Global Epidemiology最新文献

{"title":"Mortality rate of stroke and its determinants in Africa: An umbrella review of systematic review and meta-analysis","authors":"Addisu Getie ,&nbsp;Mihretie Gedfew ,&nbsp;Tegene Atamenta Kitaw ,&nbsp;Gizachew Yilak ,&nbsp;Melaku Bimerew","doi":"10.1016/j.gloepi.2025.100225","DOIUrl":"10.1016/j.gloepi.2025.100225","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke is a significant clinical condition characterized by inadequate blood flow to the brain, resulting in cerebral function loss and potential death if not promptly treated. In developed countries, stroke incidence is decreasing due to efforts targeting risk factors like high blood pressure and smoking, though aging populations sustain high overall rates. Globally, stroke ranks among the top causes of death and disability, with Africa experiencing notably high stroke-related mortality rates. Understanding these trends and predictors is crucial for shaping effective healthcare strategies and interventions to reduce stroke mortality across the continent. Therefore, this umbrella review aimed to assess the pooled prevalence of stroke mortality and its associated predictors in Africa.</div></div><div><h3>Method</h3><div>This umbrella review systematically synthesized findings from systematic reviews and meta-analyses on stroke mortality rates in Africa, following established methodology. Various databases, including PubMed, Embase, Scopus, and others, were searched up to June 2024 for English-language studies reporting stroke mortality prevalence and determinants. Data were extracted using standardized methods in Excel, and study quality was assessed using the AMSTAR tool. Heterogeneity was measured using Higgin's I² Statistics, and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Publication bias was assessed by visually inspecting funnel plots and conducting Egger's regression tests.</div></div><div><h3>Result</h3><div>In this umbrella review, data from nine systematic review and meta-analysis studies encompassed 341 primary studies with a total sample size of 170,501 stroke patients admitted to hospitals in Africa. The overall pooled prevalence of stroke mortality in Africa was 20.3 % (95 % CI: 17.3–23.2). Western Africa exhibited the highest prevalence at 27 % (95 % CI: 14.4–39.6), and hemorrhagic stroke patients had a notably higher mortality rate of 26.1 % (95 % CI: 24–28.3).</div></div><div><h3>Conclusion</h3><div>This study reveals significant variations in stroke mortality across Africa, with the highest prevalence reported in Western Africa and among hemorrhagic stroke patients. Factors associated with increased stroke mortality include severe neurological impairment (Glasgow Coma Scale &lt;8), aspiration pneumonia, older age, vascular disease, female gender, lack of aspirin treatment, reduced renal function, and diabetes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the spatial distribution and characteristics of HIV seropositivity among women in Ethiopia. A spatial analysis","authors":"Tegene Atamenta kitaw ,&nbsp;Amanuel Tadesse Koyas ,&nbsp;Bruktawite Afework Tekle ,&nbsp;Ribka Nigatu Haile","doi":"10.1016/j.gloepi.2025.100224","DOIUrl":"10.1016/j.gloepi.2025.100224","url":null,"abstract":"<div><h3>Background</h3><div>Although promising effort has been made so far, HIV remains a public health concern. Women in Ethiopia are disproportionately affected by HIV, accounting for a majority of new infections and HIV -related deaths. However, the geospatial distribution of HIV among women in Ethiopia is not well understood, making it challenging to develop geographically targeted measures. Besides, to accelerate the pathway of decreasing HIV prevalence and plan geographically specific interventions, understanding the geospatial distribution of HIV seropositivity among women plays a crucial role.</div></div><div><h3>Methods</h3><div>A spatial analysis was conducted among 14,778 weighted samples of women in the reproductive age group. Global Moran's I was computed to determine whether HIV seropositivity is randomly distributed, clustered, or dispersed. Getis-Ord Gi* spatial statistic was done to identify spatial clusters of cold and hot spot areas.</div></div><div><h3>Results</h3><div>HIV seropositivity among women in Ethiopia is distributed non-randomly (Global Moran's <em>I</em> = 0.16). The distribution of HIV ranges from 0.02 % to 6.16 %. A hotspot clustering of HIV seropositivity was identified in Addis Ababa, Harari, Dire Dawa, and Gambela region. Women residing in the primary cluster, encompassing Addis Ababa, Harari, and Dire Dawa, exhibited a substantially increased risk of HIV infection compared to the reverse group (LLR = 32.88, 95CI:26.33–39.36).</div></div><div><h3>Conclusion</h3><div>HIV seropositivity among women in Ethiopia is unevenly distributed, with clear spatial clustering. The highest concentration of cases was identified in Addis Ababa, Harari, Dire Dawa, and Gambela, with significantly elevated risk observed in the primary cluster regions. These findings underscore the importance of geographically targeted interventions to address the concentrated burden of HIV in high-risk regions.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index and mortality in a nationally representative cohort of south African adults","authors":"Annibale Cois","doi":"10.1016/j.gloepi.2025.100220","DOIUrl":"10.1016/j.gloepi.2025.100220","url":null,"abstract":"<div><h3>Aim</h3><div>To examine the association between Body Mass Index (BMI) and all-cause mortality in South Africa.</div></div><div><h3>Methods</h3><div>Longitudinal data on adults 20 years and older from five waves (2008, 2010–11, 2012, 2014–15, and 2017) of the South African National Income Dynamics Study were analysed. Survival proportional hazard models, adjusted for sociodemographic and lifestyle characteristics, were used to estimate the relationship between BMI and mortality. Sensitivity analyses were conducted to assess the robustness of the estimates.</div></div><div><h3>Results</h3><div>Of the 12,402 eligible individuals, 10917 had valid BMI measurements and were included in the analyses. During a total of 83,077 person-years of observation, 1741 individuals died.</div><div>Hazard ratios for all-cause mortality were significantly lower in the BMI range 25–40 kg/m² in comparison with the reference category of 18.5–25 kg/m² and were minimal in the range 30–35 kg/m² (HR = 0.68, 95% CI: 0.50–0.88). BMI &lt; 18.5 kg/m² was associated with an increased risk of death, with a maximum hazard ratio of 2.14 (95% CI: 1.36–3.4) in the &lt;16 kg/m² category. The pattern was repeated in the sex-specific analyses. The relationship persisted after restricting the analyses to never smokers, excluding subjects with pre-existing conditions or who died in the first two years of follow-up.</div></div><div><h3>Conclusions</h3><div>This study suggests that, in the South African adult population, BMI in the overweight or mild obesity range according to international definitions is associated with a reduced risk of mortality compared to the” healthy weight” range. Further research is needed to corroborate these results.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mathematical modelling and time series clustering of Mpox outbreak: A comparative study of the top 10 affected countries and implications for future outbreak management","authors":"Mark-Daniels Tamakloe ,&nbsp;Ametus Kuuwill ,&nbsp;Ibrahim Osumanu ,&nbsp;Helina Siripi","doi":"10.1016/j.gloepi.2025.100214","DOIUrl":"10.1016/j.gloepi.2025.100214","url":null,"abstract":"<div><div>The 2022 Mpox outbreak, characterized by its rapid cross-continental spread beyond traditionally endemic regions, presented a renewed threat to global health security. This study presents a comparative epidemiological analysis of the ten countries most affected by Mpox, integrating mathematical modelling with time series clustering, the first of its kind to analyze the 2022 WHO Mpox data. By applying an SIR-based model to estimate the effective transmission rate, basic reproduction number, time of first infection, and initial susceptible population, the study captures both the pace and persistence of Mpox spread, while critically assessing the effectiveness of national public health responses. Key findings reveal a paradox in North America: Canada exhibited a high transmission rate but a low reproduction number, indicating an elevated transmission potential per contact alongside limited secondary spread. This is likely due to concurrent containment measures or behavioral factors. In contrast, the United States, despite having a lower initial transmission rate, recorded a higher reproduction number. Similarly, Germany exhibited a similar risk trajectory, with elevated reproductive numbers despite robust infrastructure. The cases in the USA and Germany are likely due to systemic health and socio-political policy gaps and delayed behavior-targeted interventions, particularly in the population of men having sex with men (MSM). In Latin America, countries such as Peru and Mexico suffered disproportionately, likely due to limited access to healthcare, which compounded transmission dynamics and reproductive potential. Our study demonstrates that effective Mpox control is not solely dependent on health infrastructure, but also on behavioral targeting, equity, and adaptive health governance. This calls for cross-country and intercontinental collaborations towards combating current and future health shocks, including epidemics.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical inference and effect measures in abstracts of major HIV and AIDS journals, 1987–2022: A systematic review","authors":"Andreas Stang ,&nbsp;Henning Schäfer ,&nbsp;Ahmad Idrissi-Yaghir ,&nbsp;Christoph M. Friedrich ,&nbsp;Matthew P. Fox","doi":"10.1016/j.gloepi.2025.100213","DOIUrl":"10.1016/j.gloepi.2025.100213","url":null,"abstract":"<div><h3>Objectives</h3><div>With the emergence of HIV/AIDS journals, the development of the reporting of statistical inference and effect measures in published abstracts can be examined from the beginning in a new field. The aim of this study was to describe time trends of statistical inference and effect measure reporting of major HIV/AIDS journals</div></div><div><h3>Methods</h3><div>We included 10 major HIV/AIDS journals and analyzed all available PubMed entries for the period 1987 through 2022. We applied rule-based text mining and machine learning methodology to detect the presence of confidence intervals, numerical <em>p</em>-values or comparisons of p-values with thresholds, language describing statistical significance, and effect measures for dichotomous outcomes</div></div><div><h3>Results</h3><div>Among 41,730 PubMed entries from the major HIV/AIDS journals, 31,665 contained an abstract. In the early years, most abstracts reporting statistical inference contained only significance terminology without confidence intervals and <em>p</em>-values. From 1988 to 2005, each year 30 % of all abstracts contained p-values without confidence intervals. Thereafter, this reporting style continued to decline. The reporting of confidence intervals increased steadily from 1988 (11 %) to 2022 (56 %). Of the 17 % of abstracts in 2017–2022 that included any effect measure, half reported odds ratios (51 %), followed by hazard ratios (28 %) and risk ratios (16 %). Difference measures and number needed to treat or harm were very uncommon</div></div><div><h3>Conclusions</h3><div>Within the HIV/AIDS literature, there has been widespread use of confidence intervals. Most of the journals that we reviewed had a decrease in reporting only statistical significance without confidence intervals over time</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do certain blood groups increase COVID-19 severity and mortality?","authors":"Tegene Atamenta kitaw,&nbsp;Ribka Nigatu Haile","doi":"10.1016/j.gloepi.2025.100212","DOIUrl":"10.1016/j.gloepi.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>The existence of a relationship between the ABO blood group and COVID-19 severity and mortality is still an unresolved concern. Some studies report that groups O and A show a lower and higher risk of developing severe COVID-19 and mortality, respectively. Some studies also report the reverse. There are inconclusive results from different studies. Thus, this study sought to determine the possible associations of ABO blood type with COVID-19 severity and mortality.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted among 570 adults with real-time reverse transcription-polymerase chain reaction confirmed positive COVID-19 patients attending Eka Kotebe General Hospital, COVID-19 Treatment Center. A Kaplan-Meier survival curve was computed to examine the difference in survival experience between ABO blood groups. Multinomial and binary logistic regression models were fitted to determine the association between ABO blood group with COVID-19 severity and mortality, respectively.</div></div><div><h3>Result</h3><div>238 (41.8 %) COVID-19 patients had blood group B, followed by 201 (35.3 %) A, 82 (14.4 %) O, and 49 (8.6 %) AB blood type. 23.68 % of participants develop severe COVID-19. Overall, 15.26 % COVID-19-related mortality was found. No difference in survival experience was observed between ABO blood types. There was no statistically significant association between ABO blood type and COVID-19 severity, and mortality.</div></div><div><h3>Conclusion</h3><div>We found no relationship between ABO blood group differences and COVID-19 severity, and mortality. Further, well-design-controlled studies are suggested to explore the potential link of ABO blood group with COVID-19 severity and mortality.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of stroke in Pakistan and its provinces, 1990–2021: Findings from the global burden of disease study 2021","authors":"Sufyan Shahid ,&nbsp;Ali Dheyaa Marsool ,&nbsp;Maha Sajjad ,&nbsp;Muneeb Saifullah ,&nbsp;Muhammad Awais Alam ,&nbsp;Syed Ijlal Ahmed ,&nbsp;Raheel Ahmed ,&nbsp;Fahd Sultan","doi":"10.1016/j.gloepi.2025.100211","DOIUrl":"10.1016/j.gloepi.2025.100211","url":null,"abstract":"<div><h3>Background</h3><div>Despite stroke being a leading cause of death in Pakistan, no study has comprehensively analyzed national and regional trends over time. This gap limits understanding of the evolving burden and underlying risk factors.</div></div><div><h3>Methods</h3><div>We analyzed regional stroke trends in Pakistan from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data. Age-standardized incidence, prevalence, mortality, disability-adjusted life years (DALYs), and 18 modifiable risk factors were analyzed across provinces. Joinpoint regression identified temporal trends through annual percent changes (APCs), and population attributable fractions (PAFs) quantified risk contributions. All estimates incorporated 95 % uncertainty intervals and underwent sensitivity testing to ensure robustness.</div></div><div><h3>Findings</h3><div>In 2021, stroke was the second leading cause of death in Pakistan, responsible for 99,759 deaths, with an incidence of 153 and a prevalence of 1088 per 100,000 population. Age-standardized rates for incidence, prevalence, mortality, and DALYs declined overall from 1990 to 2021 (ASIR AAPC: −0.15 %), though reductions were modest. Regional trends showed the steepest declines in Islamabad and Punjab, while Balochistan experienced an increase in mortality (ASMR AAPC: +0.03 %) and DALYs (+0.05 %). Sex-specific trends showed greater declines in incidence and mortality among females, while DALY reductions were modest in both sexes, reflecting ongoing disability. High systolic blood pressure was the leading risk factor for stroke mortality (25.2 per 100,000) and DALYs (674.9 per 100,000), followed by household air pollution, ambient particulate matter, and high fasting glucose. These findings reflect the combined influence of cardiometabolic, environmental, and behavioral risks on Pakistan's evolving stroke burden.</div></div><div><h3>Interpretation</h3><div>Despite modest improvements, stroke remains a major health challenge in Pakistan, with rising long-term disability and stark regional inequalities. Strengthening prevention, equitable access, and post-stroke care is essential to curb the growing burden.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable artificial intelligence for predicting dengue outbreaks in Bangladesh using eco-climatic triggers","authors":"Md. Siddikur Rahman,&nbsp;Md. Abu Bokkor Shiddik","doi":"10.1016/j.gloepi.2025.100210","DOIUrl":"10.1016/j.gloepi.2025.100210","url":null,"abstract":"<div><h3>Background</h3><div>Dengue represents a significant public health threat in Bangladesh, characterized by its complex ecological transmission dynamics. To improve dengue prevention and control efforts, firstly, we employ state-of-the-art artificial intelligence (AI) methods to identify the roles of eco-climatic factors in predicting dengue outbreaks in Bangladesh.</div></div><div><h3>Methods</h3><div>We utilize high-performance machine learning (ML) models, XGBoost and LightGBM, combined with explainable AI (XAI) methodologies to evaluate the predictive performance and impact of various dengue determinants in Bangladesh from 2000 to 2023. The LightGBM and XGBoost models were also utilized to predict dengue cases and early warning trends from 2024 to 2030. Climatic, socio-demographic, and landscape features were used to train these models; SHapley Additive Explanations (SHAP) values and LIME (Local Interpretable Model-agnostic Explanations) were used to interpret the results.</div></div><div><h3>Findings</h3><div>Between 2000 and 2023, Bangladesh experienced the highest number of dengue cases in August, while November saw the most fatalities. The XGBoost model excelled in predicting dengue outbreaks, achieving an AUC score of 0.89, a Log Loss of 0.64. Key predictors identified by the model include population density, precipitation, temperature, and land-use patterns. Additionally, Local Interpretable Model-agnostic Explanations (LIME) provided insights into the model's predictions, highlighting the significance of population density, relative humidity, and minimum temperature in dengue outbreaks.</div></div><div><h3>Interpretation</h3><div>This study showcases the potential of XAI in uncovering the complexities of dengue outbreaks, providing a robust tool for public health interventions. Our AI-driven framework can be utilized to generate prompt and timely alerts to prevent imminent dengue and other infectious disease outbreaks.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for advancing eye care in resource-poor settings: Assessing the predictive accuracy of an AI-model for diabetic retinopathy screening in India","authors":"Rohan Chawla ,&nbsp;Prachi Karkhanis ,&nbsp;Malay Shah ,&nbsp;Aritra Das ,&nbsp;Rishabh Sharma ,&nbsp;Dhwani Almaula ,&nbsp;Pradeep Venkatesh ,&nbsp;Harsh Vardhan Singh ,&nbsp;Mukul Kumar ,&nbsp;Ramanuj Samanta ,&nbsp;Vinod Kumarl ,&nbsp;Amar Shah ,&nbsp;Bhavin Vadera ,&nbsp;Nakul Jain ,&nbsp;Akanksha Sen ,&nbsp;Shyamsundar Shreedhar ,&nbsp;Vipin Garg ,&nbsp;Soma Dhaval ,&nbsp;Kowshik Ganesh ,&nbsp;Srinivas Rana ,&nbsp;Radhika Tandon","doi":"10.1016/j.gloepi.2025.100209","DOIUrl":"10.1016/j.gloepi.2025.100209","url":null,"abstract":"<div><h3>Background</h3><div>Timely identification and treatment of Diabetic Retinopathy (DR) is critical in avoiding vision loss. DR screening is challenging, especially in resource-limited areas where trained ophthalmologists are scarce. AI solutions show promise in addressing this challenge. In this study, the performance metrics of an AI solution (MadhuNetrAI) developed in India was evaluated for referring and grading DR.</div></div><div><h3>Methods</h3><div>MadhuNetrAI was developed de novo by the All India Institute of Medical Sciences (AIIMS) and Wadhwani AI (WIAI). It was tested on 1078 fundus images (from AIIMS Delhi and an unannotated subset of publicly available EyePACS images) against two ophthalmologists and an adjudicator serving as independent gold-standard annotators, wherein the disease status of the patients remained unknown.</div></div><div><h3>Findings</h3><div>MadhuNetrAI demonstrated high sensitivity (93·2 %; CI: 89·5 %–95·6 %) and specificity (95·3 %; CI: 93·7 %–96·6 %) in detecting referable DR (moderate, severe, proliferative DR). The area-under-the-curve for referring DR against the gold standard was 0·97 (CI: 0·95–0·99) indicating excellent diagnostic performance. The agreement in grading DR severity was high (kappa = 0·89, CI: 0·86–0·91). The model performed comparably in detecting DR too.</div></div><div><h3>Interpretation</h3><div>MadhuNetrAI's ability to grade DR severity and identify referrable cases could bring DR patients to care much earlier. Further research and clinical trials are needed to ensure its reliability and generalizability across diverse populations and image qualities.</div></div><div><h3>Funding</h3><div>MadhuNetrAI was developed by technical and programmatic teams at WIAI, with inputs and contributions by the clinical team at AIIMS, and funded by USAID. The authors have no financial or non-financial conflicts of interest to disclose.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and histopathological profile of lung Cancer: Insights from a 15-year cross-sectional study at a tertiary care centre in South India","authors":"Asmita A. Mehta ,&nbsp;Keechilat Pavithran ,&nbsp;Prem Kumar Nair ,&nbsp;Vishnu Vazhoor ,&nbsp;Georg Gutjahr ,&nbsp;V.P. Lakshmi Priya","doi":"10.1016/j.gloepi.2025.100208","DOIUrl":"10.1016/j.gloepi.2025.100208","url":null,"abstract":"<div><div>Abstract</div><div>Background</div><div>In India, lung cancer accounts for 5.9 % of all cancers and 8.1 % of all cancer-related deaths, with adenocarcinoma emerging as the most common histopathological subtype in developing countries.</div><div>Aims</div><div>To analyze the shifting trends in the epidemiology and histopathology of lung cancer over 15 years, with a focus on gender differences in the prevalence of adenocarcinoma.</div><div>Method</div><div>This observational, cross-sectional study was conducted at a tertiary care center in Southern India to evaluate the trends in the epidemiology and histopathology of lung cancer over a 15-year period (2008–2022). Data were gathered from patients aged ≥18 diagnosed with primary lung carcinoma. The annual distribution of patients was documented based on age, sex, and tumor histopathology. The analysis was conducted using SPSS software.</div><div>Results</div><div>A total of 4466 newly diagnosed primary lung cancer cases were analyzed over a 15-year period. The median age at diagnosis was 64 years, with a shift in age distribution over time. The proportion of female cases rose from 20.1 % to 28.4 %, while male cases declined from 79 % to 71 %, indicating a significant gender shift. Adenocarcinoma was the most common histopathology subtype, increasing from 22 % to 40 % in men and from 32 % to 55 % in women. Significant associations were observed between histopathology subtype and age group, gender, and year of diagnosis.</div><div>Conclusion</div><div>The study revealed evolving trends in the lung cancer profile over the last 15 years. A significant increase in the prevalence of adenocarcinoma was observed, with a more pronounced rise among women compared to men.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"9 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}