Ehab A Abu-Basha, Zuhair B Ismail, Mohammad H Alboom, Ayesha Alkofahi, Basil H Amarneh, Omar Al-Omari, Alaa Fahmawi, Abdullah Alshammari, Mais Lakaideh, Shereen Shaban, Bilal Al-Omari, Hani Talafha, Zaidoun Hijazeen, Yasmin Daradkeh, Rabeh El-Shesheny, Ghazi Kayali, Whitney Bagge, William B Karesh
{"title":"Molecular diagnosis and phylogenetic analysis of a Middle East respiratory syndrome coronavirus human case in Jordan.","authors":"Ehab A Abu-Basha, Zuhair B Ismail, Mohammad H Alboom, Ayesha Alkofahi, Basil H Amarneh, Omar Al-Omari, Alaa Fahmawi, Abdullah Alshammari, Mais Lakaideh, Shereen Shaban, Bilal Al-Omari, Hani Talafha, Zaidoun Hijazeen, Yasmin Daradkeh, Rabeh El-Shesheny, Ghazi Kayali, Whitney Bagge, William B Karesh","doi":"10.1093/eurpub/ckae106","DOIUrl":"10.1093/eurpub/ckae106","url":null,"abstract":"<p><p>Middle East respiratory syndrome coronavirus (MERS-CoV) is an important zoonotic pathogen. The aim of this paper is to report one polymerase chain reaction (PCR)-positive case of MERS-CoV in a 27-year-old man who was involved in a nationwide longitudinal surveillance study of certain zoonotic diseases in Jordan including MERS-CoV. Whole-blood and nasal swab samples were collected from the man and five camels in the vicinity of his living area. The samples were subjected to enzyme-linked immunosorbent assay (ELISA) and real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV-specific antibodies and MERS-CoV genetic material, respectively. Genomic sequencing and phylogenetic analysis were also performed to detect similarities with known strains of the virus in the region. In January 2021, an ongoing surveillance study detected a MERS-CoV-positive nasal swab sample from an asymptomatic male and camels using RT-PCR. Phylogenetically, the MERS-CoV isolated in this case belonged to clade B and is clustered with other strains originating in the Arabian Peninsula. The case report represents the first PCR-positive case of MERS-CoV in an asymptomatic individual in Jordan, indicating active circulation of the virus within the population.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_1","pages":"i55-i59"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Devendra Bansal, Nada Assaad, Hend Omar Mohamed, Muralitharan Shanmugakonar, Dorothy Pacate, Khider Mohamed, Perumal Balakrishnan, Redentor Cuizon Ramiscal, Nandakumar Ganesan, Maha Hammam M A Al-Shamali, Ali A Sultan, Waqar Munir, Mohammed Abukhattab, Francis Schaffner, Muna A Al-Maslamani, Hamad Eid Al-Romaihi, Mohammed Al-Thani, Fatima Al Khayat, Elmoubashar Abd Farag
{"title":"An epidemiological risk assessment of imported malaria cases and potential local transmission in Qatar.","authors":"Devendra Bansal, Nada Assaad, Hend Omar Mohamed, Muralitharan Shanmugakonar, Dorothy Pacate, Khider Mohamed, Perumal Balakrishnan, Redentor Cuizon Ramiscal, Nandakumar Ganesan, Maha Hammam M A Al-Shamali, Ali A Sultan, Waqar Munir, Mohammed Abukhattab, Francis Schaffner, Muna A Al-Maslamani, Hamad Eid Al-Romaihi, Mohammed Al-Thani, Fatima Al Khayat, Elmoubashar Abd Farag","doi":"10.1093/eurpub/ckae127","DOIUrl":"10.1093/eurpub/ckae127","url":null,"abstract":"<p><p>Preventing local transmission of malaria from imported cases is crucial for achieving and maintaining malaria elimination. This study aimed to investigate the epidemiological characteristics of imported malaria cases and assess the distribution of malaria vectors in Qatar. Data from January 2016 to December 2022 on imported malaria, including demographic and epidemiological characteristics, travel-related information, and diagnostic results, were collected and analysed using descriptive statistics. Field surveys conducted in 2021-22 collected mosquitoes using various traps across Qatar. The collected samples underwent morphological and molecular characterization at Qatar University. A total of 2693 cases were reported, with a mean incidence of 13.5/100 000 population, decreasing from 18.8/100 000 in 2016 to 5.5/100 000 in 2020. Most cases were Plasmodium vivax (57.4%) followed by P. falciparum (40.4%). The median age was 32.9 ± 12.5 years, primarily males (86.7%), expatriates (99.6%) and notified during the hot months (July to September). Cases were mainly imported from the Eastern Mediterranean Region followed by the African and South-East Asia Region with no deaths and indigenous cases. Anopheles stephensi was identified as a widely distributed species, but none carried the Plasmodium pathogen. Despite no reports of local transmission, the presence of An. stephensi and favourable environmental conditions pose a risk in Qatar. Strengthening surveillance for imported malaria and reviewing epidemic protocols are necessary. Conventional field studies are imperative to address knowledge gaps in Anopheles mosquito ecology and biting habits in Qatar, accurately assessing the risk of local malaria transmission to support Qatar's malaria-free status.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_1","pages":"i35-i40"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiori Kodama, Riyadh Abdulameer Alhilfi, Ihab Aakef, Adnan Khamasi, Sinan Mahdi, Hameeda Mohammed Hasan, Raghad Ibrahim Khaleel, Mazin Mahdi Naji, Noor Khalid Esmaeel, Sundus Haji-Jama, Anais Legand, Olivia Keiser, Isabella Eckerle, Pierre B H Formenty
{"title":"Epidemiological analysis and potential factors affecting the 2022-23 Crimean-Congo hemorrhagic fever outbreak in Iraq.","authors":"Chiori Kodama, Riyadh Abdulameer Alhilfi, Ihab Aakef, Adnan Khamasi, Sinan Mahdi, Hameeda Mohammed Hasan, Raghad Ibrahim Khaleel, Mazin Mahdi Naji, Noor Khalid Esmaeel, Sundus Haji-Jama, Anais Legand, Olivia Keiser, Isabella Eckerle, Pierre B H Formenty","doi":"10.1093/eurpub/ckae147","DOIUrl":"10.1093/eurpub/ckae147","url":null,"abstract":"<p><p>Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne disease with a case fatality rate of up to 40% in humans, posing a significant health threat. This study investigates the 2022-23 CCHF outbreaks in Iraq, the highest recorded to date, and analyzes potential factors at the human-animal-environmental interface. Data from the Iraqi government, the World Health Organization, and the World Bank were used to analyze CCHF trends and affecting factors. This included epidemiological reports, clinical data, tick infestation and seroprevalence studies, and climate data. Descriptive and statistical analyses examined case trends, geographic and demographic characteristics, clinical manifestations, risk factors, seasonal patterns, and influencing factors. A sudden rise in CCHF cases began in southern Iraq in April 2022 and expanded across all governorates, with a shift toward urban areas. Higher incidence was observed among males, aged 25-44, and those involved in slaughtering. The most common clinical manifestation was fever (97%), followed by hemorrhagic symptoms (54%). Bleeding from the gums or mouth and subcutaneous bleeding were more frequent in patients with fatal outcomes. Seasonal patterns showed peaks during spring and fall, correlating with tick activity and potentially exacerbated by climate change. Tick infestation and seroprevalence studies indicated a high prevalence of Hyalomma ticks and CCHF seropositivity among domestic animals in southern Iraq (60%), consistent with the distribution of CCHF human cases. Iraq's ongoing CCHF outbreak demands multidisciplinary One Health strategies. The Iraqi government has adopted such a control strategy, contributing to regional and global efforts to enhance pandemic preparedness.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_1","pages":"i6-i13"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Riyaz Ahamed Shaik, Mohammad Shakil Ahmad, Mohammad Miraj, Waqas Sami, Alashjaee Ahmed Azam, Patrick Okwarah
{"title":"Evaluating the burden and transmission dynamics of chikungunya virus infections in the Eastern Mediterranean Region: a systematic review and meta-analysis.","authors":"Riyaz Ahamed Shaik, Mohammad Shakil Ahmad, Mohammad Miraj, Waqas Sami, Alashjaee Ahmed Azam, Patrick Okwarah","doi":"10.1093/eurpub/ckae165","DOIUrl":"10.1093/eurpub/ckae165","url":null,"abstract":"<p><p>The Chikungunya virus (CHIKV) presents substantial public health challenges in the Eastern Mediterranean Region (EMR), with its prevalence and interaction with other arboviruses (ABVs) remaining poorly understood. This systematic review and meta-analysis aimed to assess the prevalence of CHIKV and its association with other ABVs, such as dengue virus (DENV), Rift Valley fever virus (RVFV), malaria, and yellow fever virus (YFV), in the EMR. We systematically searched databases including PubMed, Embase, Web of Science, Scopus, Cochrane Library, CINAHL, PsycINFO, and ScienceDirect to identify epidemiological studies that report CHIKV prevalence and provide odds ratios (ORs) for CHIKV compared to other ABVs. Data analysis was performed using a random-effects model. Heterogeneity was evaluated using the χ2 test and I2 statistic. The GRADE approach was used to evaluate the quality of the studies while the AXIS tool, NOS tool, and AHRQ checklist assessed the risk of bias. The meta-analysis revealed a significant prevalence of CHIKV in the EMR. However, the studies exhibited heterogeneity, indicating variability in the results. A comparison of CHIKV with other ABVs did not show any statistically significant differences in prevalence. The meta-analysis found a notable prevalence of CHIKV in the EMR. The results also indicated that the prevalence of CHIKV is comparable to that of other ABVs in the region. These findings provide an overview of the burden of CHIKV in the EMR.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_1","pages":"i27-i34"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bartonellosis in World Health Organization Eastern Mediterranean Region, a systematic review and meta-analysis.","authors":"Zahra Tahmasebi Ashtiani, Fahimeh Bagheri Amiri, Mozhgan Ahmadinezhad, Ehsan Mostafavi, Saber Esmaeili","doi":"10.1093/eurpub/ckae123","DOIUrl":"10.1093/eurpub/ckae123","url":null,"abstract":"<p><p>Bartonella is a vector-borne zoonotic pathogen, which could also be transmitted directly and cause a variety of clinical illnesses. This study aimed to investigate the prevalence of Bartonella in countries in the WHO Eastern Mediterranean Region (WHO-EMR) region. We searched using the keywords Bartonella and the name of each country in the WHO-EMR in databases such as PubMed, ISI (Web of Science), Scopus, and Google Scholar, with a publication date range of 1990-2022 and limited to English articles. We evaluated the quality of the studies using the STROBE 6-item checklist and used the random effects model to integrate the findings of the included studies. A total of 45 papers out of 240 were included in the analysis. The results showed the prevalence of Bartonella infection among endocarditis patients was 3.8% (95% CI: 0.2-7.4) and the seroprevalence of Bartonella among other people was 27.5% (95% CI: 13.5-41.5). The overall prevalence of Bartonella spp. among animals, as determined by molecular, serological, and culture methods, was 11.9% (95% CI: 5.7-18.2), 38.9% (95% CI: 27.5-50.2), and 1.7% (95% CI: 0.5-2.9), respectively. Furthermore, the prevalence of Bartonella spp. in ectoparasites was 3.9% (95% CI: 3.5-5.2), with fleas (6.2%) showing a higher prevalence compared to lice (4.9%) and ticks (1.0%). The detection of Bartonella in all animal and ectoparasites species and human populations in the WHO-EMR with prevalence ranging from 0.3% to 23% is concerning, emphasizes the importance of conducting more comprehensive studies to gain a deeper understanding of the spread of Bartonella in these areas.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_1","pages":"i48-i54"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Breastfeeding duration, children's diet and physical activity in immigrant children living in Lisbon.","authors":"","doi":"10.1093/eurpub/ckae210","DOIUrl":"https://doi.org/10.1093/eurpub/ckae210","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Prospective relationship between family screen time rules, obesogenic behaviours, and childhood obesity.","authors":"","doi":"10.1093/eurpub/ckae207","DOIUrl":"10.1093/eurpub/ckae207","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Tisler, Karolin Toompere, Marc Bardou, Jose Diaz, Madleen Orumaa, Anneli Uusküla
{"title":"HPV-associated cancers among people living with HIV: nationwide population-based retrospective cohort study 2004-21 in Estonia.","authors":"Anna Tisler, Karolin Toompere, Marc Bardou, Jose Diaz, Madleen Orumaa, Anneli Uusküla","doi":"10.1093/eurpub/ckae152","DOIUrl":"10.1093/eurpub/ckae152","url":null,"abstract":"<p><p>Cancers represent the primary cause of mortality among people living with HIV (PLWH). However, comprehensive nationwide data regarding cancer incidence remains limited. Our objective was to evaluate the incidence rates of cancers, particularly those associated with human papillomavirus (HPV), within a nationwide study cohort. Using data from the Estonian Health Insurance Fund and the National Cancer Registry from 2004 to 2021, we calculated standardized incidence ratios (SIRs) for various cancer types among PLWH to compare to the general population with special emphases on HPV-associated cancers. A total of 7011 individuals (65.7% men) diagnosed with HIV were identified. HPV-associated cancers accounted for 21.4% of all incident cancer cases among PLWH. SIRs for HPV-associated cancers were 3.7 [95% confidence interval (CI) 2.2-6.2] among men living with HIV (MLWH) and 5.7 (95% CI 4.0-7.9) among women living with HIV (WLWH). In MLWH, the highest SIRs were for penile 12.5 (95% CI 4.0-38.7), followed by oropharyngeal 3.6 (95% CI 1.7-7.6) and anal-rectal cancers 2.7 (95% CI 1.1-6.4) in comparison to the general population. In WLWH, an increased incidence of cervical (SIR = 5.8, 95% CI 3.9-8.5), oropharyngeal (SIR = 6.1, 95% CI 1.5-24.3), and anal-rectal (SIR = 3.6, 95% CI 1.2-11.2) cancers was observed. A significantly increased risk of AIDS-defining and non-AIDS-defining cancers is reported. We demonstrate a substantially heightened risk of HPV-associated cancers among PLWH compared to the general population, underscoring the imperative for intensified screening and scaled-up vaccination along with improvement in adherence to antiretroviral therapy.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"1199-1204"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mette Bender, Charlotte Glümer, Henrik Brønnum-Hansen, Ingelise Andersen, Karsten Vrangbæk
{"title":"Disease management program in patients with type 2 diabetes.","authors":"Mette Bender, Charlotte Glümer, Henrik Brønnum-Hansen, Ingelise Andersen, Karsten Vrangbæk","doi":"10.1093/eurpub/ckae155","DOIUrl":"10.1093/eurpub/ckae155","url":null,"abstract":"<p><p>The aim of this paper was to study ethnic and socioeconomic (SEP) factors' association with provision and participation in a type 2 diabetes disease-management program. In 2016-21, 3464 persons were referred to type 2 diabetes management in Copenhagen municipality. Personalized plans included a mix of activities; program consultations, dietary education, telephone conversations, patient education, and physical training. We estimated the association between education, income, civic status, employment, and country of origin with the number of booked and participated activities using Poisson regression models. A total of 55 394 program sessions were scheduled. Small differences in booked dietary education, program consultations, telephone conversations, and patient education were seen between SEP groupings. In situations where groups with lower SEP had booked more sessions (e.g. unemployed bookings of dietary education), these were predominantly translated into equal or more participated sessions among persons with high SEP. Regarding physical training, considerably more booked and participated sessions were delivered to women with lower SEP and ethnic minorities. This study is unique, in the sense that it is the first of its kind to analyze data on diabetes-management programs, systematically collected by primary healthcare workers. Our results suggest that specific elements of the program together with a higher number of booked sessions promoted vulnerable women to participate in more physical training sessions. In closing, these findings have the potential to provide motivation and ideas for policymakers and health professionals in how to design equitable type 2 diabetes management activities.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"1112-1116"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Päivi E Korhonen, Hannu Kautiainen, Ansa T Rantanen
{"title":"Association of unemployment and increased depressive symptoms with all-cause mortality: follow-up study of a cardiovascular prevention programme.","authors":"Päivi E Korhonen, Hannu Kautiainen, Ansa T Rantanen","doi":"10.1093/eurpub/ckae175","DOIUrl":"10.1093/eurpub/ckae175","url":null,"abstract":"<p><p>Unemployment has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. However, factors behind this association remain unsettled. A primary care CVD prevention programme was conducted in two Finnish towns in 2005-07. Of the participants (n = 4450), a cohort of apparently healthy CVD risk subjects belonging to the labour force (n = 1487) was identified. Baseline depressive symptoms were assessed by Beck's Depression Inventory. Data on employment status and mortality were obtained from official statistics. The effect of employment status and depressive symptoms on all-cause mortality after a median follow-up of 15 years was estimated in models adjusted for age, sex, body mass index, non-high-density lipoprotein cholesterol, physical activity, alcohol use, current smoking, glucose metabolism, and hypertension. In comparison to employed non-depressive subjects, fully adjusted hazard ratio (HR) for all-cause mortality was 3.53 (1.90-6.57) in unemployed subjects with increased depressive symptoms, 1.26 (0.68-2.34) in unemployed non-depressive subjects, and 1.09 (0.63-1.90) in employed depressive subjects. Factors independently associated with mortality were unemployment with increased depressive symptoms [HR 3.56 (95% CI 1.92-6.61)], screen-detected diabetes [HR 2.71 (95% CI 1.59-4.63)], current smoking [HR 1.77 (95% CI 1.19-2.65)], and higher age [HR 1.10 (95% CI 1.05-1.15)]. Unemployment in itself was not associated with all-cause mortality. If unemployment was accompanied with increased depressive symptoms, risk of death was significantly elevated.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":"1140-1145"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}