Journal of Epidemiology and Global Health最新文献

{"title":"Candidiasis in Diabetes: Five-Year Retrospective on Glycaemic Control.","authors":"Aiah M Khateb, Walaa M Mohammedsaeed, Hajer Bin Shuraym, Zain J Alghamdi","doi":"10.1007/s44197-026-00585-0","DOIUrl":"10.1007/s44197-026-00585-0","url":null,"abstract":"<p><strong>Background: </strong>Fungal infections are a significant global health burden, affecting over a billion individuals annually. Diabetes mellitus (DM) is a major risk factor, with over 7 million diabetic patients in Saudi Arabia. This study aimed to identify common fungal pathogens and associated risk factors in DM patients at King Fahad Hospital in Medina.</p><p><strong>Methods: </strong>A retrospective-observational study analyzed electronic records of DM patients with positive fungal cultures from 2016 to 2021. Data included demographics, medical history, fungal isolates, resistance patterns, and biochemical parameters.</p><p><strong>Results: </strong>A 54.5 fold increase in fungal infections was observed over five years, likely reflects the synergistic impact of the COVID-19 pandemic and enhanced diagnostic surveillance alongside the physiological vulnerability of a growing diabetic population struggling with poor glycemic and renal management. Male DM patients had a higher incidence of candidiasis. Candida parapsilosis was the most common species, followed by C. albicans. High fasting glucose, elevated HbA1c, and increased creatinine levels were significantly associated with higher infection rates. Bloodstream infections were most prevalent, followed by cutaneous and respiratory infections. Resistance was observed primarily in hospitalized patients, with C. krusei, C. dubliniensis, and C. parapsilosis demonstrating significant resistance.</p><p><strong>Conclusions: </strong>This study highlights the significant burden of fungal infections in DM patients in Saudi Arabia. Candida species were the predominant isolates. Elevated glycemic control and renal function were major risk factors. The lack of a national fungal infection surveillance program hinders accurate assessment of the true burden of this disease. These findings emphasize the need for improved diagnostic strategies, targeted antifungal therapies, and enhanced surveillance programs to effectively manage fungal infections in DM patients.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031544","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":"Meta-Analysis of the Incidence and Influencing Factors of Malignant Tumors in Patients with Rheumatoid Arthritis.","authors":"Yingkai Gao, Guancheng Ye, Luyuan Gao, Cunxiang Xie, Jian Huang, Hailong Wang","doi":"10.1007/s44197-026-00574-3","DOIUrl":"10.1007/s44197-026-00574-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to systematically evaluate the incidence of malignant tumors in rheumatoid arthritis (RA) patients and identify influencing factors, providing an evidence-based foundation for early identification of high-risk groups and individualized management.</p><p><strong>Methods: </strong>Cohort studies on tumor incidence and ifluencing factors in RA patients were searched in both Chinese and English databases from inception to July 31, 2025. Two researchers independently screened literature, extracted data, and assessed quality. Meta-analysis was performed using Stata 12.0 to calculate pooled incidence and hazard ratios (HR) with 95% confidence intervals (CI). The study is registered with Prospero (CRD420251141184).</p><p><strong>Results: </strong>A total of 44 cohort studies involving 901,941 RA patients were included. The pooled incidence of malignant tumors was 4.1% (95%CI 3.3%-4.8%). Significant influencing factors were: age (HR 1.17, 95%CI 1.12-1.22), male sex (HR 1.58, 95%CI 1.23-2.04), smoking (HR 1.33, 95%CI 1.07-1.66), tumor necrosis factor inhibitor (TNFi) use (HR 0.80, 95%CI 0.66-0.97), abatacept use (HR 1.19, 95%CI 1.10-1.29), and comorbidities (HR 1.13, 95%CI 1.02-1.26), particularly lung disease (HR 2.17, 95%CI 1.48-3.17) and diabetes (HR 1.10, 95%CI 1.03-1.17). The following influencing factors without statistical significance are: body mass index(BMI), Non steroidal anti-inflammatory drugs(NSAIDs), methotrexate(MTX), biological disease-modifying antirheumatic drugs/targeted synthesis disease-modifying antirheumatic drugs(bDMARDs/tsDMARDs), interleukin-6 inhibitor(IL-6i), Janus kinase inhibitor(JAKi), glucocorticoid, serum-positive, diease duration.</p><p><strong>Conclusion: </strong>Among RA patients, older age, male sex, smoking, abatacept use, and comorbidities may be associated with increased tumor risk, while TNFi use may be associated with lower risk. Clinicians should consider these factors to identify high-risk populations for enhanced monitoring.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015836","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":"Cardiometabolic Burden of Irritable Bowel Syndrome: A Case-Control Analysis of Metabolic Syndrome Clustering.","authors":"Mohammed N Abdelaziz, Omar Abdallah, Anwar M Bshar, Mahmoud Alqenawy, Hager G Elkasabi, Nada F Mansour, Tasneem Mahmoud, Merna M E Abdelaziz, Ahmed R A Moustafa, Ahmed Almenshawy, Basma Z Elmorsy","doi":"10.1007/s44197-026-00584-1","DOIUrl":"10.1007/s44197-026-00584-1","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder, which is more frequently associated with some extra-intestinal comorbidities, particularly cardiometabolic comorbidities. Metabolic syndrome (MetS) comprises a constellation of risk factors for cardiovascular diseases, including central obesity, dyslipidemia, hypertension, and insulin resistance. Therefore, the purpose of this study was to assess the prevalence and factors associated with MetS in IBS patients.</p><p><strong>Methods: </strong>A hospital-based cross-sectional case-control study was conducted, enrolling 140 IBS patients diagnosed according to Rome IV criteria and 140 non-IBS controls from a healthcare center in Dakahlia, Egypt. Metabolic syndrome was defined using International Diabetes Federation criteria. Demographic information was collected together with anthropometric measurements and clinical and biochemical data. Binary logistic regression analysis was conducted with sequential models that adjusted for age, sex, and lifestyle factors (body mass index, smoking status, and residence). Model discrimination was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC).</p><p><strong>Results: </strong>IBS patients showed a significant increase in metabolic syndrome rates at 49.3% compared to 17.1% in controls, p-value < 0.001. The metabolic components of IBS cases showed significant elevation in the following measures: abdominal obesity occurred in 71.4% of cases compared to 44.3% in controls and fasting blood glucose levels ≥ 100 mg/dL occurred in 42.9% of cases compared to 19.3% in controls and blood pressure levels ≥ 130/85 mmHg occurred in 57.9% of cases compared to 17.9% in controls and triglyceride levels ≥ 150 mg/dL occurred in 25.7% of cases compared to 15.7% in controls. Low-density lipoprotein cholesterol levels (median values) were 115 mg/dL in cases versus 102 mg/dL in controls (p = 0.01). When age, sex, BMI, smoking status, and residence were considered in the multivariate logistic regression model, IBS status remained an independent predictor of metabolic syndrome (AOR: 7.818; 95% CI: 3.913-15.620; p < 0.001). This model demonstrated excellent discriminatory performance (AUC: 0.852; 95% CI: 0.806-0.898) and adequate calibration (Hosmer-Lemeshow: 0.442). Within the IBS cohort, BMI functioned as the only independent predictor for metabolic syndrome co-occurrence (AOR: 1.18 per unit increase; 95% CI: 1.08-1.30; p < 0.001), with the model correctly classifying 75.7% of cases (sensitivity: 73.9%; specificity: 77.5%).</p><p><strong>Conclusion: </strong>Our findings suggest that IBS may identify a subgroup of patients with elevated cardiometabolic burden, warranting routine cardiometabolic evaluation in clinical practice. However, causal relationships and temporal sequence cannot be inferred from this cross‑sectional case-control design.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015823","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":"Trends in Stunting Prevalence and Sex-based Disparities among Children under Five in Somalia, 2000-2024: A Secondary Analysis of WHO Model-based Estimates.","authors":"Abdirasak Sharif Ali, Augustus Osborne","doi":"10.1007/s44197-026-00579-y","DOIUrl":"10.1007/s44197-026-00579-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to describe the 24-year trajectory (2000-2024) of stunting prevalence among children under five years of age and quantify the magnitude and temporal stability of sex-based disparities in chronic malnutrition using WHO model-based estimates.</p><p><strong>Methods: </strong>A cross-sectional trend analysis was performed using model-based estimates extracted from the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) version 7.0. This study analysed annual stunting prevalence disaggregated by sex and utilized inequality metrics, including the difference (D), ratio (R), Population Attributable Fraction (PAF), and Population Attributable Risk (PAR), to quantify health inequities over time.</p><p><strong>Results: </strong>Stunting prevalence in Somalia decreased from 33.6% in 2000 to 23.9% in 2024, reflecting an overall reduction of 9.7 percentage points. However, sex-based disparities persisted across the study period, with males consistently experiencing higher stunting prevalence than females. In 2024, the prevalence was 25.7% (95% CI: 15.8-39.1) among males and 22.0% (95% CI: 13.0-34.8) among females. The inequality ratio remained nearly unchanged at 0.86-0.87, suggesting persistent relative inequality despite improvements in the national prevalence of stunting.</p><p><strong>Conclusion: </strong>Somalia has achieved notable reductions in chronic malnutrition over the last two decades; however, the prevalence of stunting remains a medium-to-high public health concern. The enduring vulnerability of male children to stunting highlights the need for targeted sex-sensitive nutritional interventions. To meet international health targets, policymakers must implement multisectoral strategies that address modifiable risk factors, such as maternal education, household wealth, and climate resilience.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015606","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":"Temporal Trends and Forecasted Cardiac Arrest and Hypertension-Related Mortality in U.S. Adults, 2000-2035: A Nationwide CDC WONDER Multiple Cause-of-Death Study.","authors":"Saifullah Khan, Fnu Arsheen, Muneeb Fareed, Tahreem Mari, Muhammad Hussain, Preet Memon, S M Aleem Hussain, Muhammad Hassan, Asma Naz, Yusra Ejaz, Gregg C Fonarow, Hasibullah Aminpoor","doi":"10.1007/s44197-026-00588-x","DOIUrl":"10.1007/s44197-026-00588-x","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest (CA) occurring in the setting of hypertension (HTN) represents a critical and under-recognized intersection of acute cardiovascular catastrophe and chronic vascular disease in the United States (U.S.). The coexistence of sudden cardiac dysfunction and long-standing HTN may amplify morbidity and mortality and contribute to persistent demographic and geographic disparities. This study characterizes 2000-2024 national trends in CA with concurrent HTN among U.S. adults and projects age-adjusted mortality rates (AAMRs) through 2035.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of Multiple Cause-of-Death data from the CDC WONDER database for CA with HTN mortality among adults aged ≥ 25 years (2000-2024). We calculated AAMRs and used joinpoint regression to estimate annual percent changes (APCs) and the average APC (AAPC) with 95% confidence intervals (CIs). We projected AAMRs through 2035 using Auto-ARIMA and Prophet time-series models in R (v4.5.0) and evaluated model performance using the root mean squared error (RMSE).</p><p><strong>Results: </strong>From 2000 to 2024, there were 1,693,840 deaths from CA with concurrent HTN. Overall AAMR rose from 24.56 to 31.68, with an AAPC of 0.82 (p < 0.000001). Men had higher AAMRs than women (overall AAMR: men 32.89; women 25.95). Among races, non-Hispanic (NH) Black/African American adults had the highest mortality (AAMR: 58.25). Older adults (≥ 65 years) bore the highest burden (AAMR: 122.60). Geographic differences were observed, with the West having the highest burden (AAMR: 43.75). Urban areas had higher AAMRs than rural areas (28.88 vs. 25.50). Most deaths (43.78%) occurred in medical facilities. Forecasting to 2035 indicates continued rises, particularly among men, NH Black/African American adults, older adults, West and rural areas.</p><p><strong>Conclusion: </strong>CA with concurrent HTN imposes a substantial and rising mortality burden, with pronounced demographic and geographic disparities. Continued surveillance and targeted public-health interventions are warranted.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015861","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":"Health-Related Quality of Life Deterioration Among Tuberculosis Patients During the COVID-19 Pandemic: a Convergent Mixed-Methods Study of Syndemic Vulnerability in Urban Bangladesh.","authors":"Santu Das, Rantu Das","doi":"10.1007/s44197-026-00580-5","DOIUrl":"10.1007/s44197-026-00580-5","url":null,"abstract":"<p><strong>Background: </strong>United Nations Sustainable Development Goal 3 (Target 3.3) calls for ending the tuberculosis (TB) epidemic by 2030; yet TB programmes in low-income settings remain acutely vulnerable to pandemic disruption. During the COVID-19 first wave, TB patients in urban Bangladesh faced a convergence of disease burden, pandemic-related stressors, and poverty-driven resource constraints. Systematic evidence quantifying health-related quality of life (HRQoL) deterioration in this population and identifying its modifiable structural determinants is limited.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods study was conducted among 439 TB patients attending 12 Directly Observed Treatment, Short-course (DOTS) clinics across six municipal districts in Dhaka, Bangladesh, between August and September 2020. HRQoL was measured with the EQ-5D-3L and post-traumatic stress with the Impact of Event Scale-Revised (IES-R). Multinomial logistic regression identified factors independently associated with HRQoL deterioration. Concurrently, 36 semi-structured in-depth interviews were analysed using Braun and Clarke's thematic analysis framework.</p><p><strong>Results: </strong>Pain or discomfort was reported by 46.5% of participants (95% CI: 41.9-51.1%) and anxiety or depression by 36.9% (95% CI: 32.5-41.5%). On multivariable analysis, anxiety/depression was independently associated with larger household size (adjusted OR = 1.08 per person; 95% CI: 1.03-1.14; p = 0.002), greater distance to the DOTS clinic (adjusted OR = 1.03 per km; 95% CI: 1.01-1.05; p < 0.001), and appointment intervals of ≤ 14 days versus 15-30 days (adjusted OR = 2.86; 95% CI: 1.33-7.14; p = 0.011). Drug-resistant TB was strongly associated with activity limitation (adjusted OR = 27.7; 95% CI: 8.3-92.4). Qualitative analysis identified three themes: stigma intensification through symptom conflation with COVID-19; economic hardship obstructing treatment adherence and nutrition; and perceived inadequacy of government relief for chronically ill populations.</p><p><strong>Conclusions: </strong>In this cross-sectional study, HRQoL deterioration among urban TB patients in Bangladesh during the COVID-19 pandemic was significantly associated with modifiable structural factors. These preliminary findings suggest that appointment scheduling optimisation, service decentralisation, nutritional support, and psychosocial services may reduce pandemic-era HRQoL burden. Prospective longitudinal studies are needed to establish causality and inform programme design.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015838","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":"Evaluation and Comparison of Antibiotic Prescribing Practices and Treatment Outcomes in Children with Pneumonia Admitted to Public and Private Hospitals in Pakistan: A Retrospective Study.","authors":"Ayesha Naseem, Furqan K Hashmi, Zikria Saleem, Huma Javaid, Zobia Afzal, Nimra Shakeel, Bisma Tariq, Nawaal Akbar, Ayesha Asghar, Rida Zahid, Hamid Saeed, Mohsin Ali, Zia Hasnain","doi":"10.1007/s44197-026-00589-w","DOIUrl":"10.1007/s44197-026-00589-w","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia remains a leading cause of mortality among children under five years worldwide, particularly in Pakistan.</p><p><strong>Aim: </strong>This study aimed to evaluate antibiotic prescribing practices, diagnostic utilization, and treatment outcomes among hospitalized children with pneumonia in public and private hospitals in Lahore, Pakistan.</p><p><strong>Methodology: </strong>A retrospective observational study was conducted using medical records from a public and private hospital between January and December 2021. Children aged ≤ 59 months with clinically diagnosed pneumonia were included. Pneumonia severity was classified according to World Health Organization (WHO) criteria, and antibiotic appropriateness was assessed using WHO guidelines in combination with the Gyssens classification system.</p><p><strong>Results: </strong>Among the study population, 68.7% had severe pneumonia, 17.4% non-severe pneumonia, and 13.9% very severe pneumonia. Diagnostic support was limited with chest radiographs performed in 84.2% of cases; whereas microbiological testing was low 10.2%. Streptococcus pneumoniae was the most commonly identified pathogen. Antibiotic therapy was predominantly empirical (89.2%), particularly in public hospitals. Ceftriaxone was the most frequently prescribed antibiotic (84.4%), often prescribed regardless of disease severity. Only 2.8% of prescriptions adhered to WHO treatment guidelines, while Gyssens analysis showed that 97.3% of prescriptions were inappropriate, primarily due to incorrect duration and suboptimal antibiotic selection. Treatment outcomes indicated that only 29.2% of patients were successfully discharged, while 70.8% left against medical advice (LAMA). A significant difference in outcomes was observed between public and private hospitals, with a higher discharge rate in private settings and increased LAMA in public hospitals.</p><p><strong>Conclusion: </strong>This high LAMA rate likely reflects socioeconomic constraints, caregiver-related factors, and healthcare system limitations. These findings major gaps in guideline adherence, diagnostic capacity, and rational antibiotic use. Implementation of antimicrobial stewardship programs, improved diagnostic facilities, and strict adherence to WHO guidelines are essential to optimize clinical outcomes and reduce antimicrobial resistance.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005393","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":"Intellectual and Physical Disability and Risk of COVID-19 Infection, Hospitalisation, and Mortality: A National Cohort of 3.7 Million Adults in Scotland.","authors":"Yusuff Adebayo Adebisi, Nick Bailey, Angela Henderson, Chris Dibben, Serena Pattaro","doi":"10.1007/s44197-026-00581-4","DOIUrl":"10.1007/s44197-026-00581-4","url":null,"abstract":"<p><strong>Background: </strong>Disabled people experienced disproportionately poor outcomes during the COVID-19 pandemic, but evidence remains uneven across disability status and across stages of the disease pathway. Few population-wide studies have simultaneously examined infection, hospitalisation, and mortality while distinguishing intellectual disability from physical disability. The aim of this study was to quantify associations between disability status and COVID-19 outcomes in a national Scottish cohort.</p><p><strong>Methods: </strong>This population-wide retrospective cohort study included 3,719,651 adults aged ≥ 16 years alive and resident in Scotland on 1 March 2020. Disability status was derived from the 2011 Scottish Census and categorised as intellectual disability (n = 17,354), physical disability (n = 377,706), or no recorded intellectual or physical disability (comparison group; n = 3,324,591). Participants were followed from 1 March 2020 until 30 April 2022 for first laboratory-confirmed SARS-CoV-2 infection, first COVID-19 hospitalisation, and COVID-19-related mortality. Associations were estimated using Cox proportional hazards models with sequential adjustment for demographic factors, socioeconomic factors, health-related factors, and COVID-19 vaccination status.</p><p><strong>Results: </strong>During follow-up, 306,343 participants had a first recorded SARS-CoV-2 infection, 22,945 experienced a first COVID-19 hospitalisation, and 12,893 died from COVID-19-related causes. Crude incidence rates for first recorded SARS-CoV-2 infection were highest among adults with intellectual disability, whereas crude incidence rates for COVID-19 hospitalisation and mortality were highest among adults with physical disability. In fully adjusted models, compared with adults with no recorded intellectual or physical disability, intellectual disability was associated with higher hazards of infection (HR 2.65, 95% CI 2.57-2.73), hospitalisation (HR 1.60, 95% CI 1.40-1.83), and mortality (HR 1.58, 95% CI 1.30-1.91). Physical disability was also associated with higher hazards of infection (HR 1.60, 95% CI 1.58-1.62), hospitalisation (HR 1.16, 95% CI 1.12-1.19), and mortality (HR 1.23, 95% CI 1.19-1.28). Across all three outcomes, hazards were higher for intellectual than physical disability.</p><p><strong>Conclusions: </strong>Both intellectual and physical disability were independently associated with increased risk across the COVID-19 disease pathway, with stronger associations observed for intellectual disability. These findings support disability-inclusive pandemic preparedness and prevention strategies that recognise heterogeneity of risk within the disabled population and promote equitable access to timely care.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987734","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":"Analysis of Infection Types, Pathogens, Antimicrobial Treatment, and Clinical Outcomes Data in Hospitalised Patients: Comprehensive Online Database for Antimicrobial Resistance (CODAR) Retrospective Pilot Study.","authors":"Andy Townsend, Naglaa Mohamed, Alona Kuraieva, Kristi Kuper, Alexandra Passarelli, Lili Jiang, Katherine Perez, Russell Outlaw, Vaughan Reed, Neera Hobson, Wendy Wilkinson, Stuart Bond, Jade Lee-Milner, Kuldeep Kumar, Anu Gupta, Ravneet Kaur, Yashesh Paliwal, Rafael Franco-Cendejas, Alexandra Martin-Onraët, Juan Luis Mosqueda-Gómez, Vicente Estrada, Ali Somily, Anthony Wilson, Tim Felton, Mahableshwar Albur","doi":"10.1007/s44197-026-00578-z","DOIUrl":"10.1007/s44197-026-00578-z","url":null,"abstract":"<p><strong>Background: </strong>Effective surveillance of prevalent infections, pathogen distribution, and treatment patterns help inform patient management and enhance outcomes. The Comprehensive Online Database for Antimicrobial Resistance (CODAR) pilot study aimed to provide insights into epidemiology, existing treatment strategies, and outcomes.</p><p><strong>Methods: </strong>This surveillance study (February 2023-2024) across 21 hospitals in India, Mexico, Saudi Arabia, Spain, and the United Kingdom (UK) evaluated pathogen distribution, antimicrobial treatments, and survival rates in hospitalised patients using electronic health records and hospital reports.</p><p><strong>Results: </strong>Among 8060 eligible patient records, 7434 (92.2%) with complete data were included in this analysis. Urinary tract infections (UTI), predominantly occurring in female patients (59.0%), were the most prevalent across countries (29.0%). Comorbidities such as vascular and metabolic and nutritional disorders were most commonly observed across countries included in this study. Meropenem and amoxicillin-clavulanate were most commonly used antimicrobials in India and the UK, respectively, across most infection types. Patients with skin and skin structure infections had the highest survival rates (94.4%) and shortest hospital stay (mean [standard deviation], 20.6 [33.53] days), whereas those with bloodstream infections (BSI, 81.7%), mixed infections (82.1%), and lower respiratory tract infections (LRTI, 83.3%) had relatively lower survival rates. Low proportion of patients alive (≤55.0%) with both monotherapy and combination therapy were observed with Acinetobacter baumannii (LRTI), Klebsiella pneumoniae (LRTI and BSI), and Escherichia coli (UTI) in India and Staphylococcus aureus (SSSI) and Enterococcus faecium (UTI) in the UK.</p><p><strong>Conclusion: </strong>Low survival rates associated with infections caused by specific pathogens highlight challenges in managing these infections, necessitating ongoing surveillance for effective infection control with suitable antimicrobial therapies to enhance patient care.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982093","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":"Life's Essential 8-Defined Cardiovascular Health and Mortality Risk in Cardiovascular-Kidney-Metabolic Health Stages 0-4: A Cohort Study.","authors":"Ruiyang Niu, Qiqi You, Wan Fu, Lingqi Wei, Jingjing Zeng, Yanyan Jia, Xinyi Zhang, Xiaoying Li, Shaoyong Xu","doi":"10.1007/s44197-026-00590-3","DOIUrl":"10.1007/s44197-026-00590-3","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome represents a primary contributor to global morbidity and mortality. Despite the Life's Essential 8 framework offering a comprehensive assessment of cardiovascular health (CVH), its prognostic utility in CKM syndrome remains unclear. This study aimed to investigate the association between Life's Essential 8-defined CVH and mortality risk in CKM health stages 0-4.</p><p><strong>Methods: </strong>Data were analyzed from 302,171 UK Biobank participants in CKM health stages 0-4. CVH scores were calculated based on eight components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. All-cause and cardiovascular disease (CVD) mortality were ascertained through linked health records. Cox proportional hazards models were employed to examine associations between CVH scores and mortality risks. The predictive factors for mortality risk were explored using the gradient boosting machines method.</p><p><strong>Results: </strong>Over a median follow-up of 12.7 years, 20,282 all-cause and 3,979 CVD deaths occurred. Compared with low CVH, high CVH was associated with 55% (95% confidence interval (CI): 0.42-0.49) and 67% (95% CI: 0.27-0.41) reductions in all-cause and CVD mortality. The inverse association of CVH scores with CVD mortality was stronger in non-advanced stages (P _{for interaction} = 0.002). Restricted cubic spline analysis revealed a significant nonlinear association for all-cause mortality (P _{for nonlinear} < 0.001), but not for CVD mortality (P _{for nonlinear} = 0.936). Machine learning analysis indicated that among the eight components, nicotine exposure and blood glucose scores had the highest relative influence on mortality prediction.</p><p><strong>Conclusions: </strong>Higher CVH scores were associated with lower mortality risk in CKM health stages 0-4, with stronger associations observed in non-advanced stages. Among the eight components, nicotine exposure and blood glucose scores showed stable and strong associations with mortality. These findings support the potential value of CVH assessment for risk stratification across CKM health stages.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987771","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}