from SRs. The final step was assessing the impact of losing some studies on the final results of meta-analyses.

Results: In RR₁, the initial number of references to be reviewed was reduced by half, and the inclusion list was recreated with 84% efficiency. Three out of 19 studies were missed, all having high risk of bias. Studies missed in RR₁ were included in Cochrane's meta-analyses for 23 separate outcomes, and their lack impacted significantly the final results, or the possibility to run meta-analyses, in four cases. In RR₂, 89% of trials included in the SR were captured (24/27); missing the three studies did not impact the final results of the meta-analyses. In RR₃, the list of included studies overlapped completely with Cochrane's, despite a significantly lower workload.

Conclusions: A prompt and cost-effective methodology may lead to the identification of pertinent evidence in support of healthcare policy; however, it is essential to conscientiously account for potential biases in the analysis.

Background: The present study aimed to investigate the association between COVID-19 and the cumulative incidence of depression and the potential role of sick leave in a large representative sample of German adults.

Methods: This retrospective cohort study was based on the Disease Analyzer database (IQVIA) data. This study included individuals aged ≥16 years with a COVID-19 diagnosis in 1284 general practices in Germany between March 2020 and December 2021, and the propensity score matched cohort without COVID-19. Univariable Cox regression analysis assessed the association between COVID-19 and depression.

Results: The present study included 61,736 individuals with and 61,736 without COVID-19 (mean age 46.1 years; 49 % women). Patients visited their physicians about 4.3 times per year during the follow-up period. About 25.5 % of patients were diagnosed with COVID-19 in 2020 and 74.5 % in 2021. In this representative sample of German adults, COVID-19 infection was associated with a higher cumulative incidence of depression, and this cumulative incidence was greater in women than men. As compared with non-COVID-19, COVID-19 with ≤2 weeks sick leave duration was associated with 17 % higher depression risk (HR: 1.17; 95 % CI: 1.09-2.16), COVID-19 with >2-4 weeks sick leave duration with 37 % higher depression risk (HR: 1.37; 95 % CI: 1.11-1.69), and COVID-19 with >4 weeks sick leave duration with 2 times higher depression risk (HR: 2.00; 95 % CI: 1.45-2.76).

Conclusion: COVID-19 sick leave was positively associated with a risk for depression, and the longer the duration of sick leave, the higher the cumulative incidence of depression.