Frontiers in epidemiology最新文献

Introduction: We investigate the relationship between bias, that is, cognitive distortions about the severity of infectious disease and social well-being.

Materials and methods: First, we establish empirically the existence of bias and analyze some of its causes; specifically, during the COVID-19 pandemic. Second, we derive an integrated economic-epidemiological differential equation model from an agent-based model that combines myopic rational choice with infectious disease dynamics. Third, we characterize axiomatically a model of an ethical, impartial, eudaemonistic and individualist observer. We prove that such an observer evaluates the state of society (social welfare or social well-being) according to the utilitarian principle.

Results: We show numerically that while increased risk-perception indeed improves epidemiological outcomes such as peak of infections and total incidence, the impact on social well-being is ambiguous.

Discussion: This result urges to look beyond cases and deaths. We also discuss problematic aspects of the simplified utilitarian principle.

Conclusion: Finally, we point out three possible future research directions and highlight some critical issues that arise in the normative direction.

Introduction: Leishmaniasis is a highly prevalent neglected tropical disease. It represents a significant public health concern in northern Africa, particularly in Morocco. To assess the extent of the disease at the provincial level, as well as the temporal evolution of CL cases and their geographic distribution.

Methods: 834 cases of cutaneous leishmaniasis (CL) diagnosed positive by the hygiene and health laboratory of the health delegation of the province of Essaouira during the period from January 1st, 2014 to December 31st, 2023.

Results and discussion: Among the 57 communes of the province, three are hyper-endemic and represent the main foci of LC; Elhanchan, Had Draa, Smimou with 66.42% of cases. Other communes with significant increases include Aguerd, with 15.6% of cases, an incidence peak of 279.7 per 100,00.0 in 2022, and Bizdad, 11.8% with an average incidence of 41.1 per 100,000. The transmission of the parasitosis continues to spread to create new outbreaks each year and reach 25 municipalities in the province which have experienced at least one positive case in 2023. Two new outbreaks appeared after 2018 in Sidi Kaouki (5% of cases) and Tidzi (5.6%). The temporal analysis shows a significant rise in cases over time, with an annual average of 83 cases. The trend paused during the COVID-19 lockdown but resumed exponentially, peaking in 2023. The overall incidence in the province increased from 11.1 per 100,000 in 2015 to 40.3 per 100,000 in 2023, with a significant rise over the study period (p < 0.001). The average incidence during this time was 18.32 per 100,000, showing considerable variability across different years.

Conclusion: The spread of cutaneous leishmaniasis in the province of Essaouira is multifactorial and results from the complex interaction between vectors, parasites, the environment, and human behaviors. A better understanding of these factors is essential to developing effective disease prevention and controlling strategies.

Background: Chronic kidney disease (CKD) has a significant impact on public health with a high morbidity and death rate. Most diabetic patients, in the course of their lives, develop diabetic kidney disease. In the least developed nations, its size is outstripping itself. This study aimed to determine the prevalence of chronic kidney disease and associated factors among adult diabetic patients.

Methods: A hospital-based cross-sectional study was conducted on 328 adult diabetic patients from 1 December 2023 to 4 April 2024 at the Ayder Comprehensive Specialized Hospital, northern Ethiopia. A systematic random sampling method was utilized to select the study participants. Pretested structured questionnaires were used to collect sociodemographic, economic, and behavioral/lifestyle factors. Medical records were also reviewed to collect clinical data. Creatinine analysis was performed by kinetic alkaline picrate method and Chronic Kidney Disease Epidemiology Collaboration 2021 equation was used to calculate the glomerular filtration rate from the serum creatinine, age, and sex. Proteinuria was determined by using the dipstick semiquantitative method. Data were entered and analyzed using SPSS version 29. A variable with a p-value of <0.25 in bivariate logistic regression analyses was analyzed in multivariate logistic regression to identify the associated factors. In multivariable logistic regression, a variable was deemed statistically significant if it had a p-value <0.05. Associations were presented as odds ratio (OR) along with 95% confidence intervals (CIs).

Results: The prevalence of chronic kidney diseases in adult diabetic patients was 26.5% (95% CI, 21.8%-31.7%). About 5.2%, 12.5%, 7.3%, 0.9%, and 0.6% had stage 1-5 chronic kidney diseases, respectively. Hypertension [adjusted OR (AOR) = 2.390; 95% CI, 1.394-4.099, p = 0.002], >10-year duration of diabetes (AOR = 2.585; 95% CI, 2.321-5.807; p = 0.001), and family history of kidney diseases (AOR = 2.884; 95% CI, 1.338-6.218; p = 0.007) were associated factors of chronic kidney diseases.

Conclusions: The study revealed that one in four diabetic patients had chronic kidney disease. Special attention should be given to patients with family history of CKD, long duration on diabetes, and concomitant hypertension.

Introduction: Seasonal influenza poses significant societal costs, including illness, mortality, and reduced work productivity. Vaccination remains the most effective strategy for preventing the disease, yet vaccination rates in the United States fall below 50% for adults. Understanding the factors influencing vaccination decisions is crucial for designing interventions to improve uptake. This study investigates how personal experiences and the experiences of social contacts affect individual decisions to get vaccinated against influenza.

Methods: A multi-year longitudinal survey study was conducted to examine the impact of personal and social network experiences on vaccination decisions. Participants' vaccination behaviors and experiences with influenza were tracked over time. To model these influences, we developed a memory-based vaccination decision model using the Adaptive Control of Thought - Rational (ACT-R) integrated cognitive architecture, which incorporates cognitive processes associated with memory and decision-making.

Results: The survey results demonstrated that both personal experiences with influenza and the experiences of close social contacts significantly influenced vaccination decisions. The memory-based model, built within the ACT-R framework, effectively captured these effects, providing a computational representation of how personal and social factors contribute to vaccination behaviors.

Discussion: The findings suggest that personal and social experiences play a critical role in shaping vaccination decisions, which can inform the development of targeted interventions to increase vaccination uptake. By incorporating cognitive processes into the model, we identified potential strategies to enhance vaccine promotion efforts, such as recalling past experiences with illness to motivate individuals to get vaccinated.

Background: Solid waste collectors play an important role in maintaining health and hygiene in cities globally. The risk levels are very high in low-income countries since solid waste collectors have low socio-economic status and are exposed directly, unknowingly, and without adequate personal protection to municipal solid waste that contains hazardous materials. Solid waste collectors in Ethiopia are at high risk of occupational injuries due to the manual collection of hazardous solid waste by hand. In Jigjiga city, so far, there has been no study or published research showing the prevalence of occupational injuries and associated factors among municipal solid waste collectors.

Objective: To assess the prevalence of occupational injuries and associated factors among solid waste collectors in Jigjiga City, Somali Regional State, Ethiopia, 2023.

Methods: An institutional cross-sectional study was conducted in Jigjiga City, Somali Regional State, involving 247 solid waste collectors. Data was collected through an observational and structured questionnaire and analyzed using Epi Info and STATA software programs. The study used systematic random sampling techniques and bivariate and multivariable logistic regression analyses to determine the statistical association between the outcome variable and independent variables. The significance of the association was tested using the 95% confidence interval and p value (<0.05).

Results: The overall prevalence of occupational injuries was 54.7% (95% CI: 48.2%, 60.6%). Training on health and safety measures before employment [AOR: 0.43, 95% CI (0.24, 0.80)], sleeping problems [AOR: 3.28, 95% CI (1.86, 5.78)] and Temporary workers [AOR: 2.14, 95% CI (1.16, 3.95)] were significantly associated with occupational injuries.

Conclusion: The prevalence rate of occupational injuries among solid waste collectors in Jigjiga City was high. There should be preventive measures, like giving Training on Health and safety before employment, to safeguard the health and safety conditions of the workers.

During the COVID-19 pandemic, which spanned much of 2020-2023 and beyond, daily case and death counts were recorded globally. In this study, we examined available mortality counts and associated case counts, with a focus on the estimation missing information related to age distributions. In this paper, we explored a model-based paradigm for generating age distributions of mortality counts in a spatio-temporal context. We pursued this aim by employing Bayesian spatio-temporal lagged dependence models for weekly mortality at the county level. We compared three US states at the county level: South Carolina (SC), Ohio, and New Jersey (NJ). Models were developed for mortality counts using Bayesian spatio-temporal constructs, incorporating both dependence on current and cumulative case counts and lagged dependence on previous deaths. Age dependence was predicted based on total deaths in proportion to population estimates. This latent age field was generated as counterfactuals and then compared to observed deaths within age groups. The optimal retrospective space-time models for weekly mortality counts were those with lagged dependence and a function of caseload. Added random effects were found to vary across states: Ohio favored a spatially correlated model, while SC and NJ favored a simpler formulation. The generation of age-specific latent fields was performed for SC only and compared to a 15-month, 13-county data set of observed >65 age population. It is possible to model spatio-temporal variations in mortality at the county level with lagged dependencies, spatial effects, and case dependencies. In addition, it is also possible to generate latent age-specific fields based on estimates of death risk (using population proportions or more sophisticated modeling approaches). More detailed data will be needed to make more calibrated comparisons for future epidemic monitoring. The proposed discrepancy tool could serve as a useful resource for public health planners in tailoring interventions during epidemic situations.

Background: The health effects of alcohol consumption, particularly regarding potential protective benefits of light to moderate intake compared to abstinence, remain a subject of ongoing debate. However, epidemiological studies face limitations due to imprecise exposure measurements and the potential for bias through residual confounding and reverse causation. To address these limitations, we conducted a systematic review of Mendelian Randomization (MR) studies examining the causal relationship between alcohol consumption and cancers, cardiovascular, liver, and neurological diseases.

Methodology: We searched PubMed, ScienceDirect and Embase and Europe PMC up to 05/2024 for MR studies investigating the association of genetically predicted alcohol consumption with cancers, cardiovascular, liver and neurological diseases. We assessed methodological quality based on key elements of the MR design a genetic association studies tool.

Results: We included 70 MR studies that matched our inclusion criteria. Our review showed a significant association of alcohol consumption with multiple cancers such as oral and oropharyngeal, esophageal, colorectal cancers, hepatocellular carcinoma and cutaneous melanoma. While the available studies did not consistently confirm the adverse or protective effects of alcohol on other cancers, such as lung cancer, as suggested by observational studies. Additionally, MR studies confirmed a likely causal effect of alcohol on the risk of hypertension, atrial fibrillation, myocardial infraction and vessels disease. However, there was no evidence to support the protective effects of light to moderate alcohol consumption on cognitive function, Alzheimer's disease, and amyotrophic lateral sclerosis, as reported in observational studies while our review revealed an increased risk of epilepsy and multiple sclerosis. The available studies provided limited results on the link between alcohol consumption and liver disease.

Conclusions: Despite the valuable insights into the causal relationship between alcohol consumption and various health outcomes that MR studies provided, it is worth noting that the inconsistent ability of genetic instrumental variables to distinguish between abstainers, light and moderate drinkers makes it difficult to differentiate between U or J-shaped vs. linear relationships between exposure and outcome. Additional research is necessary to establish formal quality assessment tools for MR studies and to conduct more studies in diverse populations, including non-European ancestries.

Systematic review registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021246154, Identifier: PROSPERO (CRD42021246154).

Background: Health-related quality of life (HRQoL) is crucial for understanding how health conditions impact overall well-being. The EuroQol-5 Dimension (EQ-5D) is a widely used tool for measuring HRQoL across diseases. In Ethiopia, this tool has been employed to assess HRQoL across various healthcare settings. This study aims to summarize EQ-5D-derived health outcomes in Ethiopian populations and identify key determinants influencing these outcomes.

Methods: A systematic search of PubMed, Embase, and Scopus was conducted through May 2024, with no publication date restrictions, focusing on HRQoL and EQ-5D instruments in Ethiopian populations. Grey literature searches were also performed using Google's Advanced Search. Cross-sectional studies across various diseases were included. Data were extracted by two independent reviewers, and pooled mean EQ-5D utility and EQ-5D visual analog scale (EQ-VAS) scores were calculated using a random-effects model in STATA software version 17. Study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) checklist, and heterogeneity was assessed using the I² statistic.

Results: Fourteen cross-sectional studies involving 5,639 patients from 2019 to 2024 in Ethiopia were analyzed. Health utility values varied across diseases, with pain/discomfort and anxiety/depression being the most commonly affected dimensions. The pooled EQ-5D utility for HIV patients was 0.88, and the EQ-VAS score was 76.59. For diabetes mellitus (DM) patients, the pooled utility was 0.78, and the EQ-VAS score was 69.36. For COVID-19 patients, the pooled utility was 0.86, and the EQ-VAS score was 74.56. Cancer patients had a pooled EQ-VAS score of 67.87.

Conclusion: The EQ-5D is a reliable tool for measuring HRQoL in Ethiopian patients across various diseases. The study's pooled EQ-5D scores provide valuable insights for future economic evaluations in the Ethiopian healthcare system.

Systematic review registration: https://doi.org/10.1136/bmjopen-2024-085354, PROSPERO (CRD42024505028).

Background: A sharp increase in reported brucellosis incidence was observed in northwestern Tajikistan (from 1.0/100,000 people in January-May 2022 to 32.7/100,000 in January-May 2023). Most (82%) cases were from the same remote mountainous village (population = 10,712). The aim of this study was to identify risk factors for brucellosis infection and mitigate disease risk.

Methods: Using a case-control design, we conducted face-to-face interviews and collected blood samples during May-June 2023. Fifty-seven cases and 114 controls were recruited. Cases were the first person in a household diagnosed with brucellosis during February-June 2023 with positive serum agglutination test and antibody titers ≥1/160 from blood samples. Two controls were selected for each case (neighbors from different households matched by age and sex). Controls testing positive were excluded and replaced. We conducted conditional multivariable logistic regression to calculate adjusted odds ratio (AOR) and 95% confidence intervals (CI).

Results: Among the 87 brucellosis patients reported, 57 (66%) agreed to participate and didn't have secondary cases in the household. Of the 57 cases, 68% were 15-44 years old, and 44% were male. Cases peaked in May 2023. Common symptoms were joint pain (95%), fever (84%), weakness (72%), and night sweats (65%). Of selected controls, 13% tested positive and were excluded. All cases and 94% of controls owned livestock (mostly cattle, sheep, or goats); no animals had not been vaccinated in the past 5 years. Brucellosis was associated with consumption of both homemade kaymak (clotted cream) and home-raised meat compared with neither (AOR: 59 [95%CI: 4.3-798], p < 0.01), home-raised meat but not kaymak compared with neither (AOR: 54 [4.0-731], p < 0.01), and involvement in animal slaughter compared with no involvement (AOR: 36 [2.8-461], p < 0.01).

Conclusion: Contact with unvaccinated livestock or consumption of their products was a key contributor to this outbreak in a remote village of Tajikistan. With 13% of controls testing positive, true incidence was likely greater than reported. Following our investigation, a brucellosis awareness education campaign and animal vaccination campaigns were carried out in the region and only one case was reported in September 2023.