Epidemiology and Infection最新文献_第2页

An evaluation of the performance and usability of a measles IgM rapid diagnostic test within the Uganda national surveillance program using capillary blood and oral fluid samples. 评估乌干达国家监测规划中使用毛细血管血液和口腔液样本的麻疹IgM快速诊断测试的性能和可用性。

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102052

Josephine Bwogi, Lenesha Warrener, Phionah Tushabe, Irene Turyahabwe, James Peter Eliku, Henry Bukenya, Prossy Namuwulya, Theopista Kabaliisa, Tom Lutalo, David Featherstone, David W Brown

{"title":"An evaluation of the performance and usability of a measles IgM rapid diagnostic test within the Uganda national surveillance program using capillary blood and oral fluid samples.","authors":"Josephine Bwogi, Lenesha Warrener, Phionah Tushabe, Irene Turyahabwe, James Peter Eliku, Henry Bukenya, Prossy Namuwulya, Theopista Kabaliisa, Tom Lutalo, David Featherstone, David W Brown","doi":"10.1017/S0950268826102052","DOIUrl":"https://doi.org/10.1017/S0950268826102052","url":null,"abstract":"Performance of a prototype measles IgM rapid diagnostic test (RDT) was evaluated during suspected measles outbreaks in Uganda.Oral fluid (OF), capillary blood (CAP) and serum samples were collected from participants. OF and CAP were tested using the RDT at patient contact, while usability was assessed through questionnaires administered to health workers, patients, and guardians. Residual OF and IgM-positive RDTs from OF testing underwent measles qRT-PCR at Uganda Virus Research Institute. RDT performance was compared with Siemens anti-measles IgM ELISA performed on sera and with true measles cases, defined as measles ELISA IgM-positive and/or OF RT-PCR positive.Compared to ELISA, RDT sensitivity and specificity were 97.9% (95% CI: 93.7%-99.3%) and 91.7% (95% CI: 84.7%-95.7%) for CAP, and 96.7% (95% CI: 92.2%-98.6%) and 88.0% (95% CI: 80.7%-92.8%) for OF, respectively. Compared with true measles cases, sensitivity and specificity were 90.4% (95% CI: 84.9%-94.1%) and 89.2% (95% CI: 81.5%-94.0%) for CAP, and 88.5% (95% CI: 82.8%-92.5%) and 86.1% (95% CI: 78.1%-91.5%) for OF, respectively.OF and CAP sampling, and RDT use were highly acceptable, and health workers reported the RDT could improve measles management. The RDT demonstrated good accuracy and usability for outbreak settings.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e125"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public health surveillance of Yersinia species in England, 2017-2024. 2017-2024年英国耶尔森菌公共卫生监测

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102167

Ella V Rodwell, Ella Te Wierik Durrant, Nicola K Love, David R Greig, Grace King, Iain Hayden, Vanessa Wong, Marie Anne Chattaway, Claire Jenkins, Gauri Godbole

{"title":"Public health surveillance of Yersinia species in England, 2017-2024.","authors":"Ella V Rodwell, Ella Te Wierik Durrant, Nicola K Love, David R Greig, Grace King, Iain Hayden, Vanessa Wong, Marie Anne Chattaway, Claire Jenkins, Gauri Godbole","doi":"10.1017/S0950268826102167","DOIUrl":"https://doi.org/10.1017/S0950268826102167","url":null,"abstract":"Yersinia pseudotuberculosis and Yersinia enterocolitica are globally found zoonotic gastrointestinal bacteria known to cause human infections, transmitted by consumption of contaminated food or environmental contact. Y. enterocolitica is the dominant species in causing yersiniosis, and is under ascertained in England. Diagnostic laboratories across England undertake detection of Yersinia in stool and other sterile sites using UK Standards for Microbiology Investigations. In 2022, there was an exceedance of invasive and gastrointestinal Yersinia notifications across England. Recommendations were made that all Yersinia detected in diagnostic laboratories be cultured and sent to England's national reference laboratory, Gastrointestinal Bacteria Reference Unit, UK Health Security Agency for whole genome sequencing, speciation, genomic profiling, and clustering. Here we describe the epidemiology of all Yersinia spp. reported in England to the UKHSA from the regional laboratories and the reference laboratory leading up to and following the exceedance in 2022. We aim to capture and describe the changes and developments in surveillance of Yersinia spp. between 2017 and 2024.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e132"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genomic surveillance of COVID-19 in Hong Kong (2020-2023): Analysing SARS-CoV-2 variants, mutations, and their impact on viral entry. 香港COVID-19基因组监测（2020-2023）：分析SARS-CoV-2变异、突变及其对病毒进入的影响

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102040

John David Pilapil, May Anne Mata, Ricardo Del Rosario, Mark Joseph Pasciolco, King Lau Chow, King Lun Yeung

{"title":"Genomic surveillance of COVID-19 in Hong Kong (2020-2023): Analysing SARS-CoV-2 variants, mutations, and their impact on viral entry.","authors":"John David Pilapil, May Anne Mata, Ricardo Del Rosario, Mark Joseph Pasciolco, King Lau Chow, King Lun Yeung","doi":"10.1017/S0950268826102040","DOIUrl":"https://doi.org/10.1017/S0950268826102040","url":null,"abstract":"We analysed 15,982 quality-controlled SARS-CoV-2 genome sequences from Hong Kong, obtained from NCBI and GISAID between 2020 and 2023, to characterize lineage dynamics, mutational profiles, demographic distributions, and variant-specific viral entry. Genomic surveillance identified 543 lineages and 5,982 unique mutations. Lineages A, B, and B.4 dominated the initial epidemic waves, whereas Delta and Omicron emerged and predominated in later waves. Omicron BA.1 and BA.2 exhibited distinct distributions across gender and age groups, while JN.1 harboured several novel mutations. Molecular simulations comparing spike receptor-binding domain (SRBD)-ACE2 interactions revealed significant differences in binding affinity among variants (F = 4.404, p = 9.12 × 10⁻⁷). JN.1 demonstrated enhanced ACE2-binding affinity, suggesting increased viral entry and potential transmissibility. By integrating genomic, demographic, and molecular evidence, this study provides a comprehensive account of SARS-CoV-2 evolution in Hong Kong and highlights the public health relevance of emerging variants. These findings support sustained genomic surveillance and demographic monitoring to strengthen pandemic preparedness. Future research should evaluate public health strategies and adopt holistic frameworks integrating population characteristics with genomic evidence to mitigate the effects of future variants.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e124"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing a risk management framework to improve public health outcomes by enumerating and serotyping Salmonella in ground turkey - CORRIGENDUM. 制定风险管理框架，通过对土火鸡中的沙门氏菌进行枚举和血清分型来改善公共卫生结果-勘误表。

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102179

Fernando Sampedro, Francisco Garces-Vega, Ali J Strickland, Craig W Hedberg

引用次数: 0

Presence of post-COVID-19 condition in six ethnic groups in Amsterdam, the Netherlands: a retrospectively reconstructed time interval approach. 荷兰阿姆斯特丹六个族裔群体中存在covid -19后状况：回顾性重建时间间隔方法

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S095026882610199X

Merve Spronk, Anders Boyd, Sophie Louise Campman, Vita Jongen, Henrike Galenkamp, Felix Chilunga, Charles Agyemang, Janke Schinkel, Elke Wynberg, Karien Stronks, Maria Prins

{"title":"Presence of post-COVID-19 condition in six ethnic groups in Amsterdam, the Netherlands: a retrospectively reconstructed time interval approach.","authors":"Merve Spronk, Anders Boyd, Sophie Louise Campman, Vita Jongen, Henrike Galenkamp, Felix Chilunga, Charles Agyemang, Janke Schinkel, Elke Wynberg, Karien Stronks, Maria Prins","doi":"10.1017/S095026882610199X","DOIUrl":"https://doi.org/10.1017/S095026882610199X","url":null,"abstract":"In this retrospective cohort study, we assessed the prevalence of post-COVID-19 condition (PCC) and its determinants among six ethnic groups in Amsterdam, the Netherlands. We analysed data from participants of the HELIUS cohort with SARS-CoV-2 infection who answered questions on the presence and duration of COVID-19-related symptoms between May and November 2022. We estimated the prevalence of PCC, defined as having ≥1 of 15 pre-determined COVID-19-related symptoms remaining for at least 3 months after infection, by ethnicity at several timepoints since infection adjusted for age and sex, and assessed determinants of PCC overall using logistic regression. Of 932 infected participants, 31% [95% confidence interval (95%CI): 27%-37%] developed PCC. At 3 months after infection the adjusted prevalence of PCC varied from 17% (95%CI: 13%-24%) in the Dutch-origin group to 41% (95%CI: 34%-48%) in the South-Asian Surinamese group, and was significantly higher among participants of South-Asian Surinamese, Turkish and Moroccan origin compared to those of Dutch origin (all P < 0.001). Participants who were of South-Asian Surinamese origin, older, female, without a vocational education or university degree, or obese were more likely to have PCC. Those of Ghanaian origin or infected during the period of Omicron predominance were less likely to have PCC. There were clear between-ethnic differences in the prevalence of PCC, which was more common in individuals of South-Asian Surinamese, Turkish, and Moroccan origin compared to those of Dutch origin. These differences mirror ethnic differences in SARS-CoV-2 infection and disease severity. Certain factors of PCC emerged, while consistent across ethnic groups.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e121"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burden of RSV hospital disease and its comorbidities in adults in Spain (2016-2023). 西班牙成人RSV医院疾病负担及其合并症（2016-2023）

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102076

Fernando Trigo, Jose Maria Guillen, Valentin Hernandez-Barrera, Ruth Gil, Angel Gil

{"title":"Burden of RSV hospital disease and its comorbidities in adults in Spain (2016-2023).","authors":"Fernando Trigo, Jose Maria Guillen, Valentin Hernandez-Barrera, Ruth Gil, Angel Gil","doi":"10.1017/S0950268826102076","DOIUrl":"10.1017/S0950268826102076","url":null,"abstract":"This observational descriptive study analyses the hospital burden of respiratory syncytial virus (RSV) among adults in Spain using the Minimum Basic Data Set (MBDS) from the Spanish National Hospital Data Surveillance System. Hospital admissions of adults diagnosed with non-bronchiolitis RSV infection between 2016 and 2023 were identified using ICD-10-CM codes. A total of 288,297 RSV-related hospitalizations were recorded, with a mean patient age of 76.18 years. The overall hospitalization rate was 92.43 per 100,000 inhabitants, and the mortality rate was 5.32 per 100,000. The most common severe comorbidities at admission were congestive heart failure, diabetes, and chronic obstructive pulmonary disease. Patients aged over 65 years had a significantly higher risk of in-hospital mortality (OR 1.78; 95% CI: 1.64-1.93) compared to those aged 40-64 years, increasing to 2.22 (95% CI: 2.05-2.40) in the presence of at least one severe comorbidity. Male sex was also associated with increased mortality risk (OR 1.24; 95% CI: 1.20-1.28). In conclusion, RSV represents a substantial cause of hospitalization and mortality among adults in Spain, particularly in patients over 60 years, males, and those with underlying comorbidities.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e127"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to Powell and Ebel. 对鲍威尔和埃贝尔的回应。

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102064

Fernando Sampedro, Craig W Hedberg

引用次数: 0

A large audit of Cobas CT/NG screening and Xpert CT/NG supplemental testing reveals low confirmatory rates in oropharyngeal samples with evidence of commensal cross-reactivity with an isolate of Neisseria lactamica. Cobas CT/NG筛查和Xpert CT/NG补充检测的大量审计显示，口咽样本的确诊率很低，有证据表明与内酰胺奈瑟菌分离株存在共交叉反应性。

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102039

Ashley McEwan, Jay Lucidarme, Thomas Whitfield, Rachel Buttery, Peter Tilston, Nicholas Machin, Malcolm Guiver

{"title":"A large audit of Cobas CT/NG screening and Xpert CT/NG supplemental testing reveals low confirmatory rates in oropharyngeal samples with evidence of commensal cross-reactivity with an isolate of Neisseria lactamica.","authors":"Ashley McEwan, Jay Lucidarme, Thomas Whitfield, Rachel Buttery, Peter Tilston, Nicholas Machin, Malcolm Guiver","doi":"10.1017/S0950268826102039","DOIUrl":"https://doi.org/10.1017/S0950268826102039","url":null,"abstract":"Sensitive and high-throughput testing for Neisseria gonorrhoeae (NG) is widely underpinned by automated commercial solutions using nucleic acid amplification tests. We outline our experience of using Roche Cobas 8800 CT/NG (Cobas NG) for primary testing of NG at scale. Over 360000 specimens were tested over a three-year period. A disproportionate number of 'indeterminate' oropharyngeal swabs (25%) tested positive by Cobas NG but failed to confirm by Xpert CT/NG, significantly higher than genital samples (4%) (chi-square p-value <0.05). Such samples are highly problematic, as they fail to provide a definitive result for the patient. To investigate this non-specificity, publicly available sequences for Cobas NG DR-9 targets were aligned with Neisseria genome databases. We found a strain of Neisseria lactamica (PubMLST 49718), isolated from a throat swab, which was predicted to cross-react with Cobas NG. We subsequently confirmed a Cobas NG false-positive result with this isolate. BLAST analysis showed the target gene NG DR-9 was rare among available non-NG Neisseria whole genome sequences. This may suggest the existence of an as-yet unknown and difficult to cultivate oral commensal that contains NG DR-9. Our findings further highlight the need for NG confirmatory testing of oropharyngeal samples screened with Cobas NG.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e123"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burden of healthcare-associated infections in tertiary care hospitals in six countries of the Gulf Cooperation Council: A point prevalence survey. 海湾合作委员会六个国家三级保健医院的卫生保健相关感染负担：点状流行病学调查。

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826101964

Majid M Alshamrani, Aiman El-Saed, Fayssal Farahat, Mohammed Al Zunitan, Mohammed Abalkhail, Sarah Alfayez, Najiba Mohamed Abdulrazzaq, Afaf Merza Mohamed, Abdulrhman Ibrahim Mohana, Nawal Al Kindi, Jameela Ali Al-Ajmi, Kelly Schrapp, Rana H Almaghrabi, Hussam Alobaida, Amal Al Tai, Fatimah Saad Alshahrani, Zahir O Babiker, Najla Ibrahim Alrabei, Maher Alharbi, Khaled Al Sager, Ahmad Subhi, Wafa Al Nasser, Abdulmajid Al Arfaj, Syed Nazeer, Maida Balila, Alaa Alqurashi, Nouf Alzuhayri, Salman Alhajri, Rasha Alfawaz, Sami Almudarra, Pasi Penttinen

{"title":"Burden of healthcare-associated infections in tertiary care hospitals in six countries of the Gulf Cooperation Council: A point prevalence survey.","authors":"Majid M Alshamrani, Aiman El-Saed, Fayssal Farahat, Mohammed Al Zunitan, Mohammed Abalkhail, Sarah Alfayez, Najiba Mohamed Abdulrazzaq, Afaf Merza Mohamed, Abdulrhman Ibrahim Mohana, Nawal Al Kindi, Jameela Ali Al-Ajmi, Kelly Schrapp, Rana H Almaghrabi, Hussam Alobaida, Amal Al Tai, Fatimah Saad Alshahrani, Zahir O Babiker, Najla Ibrahim Alrabei, Maher Alharbi, Khaled Al Sager, Ahmad Subhi, Wafa Al Nasser, Abdulmajid Al Arfaj, Syed Nazeer, Maida Balila, Alaa Alqurashi, Nouf Alzuhayri, Salman Alhajri, Rasha Alfawaz, Sami Almudarra, Pasi Penttinen","doi":"10.1017/S0950268826101964","DOIUrl":"https://doi.org/10.1017/S0950268826101964","url":null,"abstract":"A cross-sectional study using point prevalence survey (PPS) methodology was conducted on May 20, 2024, at 18 tertiary care hospitals located in the 6 Gulf Cooperation Council (GCC) countries to assess the prevalence of healthcare-associated infections (HAIs) and associated pathogens. The measured outcome was the presence of active HAIs in different hospital units. During the PPS day, 651 HAI events were detected among 580 patients after reviewing the information of 6826 patients. The prevalence of patients with HAIs was 8.5% (95% CI 7.8%-9.2%). The prevalence was higher in older patients (11.8%, 95% CI 10.2%-13.4%), in intensive care units (24.6%, 95% CI 21.5%-27.8%), and in specialty care areas (12.7%, 95% CI 9.8%-15.7%). The most frequent type of HAIs was pneumonia (27.8%), followed by bloodstream infection (25.0%), urinary tract infection (10.9%), and skin infection (9.7%). Device-associated HAIs represented 15.4% of all HAIs, with ventilator-associated pneumonia, central line-associated bloodstream infection, and catheter-associated urinary tract infection being the main types. Approximately 61.9% of HAIs were microbiologically confirmed. Out of them, 65.3% were caused by Gram-negative bacteria and 31.8% were caused by multidrug-resistant pathogens. The findings confirm that the high HAI burden in GCC hospitals is higher in high-resource countries but lower in lower/middle-resource countries.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e120"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

County-level differences in Salmonella incidence across urban and rural United States, 2011-2023. 2011-2023年美国城乡沙门氏菌发病率的县级差异

IF 2.5 4区医学

Epidemiology and Infection Pub Date : 2026-10-14 DOI: 10.1017/S0950268826102192

Lavin A Joseph, Lyndsay Bottichio, Ethel V Taylor, Grace Bagwell Adams, Suhang Song

{"title":"County-level differences in Salmonella incidence across urban and rural United States, 2011-2023.","authors":"Lavin A Joseph, Lyndsay Bottichio, Ethel V Taylor, Grace Bagwell Adams, Suhang Song","doi":"10.1017/S0950268826102192","DOIUrl":"https://doi.org/10.1017/S0950268826102192","url":null,"abstract":"Salmonella is a leading cause of foodborne illness in the United States, yet rural-urban differences in incidence and their underlying drivers remain poorly characterized. We conducted an ecological analysis of deidentified probable and confirmed Salmonella cases from the National Notifiable Diseases Surveillance System (NNDSS), 2011-2023, to evaluate temporal, regional, and population-level determinants of Salmonella incidence. Multivariable negative binomial models assessed rural-urban differences nationally and by U.S. Census region, and Blinder-Oaxaca decomposition quantified contributions of demographic, socioeconomic, healthcare access, and health-related factors. Age-adjusted incidence was consistently higher in rural than in urban counties. After adjustment, rural counties had higher incidence nationally and separately in all four regions (Northeast, Midwest, West, and South). County-level factors explained 66% of the national rural-urban gap, driven primarily by age structure, income, education, and food environment. Adults aged ≥65 years accounted for approximately 60% of the explained difference and were the dominant contributor in some regions. Regional variation was evident, with age predominating in the Midwest and West and education contributing more in the Northeast and South. A substantial unexplained component remained. These findings highlight persistent, regionally heterogeneous disparities and underscore the need for targeted, region-specific surveillance and prevention strategies.","PeriodicalId":11721,"journal":{"name":"Epidemiology and Infection","volume":"154 ","pages":"e134"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0