Frontiers in epidemiology最新文献

Objective: This study analyzed the trend, seasonal variations and forecasting of chronic respiratory disease morbidity in charcoal producing areas, northwest Ethiopia, aiming to provide evidences in planning, designing strategies, and decision-makings for preparedness and resource allocation to prevent CRD and reduce public health burden in the future.

Materials and methods: The trend, seasonal variation, and forecasting for CRD were estimated using data collected from the three zones of Amhara region annual reports of DHIS2 records. Smoothing decomposition analysis was employed to demonstrate the trend and seasonal component of CRD. The ARIMA (2, 1, 2) (0, 0, 0) model was used to forecast CRD morbidity. The model's fitness was checked based on Bayesian information criteria. The stationarity of the data was assessed with a line chart and statistically with the Ljung-Box Q-test. SPSS version 27 was utilized for statistical analysis.

Results: The annual morbidity rate of CRD has shown an increasing trend in both sexes over a seven-year period among people aged 15 years and older. Seasonal variation in CRD morbidity was observed. The smoothing decomposition analysis depicted that the seasonal component was attributed to 44.47% and 19.16% of excess CRD cases in the period between September to November, and June to August, respectively. A substantial difference among the three zones of the Amhara region in CRD morbidity rate was noted, with the highest observed in the Awi zone. Forecasting with the ARIMA model revealed that CRD-related morbidity will continue to increase from 2020 to 2030.

Conclusion: The study revealed that the CRD morbidity rate has shown an increasing trend from 2013 to 2019. Seasonal variation in the CRD morbidity rate was observed, with the highest peak from September to November. The morbidity attributed to CRD will continue to increase for the next ten years (2020-2030). Therefore, this study could potentially play a groundbreaking role. Further study is warranted to understand the risk factors and facility readiness through a further understanding of seasonality and future trends.

Objectives: Surveillance of acute respiratory infection (ARI) informs vaccination, preventive, and management decisions. In many countries, immunofluorescence is the cornerstone for ARI surveillance. We aimed to determine the effect of adding multiplex polymerase chain reaction (mPCR) to conventional surveillance in ARI.

Methods: Respiratory samples from patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) were tested by a conventional approach [direct immunofluorescence (DIF) and SARS-CoV-2 PCR, and a subset of samples underwent routine testing]. Negative specimens were tested by multiplex PCR (mPCR), and remain negative samples were sequenced. Descriptive, multivariable regression analyses were conducted.

Results: Between March and June 2022, 299 patients were enrolled. Pathogens were detected in 43.8% of samples (131/299) tested by the conventional approach. Of the 168 negatives after the conventional approach, 157 (93.4%) were positive by mPCR, increasing the detection rate to 96.3% (288/299). With the conventional approach, the most frequent pathogen was respiratory syncytial virus (50.3%, 66/131), whereas with mPCR it was Haemophilus influenzae (37.5%, 63/168). mPCR significantly improved pathogen detection in ARI surveillance (Adjusted Incidence Rate Ratios 4.22 95% IC 4.22-5.85).

Conclusion: Adding mPCR to respiratory surveillance conventionally based on DIF significantly enhanced virus and bacteria detection. mPCR should be considered for routine ARI surveillance.

Introduction: Scientific evidence shows that contemporary and emerging factors contribute to high blood lead concentrations in different populations. The study aimed to determine blood lead concentrations and risk factors associated with high blood lead concentrations among young males in conflict with the law.

Methods: A cross-sectional analytical study was conducted among 192 conveniently selected participants from two youth secure (correctional) facilities in Gauteng Province, South Africa.

Results: The study's overall blood lead concentration median was 3.30 μg/dl, ranging from 0.85 to 48.11 μg/dl. Young males born outside of South Africa (median = 8.78 μg/dl) and in villages (median = 4.95 μg/dl), working before coming to the facility (median = 5.23 μg/dl) and involvement in illegal mining (median = 9.00 μg/dl) had high blood lead concentrations in this study. Contemporary and emerging risk factors such as being born outside the country (AOR: 3.10, 95%CI: 1.01-1.88), involvement in illegal mining activities (AOR: 1.36, 95%CI: 1.14-1.91) and staying in a house with peeling paint on the outside (AOR: 2.26, 95%CI: 1.12-4.30) were found to influence blood lead concentration.

Discussion: The study findings show that contemporary (co-existing) and emerging factors influence blood lead concentrations. Therefore, there is a need to investigate these factors further in communities that may be affected. Lastly, there is a need for a holistic approach involving multiple sectors to introduce human lead concentration screening and preventive programmes.

Background: There is limited evidence on prevalence and risk factors for hepatitis C virus (HCV) infection among waste handlers in Sidama region, Ethiopia; however, this knowledge is necessary for effective prevention of HCV infection in the region.

Methods: A cross-sectional study was conducted among randomly selected waste collectors from October 2021 to 30 July 2022 in different public hospitals of Sidama region of Ethiopia. Serum samples were collected from participants and screened for anti-HCV using rapid immunochromatography assay. Socio-demographic and risk factor information of waste handlers was gathered by pretested and well-structured questionnaires The generalized linear model (GLM) was conducted using R software, and P-value <0.05 was declared statistically significant.

Results: From a total of 282 participating waste handlers, 16 (5.7%) (95% CI = 4.2-8.7) were infected with hepatitis C virus. Educational status of waste handlers was the significant demographic variable that was associated with hepatitis C virus (AOR = 0.055; 95% CI = 0.012-0.248; P = 0.000). More married waste handlers, 12 (75%), were HCV positive than unmarried, 4 (25%) and married waste handlers were 2.051 times (OR = 2.051, 95% CI = 0.644-6.527, P = 0.295) more prone to HCV infection, compared to unmarried, which was statistically insignificant. The GLM showed that exposure to blood (OR = 8.26; 95% CI = 1.878-10.925; P = 0.037), multiple sexual partners (AOR = 3.63; 95% CI = 2.751-5.808; P = 0.001), sharp injury (AOR = 2.77; 95% CI = 2.327-3.173; P = 0.036), not using personal protective equipment (AOR = 0.77; 95% CI = 0.032-0.937; P = 0.001), contact with jaundiced patient (AOR = 3.65; 95% CI = 1.093-4.368; P = 0.0048) and unprotected sex (AOR = 11.91; 95% CI = 5.847-16.854; P = 0.001) remained statistically significantly associated with HCV positivity.

Conclusions: The study revealed that there was a high prevalence of hepatitis C virus infection among waste handlers in Sidama region, Ethiopia. This demonstrated that there is an urgent need to increase preventative efforts and strategic policy orientations to control the spread of the hepatitis C virus.

Background: Hepatitis B virus (HBV) infection poses a significant global health challenge, leading to approximately 1.1 million deaths annually. Informal caregivers of HBV patients face an increased risk of exposure, yet there is limited research on their awareness and infection prevention practices. This study aimed to evaluate the awareness and practices regarding HBV among informal caregivers in public hospitals in Addis Ababa, Ethiopia, in 2024.

Methods: An institutional-based cross-sectional study was conducted from May 15 to July 15, 2024, involving 422 informal caregivers selected through a systematic random sampling. Data were collected using structured, interviewer-administered questionnaires that were pretested. The data were analyzed using SPSS version 26, with logistic regression identifying factors influencing awareness and practices, set at p < 0.05.

Results: Out of 414 surveyed caregivers (response rate: 98.1%), the mean age was 34.31 years (±12), with 63% female and 47.6% single. Only 24.9% (95% CI: 20.7-29.1%) showed good awareness, and merely 11.6% (95% CI: 8.5-14.7%) demonstrated good practices. Key factors associated with better awareness included caregivers' positive attitudes (AOR: 2.54) and patient functional levels (AOR: 1.9). Good practices were linked to higher education levels (AORs: 4.84 and 5.3), acute disease status (AOR: 3.6), and positive attitudes (AOR: 4.37).

Conclusions: The study reveals inadequate awareness and practices among informal caregivers compared to national averages. Awareness was linked to caregivers' attitudes and patient activity levels, while education, awareness, attitudes, and disease type significantly influenced good practices.

During the SARS-CoV-2 pandemic, the effective reproduction number (R-eff) has frequently been used to describe the course of the pandemic. Analytical properties of R-eff are rarely studied. We analytically examine how and under which conditions the conventional susceptible-infected-removed (SIR) model (without infection age) serves as an approximation to the infection-age-structured SIR model. Special emphasis is given to the role of R-eff, which is an implicit parameter in the infection-age-structured SIR model and an explicit parameter in the approximation. The analytical findings are illustrated by a simulation study about an hypothetical intervention during a SARS-CoV-2 outbreak and by historical data from an influenza outbreak in Prussian army camps in the region of Arnsberg (Germany), 1918-1919.

Purpose: We aimed to assess the burden of Fungal Skin Diseases (FSD) in 2021 and explore the changing trends from 1990 to 2021 across different age groups and time periods.

Methods: This study extracted three key indicators of the burden of FSD from the Global Burden of Disease (GBD) 2021 study: prevalence, incidence, and disability-adjusted life years (DALYs). The results were presented using point estimates and Uncertainty Intervals (UIs), and secondary analysis was conducted on these data to assess the changing trends in the burden of FSD using percentage change.

Results: In 2021, the global cases of prevalence, incidence, and DALYs of FSD were reported at 616.5 million, 1,729.2 million, and 3,429.5 thousand, respectively, an increase of approximately 68% since 1990. The age-standardized rates per 100,000 population for prevalence, incidence, and DALYs were 7,789.6, 21,668.4, and 43.4, respectively. These rates represent percentage increases of 6.21%, 3.74%, and 6.56% since 1990. In terms of age distribution, the ages for FSD-related prevalence, incidence, and DALYs peak cases globally were in the 5-9 age group, with distinct age groups observed in low and low-middle, middle, high-middle and high SDI regions at 5-9 years, 45-49 years, and 70-74 years, respectively.

Conclusion: Over the past 32 years, there has been a significant increase in the global burden of FSD. With improvements in the Socio-Demographic Index (SDI), the age groups for FSD-related peak cases are gradually shifting towards older age groups. This indicates the need to allocate healthcare resources rationally to address the challenges arising from the significant differences in geographic distribution, gender, and among different populations.

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.