BMC Public Health最新文献

Background: Field Epidemiology Training Programs (FETPs) aim to develop a skilled public health workforce through applied competency-based learning. With 98 programs globally and over 20,000 graduates, these programs play a crucial role in disease preparedness and response activities around the world. Despite their importance, there have been few published evaluations. This paper presents the results of a consensus-building process to develop a preferred array of indicators for evaluating the outputs, outcomes, and impacts of FETPs.

Methods: We conducted a modified Delphi study to reach consensus on preferred evaluation indicators for FETPs. An initial list of evaluation indicators were identified from literature reviews and consultations with impact evaluation experts and FETP professionals. A modified Delphi process was subsequently employed, involving two rounds of surveys and a final expert review meeting, to reach consensus on indicators. The Delphi panel included 23 experts representing diverse global regions and FETP roles.

Results: Consensus was reached to include 134 evaluation indicators in the final impact evaluation framework. These indicators were grouped as output, outcome, and impact indicators.

Conclusions: This study presents the first FETP impact evaluation framework with a comprehensive list of evaluation indicators for FETPs. This list of indicators is intended as a resource to promote and enhance the evaluation of FETPs and thus improve these important training programs which aim to strengthen national, regional and global health security.

Background: Cancer is a critical disease that affects a person physically, mentally, socially, and in many other aspects. During the treatment stage of cancer, patients suffer from various health complexities, especially elderly people, which might result in the onset of other diseases development of a comorbid condition. Several studies have shown comorbidity plays a crucial role in cancer survival. However, there remains a lack of comprehensive statistical techniques at the national level studies to assess the significance of comorbidities development in cancer. Our research aims to address this gap by comparing cancer and non-cancer individuals over four years' time period.

Methods: The Health Retirement Study (HRS) data was used to extract information from 6651 participants aged more than 50. Within a 4-year time span, cross-sectional observations were created whether comorbidities or not based on the development of diseases such as high blood pressure, diabetes, heart disease, stroke, lung disease, and psychological disease.

Results: In the multivariable regression model, we observed higher chances of developing comorbidity (OR = 1.321, p-value 0.0051) among the cancer group compared to the non-cancer group, adjusting the socio-economic factors. Moreover, the socio-economic factors were found to be significantly associated with cancer leading to applying the propensity score matching with (1:3 matching). Finally, the balanced data also showed significantly higher chances of developing comorbidity (OR = 1.294, p-value 0.0207) among cancer patients.

Conclusions: The above findings demonstrated the imperative development of enhanced treatment protocols, which prioritize the overall health of cancer patients, thereby reducing their susceptibility to additional illnesses.

Background: The superblocks model of Barcelona (Spain) seeks to reorganize the city based on reversing the distribution of public space between vehicles and people by prioritizing citizens, thus improving their environmental conditions and quality of life. The objective of this paper was to describe the effects on environmental, health and quality of life of the first three superblocks implemented, discuss the lessons learned, and provide recommendations for the future.

Methods: The evaluation included different approaches depending on the superblock analyzed: A pre-post-intervention health survey, environmental measures of air quality, the Microscale Audit of Urban Landscapes for Pedestrians (MAPS), an observational study on target areas of physical activity (SOPARC), ethnographic guerrilla studies, and focus groups.

Results: Residents and workers in all three of the evaluated superblocks reported a perceived improvement in well-being, tranquillity and quality of sleep, some reduction in noise and pollution and an increase in social interaction. The built environment of the superblocks clearly influenced walkability, and the lower car traffic volume improved air quality measures. In one of the superblocks, the same intervention calmed traffic in one of the areas but not in another.

Conclusions: Although on a small scale, this evaluation of the environmental, and health effects of the superblocks provides support for expanding the model to other areas of the city.

Background: Non-communicable diseases (NCD) have become the leading cause of premature death and disability in the Pacific region, with the development of health literacy an important factor for the prevention and control of NCD. Health literacy is an important lifelong asset that can be developed in adolescents through engagement in schooling and curriculum. The aim of this study was to explore Ni-Van adolescents' health literacy knowledge and capabilities regarding food and nutrition, climate change and digital technology solutions.

Methods: Two Ni-Van schools participated in the study (one urban (School A) and one rural school (School B)), with 44 students (68% female) comprising 14 small groups participating in one workshop and booklet activities in April 2023. The 14 workshop booklet responses were deductively analysed using Nutbeam's health literacy hierarchy.

Results: School  A's booklet responses showed that interactive health literacy responses were dominant (54%), followed by functional (34%) and critical learning activities (12%), whereas School B's responses showed that functional health literacy responses were dominant (65%), followed by interactive (28%) and critical (5%).

Conclusion: The findings show that students in both schools were less likely to engage in critical, compared with functional and interactive health literacy levels. This is an important consideration for future workshops, as well as curriculum and teacher training in Vanuatu, as Vanuatu (and other PICTs) are more susceptible to the effects of climate change and food sustainability issues.. Without a focus on developing critical health literacy knowledge and capabilities throughout the schooling years, this is a missed opportunity to create enabling environments that reduce youth exposures to NCD risk factors.

Background: Older domestic migrants have a higher risk of infection of tuberculosis or reactivation of latent tuberculosis than other populations in China. This study aimed to assess the exposure level of older domestic migrants to tuberculosis education and its association with social participation.

Methods: Data were extracted from the 2017 China Migrants Dynamic Survey (CMDS). A total of 5,787 study participants over 60 years of age were eligible for this study. Multilevel logistic regression models were established to determine the association between social participation and exposure to tuberculosis education after adjustment for variations in sociodemographic characteristics of the participants and health resources available in their migration destinations. Propensity score matching (PSM) was conducted to precisely estimate the average treatment effect on the treated (ATT) of social participation on exposure to tuberculosis education.

Results: Only 28.5% of study participants reported exposure to tuberculosis education in various forms over the past year in their migration destination. Participation in social activities, both membership-based (aOR:1.68, 95% CI:1.46-1.94,) and non-membership-based (aOR:1.66, 95% CI:1.44-1.91) were associated with higher exposure to tuberculosis education after adjustment for variations in covariates. Those who resided in a province with higher prevalence of tuberculosis and higher health expenditure, established a local personal health record, were aware of the essential public health services, had a job, obtained higher levels of education, and self-rated good health were more likely to be exposed to tuberculosis education. The ATT of social participation reached 0.10, indicating an increase of 10% exposure to tuberculosis education in those with active social participation.

Conclusions: Low levels of exposure to tuberculosis education in older migrants are evident in China. Social participation is associated with higher exposure to tuberculosis education.

Background: Given the limited evidence on the side effects of AZD1222 booster in individuals previously vaccinated with Sinopharm BBIBP-CorV, we conducted a cohort event monitoring study to capture adverse events in those receiving AZD1222 booster doses (first or second) after Sinopharm BBIBP-CorV vaccination in Iran.

Methods: This active COVID-19 vaccine safety surveillance study was conducted in vaccination centers across 12 provinces in Iran. The study population included individuals who had received two doses of Sinopharm BBIBP-CorV and either a first or second AZD1222 booster dose. Each participant was followed for 13 weeks after their booster dose.

Results: A total of 28,742 participants were included, with 13,428 females (46.72%) and 15,314 males (53.28%). The average age was 43.25 ± 14.90 years. Of the total, 82.46% were recruited retrospectively through vaccination registration. Among 16,944 individuals with available polymerase chain reaction test results, 118 tested positive for COVID-19 between 14 and 90 days post-booster. There were 123 hospital admissions, with 18 cases showing a higher likelihood of being associated with adverse events following immunization (AEFIs) or serious adverse events (SAEs). After excluding deaths unrelated to vaccination, four deaths were potentially linked to AEFIs or SAEs. The cumulative incidence rates for hospital admissions and deaths were 106.40 and 13.90 per 100,000 individuals, respectively.

Conclusion: The study indicates that AZD1222 booster doses are safe for individuals previously vaccinated with Sinopharm BBIBP-CorV, with rare adverse events and an acceptable safety profile. This supports the use of heterologous booster strategies, though ongoing monitoring and improved pharmacovigilance are essential to detect any potential long-term effects.

Background: We aimed to investigate global, regional, and national burden of chronic kidney disease (CKD) and its underlying etiologies from 1990 to 2021.

Methods: We summarized the results of the Global Burden of Disease (GBD) 2021 to derive the disease burden of CKD by considering four distinct types of epidemiological data, namely incidence, prevalence, mortality, and disability-adjusted life years (DALYs). The Joinpoint regression analysis, which is skilled in calculating annual percentage change (APC) and average annual percentage change (AAPC), was used to estimate global trends for CKD from 1990 to 2021.

Results: The age-standardized mortality rate (ASMR) and age-standardized DALYs rate of CKD were more prominent in regions with Low and Low-middle socio-demographic index (SDI) quintiles. From 1990 to 2021, the countries with the largest increases in ASMR were Ukraine. Globally, the most common cause of death for CKD was type 2 diabetes mellitus (T2DM), while the most common cause of prevalence, incidence, and DALYs was the other and unspecified causes. The main causes of death and DALYs from CKD varied in different parts of the world. The disease burden of CKD increased with age. In most age groups, the global prevalence and incidence of CKD were higher in females than males. At all ages, the global mortality rate and DALYs rate of CKD were higher in males compared to females. Joint point regression analysis found that from 1990 to 2021 the global age-standardized prevalence rate (ASPR) revealed a downward trend, while age-standardized incidence rate (ASIR), ASMR, and age-standardized DALYs rate showed an upward trend, with the most notable increase in ASMR during the 1997-2000 period and in age-standardized DALYs rate during the 1996-2003 period.

Conclusions: The study unveiled the uneven global distribution of the burden of CKD and its attributable causes. From 1990 to 2021, an increase in the burden of incidence, mortality, and DALYs due to CKD was observed. Population growth and aging will contribute to a further increase in the burden of CKD. Healthcare providers should develop health policies, and optimize the allocation of medical resources, based on age, sex, region, and disease type.

Background: Rural areas in the Southern hemisphere bear the brunt of inadequate sanitation services and high prevalence of open defecation. Our study in an Indonesian remote village underscores the critical role of psychosocial factors influencing sanitation behavior in such marginalised communities. This study explores contextual and RANAS (Risk, Attitudes, Norms, Abilities, and Self-regulation) psychosocial factors determining sanitation behaviour in rural Indonesia.

Methods: In a cross-sectional survey of 371 rural households, we gathered data on personal characteristics, sanitation behaviours, and RANAS factors and performed regression analysis.

Results: We found that most respondents do not use the toilet regularly, and no household has safely managed sanitation facilities. Among all contextual factors, households with equal power in determining household expenses between husbands and wives and households with access to hygiene information tend to practice better sanitation behaviours and latrine use. Meanwhile, RANAS factors that primarily affect sanitation behaviour in this study are remembering (part of self-regulation, OR = 0.35), followed by feeling (attitude, OR = 0.31) and commitment (self-regulation, OR = 0.18).

Conclusions: One in every four people interviewed in rural Luwu practices open defecation and no household has access to safely managed sanitation. In reducing open defecation rate in rural areas of Indonesia, the government should strengthen their efforts and concentrate on programmes that address the three identified psychosocial variables, along with improving access. While many studies on the determinants of sanitation behaviours in LMICs analyse contextual factors only, we argue that Indonesian sanitation behavioural interventions should use the RANAS model to identify psychosocial factors.

Background: In China, public preschools only admit children from local permanent resident families, differing from private preschools admitting children mostly from transient population families such as work migrants. Thus, this study aims to compare pinworm infection rate and its risk factors between private and public preschools to contribute to the limited understanding of the disparities.

Methods: A three-year cross-sectional study was conducted in Jiangsu Province, China from 2019 to 2021. In each study site, two preschools types were selected: private preschool and public preschool. Multi-stage cluster sampling was applied. The study sites, preschools, and classes were selected based on convenience and cooperation. The calculated sample size for each preschool was 229. Participants were expected to proportionally distributed across the lower, the middle, and the upper grade to balance the age bracket. Questionnaire surveys were administered to parents with teachers' help. One adhesive cellophane tape swab sample was collected by local health workers from children in the morning at preschool. Single factor and multiple backward logistic regression analysis were conducted to identify the risk factors for pinworm infections.

Results: This study enrolled 3678, 2568, and 2529 preschool children in 2019, 2020, and 2021, respectively. The three-year pooled infection rate was 0.88% (1.46% for private preschool and 0.18% for public preschool). The pinworm infection rates were statistically higher in private preschool children than in public preschool children (2.07% vs. 0.24% in 2019, P-value < 0.001; 0.82% vs. 0.08% in 2020, P-value = 0.014; 1.22% vs. 0.19% in 2021, P-value = 0.008; respectively). Private preschool was a risk factor for pinworm infection (OR = 6.534, 95%CI = 2.523-22.336). Older age and worse hygiene habit were risk factors among private preschool children (OR = 1.476, 95%CI = 1.152-1.911; OR = 1.311, 95%CI = 1.053-1.606). Among public preschool children, a medium or higher family income level was a protective factor for pinworm infection (OR = 0.081, 95%CI = 0.011-0.413).

Conclusion: The results indicate that private preschool with children mostly from transient population should be prioritized for pinworm control. It is valuable for policymakers and health staff aiming to improve sanitation and reduce pinworm infections.