Journal of Epidemiology and Global Health最新文献

{"title":"The Prevalence of Methicillin-resistant Staphylococcus aureus in Clinical Settings of Pakistan: A Systematic Review and Meta-Analysis.","authors":"Sardar Ali, Muhammad Shafiq, Abdul Aziz, Najm Ur Rahman, Md Akibul Hasan Bakky","doi":"10.1007/s44197-026-00587-y","DOIUrl":"10.1007/s44197-026-00587-y","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) represents a significant and growing public health challenge in Pakistan, due to antibiotic misuse, weak infection control measures and rapid bacterial evolution. Determining the overall prevalence of MRSA in the country is crucial for informing targeted treatment protocols and effective management strategies. This study conducted a systematic review and meta-analysis to establish the pooled prevalence of MRSA in Pakistan.</p><p><strong>Methods: </strong>We searched electronic databases (Google Scholar, PubMed, Embase) for studies published between 2015 and 2025. The PRISMA guidelines were followed to conduct this systematic review. Meta-analyses were performed using R Studio software, applying both fixed- and random-effects models to calculate pooled prevalence. The heterogeneity was assessed using the I² statistics. Publication bias was assessed using Begg's and Egger's tests. Most studies used cefoxitin disk diffusion to characterize MRSA, while some studies used PCR to detect the mecA gene.</p><p><strong>Results: </strong>Sixty-eight studies meeting the inclusion criteria were analyzed. The overall pooled MRSA prevalence was estimated at 50% (95% CI: 45-54%), with I² = 98.9). Year-wise subgroup analysis revealed significant variation from 2015 to 2025, with estimates ranging from 64% (95% CI: 26-90%), with I² = 96.68 in 2022 to a low of 34% (95% CI: 17-56%), with I² = 99.16 in 2020, which may be due to reduced healthcare access and infection control measures implemented during the COVID-19 lockdowns. The pooled estimate among general patients and healthcare personnel was 50% (95% CI: 44-57%), with I² = 98.5 and 44% (95% CI: 30-60%), with I² = 95.4, respectively. The subgroup differences test (p = 0.54) for population type revealed no statistically significant difference. The Begg's test (p = 0.2378) and Egger's test (p = 0.8893) showed no significant evidence of bias. The significant variation between the two diagnostic methods (p = 0.03) showed that the observed heterogeneity may be due to diagnostic methods used across the studies.</p><p><strong>Conclusion: </strong>The high pooled prevalence of MRSA in Pakistan highlights an urgent need for strengthened antimicrobial stewardship, standardized surveillance systems, and integrated infection prevention strategies.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972904","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":"Review of the Microbial Spectrum of Mixed Respiratory Fungal Infections.","authors":"Aiah M Khateb","doi":"10.1007/s44197-026-00583-2","DOIUrl":"10.1007/s44197-026-00583-2","url":null,"abstract":"<p><strong>Background: </strong>This review examines the increasing clinical challenge of mixed respiratory fungal infections (MRFIs), emphasizing interkingdom interactions and their impact on disease progression and patient outcomes.</p><p><strong>Main body: </strong>We critically analyze current literature on the clinical implications, risk factors, and diagnostic complexities of MRFIs, with a primary focus on fungal-bacterial, fungal-viral, and fungal-parasitic co-infections. Fungal-bacterial co-infections, often involving Candida spp. and Pseudomonas aeruginosa, significantly worsen disease severity. Fungal-viral co-infections, particularly in COVID-19 patients with Candida albicans and Aspergillus fumigatus, represent a major threat. While rare, fungal-parasitic co-infections pose risks for immunocompromised individuals. The review highlights diagnostic difficulties due to non-specific symptoms and the vital need to distinguish colonization from true infection. It also explores the complex symbiotic, synergistic, and antagonistic relationships between fungi and other microorganisms, alongside the immune-modulating role of commensal fungi.</p><p><strong>Conclusion: </strong>Ultimately, this review seeks to enhance understanding of MRFIs to improve diagnostic and therapeutic strategies and patient care.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972964","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 Influence of Seasonality and Antimicrobial Resistance Genes on Biofilm Formation in Hospital-Acquired Resistant Bacteria.","authors":"Hila Ben-Amram, Doron Ben-Gad, Maya Azrad, Shimon Edelshtein, Keren Agay-Shay, Avi Peretz","doi":"10.1007/s44197-026-00582-3","DOIUrl":"10.1007/s44197-026-00582-3","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired resistant infections (HARI) are difficult to manage due to limited treatment options and their ability to withstand stress conditions through biofilm production. HARI were defined as infections occurring at least 48 h after hospital admission. This work aimed to assess the distribution of HARI-associated bacterial species in north Israel and to investigate associations between biofilm formation and extended-spectrum β-lactamase(ESBL) genes, bacterial and patient characteristics, and hospitalization length, season and year.</p><p><strong>Methods: </strong>Methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii), ESBL-producing Escherichia coli (ESBL-E. coli), Klebsiella pneumoniae (ESBL-K. pneumoniae) and Proteus mirabilis (ESBL-P. mirabilis) were isolated from 569 blood, urine, wound and respiratory samples of hospitalized patients with HARI during 2020-2022 in north Israel. Enterobacterales were included if ESBL-positive (Vitek 2 and disc tests), and Acinetobacter and Pseudomonas if resistant to ≥ 3 antibiotic families. Biofilm-formation capacity was assessed by the crystalline violet method. ESBL genes were detected by real-time PCR. Data regarding season, time to infection, bacterial species, patient demographics, year, and hospital department, were collected from medical records.</p><p><strong>Results: </strong>ESBL-K. pneumoniae was the most prevalent (31.6%) bacteria. Strong biofilms were produced by 346 (60.8%), most of the strong biofilm producers were K. pneumoniae, accounting for 160 out of 346 strong-biofilm isolates (46.2%). bla_CTX-M was the most commonly detected ESBL gene (87.7%). Most strains (61.2%) carried more than one ESBL gene. Hospitalization season had a notable impact on biofilm production, with a heightened risk of infection by robust biofilm producers during spring, summer and autumn compared to winter. Furthermore, the presence of bla_SHV and bla_TEM genes were significantly associated with enhanced biofilm production. Bacteria harboring all three ESBL genes exhibited the highest biofilm production capacities, compared to those carrying fewer than three.</p><p><strong>Conclusions: </strong>Biofilm-production intensity differs across bacterial species and seasons and is influenced by the presence of ESBL genes.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972898","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 Enterobacterales Producing Extended-Spectrum Beta-Lactamases According to One Health Approach in Burkina Faso: A Systematic Review with Meta-Analysis.","authors":"William Alix L Tiendrebeogo, Sibidou Yougbaré, Palpouguini Lompo, Serge Ouoba, Daniel Valia, M Christian Tahita, Halidou Tinto, G B Leon Savadogo","doi":"10.1007/s44197-026-00571-6","DOIUrl":"10.1007/s44197-026-00571-6","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) represents an important public health challenge worldwide. Given the significant and interdependent human, animal and environmental dimensions of this resistance, a 'One Health' approach is necessary to combat it. However, its extent remains poorly known and understood in resource-limited settings. This study aims to describe the current prevalence of antibiotic resistance and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales species according to One Health approach in Burkina Faso.</p><p><strong>Methods: </strong>PubMed, Hinari, African Journal Online, Scopus and Google Scholar were the bibliographic databases used for screening of the relevant articles according to the reporting elements for systematic reviews and meta-analyses (PRISMA). The meta-analysis was performed using the statistical analysis R software version 4.2.3 (2023).</p><p><strong>Results: </strong>A total of 24 research articles were included in this systematic review and meta-analysis. E. coli, Klebsiella spp., Enterobacter spp. and Salmonella spp. were the most frequently reported bacteria from at least two sources. The environment had the highest rate of ESBL-producing Enterobacterales (60.01%). The highest proportion of ESBL production was recorded for E. coli in all sources (64.92%).</p><p><strong>Conclusion: </strong>Our study showed a significant cluster prevalence of ESBL Enterobacterales species from all sources, with the highest prevalence found in the environment. Strong resistance to commonly used antibiotics was found in these species. Studies in humans were far more numerous than those in animals and the environment. This highlights the need to strengthen integrated interventions according to One Health approach to fill the gaps in the fight against the emergence and spread of AMR in Burkina Faso.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972791","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":"Association Between Extreme Climate Exposures and Bodily Pain: Evidence from the Chinese Health and Retirement Longitudinal Study.","authors":"Shilong Zhang, Yaoyang Ban, Feng Su","doi":"10.1007/s44197-026-00586-z","DOIUrl":"10.1007/s44197-026-00586-z","url":null,"abstract":"<p><strong>Background and aims: </strong>Extreme climate events may be associated with increased bodily pain, particularly among aging populations. However, individual-level evidence linking specific climate exposures to pain outcomes remains limited. This study examined the association between extreme climate exposure and pain in different body regions among middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>This study used data from the Chinese Health and Retirement Longitudinal Study (CHARLS, 2011-2020), which included 65,693 person-wave observations. Pain outcomes across the 15 body regions were self-reported. Climate exposure indices (extreme temperature, rainfall, drought, and the composite Climate Physical Risk Index [CPRI]) were derived from city-level meteorological data. Generalized additive mixed models were used to assess associations, adjusting for demographics, lifestyle, health status, cognitive function, frailty, and chronic disease.</p><p><strong>Results: </strong>The composite CPRI was significantly associated with higher likelihood of reporting pain across most body regions (e.g., most severe neck pain, β = 0.0121). Extreme low temperatures and rainfall were significantly associated with pain in the knee, chest, and stomach. Vulnerability was significantly increased among rural residents, older adults (≥ 65 years), women, and those reporting poorer health or greater frailty. These findings remained robust in the sensitivity analyses.</p><p><strong>Conclusions: </strong>Exposure to extreme climatic conditions is significantly associated with higher likelihood of reporting pain across multiple body regions among middle-aged and older Chinese adults. These associations are primarily immediate, suggesting that timely public health strategies might be beneficial in mitigating potential climate-related discomfort during extreme weather events. Increased vulnerability among older adults, women, rural populations, and frail individuals also highlights the need for targeted intervention strategies to mitigate climate-related health risks.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963943","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":"Factors Influencing Tuberculosis Treatment Outcomes in Lalitpur District, Nepal: A Retrospective Cohort Study.","authors":"Krishna Kumar Khatri, Durga Datta Chapagain, Tae Hyun Kim, Suk-Yong Jang, Sunjoo Kang, Vasuki Rajaguru, Do Won Kim","doi":"10.1007/s44197-026-00573-4","DOIUrl":"10.1007/s44197-026-00573-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tuberculosis (TB) remains a major public health challenge in low- and middle-income countries, including Nepal. Understanding the factors associated with TB treatment outcomes is essential for improving disease control and patient management.</p><p><strong>Methods: </strong>A retrospective study was conducted using TB program data from Lalitpur District, Nepal. De-identified patient records were extracted from the Health Information Management System and the national e-TB register. Sociodemographic, behavioral, and clinical variables were analyzed. Descriptive statistics summarized patient characteristics, while Pearson's chi-square test assessed associations between variables and treatment outcomes. Multivariable logistic regression was used to identify predictors of treatment success.</p><p><strong>Results: </strong>A total of 2,779 TB patients were included in the study. The overall treatment success rate was high, with most patients completing treatment successfully. Age, gender, and HIV status were significantly associated with treatment outcomes. Patients older than 60 years had higher odds of unsuccessful treatment compared with younger patients. Female patients showed higher odds of treatment success than males. HIV-positive patients had significantly poorer treatment outcomes compared with HIV-negative individuals. Other factors, including ethnicity, residence, smoking status, TB type, registration type, treatment category, DOTS delivery approach, and GeneXpert results, were not significantly associated with treatment success.</p><p><strong>Conclusion: </strong>Age, gender, and HIV status were key predictors of TB treatment outcomes in Lalitpur District. Strengthening integrated TB-HIV care, improving follow-up among older patients, and enhancing treatment adherence among male patients may help improve treatment success rates. These findings provide evidence to support targeted TB control strategies and contribute to achieving the World Health Organization's End TB Strategy goals.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941569","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 Global Burden of Human Metapneumovirus in High-Risk Adults: A Systematic Literature Review and Meta-Analysis.","authors":"Kashmira Date, Evangelia Antoniou, Aleksandra Polkowska-Kramek, Philip Zachariah, Anna Dorste, Jennifer Granda Acaro, Lauren Mason, Laura Mora, Jennifer Eeuwijk, Pimnara Peerawaranun, Kyla Hayford, Bradford D Gessner, Harish Nair, Elizabeth Begier","doi":"10.1007/s44197-026-00567-2","DOIUrl":"10.1007/s44197-026-00567-2","url":null,"abstract":"<p><strong>Background: </strong>Human metapneumovirus (hMPV) is an under-recognized cause of severe respiratory illness in high-risk adults. We conducted a systematic review and meta-analysis to quantify hMPV prevalence and clinical outcomes in adults with chronic underlying conditions predisposing them to severe respiratory illness, including the immunocompromised.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and BioRelate (January 2010 to February 2025) for studies of laboratory-confirmed hMPV in adults (≥ 18 years) with high-risk chronic or immunocompromising conditions. We extracted data on hMPV positivity and key outcomes (hospitalization, intensive care unit [ICU] admission, respiratory support, length of stay, and mortality). We performed random-effects meta-analyses for outcomes reported in ≥ 3 studies and assessed study quality using an adapted Joanna Briggs Institute checklist.</p><p><strong>Results: </strong>We included 72 studies. Among immunocompromised adults with hMPV infection, 55.2% (95% confidence interval [CI], 42.0-67.7%) required hospital admission. Among immunocompromised patients hospitalized with respiratory illness, hMPV was detected in 5.4% (95% CI, 2.7-10.8%). Among patients with cardiovascular disease, 11.4% (95% CI, 8.0-16.1%) tested positive for hMPV. Regarding patients with chronic respiratory conditions, 3.4% (95% CI, 2.4-5.0%) of patients with chronic obstructive pulmonary disease exacerbations and 7.6% (95% CI, 2.5-20.5%) of patients with asthma exacerbations were hMPV-positive. Among hospitalized hMPV-positive high-risk patients, 13.0% (95% CI, 8.8-18.9%) required ICU admission, 43.6% (95% CI, 34.9-52.7%) required supplemental oxygen, and 7.3% (95% CI, 1.2-33.8%) required mechanical ventilation. The mean length of hospital stay was 10.4 days (95% CI, 3.4-17.4%). The pooled case fatality ratio among hospitalized adults with hMPV infection was 2.4% (95% CI, 0.1-35.1%).</p><p><strong>Conclusions: </strong>hMPV is a substantial cause of severe respiratory illness in high-risk adults. Enhanced detection, surveillance, and preventive strategies are needed to reduce hMPV-associated morbidity in vulnerable populations.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930337","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":"Understanding Gender Gaps in Tobacco Consumption among Middle-Aged and Elderly Indians: Decomposition Analysis of LASI 2017-18.","authors":"Pritam Halder, Baridalyne Nongkynrih, Madhur Verma, Swarup Das, Sukhmeen Kaur, Pradeep Sharma, Maish Chandra Prabhakar, Saumyarup Pal, Ankita Chattopadhyay, Shivani Rathor, Suprakash Mondal","doi":"10.1007/s44197-026-00577-0","DOIUrl":"10.1007/s44197-026-00577-0","url":null,"abstract":"<p><strong>Background: </strong>While India is among the top consumers of tobacco globally, research is mostly limited to younger age groups. The present study aims to estimate the distribution of gender disparities in tobacco consumption across states and union territories. Further, our objective was to estimate socioeconomic inequalities of tobacco consumption as per wealth index across gender, and to determine the contribution of different demographic, socioeconomic, health related and behavioural factors to the gender disparities in tobacco consumption.</p><p><strong>Methods: </strong>We did a secondary analysis of the data from 66,606 participants aged ≥ 45 years who participated in the first wave of the Longitudinal Aging Study in India (LASI) between 2017 and 18. Weighted distribution of gender disparities in tobacco consumption was documented as per Indian states and union territories with spatial distribution by Indian map, categorised into low, medium and large. Socioeconomic disparities were documented using a concentration curve as per gender. Multivariate decomposition analysis was conducted to estimate the contribution of different demographic, socioeconomic, health-related and behavioural factors separately. P-value less than 0.05 was considered as statistically significant.</p><p><strong>Results: </strong>About 36.78% of the participants were consuming any form of tobacco. The prevalence was higher among males (57.58%) than females (19.11%), and elderly (39.72%) than middle-aged (33.82%) participants. We observed gender disparity with male predominance across all Indian states and union territories, with wide sub-national variation. As per the wealth index, the prevalence of tobacco consumption was significantly inclined towards the poorest (concentration index (95% CI): -0.067 (-0.075 to -0.059)) which was higher among males (-0.096 (-0.108 to -0.083)). Multivariate decomposition results showed that differences in endowment (E)/ composition accounted for 18.49%, whereas effect/ coefficient (C) differences accounted for 81.51% of the gender difference. The differences were mainly contributed by concurrent alcohol consumption (21.90%), media exposure (-5.09%), age (-4.19%), and regional differences.</p><p><strong>Conclusions: </strong>Tobacco consumption among older adults in India remains high, with marked gender disparities and socioeconomic inequalities. The decomposition analysis showed that the majority of the gender gap was accounted for by differences in the effects of characteristics (coefficients) rather than their distribution (endowment/ composition), indicating that gendered behavioural and contextual factors play a substantial role. These findings highlight the need for gender-sensitive and equity-oriented public health strategies to address tobacco use among vulnerable groups, while recognizing that the observed relationships are associative in nature.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930306","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":"Epidemiological Determinants and Health-Related Predictors of Self-Perceived Health among Community-Dwelling Older Adults Aged 65 Years and Over: Evidence from a Community-Based Study Involving 10,321 Participants.","authors":"Mehmet Emin Arayici, Ali Kose, Hatice Simsek","doi":"10.1007/s44197-026-00576-1","DOIUrl":"10.1007/s44197-026-00576-1","url":null,"abstract":"<p><strong>Background: </strong>Self-perceived health, defined as an individual's subjective evaluation of their overall health status, is a widely recognized indicator of health among older adults and is strongly associated with objective health outcomes. Identifying epidemiological and health-related determinants of poor self-perceived health among older individuals is essential to improve targeted interventions and resource allocation.</p><p><strong>Methods: </strong>This community-based cross-sectional study included 10,321 older adults aged 65 years and over. The data were obtained from the 2023 Turkey Elderly Profile Survey conducted between 23 October and 18 December 2023. The survey was carried out by the Turkish Statistical Institute (TUIK) in collaboration with the Ministry of Family and Social Services to inform aging-related policies. Data were collected on sociodemographic characteristics, lifestyle behaviors, clinical conditions, depressive symptoms, and self-perceived health. Univariable and multivariable logistic regression analyses were undertaken to identify factors associated with poor self-perceived health.</p><p><strong>Results: </strong>The mean age of the study population was 72.8 ± 6.4 years (range: 65-115 years); 45.5% (n = 4,698) of participants were male and 54.5% (n = 5,623) were female. The prevalence of participants rating their health status as \"bad\" was 77.2%. In the multivariable analysis, age ≥ 75 years (aOR = 1.25, 95% CI: 1.09-1.42, p = 0.001), female gender (aOR = 1.19, 95% CI: 1.06-1.34, p = 0.004), the presence of chronic disease (aOR = 8.31, 95% CI: 7.42-9.30, p < 0.001), hearing impairment (aOR = 1.88, 95% CI: 1.46-2.43, p < 0.001), visual impairment (aOR = 1.80, 95% CI: 1.39-2.33, p < 0.001), and not having a spouse (aOR = 1.15, 95% CI: 1.01-1.31, p = 0.036) were associated with increased odds of poor self-perceived health. Mild and severe depression (aOR = 2.08, 95% CI: 1.84-2.36, p < 0.001; aOR = 5.89, 95% CI: 4.41-7.88, p < 0.001, respectively) were also significantly associated with increased odds of poor self-perceived health. Conversely, having a medium (aOR = 0.77, 95% CI: 0.64-0.92, p = 0.004) or high education level (aOR = 0.62, 95% CI: 0.52-0.74, p < 0.001), and engaging in physical activity (aOR = 0.67, 95% CI: 0.60-0.75, p < 0.001) were associated with decreased odds of poor self-perceived health.</p><p><strong>Conclusions: </strong>Poor self-perceived health among community-dwelling older adults is highly prevalent and strongly influenced by demographic, lifestyle, clinical, and psychosocial factors. Public health strategies aimed at improving subjective health perceptions should address modifiable determinants, including chronic disease management, physical activity promotion, and mental health interventions.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930283","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":"Modern Conflicts as Global Health System Shocks: A Multi-level Framework.","authors":"Yousef Khader, Haitham Bashier, Mohannad Al Nsour","doi":"10.1007/s44197-026-00575-2","DOIUrl":"10.1007/s44197-026-00575-2","url":null,"abstract":"<p><p>Armed conflict remains a major determinant of population health, with consequences extending well beyond immediate mortality and injury. These effects include disruption of health systems, environmental hazards, and broader socioeconomic instability. The ongoing conflict involving Iran, Israel, and the United States represents a rapidly evolving crisis with implications not only for affected populations but also for regional and global health systems. In this perspective, we argue that conflicts occurring within strategically critical energy and trade corridors should be understood as global health system shocks. Such events generate multi-level impacts that extend beyond national borders and propagate through tightly linked global systems. We introduce a Global Health System Shock Framework that conceptualizes these effects across three levels: direct local impacts, indirect regional consequences, and systemic global disruptions mediated through energy markets, food systems, and medical supply chains. Key risks include trauma-related morbidity and mortality, damage to healthcare infrastructure, environmental exposures linked to energy facilities, and a growing mental health burden. At the global level, disruptions to energy flows and fertilizer supply chains are already influencing fuel prices, agricultural production, and food security. Viewing modern conflicts through this lens underscores the need for coordinated, health-centered responses that prioritize resilience, protect health infrastructure, and anticipate downstream global effects. This perspective highlights the need to reframe conflict preparedness as a cross-sector global health priority.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930286","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}