Journal of Epidemiology and Global Health最新文献

{"title":"Patterns of Infection and Their Impact on Survival in Lung Cancer Patients: A Retrospective Study From Saudi Arabia.","authors":"Hana Abdalla, Reem Abaalala, Noor Alsaadoun, Hassan Robaidi, Qais Dirar, Sara I Abdelfattah, Khaled Alkattan, Atef M Shibl","doi":"10.1007/s44197-026-00563-6","DOIUrl":"10.1007/s44197-026-00563-6","url":null,"abstract":"<p><p>BACKGROUND: Globally, Lung cancer remains one of the leading causes of cancer-related mortalities. Infection-related complications represent a relevant concern in lung cancer patients’, being substantial risk factors for morbidity and mortality. AIMS: This study aims to a) determine the prevalence of infection among lung cancer patients’, b) identify the predominant pathogens and infection type, c) evaluate the impact of infection on the overall patients’ survival, and d) evaluate potential factors impact on patients’ overall survival. METHODS: In this retrospective study, clinical and laboratory data from 394 lung cancer patients treated at King Faisal Specialist Hospital & Research Center in Riyadh, Saudi Arabia, between 2015 and 2019, were analyzed. Descriptive statistics summarized patients’ characteristics. Associations were assessed using a chi-square test, and survival differences were analyzed using Kaplan-Meier and univariate cox proportional hazard regression analysis. Multivariate Cox proportional hazards regression was conducted to assess the potential factors that affect patients’ survival. A p-value < 0.05 was considered statistically significant. RESULTS: Among 394 lung cancer patients 153 (38.8%) developed infections. Bacterial infection were most prevalent (54.25%), followed by polymicrobial infections (32.03%), viral (9.80%), fungal (3.27%), and parasitic infection (0.65%). Gram-negative bacteria were the most predominant pathogens (44.35%). Diabetes mellitus was significantly associated with infection (p = 0.004). Patients without infection had significantly higher survival rates (p = < 0.001). Multivariate Cox proportional hazards regression showed that tumor stage (stage IV), immunotherapy, targeted therapy, and surgical intervention have a significant effect on patient’s survival. CONCLUSION: Infections, particularly bacterial and gram negative, are common and negatively impact survival in lung cancer patients. Early identification and management of infections, especially among diabetic patients, may improve clinical outcomes. The crucial need to promptly identify the causative agents associated with lung cancer patients, as this can significantly enhance patients’ survival rates. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773167","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":"Hotspot Mapping, Spatiotemporal Clustering and Forecasting of Malaria Incidence in Uganda, 2014-2023: Strategies to Inform Targeted Public Health Interventions.","authors":"George Paasi, Jimmy Patrick Alunyo, Alice Nakiyemba, Gilbert Gilibrays Ocen, Stephen Pande, Florence Alaroker, Paul John Waako, Peter Olupot-Olupot","doi":"10.1007/s44197-026-00562-7","DOIUrl":"10.1007/s44197-026-00562-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Malaria remains a major public health problem in Uganda, with marked spatial and temporal variation in incidence. A clearer understanding of these patterns is essential for targeting control efforts. This study quantified spatial heterogeneity, spatiotemporal clustering, and temporal dynamics of malaria incidence in Uganda (2014-2023), and generated probabilistic forecasts intended to support targeted malaria control and surveillance planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This ecological study used district-level malaria surveillance data from Uganda's District Health Information System 2 (DHIS2) from 2014 to 2023. Spatial heterogeneity was described using choropleth mapping with Jenks natural breaks classification. Emerging Hot Spot Analysis (EHSA) was used as the primary method to identify statistically significant spatiotemporal hotspot and cold spot dynamics. Exploratory secondary analyses included district-level Mann-Kendall trend testing and time series clustering. National monthly malaria counts were modelled using an ARIMA(2,1,1) framework, and forecasts with prediction intervals were generated to describe near-term trajectories under continuation of historical patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Malaria burden showed marked spatial heterogeneity across Uganda. Higher burden was concentrated in West Nile, Acholi, and Lango, with additional elevated burden in parts of Karamoja, Teso, Busoga, Bukedi and northern Buganda, while lower burden was observed across much of Tooro, Bunyoro, southern Buganda, Bugisu, Sebei, Kigezi, and Ankole. EHSA identified distinct spatiotemporal hotspot dynamics: sporadic hotspots were concentrated in West Nile, oscillating hotspots predominated in Karamoja and extended into parts of Teso and Sebei, and consecutive hotspots formed a narrower corridor through parts of Lango, Bunyoro, Busoga, southern Buganda. New hotspots were few and localized, occurring mainly in Teso and northern Buganda, whereas sporadic cold spots were largely confined to Kigezi in the south-west. Exploratory secondary analyses were broadly consistent with these patterns: time-series clustering separated districts into lower- and higher-burden trajectory groups, and Mann-Kendall trend testing showed upward trends concentrated mainly in Karamoja, with localized increases in Busoga, Teso, Buganda, Acholi, and West Nile, while downward trends were restricted to Kigezi. At the national level, the ARIMA(2,1,1) model reproduced the main level and seasonal oscillations in the series and suggested a gradually increasing underlying trend, with monthly malaria cases projected to remain approximately 1.0 to 1.2 million through 2030. Exploratory decomposition indicated a recurring seasonal pattern, with incidence generally rising from March to a primary peak in April to June.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Malaria transmission in Uganda remains highly heterogeneous, with consecutive, sporadic and oscillating ","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773185","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 Congenital Anomalies in Live-Born Infants in Iran: Clinical, Environmental, and Demographic Perspectives.","authors":"Mahboubeh Hojati, Shahrokh Izadi, Marjan Mansourian","doi":"10.1007/s44197-026-00533-y","DOIUrl":"10.1007/s44197-026-00533-y","url":null,"abstract":"<p><p>OBJECTIVE: The primary aim of the study was to evaluate the incidence of congenital anomalies (CAs) and their association with maternal and environmental factors among live-born infants in Isfahan Province, Iran. METHODS: This cross-sectional study was conducted from September 2023, to May 2024. A total of 2555 women of reproductive age (15–55 years) who had at least one live birth, residing in Isfahan Province (central Iran), were selected using multistage random sampling from the internet-based health event database of the Ministry of Health, known as SIB. These women were invited to complete an online validated questionnaire, either during a telephone interview or in person. Univariate and multivariable logistic regression analyses were conducted to investigate the relationships between CAs and factors such as maternal age, consanguinity, parity, socioeconomic status, lifestyle, and nutritional characteristics. RESULTS: A total, 34 live births were classified as CAs, representing 1.33% (95% confidence interval: 0.92–1.85), which is lower than the national estimate of 1.8% and the global estimate of 2–3% for major congenital anomalies, as reported in the World Health Organization’s fact sheet on congenital anomalies. The significant predictors of congenital anomalies were advanced maternal age (odds ratio [OR] = 1.05, 95% CI: 1.00–1.09, p = 0.001), first-degree consanguineous marriage (OR = 5.46, 95% CI: 2.16–9.20, p < 0.001), and higher parity (OR = 6.80, 95% CI:1.85–24.98 for four or more pregnancies, p = 0.002). CONCLUSION: These findings highlight the importance of targeted interventions, including expanded genetic counseling, improved prenatal screening for high-risk groups, and the creation of a national CA registry. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773170","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":"Development and Internal Validation of a Prognostic Model for Delayed Ambulation Recovery After Major Abdominal Surgery in Northwest Ethiopia. A Prospective Multicenter Study.","authors":"Mulualem Endeshaw Zeleke, Miteku Andualem Limenih, Meron Asmamaw Alemayehu, Samrawit Tsegaye Mekonnen","doi":"10.1007/s44197-026-00555-6","DOIUrl":"10.1007/s44197-026-00555-6","url":null,"abstract":"<p><p>BACKGROUND: Delayed ambulation recovery following major abdominal surgery presents a significant prognostic challenge, contributes to increased morbidity, mortality, and prolonged hospital stay. Despite recommendations advocating early mobilization, many patients, especially in low-resource settings, experience delayed recovery, and practical risk prediction models are lacking to identify high-risk patients to implement targeted interventions and personalized care. OBJECTIVE: To develop and internally validate a prognostic model predicting delayed ambulation recovery on postoperative day one after major abdominal surgery. METHODS: A prospective follow-up study was conducted on 645 patients who underwent major abdominal surgery between April to July 2025. Data were collected by Kobo Toolbox and analyzed using R software version 4.4.3. Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression were used for model development. Model performance was evaluated via Receiver Operating Characteristic-Area Under the Curve (ROC-AUC), calibration plots, and Hosmer–Lemeshow tests. Internal validation was done via bootstrapping. Clinical utility was assessed by decision curve analysis, and results were presented in a nomogram. RESULTS: Delayed ambulation recovery was observed in 48.4% (95%CI: 44.5–52.2) of patients. The model identified ten predictors (comorbidity, pain, NG tube, drain, general anesthesia, lower abdominal surgery, fluid amount > 2000 ml, blood loss > 500 ml, surgical duration > 2 h and open surgery). The model shows strong discrimination with an AUC of 0.85 (95% CI: 0.82–0.88) and calibration (Hosmer–Lemeshow p = 0.209). Internal validation revealed AUC of 0.84, with minimal overfitting. The model yielded sensitivity of 79.4%, specificity of 82.6%, and overall accuracy of 81.2%( 95% CI: 78%, 84%). The decision curve analysis offers greater net benefit than treating all or none across a wide range of risk thresholds probabilities. CONCLUSION: A practical prognostic model was developed using easily accessible clinical and surgical predictors and displayed in a nomogram. The model demonstrated a good predictive ability for delayed ambulation recovery after major abdominal surgery. Applying the model helps clinicians with perioperative screening and targeted management of surgical patients in this population. We recommend that other researchers to externally validate the model for transportability. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729174","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":"Global Health Reform through a Regional Lens: The Middle East and Central Asia Perspective.","authors":"Yousef Khader, Mohannad Al Nsour, Randa Saad, Antonio Sarria-Santamera, Nader Kabbani, Aruzhan Montayeva, Kuanysh Yergaliyev, Laura Kozhageldiyeva, Nejla Ben Mimoune, Theresa Madubuko, Shadi Saleh","doi":"10.1007/s44197-026-00560-9","DOIUrl":"10.1007/s44197-026-00560-9","url":null,"abstract":"<p><p>BACKGROUND: Reform of the global health architecture has emerged as a central policy priority, yet regionally grounded perspectives that translate critical analysis into actionable directions remain limited. This gap is particularly evident in the Middle East and Central Asia (MECA), a region characterized by diverse political and economic contexts, fragile and emergency-prone settings, and wide variation in health system capacity and governance. This study aimed to assess MECA stakeholders’ perspectives on the strengths and weaknesses of the current global health architecture, articulate a shared regional vision for future governance, and identify and prioritize reform directions relevant to the MECA context. METHODS: A mixed-methods, multi-phase deliberative policy dialogue approach was employed. Data were collected through semi-structured interviews with 47 key informants, an online survey of 248 stakeholders from 17 MECA countries, and a two-day regional dialogue involving 49 senior leaders from 14 countries. The exercise culminated in a structured prioritization completed by 34 participants. Qualitative data were analyzed thematically using a hybrid inductive–deductive approach, quantitative data were summarized descriptively, and findings were triangulated across phases. RESULTS: Findings were synthesized into five priority reform directions reflecting shared concerns around governance imbalances, fragmented financing, and limited regional agency. Aligning global health financing and technical support with nationally defined priorities emerged as the top priority, selected by over 90% of participants in the prioritization exercise. Strengthening regional leadership and enhancing regional collaboration mechanisms were each prioritized by approximately 70% of participants. Strengthening regional data and digital systems as shared public goods was prioritized by 69%, while reinforcing national leadership for integrated, primary health care (PHC)–centered systems was prioritized by 63%. Across reform areas, participants emphasized strengthening and connecting existing institutions rather than creating new structures and highlighted the importance of clear implementation frameworks, accountability mechanisms, and measurable progress indicators. CONCLUSIONS: From a MECA perspective, effective global health reform requires a shift away from fragmented, externally driven models toward more regionally anchored, country-led, and integrated systems grounded in shared accountability. This includes rebalancing decision-making power, improving coherence across governance and financing mechanisms, and strengthening national and regional ownership of health priorities. These findings provide an empirically grounded regional perspective to inform ongoing global discussions on building more equitable, resilient, and responsive health systems. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716828","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":"Seroprevalence and Molecular Epidemiology of Hepatitis B and D Viruses in Mauritania: a Systematic Review and Meta-Analysis.","authors":"Sidi Mohamed Cheikh Bouna, Nabil Said Abdellah, Habiba Kamal, Mohamed Hemeyine, Ahmed Houmeida, Vanessa Meier Stephenson, Sayeh Ezzikouri, Soo Aleman, Souad Aboudkhil","doi":"10.1007/s44197-026-00559-2","DOIUrl":"10.1007/s44197-026-00559-2","url":null,"abstract":"<p><p>Mauritania has a high prevalence of chronic hepatitis B virus (HBV) and hepatitis D virus (HDV), posing a major public health burden. A comprehensive analysis of seroprevalence, transmission dynamics, and molecular epidemiology would help inform strategies for public health interventions. This study systematically reviews the published literature in the field between 1983 and 2024, employing PRISMA 2020 guidelines. Where insufficient data were available for meta-analyses on specific inquiries, summative descriptions were included. Eight studies involving 19,781 participants were included. The pooled HBsAg seroprevalence was 15.2% (95% CI: 12.8%–18.0%; I2 = 91.9%; p < 0.0001) by meta-analysis. Among HBV-exposed individuals, male sex, lower education levels, and certain occupations were more commonly observed. Genotype D dominated HBV strains (50%), followed by E (36.2%), A (12%), and G (0.5%). Among 1739 HBsAg-positive individuals from five studies, the seroprevalence of anti-HDV antibodies was 21.2% (95% CI, 14.7%—29.4%; I2 = 94.1%; p < 0.0001), with HDV-RNA detectable in 52.0% of cases. Occupation and geographic location were more commonly observed among HDV-infected individuals. HDV-1 was the predominant genotype (89.3%), followed by HDV-5 (10.7%). Given the dual epidemic of HBV and HDV faced by Mauritania, targeted public health strategies will be needed. This systematic review and meta-analysis outlines some of the known epidemiology, both molecular and social, to aid the focus of public health programs.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716887","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 in Antibiotic Resistance of Klebsiella pneumoniae and Antibiotic Consumption: A Six-year Longitudinal Surveillance Study : Temporal Trends of Resistance and Consumption of Antibiotics to K. pneumoniae.","authors":"Divya Bhat, Asha K Rajan, Neeraja Raju, Vandana Kalwaje Eshwara, Muralidhar Varma, Shashikiran Umakanth, Girish Thunga, Vishal Shanbhag","doi":"10.1007/s44197-026-00553-8","DOIUrl":"10.1007/s44197-026-00553-8","url":null,"abstract":"<p><p>BACKGROUND: Antimicrobial resistance in Klebsiella pneumoniae represents a major challenge to healthcare systems. While antibiotic consumption is a key driver of resistance, long-term, setting-specific data linking antimicrobial use with resistance trends remain limited. This study aimed to evaluate temporal trends in antibiotic consumption and corresponding resistance patterns in K. pneumoniae over a six-year period. METHODS: This retrospective, longitudinal surveillance study was conducted at a tertiary-care hospital from January 2019 to December 2024. Non-duplicate K. pneumoniae isolates recovered from various specimens were included. Antimicrobial susceptibility testing was performed using standardized laboratory methods and interpreted accordingly. Antibiotic consumptions data were extracted from electronic records, and quantified annually, with stratification by ICU and non-ICU settings. Temporal trends in resistance and consumption were analysed descriptively using various graphical representation. RESULTS: Over the time, antibiotic consumption demonstrated a progressive shift toward broader spectrum and reserve agents, with a sustained increase in carbapenem use and persistently high fluoroquinolone utilization. Fluoroquinolone susceptibility remained uniformly low despite continued high use, whereas carbapenem susceptibility showed temporal fluctuations with an overall declining trend in later years. A transient improvement in susceptibility across multiple classes was observed in 2021, followed by renewed erosion thereafter. In contrast, aminoglycosides and tigecycline retained relatively stable activity, paralleling their restrained use. CONCLUSION: This six-year surveillance study highlights parallel temporal trends between antibiotic consumption patterns and evolving resistance in K. pneumoniae, with pronounced effects in critical care and bloodstream infections. Integrating consumption data with resistance surveillance is essential to inform setting-specific antimicrobial stewardship strategies and preserve the effectiveness of existing antibiotics in high-resistance healthcare environments. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690464","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":"Distribution of Abnormal Hemoglobins in Saudi Arabia: Analysis of Private Sector Laboratory Data.","authors":"Omar M Raslan, Osman O Radhwi, Hadia B Al Mahdi, Eman M Mansory","doi":"10.1007/s44197-026-00557-4","DOIUrl":"10.1007/s44197-026-00557-4","url":null,"abstract":"<p><p>BACKGROUND: Hemoglobinopathies are inherited blood disorders causing both a global and regional burden on health care systems and on affected individuals. Our study describes the epidemiological and statistical distribution of hemoglobin patterns in individuals referred to a large private-sector laboratory network in Saudi Arabia. OBJECTIVE: Our study investigates the distribution of hemoglobin patterns among individuals tested at Alborg laboratories, their Complete Blood Count (CBC) parameters as well as regional distributions. METHODS: This is a retrospective analysis of a 10-year database that included demographic data, hemoglobin electrophoresis patterns, CBC parameters and ferritin levels. RESULTS: A total of 83,821 individuals were included in the study, of which 53.6% were females with a mean age of 23 years old. The normal hemoglobin pattern was most frequent (63.7%), followed by Sickle Cell Disease (SCD) (19.96%), Thalassemia trait (8.37%), and Sickle Cell Trait (SCT) (5.28%). As for regional data, the largest number of samples came from Makkah (38.5%), followed by Eastern Region (30.2%) then Al-Riyadh (9.3%), collectively representing 78% of the total sample. Highest mean hemoglobin values were found in patients with normal hemoglobin pattern (12.5 g/dL) and the lowest was in the HPFH group (7.8 g/dL). CONCLUSION: This large, multi-regional private-sector study demonstrates the national hemoglobin patterns of individuals undergoing laboratory testing, with geographic patterns of abnormal hemoglobins that parallel those reported in former public-sector national screening programs. These findings may inform targeted screening, counseling and resource allocation strategies in Saudi Arabia. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674323","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":"Rising Mortality from Sleep Apnea and Hypertension in U.S. Adults: A 23-Year Epidemiological Analysis And Impact of the COVID-19 Pandemic (2000-2023).","authors":"Mohid Zulfiqar, Muhammad Tahir, Hassan Abdul Aziz Dhedhi, Ammad Uddin, Muhammad Khalid Afridi, Hermann Yokolo, Saad Ahmed Waqas","doi":"10.1007/s44197-026-00552-9","DOIUrl":"10.1007/s44197-026-00552-9","url":null,"abstract":"<p><p>BACKGROUND: Obstructive Sleep Apnea (OSA) and hypertension (HTN) are prevalent, interrelated conditions associated with significant cardiovascular morbidity. Despite their rising burden, mortality trends for their co-occurrence remain underexplored. OBJECTIVE: To assess U.S. mortality trends related to OSA and HTN from 2000 to 2023, analyzing demographic, geographic, and temporal patterns. METHODS: Mortality data for adults aged ≥ 25 were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent changes (APCs) were calculated using joinpoint regression, stratified by sex, race/ethnicity, age, urbanization, and Census regions. RESULTS: From 2000 to 2023, 127,668 deaths were attributed to OSA and HTN. AAMRs rose from 0.44 (95% CI: 0.41–0.47) in 2000 to 4.87 (95% CI: 4.79–4.96) in 2023, with an average annual percent change of + 11.55% (95% CI: 10.41–12.70). Men had higher mortality rates than women (2023: 7.05 vs. 3.05). Non-Hispanic Black adults exhibited the highest AAMRs, followed by Non-Hispanic Whites and Hispanics. Adults ≥ 65 years accounted for 62.4% of deaths. Rural areas had higher mortality than metropolitan areas (2.04 vs. 1.69). States like Oregon had rates nearly five times higher than New York. Mortality peaked in 2018–2021, aligning with the COVID-19 pandemic. Heart disease was the leading underlying cause. CONCLUSIONS: OSA and HTN-related mortality has surged over two decades, with pronounced disparities by sex, race, age, and region. Targeted prevention, screening, and intervention strategies are urgently needed, particularly for elderly, minority, and rural populations. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662819","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 Risk Factors of Heat-Related Illness Among Pilgrims During the Hajj Season 2024: A Cross-Sectional Study.","authors":"Elbagir A Elfaki, Hatem A Sembawa, Ahmed Hassan Badrek Alamodi, Nahla H Hariri, Majed S Obaid, Amar Mohammad A Alkhotani, Ismail A Alghamdi, Muhammad Irfanullah Siddiqui, Heba M Adly, Mohammed A Garout, Adeeb A Bulkhi, Hani M Almoallim, Altaf Ahmed Abdulkhaliq, Saleh A K Saleh, Aous S Alhazmi, Abdulrahman T Taeyb, Mohammed J Basnawi, Ammar A AbuSeer, Hassan H Abu Rokbah, Jaffar A Al-Tawfiq, Maher N Alandiyjany, Rania Abubaker Bagabir, Nizar S Bawahab, Ghadah Alsaleh, Hala Aljishi, Fahad A Alamri, Anas A Khan","doi":"10.1007/s44197-026-00550-x","DOIUrl":"10.1007/s44197-026-00550-x","url":null,"abstract":"<p><p>BACKGROUND: Heat-related illnesses (HRIs) remain a significant health concern during mass gatherings (MGs), where high temperatures and physical exertion exacerbate physiological stress. This study examines the clinical spectrum, management practices, and treatment outcomes of HRIs among pilgrims during the 2024 Hajj season, to inform public health responses and mitigation strategies. METHODS: A cross-sectional study was conducted across nine healthcare facilities in Makkah and the Mashaer region during the 2024 Hajj. Data were retrospectively extracted from medical health care facilities registries using a standardized form to capture demographic characteristics, clinical presentation, management interventions, and in-hospital outcomes of patients diagnosed with heat-related illness. RESULTS: Of the 2,785 screened patients, 2,551 had complete clinical records, and 1,576 met the diagnostic criteria for heat exhaustion or heatstroke, with outcome data available. Most of the patients were male (1,171; 74.3%), with nearly half aged 60 years or older (776; 49.2%) and a large proportion aged 39–59 years (693; 44.0%). The majority were non-Saudi pilgrims (1,419; 90%), primarily from Arab countries, with 793 (50.3%) from these regions. A total of 1,094 patients (69.4%) had no prior history of HRIs. Common symptoms included altered mental status in 635 (40.3%) patients, dizziness in 486 (30.8%), and management interventions included intravenous fluid administration in 569 cases (36.1%) and the application of cooling measures in emergency settings for 1,105 patients (70.1%). The overall mortality rate was 77 (4.9%) cases. Intensive care unit (ICU) admission and elevated lactic acid levels were significantly associated with poor outcomes. CONCLUSION: Heat-related illness during the Hajj remains a major public health concern, with a substantial clinical burden and potentially severe outcomes. Early recognition, timely intervention, and targeted education are essential for high-risk groups. Strengthening frontline preparedness and resource deployment is crucial to reducing its potential impact. </p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662808","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}