Journal of Epidemiology and Global Health最新文献

{"title":"Pushed, Pulled, and Moored: A Systematic Review and Meta-analysis of Migration Intentions Among Medical Trainees in the Arab Region.","authors":"Yusof Mohamed Omar, Mohamed Ashraf Elsaadany, Nour Edin Darwish, Yousuf Darwish, Lina Mohamed Omar, Mohamed Hossam Ghazy, Tasneem Deibes, Karim A Elsodany, Jamal Ahmad","doi":"10.1007/s44197-026-00640-w","DOIUrl":"https://doi.org/10.1007/s44197-026-00640-w","url":null,"abstract":"<p><strong>Introduction: </strong>The Arab region is experiencing substantial outward migration amid persistent healthcare workforce shortages. However, reported prevalence estimates and reasons vary considerably across studies. Therefore, we aimed to estimate the pooled prevalence of migration intentions among medical trainees in the Arab region and summarize the reported drivers of migration using the Push-Pull-Mooring (PPM) framework.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Embase, and Web of Science in April 2026, supplemented by backward and forward citation searching. Studies were eligible if they reported discrete prevalence estimates of migration intentions among medical students, interns, or residents in Arab countries. The pooled prevalence was calculated using a random-effects model with a generalized linear mixed model and logit transformation. Heterogeneity was primarily assessed using Tau². Risk of bias was assessed using the Newcastle-Ottawa Scale adapted for descriptive cross-sectional studies (NOS-xs2).</p><p><strong>Results: </strong>Thirty-one studies comprising 21,614 Arab medical trainees were included. The overall pooled prevalence of migration intention was 70.7% (95% CI: 63.2%-77.2%), with substantial heterogeneity (Tau² = 0.84). Subgroup analyses were not statistically significant except for region (p = 0.030), with the Nile Valley reporting the highest prevalence (74.3%; k = 14) and the Arabian Peninsula reporting the lowest (41.5%; k = 3). Prevalence was numerically highest among medical students (76.0%), followed by residents (65.4%) and interns (56.7%). By intention type, general migration intent was highest (74.1%), followed by training-related (71.5%) and work-related migration (61.9%). War and insecurity (k = 10), financial insecurity (k = 9), and poor working conditions (k = 7) were the most frequently reported push factors, while higher pay (k = 11), better training opportunities (k = 10), and career growth (k = 10) were the frequently reported pull factors. Family ties (k = 6) and patriotism (k = 5) were the frequently reported mooring influences.</p><p><strong>Conclusions: </strong>More than two-thirds of medical trainees in the Arab region report intentions to migrate abroad, highlighting a major regional health workforce challenge. While intentions do not equate to actual migration behavior, the findings nevertheless support the need for health workforce policies that strengthen physician retention through investment in competitive remuneration, safe working environments, and high-quality local postgraduate training pathways while addressing broader sociopolitical drivers of migration.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Arthritis in Systemic Lupus Erythematosus in Pakistan: A Systematic Review and Meta-analysis.","authors":"Muhammad Imran Khan, Humera Qureshi, Fazal Hassan, Sohail Akhtar, Sadique Ahmad, Abdelhamied A Ateya, Mohammed A El-Affendi","doi":"10.1007/s44197-026-00644-6","DOIUrl":"10.1007/s44197-026-00644-6","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations that significantly affect patients' quality of life. Arthritis is one of the most common and disabling manifestations of SLE. This study aimed to provide a comprehensive estimate of the prevalence of arthritis among patients with SLE in Pakistan and to evaluate regional and temporal variations.</p><p><strong>Methods: </strong>Two independent reviewers selected eligible studies, extracted the data, and assessed the risk of bias. A random-effects meta-analysis was performed to account for between-study heterogeneity. Subgroup analyses and meta-regression were conducted to explore potential sources of study-level variation.</p><p><strong>Results: </strong>A total of 10 studies involving 1,292 participants were included in the meta-analysis. The pooled prevalence of arthritis among patients with SLE was 60.68% (95% CI: 46.41%-74.08%). Subgroup analysis showed that the highest prevalence was observed in Khyber Pakhtunkhwa (KP) (78.13%; 95% CI: 74.83%-81.11%), followed by Punjab (58.94%; 95% CI: 38.19%-78.15%) and Sindh (57.28%; 95% CI: 29.43%-82.82%). Studies published after 2010 reported a higher pooled prevalence (67.89%; 95% CI: 54.47%-79.95%) than those published before 2010 (42.11%; 95% CI: 34.74%-49.67%).</p><p><strong>Conclusion: </strong>The high prevalence of arthritis among patients with SLE in Pakistan highlights the need for improved screening, early diagnosis, and effective management strategies to reduce disease burden and improve patient outcomes.</p><p><strong>Prospero registration number: </strong>This systematic review and meta-analysis was registered with PROSPERO (CRD42023420108) on May 1st, 2023.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illness Perception and its Association with Emotional Distress Among Adults with Migraine: A Cross-Sectional Study.","authors":"Tahneem Yaseen, Muhammad Umair Afzal, Muhammad Shahid Iqbal, Seerat Shahzad, Muhammad Zahid Iqbal, Khalid M Orayj, Saad S Alqahtani","doi":"10.1007/s44197-026-00646-4","DOIUrl":"https://doi.org/10.1007/s44197-026-00646-4","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a prevalent and disabling neurological disorder that significantly impairs quality of life. In Pakistan, limited awareness, stigma, and sociocultural misconceptions often delay diagnosis and treatment. Understanding how patients perceive their illness is essential for improving management and outcomes.</p><p><strong>Objective: </strong>This study explored illness perceptions of migraine among adults in Lahore, Pakistan, and examined their associations with demographic, clinical, and psychological factors.</p><p><strong>Methods: </strong>A community-based cross-sectional survey was conducted from July to September 2025 using the Brief Illness Perception Questionnaire (B-IPQ). Adults aged 18-70 years with a clinician-diagnosed migraine were recruited through online platforms. Sociodemographic and clinical data were analyzed using SPSS v23. Non-parametric tests and multiple regression analyses were applied to identify correlates and factors independently associated with emotional response.</p><p><strong>Results: </strong>Of 230 participants, 66.5% were male and 72.2% aged 18-25 years. Psychological and lifestyle factors i.e. stress (11.7%), anxiety (10.8%), and tension (8.7%) were the most frequently perceived causes of migraine. Women and unemployed participants reported significantly higher emotional impact (p < .05). Longer illness duration correlated with stronger chronicity beliefs, and higher attack frequency was linked to greater concern and distress. Regression analysis identified gender, symptom identity, concern, and illness coherence as factors independently associated with emotional response (p < .05).</p><p><strong>Conclusion: </strong>Negative illness perceptions, particularly heightened concern and emotional reactivity, were correlated with psychological distress among migraine patients. Interventions promoting adaptive illness beliefs and psychoeducation may enhance coping, adherence, and overall quality of life in this population.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Hypertension on the Health-related Quality of Life of People Living with Hypertension in Dschang, Cameroon: Comparative Analytical Cross-section.","authors":"Omi Salamatou Ngambu, Clarisse Mapa-Tassou, Sylvain Raoul Simeni Njonnou, Franck Gerre Yemele, Zidane Tapontsop Tsakeng, Guy Calvin Mbongo'o Nko'o, Siméon Pierre Choukem","doi":"10.1007/s44197-026-00637-5","DOIUrl":"https://doi.org/10.1007/s44197-026-00637-5","url":null,"abstract":"<p><strong>Background: </strong>Hypertension has significant socioeconomic consequences and adversely affects the health-related quality of life (HRQOL) of people living with hypertension. In Cameroon, although one-third of adults have hypertension, no study has previously examined its impact on the HRQoL of individuals. This study aimed to assess the effect of hypertension on the HRQoL of people living with hypertension followed up in three health facilities in the Dschang Health District.</p><p><strong>Methodology: </strong>We carried out a comparative analytical cross-sectional study to compare people with a confirmed diagnosis of hypertension (exposed group) with age-, sex-, and location-matched participants without hypertension (unexposed group). Data were collected through face-to-face interviews via a standardized questionnaire including the Health Utilities Index Mark 3 (HUI3) to assess HRQoL. Data were analysed using SPSS software, and the significance threshold was set at 5%. Comparisons between the two groups were performed using multivariable linear regression for continuous HUI3 scores and logistic regression for binary HRQoL outcomes.</p><p><strong>Results: </strong>A total of 196 participants were enrolled in this study, with 98 in each group. The median age of the subjects was 66 years (IQR: 60-73.25), and most of the participants were females (62.2%). Among chronic comorbidities, diabetes was significantly more common among participants with hypertension (OR = 30.961 [6.87-139.51], p value = 0.001). Compared with those without hypertension, people with hypertension had significantly poorer HRQoL (a difference of 0.2017 in the overall mean HUI score, p < 0.001), and this difference was more than 6 times greater than the clinically important difference of 0.03. Neither a longer duration of hypertension since diagnosis nor the overall burden of comorbidities was associated with a reduction in HRQoL.</p><p><strong>Conclusion: </strong>These findings underscore the importance of integrating routine HRQoL assessment and comprehensive management of hypertension into hypertension care programs. They also support continued investment in health promotion and primary prevention strategies aimed at reducing the burden of hypertension and diabetes in Cameroon and other low- and middle-income settings.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Mortality Surveillance in Case Detection and Response During the 2025 Sudan Virus Disease Outbreak in Uganda.","authors":"Rubangakene Moses, Caroline Kyozira, Douglas Bulafu, Mgamb Elizabeth, Rawlance Ndejjo, Okware Solome, Abok Patrick, Agwang Winnie, Steven N Kabwama, Katushabe Edson, Katusiime Maureen, Mwine Patience, Rhoda K Wanyenze, Kasonde Mwinga, Muruta Allan","doi":"10.1007/s44197-026-00643-7","DOIUrl":"10.1007/s44197-026-00643-7","url":null,"abstract":"<p><strong>Background: </strong>Developing countries like Uganda, face challenges in containing filovirus outbreaks such as Sudan virus disease (SVD). The 2025 Sudan Virus Disease outbreak in Uganda predominantly affected urban and peri-urban areas. To curtail the outbreak, mortality surveillance was integrated into the response strategies. This paper describes how mortality surveillance was implemented, its contribution to case detection and to the triggering of response actions, and the facilitators and barriers to its implementation during this outbreak.</p><p><strong>Methods: </strong>A retrospective descriptive document review was conducted, analyzing situation reports, meeting minutes, technical briefs, and mortality surveillance summaries generated by the Incident Management Team between the declaration of the outbreak (30 January 2025) and its official end (26 April 2025). We described the implementation processes, the contribution of mortality surveillance to case detection and response, and the facilitators and barriers to its implementation during the 2025 Sudan virus disease (SVD) outbreak.</p><p><strong>Results: </strong>During the 2025 Sudan Virus Disease outbreak, mortality surveillance was rapidly activated and integrated into active surveillance. Mortality surveillance was conducted systematically involving the following community engagement; death notification; epidemiological investigations; and containment measures such as contact tracing, quarantine, and safe and dignified burials. Mortality surveillance contributed to case detection: 3/14 (21.4%) cases registered during the outbreak were identified through investigations triggered by death alerts. These detections informed public health measures such as contact tracing and quarantine of contacts, which may have contributed to interrupting potential transmission chains. Key facilitators included strong coordination and leadership, the use of digitized data tools, capacity building and community engagement and involvement. Persistent barriers included underreporting from informal settlements and private clinics, logistical delays in sample transportation, and lack of mortality surveillance guidelines during the outbreak.</p><p><strong>Conclusion: </strong>The 2025 Sudan virus disease outbreak in Uganda demonstrates the potential value of integrating mortality surveillance into outbreak detection and response, particularly in urban and informal settings. Strengthening mortality surveillance systems should be considered a core component of epidemic preparedness and response strategies in low- and middle-income countries facing recurrent filovirus threats.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Delayed Malaria Treatment-Seeking Among Under-Five Children in a Post-Conflict District of Northern Ethiopia: A Facility-Based Unmatched Case-Control Study.","authors":"Gebreanenia Gebretsadik Gebremamas, Fissha Brhane Mesele, Senait Alemayehu Abrha, Desalegn Massa","doi":"10.1007/s44197-026-00638-4","DOIUrl":"10.1007/s44197-026-00638-4","url":null,"abstract":"<p><strong>Background: </strong>Delayed treatment seeking for malaria among under-five children remains a major public health problem in low-resource and post-conflict settings. However, there is limited evidence on its determinants in a post-conflict district. This study aimed to identify determinants of delayed malaria treatment seeking among under-five children in a post-conflict district of Northern Ethiopia, 2024.</p><p><strong>Methods: </strong>A facility-based unmatched case-control study was conducted in Samre District, Tigray, from March 18 to May 18, 2024. The study included 364 under-five children (182 cases and 182 controls) selected through systematic random sampling. Delayed malaria treatment-seeking was defined as seeking care more than 24 h after the onset of fever or malaria symptoms, whereas timely treatment-seeking was defined as seeking care within 24 h. Data were coded and entered into EpiData and analyzed using the Statistical Package for the Social Sciences version 27. Bivariable logistic regression was first used to select candidate variables at P < 0.2 for further analysis. In the multivariable analysis, variables with P < 0.05 were considered statistically significant. The Hosmer-Lemeshow test was used to assess model fit (P > 0.05).</p><p><strong>Results: </strong>Among the participants, delayed treatment-seeking was independently associated with caregiver's lack of formal education (AOR = 2.7; 95% CI: 1.19-6.12), poor perception of malaria (AOR = 3.5; 95% CI: 1.71-7.37), self-medication (AOR = 8.3; 95% CI: 3.78-18.27), no previous history of malaria (AOR = 4.6; 95% CI: 2.34-8.94), and residence more than 5 km from a health facility (AOR = 7.8; 95% CI: 3.70-16.32).</p><p><strong>Conclusion: </strong>Delayed malaria treatment-seeking was associated with caregiver educational level, malaria perception, self-medication, previous malaria experience, and geographic access to health facilities. In this post-conflict setting, strengthening caregiver education, reducing self-medication, and improving access to primary malaria services in remote communities should be prioritized.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factor of Meningococcal Carriers of Indonesian Umrah Pilgrims.","authors":"Maria Lawrensia Tampubolon, Vivi Setiawaty, Verawati Sulaiman, Teguh Sarry Hartono, Siti Maemun, Tri Yuli Setianingsih, Aninda Dinar Widiantari, Nadia Humaira, Rofiud Darojat, Arni Sulistia, Rustika Rustika, Armedy Ronny Hasugian, Harimat Hendarwan","doi":"10.1007/s44197-026-00630-y","DOIUrl":"10.1007/s44197-026-00630-y","url":null,"abstract":"<p><strong>Background: </strong>Meningococcal meningitis (MM) cases are increasing in 2024. The infection spread widely during mass gatherings, including religious activities like Umrah. In 2023, the total number of Indonesia's Umrah pilgrims was 1.2 million people, much larger than the Hajj pilgrims (209.782 people). Thus, it is estimated that the number of meningococcus carriers also increased. Besides, there is no surveillance system for the Umrah pilgrimage to prevent Neisseria meningitidis from entering the country. The conducted study aimed to describe the proportion of meningococcal carriers among Indonesian Umrah pilgrims and their associated factors.</p><p><strong>Methods: </strong>The study was cross-sectional among the Umrah pilgrims who arrived via Soekarno-Hatta International Airport and Juanda International Airport. A self-administered questionnaire was sent to each participant and validated at arrival. An oropharyngeal swabs and blood draws (only if symptoms were present) were obtained. RT-PCR examinations were performed to identify N. meningitidis.</p><p><strong>Results: </strong>The study enrolled 900 pilgrims with a mean age of 51.34 ± 12.98 (17-79), with 50.9% female. Nearly 9.5% of pilgrims declared having a comorbid disease, and 100% had been vaccinated. N. meningitidis was detected in 201 participants (22.3%) in oropharyngeal swabs as indicator of transmission potential and the need for surveillance.</p><p><strong>Conclusions: </strong>The analysis data showed that marital status and timing of meningococcal vaccine significantly correlate with meningococcal Carrier. Meningitis surveillance must be done routinely and systematically to decrease the risk of the disease.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Family Planning Mobile Application and Enhanced Counseling on the Use of Modern Family Planning Methods Among Postpartum Women in Jordan.","authors":"Yousef Khader, Sara Abu Khudair, Mohannad Al Nsour, Abdulhakeem Mahmoud Okour","doi":"10.1007/s44197-026-00635-7","DOIUrl":"10.1007/s44197-026-00635-7","url":null,"abstract":"<p><strong>Introduction: </strong>To improve women's reproductive health and reproductive rights, appropriate interventions are needed to support family planning (FP) use during the postpartum period. Evidence on Arabic-language digital health interventions remains limited. This study aimed to assess the effect of enhanced counseling, alone and combined with an mHealth application, on modern FP method use among postpartum married women in Jordan.</p><p><strong>Methods: </strong>A three-arm, parallel-group controlled trial with systematic individual allocation was conducted in six primary healthcare centers. Within each center, consecutively enrolled eligible women were assigned using a prespecified repeating 1:3:3 sequence to standard care, enhanced FP counseling, or enhanced counseling plus an Arabic-language mHealth application. Enhanced counseling was delivered by midwives who completed a five-day training workshop; the mHealth intervention provided FP information and 40 push notifications over the intervention period.</p><p><strong>Results: </strong>At four months after baseline, 79.6% of women in the control group, 83.5% in the enhanced counseling group, and 96.9% in the enhanced counseling plus mHealth group reported using any FP method (p < 0.001). The corresponding proportions reporting use of a modern FP method were 17.2%, 49.7%, and 59.9%, respectively (p < 0.001). Compared with the control group, enhanced counseling was associated with substantially higher odds of modern FP methods use (aOR = 4.49; 95% CI: 3.05-6.62; p < 0.001) and higher odds of exclusive breastfeeding (aOR = 1.52; 95% CI: 1.09-2.13; p = 0.014), while the odds of using any FP method were not significantly different (aOR = 1.15; 95% CI: 0.77-1.73; p = 0.494). Enhanced counseling plus mHealth was associated with higher odds of any FP method use (aOR = 8.49; 95% CI: 4.72-15.28; p < 0.001), modern FP method use (aOR = 7.18; 95% CI: 4.85-10.63; p < 0.001), and exclusive breastfeeding (aOR = 2.49; 95% CI: 1.78-3.49; p < 0.001) compared with control.</p><p><strong>Conclusion: </strong>Enhanced FP counseling, particularly when combined with the mHealth intervention, was associated with higher short-term uptake of modern FP methods among postpartum women. These findings support further evaluation of strengthened counseling and Arabic-language digital FP tools as components of routine maternal and child health services.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Adjusted Phenome-Wide Analysis Identifies Liver Enzymes and Lipid Markers Associated with Prevalent Breast Cancer in the Qatar Biobank.","authors":"Lama Abujamous, Shereena Mohd Arif, Hamda Al-Thawadi, Rozaimi Razali","doi":"10.1007/s44197-026-00628-6","DOIUrl":"10.1007/s44197-026-00628-6","url":null,"abstract":"<p><p>Most evidence linking phenotypic traits to breast cancer risk derives from Western populations, leaving a critical gap for the Middle East and North Africa region, where breast cancer presents at younger ages and where demographic, metabolic, and lifestyle profiles differ substantially. To address this, we conducted an exploratory phenome-wide association analysis within the Qatar Biobank, systematically screening 93 demographic, anthropometric, biochemical, lifestyle, and medical history variables among 96 women with physician-confirmed breast cancer and 471 healthy controls. A three-stage filtering pipeline: i) Benjamini-Hochberg-corrected significance, ii) Cliff''s Delta effect sizes, and iii) crude odds ratios, reduced 42 initial associations to 18 candidates, which were then evaluated using age-adjusted logistic regression with confounding quantified by percentage change in log-transformed odds ratios. Age was the dominant correlate of breast cancer status (OR = 1.10 per year, 95% CI: 1.08-1.13), and its adjustment fundamentally reshaped the association landscape: metabolic and anthropometric markers including glycated haemoglobin, body mass index, and waist circumference lost significance entirely, with effect attenuations exceeding 100% and reversal of effect direction, revealing these associations as artefacts of the 20-year median age gap between groups. In contrast, alanine aminotransferase, aspartate aminotransferase, total cholesterol, and LDL cholesterol remained statistically significant after adjustment for age. Multivariable models indicated that these four markers correspond to two mutually independent associations, hepatic and lipid, neither explained by adiposity or glycaemic status. Because all measurements were taken at a single visit after diagnosis had already occurred in the case group, these differences cannot be assigned a temporal direction and may reflect the consequences of disease, its treatment, or selective survival rather than pre-diagnostic biology. They are reported as exploratory cross-sectional correlates of prevalent breast cancer status requiring replication in an incident-case cohort, not as risk factors.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Estimation Precision in Sensitive Public Health Data: Implications for Evidence-Based Decision-Making.","authors":"Li Honghe, Faiza Shah, Muhammad Imran Shahid, Kunpeng Ai","doi":"10.1007/s44197-026-00627-7","DOIUrl":"10.1007/s44197-026-00627-7","url":null,"abstract":"<p><strong>Introduction: </strong>Reliable estimation of sensitive public health outcomes, such as underreported COVID-19 cases and vaccine hesitancy, is frequently hindered by social stigma and nonresponse bias, particularly in culturally sensitive contexts like Pakistan. Traditional surveys often underestimate prevalence, limiting the effectiveness of public health interventions.</p><p><strong>Methods: </strong>Multi-stage stratified paired response frameworks (MSPRFs) incorporating two and three-stage randomization with dual scrambling mechanisms under stratified simple random sampling were applied. A cross-sectional survey of 1,200 participants (600 urban, 600 rural) from Faisalabad, Lahore, Multan, and Rawalpindi (June-August 2021) was conducted using anonymous questionnaires to collect data on outbreak cases and vaccine hesitancy.</p><p><strong>Results: </strong>The MSPRFs demonstrated substantially enhanced estimation efficiency (PRE 290-399%) relative to conventional methods. MSPRF-I estimated COVID-19 prevalence at 16.8% (urban) and 20.8% (rural), compared with reported rates of 12.1% and 13.6%; MSPRF-II estimated 16.8% and 19.2% versus reported 12.6% and 14.6%. Vaccine hesitancy was estimated at 33.8% (MSPRF-I) and 29.5% (MSPRF-II), relative to 24.3% reported. Urban respondents exhibited higher reporting sensitivity ([Formula: see text]) than rural respondents ([Formula: see text]), indicating geographic disparities in disclosure behavior.</p><p><strong>Conclusion: </strong>MSPRFs provide a robust, privacy-preserving methodology for accurately estimating underreported COVID-19 cases and vaccine hesitancy, supporting evidence-based public health decision-making. MSPRF-II offers marginally higher adjustment efficiency due to inclusion of a truthful-response component. These frameworks are appropriate for sensitive epidemiological surveys in contexts where conventional self-reporting underestimates prevalence.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"16 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}