Journal of Epidemiology and Global Health最新文献

{"title":"Pediatric Trauma Mortality in Jerusalem's Israeli Healthcare System: A Retrospective Analysis.","authors":"Rebecca Brooks, Daniel Marcus, Hagay Stern, David Rekhtman, Saar Hashavya, Shaden Salameh, Giora Weiser, Uri Pollak, Jacques Braun, Itai Shavit","doi":"10.1007/s44197-025-00391-0","DOIUrl":"10.1007/s44197-025-00391-0","url":null,"abstract":"<p><p>Jerusalem's intricate geopolitical environment, ethnic diversity, and divided healthcare systems between its East and West regions may impact pediatric trauma mortality. This study investigated pediatric trauma mortality rates in Jerusalem's Israeli healthcare system. We conducted a retrospective cohort study on Jerusalem residents under 18 who died from trauma in the Emergency Department (ED) or within a week of hospital admission (ED/7-day) between January 2013, and December 2023. Jerusalem's overall population data were obtained from the Israel Central Bureau of Statistics. During the study period, 121 pediatric trauma patients had ED/7-day death, 82 were Jerusalem residents. The annual mortality incidence among the city population was 2.1/100,000. Twenty-three children were Jews and 59 were East Jerusalem Arabs. The trauma mortality Incidence Rate Ratio for Arab versus Jewish children was 3.6 (95% CI 2.2-5.9). Death was declared upon ED arrival or within one hour in 52% (95% CI 30.6-73.1%) and 64% (95% CI 50.9-76.4%) of the Jewish and Arab children, respectively. In 2/23 [8.7% (95% CI 1.0-28.0%)] Jews, and 2/59 [3.4% (95% CI 0.4-11.7%)] Arabs, death occurred due to an injury related to the Israeli-Palestinian conflict. In 13/59 [22% (95% CI 12.3-34.7%)] of the Arabs, resuscitation was initiated in a community clinic before the arrival of Emergency Medical Services (EMS), and in 5/59 [8.5% (95% CI 2.8-18.7%)] the child was brought to the hospital by caregivers rather than by EMS. This study provides evidence that Jerusalem's child trauma death rate in Jerusalem's Israeli healthcare system is comparable to high-income European countries. However, East Jerusalem Arab children are more vulnerable to trauma-related deaths than Jewish children. These results provide a basis for targeted trauma prevention programs.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"49"},"PeriodicalIF":3.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710086","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":"Advancing Health Through Sustainable Development Goals-Saudi Arabia's Mid-Journey Progress and Insights.","authors":"Abdullah M Alarifi, Najim Z Alshahrani, Hani Jokhdar, Abdullah M Asiri","doi":"10.1007/s44197-025-00385-y","DOIUrl":"10.1007/s44197-025-00385-y","url":null,"abstract":"<p><p>A critical component of Saudi Arabia's Vision 2030 reform agenda is its alignment with the Sustainable Development Goals (SDGs), particularly SDG 3, which is dedicated to the promotion of health and well-being for all. This narrative review offers a mid-term assessment of Saudi Arabia's progress in attaining these objectives, with a particular emphasis on the public health initiatives and comprehensive healthcare reforms that have been implemented as part of this vision. The Kingdom has accomplished substantial reductions in maternal and neonatal mortality rates, with skilled birth attendance reaching nearly universal levels. Saudi Arabia is a regional leader in the field of infectious diseases, having achieved the 95-95-95 HIV targets and significantly reduced the incidences of tuberculosis and malaria. Additionally, the rates of premature mortality from conditions such as cancer, diabetes, and cardiovascular diseases have decreased as a result of efforts to combat non-communicable diseases. Mental health services have been substantially expanded, which has resulted in one of the lowest suicide rates reported worldwide. Substantial investments have collectively improved the universality and quality of healthcare services in health infrastructure, such as the expansion of primary healthcare centers and the integration of digital health solutions, which have supported these health achievements. Saudi Arabia continues to confront persistent obstacles, including the management of the increase in non-communicable diseases, the mitigation of environmental health risks, and the reconciliation of healthcare access disparities, despite these accomplishments. The review recommends that the social determinants of health be addressed through a sustained commitment to cross-sectoral collaboration, enhanced data collection and utilization for health policy-making, and further integration of technology in healthcare delivery. This review not only emphasizes the Kingdom's successes but also the intricate challenges it has encountered, providing valuable insights into the strategic planning required to maintain health gains and achieve SDG 3 by 2030. Saudi Arabia's innovative approach and robust policy implementation serve as a model for the integration of health priorities into national development frameworks, thereby improving health outcomes and contributing to sustainable development.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"48"},"PeriodicalIF":3.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700579","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":"Quantifying Suicide Risk in Prostate Cancer: A SEER-Based Predictive Model.","authors":"Jiaxing Du, Fen Zhang, Weinan Zheng, Xue Lu, Huiyi Yu, Jian Zeng, Sujun Chen","doi":"10.1007/s44197-025-00384-z","DOIUrl":"10.1007/s44197-025-00384-z","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer patients have a significantly higher risk of suicide compared to the general population. This study aimed to develop a nomogram for identifying high-risk patients and providing empirical evidence to guide effective intervention strategies.</p><p><strong>Methods: </strong>We analyzed data from 176,730 prostate cancer patients diagnosed between 2004 and 2021, sourced from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were randomly allocated to training (n = 123,711) and validation (n = 53,019) cohorts in a 7:3 ratio. Feature selection was conducted using the Least Absolute Shrinkage and Selection Operator (LASSO), followed by model construction with Cox proportional hazards regression. The results were visualized using nomogram. Model performance was evaluated with time-dependent receiver operating characteristic (ROC) curves, concordance index (C-index), and internal validation.</p><p><strong>Results: </strong>Multivariate analysis identified seven independent predictors of suicide. The nomogram demonstrated favorable discriminative capability in both cohorts, with C-index of 0.746 and 0.703 for the training and bootstrapped validation cohorts. Time-dependent ROC analysis indicated strong accuracy in predicting suicide risk. Calibration plots displayed high concordance between predicted probabilities and actual outcomes, Kaplan-Meier analysis confirmed the model's significant discriminative ability among risk groups.</p><p><strong>Limitations: </strong>This retrospective study, based on SEER data, lacks detailed clinical and mental health information. Additionally, potential coding errors and reporting biases may affect the accuracy of the results.</p><p><strong>Conclusion: </strong>We developed a applicable nomogram for the individualized quantification of suicide risk in prostate cancer patients. This model provides clinicians with a robust tool for identifying high-risk patients and implementing timely interventions.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"46"},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670043","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":"Uncovering the Burden of Influenza-Associated Illness across Levels of Severity in the Kingdom of Saudi Arabia Across Three Seasons.","authors":"Amal M Alshahrani, Ezzualdeen Okmi, Sheena G Sullivan, Stefano Tempia, Amal Barakat, Hala Abou El Naja, Amir Aman, Osman Hamedelneil, Mutaz Mohamed, Seham F Basheer, Ghaliah Albugami, Randah Alalweet, Norah Alhazir, Lama Alwalan, Najim Z Alshahrani, Haleema Alsreehi, Abdullah M Asiri","doi":"10.1007/s44197-025-00390-1","DOIUrl":"10.1007/s44197-025-00390-1","url":null,"abstract":"<p><strong>Background: </strong>Influenza imposes a substantial global health burden, particularly among high-risk populations such as the elderly, young children, and individuals with chronic conditions. In Saudi Arabia, a national influenza sentinel surveillance program was established in 2017 to monitor respiratory virus trends, yet comprehensive estimates of the influenza-associated burden remain limited. This study aims to address this gap by quantifying influenza-associated severe acute respiratory infection (SARI) hospitalization rates and estimating the broader influenza burden across severity levels.</p><p><strong>Methods: </strong>Data from four sentinel hospitals in three regions of Saudi Arabia were analyzed across three influenza seasons: 2017-2018, 2018-2019, and 2022-2023. Weekly SARI case counts were combined with census population data to calculate SARI hospitalization rates per 100,000 population. Influenza positivity rates, derived from laboratory-confirmed cases, were used to estimate influenza-associated SARI hospitalization rates, stratified by age and season. The John Hopkins University/WHO Seasonal Influenza Burden Disease Estimator (Flutool) was employed to extrapolate national estimates of influenza-associated hospitalizations, deaths, and mild/moderate cases. Confidence intervals and age-specific stratifications were computed to enhance precision and comparability.</p><p><strong>Results: </strong>The average annual SARI hospitalization rate was 294 per 100,000 population (95% CI: 288-300). Influenza-associated SARI hospitalization rates averaged 48 per 100,000 population (95% CI: 45-50), with the highest burden observed in individuals aged 65 years and older (269 per 100,000, 95% CI: 240-301) and children aged 0-4 years (118 per 100,000, 95% CI: 107-131). Seasonal variation was noted, with the highest rates in the 2017-2018 season. National estimates suggested a substantial burden, with influenza-associated hospitalizations totaling 17,678 in 2017-2018, 7,683 in 2018-2019, and 13,982 in 2022-2023. The flutool analysis estimated annual influenza-associated deaths ranging from 30 to 4,441 and mild/moderate cases reaching up to 6.3 million in the most severe season.</p><p><strong>Conclusions: </strong>This study demonstrates a significant burden of influenza-associated SARI hospitalizations in Saudi Arabia, with the highest rates observed in the elderly and young children. Seasonal variation was evident, highlighting the urgent need to enhance influenza vaccination coverage, particularly among high-risk groups such as the elderly and young children, to reduce severe outcomes. Expanding sentinel surveillance to more regions and incorporating detailed clinical and economic data are recommended to better inform public health policies. Strengthening pandemic preparedness and tailoring vaccination campaigns based on seasonality and age-specific risk will be critical for mitigating the influenza burden in Saudi Arabia.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"47"},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670044","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 Trends and Progress in Schistosomiasis Elimination in Saudi Arabia (2021-2023): Implications for Neglected Tropical Disease Control.","authors":"Mawahib Ahmed, Basmah Alharbi","doi":"10.1007/s44197-025-00388-9","DOIUrl":"10.1007/s44197-025-00388-9","url":null,"abstract":"<p><p>Schistosomiasis, a frequently overlooked parasitic disease, affects individuals worldwide. A comprehensive population-based observational study was conducted to assess the prevalence of schistosomiasis among both Saudi and non-Saudi residents. The primary objective of this research was to investigate the incidence of this parasitic infection within the population. Data on schistosomiasis incidence were collected by the Ministry of Health from January 2021 to December 2023. The chi-square test was employed to analyze the data and determine the incidence rates of schistosomiasis by type, gender, and nationality. Between 2021 and 2023, a total of 115 cases of schistosomiasis were reported. Among these, 61.7% were classified as intestinal schistosomiasis, 34.8% as urinary schistosomiasis, and 3.5% as mixed schistosomiasis. The findings revealed statistically significant differences (P < 0.05) in the prevalence rates of the different forms of schistosomiasis. Notably, 79.8% of the cases were observed in men, while women accounted for 20.2% of the cases. Furthermore, a majority of the reported cases (72%) were found among non-Saudi individuals. This study offers important insights into the epidemiology of schistosomiasis in Saudi Arabia. These findings underscore the effectiveness of public health interventions implemented in the country and provide a strategic framework for the global elimination of schistosomiasis.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"45"},"PeriodicalIF":3.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657483","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":"Shifting Trends in the Epidemiology and Management of Idiopathic Pulmonary Fibrosis in the Era of Evidence-Based Guidelines: a Nationwide Population Study.","authors":"Tang-Hsiu Huang, Shen-Huan Wei, Chin-Wei Kuo, Hsin-Yu Hou, Chao-Liang Wu, Sheng-Hsiang Lin","doi":"10.1007/s44197-025-00377-y","DOIUrl":"10.1007/s44197-025-00377-y","url":null,"abstract":"<p><strong>Background: </strong>Advances in the understanding of idiopathic pulmonary fibrosis (IPF) and international cooperation have led to the publication and subsequent updates of international practice guidelines. The impact of these guidelines, especially significant updates occurring after 2011, on IPF epidemiology and clinical practices remains relatively unexplored.</p><p><strong>Methods: </strong>This retrospective nationwide population-based study utilized the Whole-Population Datafiles (WPD) of Taiwan's National Health Insurance Research Database that contained basic demographics, complete claim data, and causes of death for all insured persons. We refined the code-based definition to identify IPF cases from the WPD between 2011 and 2019. Independent validation confirmed the high accuracy of this definition. We analyzed the annual standardized rates of IPF incidence, prevalence, overall and IPF-specific all-cause mortality. Additionally, we examined trends in the prescription of selected medications and the proportions of patients with respiratory failure receiving invasive (IMV) and non-invasive (NIV) mechanical ventilation.</p><p><strong>Results: </strong>We included 4359 incident cases of IPF. From 2011 to 2019, the annual standardized incidence rates increased from 1.66 (95% confidence interval [CI], 1.36-1.97) to 11.35 (95% CI, 10.65-12.04) per 100,000 standard population, and the annual standardized prevalence rates increased from 1.98 (95% CI, 1.65-2.31) to 27.25 (95% CI, 26.17-28.33) per 100,000 standard population. The standardized IPF-specific all-cause mortality and respiratory failure rates remained stable. Male and older patients received IPF diagnoses more frequently, and experienced higher mortality rates, compared to their female and younger counterparts. Most deaths were attributed to respiratory causes, without significant seasonal variation. Changing trends in the management of IPF mirrored with the evolving guideline recommendations, and showed diminishing roles of immunosuppressants, growing usage of antifibrotics, and NIV usage surpassing IMV.</p><p><strong>Conclusions: </strong>Our findings reflected the longitudinal impact of the recently evolving guideline recommendations on IPF epidemiology and real-world management.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"44"},"PeriodicalIF":3.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649069","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":"Mortality Projections, Regional Disparities in the Burden of Neonatal Disorders, and the Status of Achieving SDG Targets by 2030 in South Asia: Insights from the Global Burden of Disease Study 2021.","authors":"Manya Soni, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, Rangaswamy Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Rukshar Syed, Gajendra Sharma, Sunil Kumar, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Sanjit Sah, Muhammed Shabil, Abhay M Gaidhane, Mahendra Singh","doi":"10.1007/s44197-025-00359-0","DOIUrl":"10.1007/s44197-025-00359-0","url":null,"abstract":"<p><strong>Background: </strong>Neonatal disorders represent a significant public health challenge, particularly in low- and middle-income countries, where they account for 79% of global neonatal mortality. South Asia, comprising countries such as India, Pakistan, Bangladesh, Nepal, and Bhutan, bears a disproportionately high burden, contributing to 38% of the world's neonatal deaths. Despite notable progress, South Asia remains off track in meeting the Sustainable development goals (SDG). This study aims to assess the current burden, trends in neonatal disorders, and forecast mortality rates across South Asian countries, providing insights to guide investment priorities and improve neonatal outcomes.</p><p><strong>Methods: </strong>Data for this study were sourced from the Global burden of disease (GBD) 2021 study, which utilizes a Bayesian meta-regression model to estimate mortality, prevalence, and disability-adjusted life years (DALYs). Spatial maps depicting the age-standardized prevalence rate and age-standardized mortality rate for neonatal disorders in South Asia were generated using QGIS software. Mortality forecasts for the period 2022-2031, attributed to various neonatal disorders, were produced employing the Auto-Regressive Integrated Moving Average model in R software. Additionally, an analysis of overall neonatal mortality trends from 1980 to 2021 was conducted, supplemented by a heat map that compares DALYs attributable to various neonatal disorders across South Asian countries in 2021.</p><p><strong>Results: </strong>Between 1980 and 2021, South Asia experienced a substantial decline in neonatal mortality rates, with India and Bangladesh leading the progress. Mortality decreased by 40%, while DALYs fell by 35%, despite a 15% increase in the prevalence. The prevalence of neonatal encephalopathy due to birth asphyxia and trauma surged by 355%, yet its mortality dropped by 31%. Pakistan recorded the highest neonatal mortality and disease burden, particularly for hemolytic disease and other neonatal jaundice and neonatal encephalopathy due to birth asphyxia and trauma. In India and Bangladesh, neonatal preterm birth and neonatal sepsis and other neonatal infections contributed most to mortality. Neonatal encephalopathy due to birth asphyxia and trauma accounted for the highest DALYs. Forecasts predict continued reductions in neonatal mortality across South Asia, except in Pakistan, where persistently high rates are expected till 2031.</p><p><strong>Conclusion: </strong>For South Asian countries to meet the SDG target for neonatal mortality by 2030, intensified and continuous efforts are required. These efforts should focus on identifying high-risk pregnancies and improving the quality of care during childbirth to address the root causes and reduce preventable neonatal deaths.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"43"},"PeriodicalIF":3.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624848","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":"Impact of Control Interventions on Malaria Incidence in the General Population of Mali.","authors":"Mady Cissoko, Issaka Sagara, Abdoulaye Guindo, Mahamane Maiga, Pascal Dembélé, Cedric S Bationo, Sokhna Dieng, Issa Diarra, Abdoulaye Katilé, Diahara Traoré, Nadine Dessay, Jean Gaudart","doi":"10.1007/s44197-025-00381-2","DOIUrl":"10.1007/s44197-025-00381-2","url":null,"abstract":"<p><strong>Background: </strong>The increase in malaria incidence and the reduction of funding for malaria control have highlighted the need to step up efforts in the fight against malaria in Mali. To further refine the malaria control strategy implemented in the country, this study aimed to evaluate the impact of control interventions at the health district level on malaria incidence in the general population.</p><p><strong>Method: </strong>Malaria, rainfall, and intervention data were collected for the 75 health districts of Mali for the period from April 2017 to March 2022. The impact of the different control interventions on malaria incidence in the general population was assessed at the health district level with a Generalized Additive Mixed Model considering rainfall.</p><p><strong>Results: </strong>Although coverage rates varied widely between health districts, most interventions showed an improvement in coverage over the study period. Two interventions had a small impact on incidence: long-lasting insecticidal net mass distribution (LLIN), with a reduction rate of 2.2 ‰ for an adjusted coverage rate from 30.0 to 79.0% (odds ratio (OR): 0.998; 95% confidence interval (CI) 0.997-0.999), and seasonal malaria chemoprevention (SMC), with a reduction rate of 1.9 ‰ for an adjusted coverage rate from 30.0 to 80.0% (OR: 0.9979; 95% CI 0.996-0.998).</p><p><strong>Conclusion: </strong>The analysis found a small impact of LLIN and SMC on malaria incidence at the district level. Malaria control should be reinforced by improving coverage and utilization rates in the general population and in the most vulnerable groups and by deploying larger numbers of community health workers where needed.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"40"},"PeriodicalIF":3.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615492","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 Dynamics of Microbial Community Composition and Antimicrobial Resistance in a Mass Gathering Setting Using Culturomics and Metagenomic Approaches.","authors":"Neha Verma, Nikeeta Chavan, Karanbir S Aulakh, Avinash Sharma, Yogesh Shouche, Vemuluri Venkata Ramana","doi":"10.1007/s44197-025-00382-1","DOIUrl":"10.1007/s44197-025-00382-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Antimicrobial resistance (AMR) is one of the major global concerns in the current scenario. Mass-gathering events in fast-developing and densely populated areas may contribute to antibiotic resistance. Despite meticulous planning and infrastructure development, the effect of mass gatherings on microbial ecosystems and antibiotic resistance must be investigated. This study used culture and metagenome-based methods to investigate and compare the bacterial diversity, AMR profile & mechanism of resistance for bacteria in water samples collected from the mass gathering event (2019 Prayagraj Kumbh Mela in Uttar Pradesh, India) with the control samples, collected during no mass gathering.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study analyzed the water samples collected from a mass gathering event held in February 2019. Water samples collected in this study were grouped into \"Test\" (mass gathering event) and \"Control\" (no mass gathering event) groups. This study involved methods including culturomics, antibiotyping, phenotypic & genotypic identification methods, and metagenomics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There is a significant variation observed in the evenness and richness of bacterial diversity and MDR profile, expressed in terms of the relative abundance of the bacterial species between test and control samples. Out of the total multi-drug resistant (MDR) strains identified in the Prayagraj sample, the majority were derived from the test sample. A pathway-based analysis of MDR strains revealed the highest levels of acquired resistance were related to the inhibition of cell wall synthesis primarily in Pseudomonas spp., followed by resistance to protein synthesis and nucleic acid synthesis pathways. Additionally, the overall resistance profile of the test sample demonstrated a significantly elevated resistome for beta-lactams, particularly in the Pseudomonas spp. Additionally, several ESBL (Extended-spectrum beta-lactamase)-associated gene variants were identified. The test sample showed a two-fold increase in the prevalence and diversity of common beta-lactam gene variants in addition to the presence of unique variants. Using the metagenomics approach, we investigated the mechanism of antibiotic resistance, and it revealed a dominant trend in antibiotic efflux and inactivation pathways within both the test and control samples. Overall, the bacterial diversity, abundance (including AMR strains of human origin), and ARGs were relatively higher in the Test sample compared to the control sample which was collected 3 months after the mass gathering event.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study found significant variations in microbial communities, MDR strains, and ARGs due to environmental and human influences. Pseudomonas spp. was the most abundant MDR strain, primarily resistant to cell wall synthesis inhibitors. The test sample showed an increased resistome for beta-lactams, while the control sample had reduce","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"41"},"PeriodicalIF":3.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615411","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 Factors with Potentially Inappropriate Prescribing among Older Surgical Outpatients in China: A Nationwide Cross-sectional Study in 100 Hospitals.","authors":"Fangyuan Tian, Zhaoyan Chen, Jinyuan Zhang, Ying Zhang, Qiyi Feng","doi":"10.1007/s44197-025-00378-x","DOIUrl":"10.1007/s44197-025-00378-x","url":null,"abstract":"<p><strong>Background: </strong>Older outpatients face a heightened risk of potentially inappropriate prescribing (PIP). However, there is a paucity of evidence evaluating PIP in older outpatients attending surgical outpatient departments in China using Chinese-specific criteria. This study aimed to assess the prevalence of PIP and identify associated factors within this population.</p><p><strong>Methods: </strong>A cross-sectional design was employed, utilizing prescription data from older surgical outpatients across 100 hospitals in seven Chinese cities between January and December 2021. PIP was assessed based on Chinese criteria, and multivariate logistic regression analysis was performed to identify risk factors. Trends were analyzed using the average annual percent change (AAPC) via joinpoint regression.</p><p><strong>Results: </strong>A total of 357,135 prescriptions for older surgical outpatients were analyzed. The prevalence of PIP according to Chinese criteria was 13.06%. The five most commonly identified potentially inappropriate medications (PIMs) were doxazosin, clopidogrel, tolterodine, estazolam, and the concurrent use of more than two NSAIDs, which together accounted for 52.73% of all PIMs. From January to December, the prevalence of PIP exhibited a slight decrease, from 13.29 to 13.21% (AAPC: -0.278%). Logistic regression revealed that factors such as tertiary-level hospital status, polypharmacy, pain, sleep disorders, hypertension, benign prostatic hyperplasia, and stone disease were positively associated with PIP in older surgical outpatients.</p><p><strong>Conclusions: </strong>The study found that while the prevalence of PIP among older surgical outpatients in China is relatively low, attention is needed to the widespread use of certain PIMs.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"39"},"PeriodicalIF":3.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615405","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}