Global Epidemiology最新文献

{"title":"Statistically significant results from low-power analyses: A comedy of errors","authors":"Cyril Jaksic,&nbsp;Thomas Perneger,&nbsp;Christophe Combescure","doi":"10.1016/j.gloepi.2026.100250","DOIUrl":"10.1016/j.gloepi.2026.100250","url":null,"abstract":"<div><h3>Background</h3><div>When low-power analyses yield statistically significant results, they likely overestimate the true effect. Although sample estimates are symmetrically distributed around the true value, those that are by chance very high are more likely to achieve statistical significance. The bias induced by the significance filter increases as power decreases. Here we sought to quantify the estimation bias associated with low power and to contrast it with the type M error, which assesses the same phenomenon from a different perspective.</div></div><div><h3>Methods</h3><div>We used simulations to quantify estimation bias in relation to power among statistically significant results. We computed the type M error, relative bias (ratio of the estimated mean differences and the true value), and proportions of results with various levels of over- and under-estimation.</div></div><div><h3>Results</h3><div>For a medium effect size (Cohen's d of 0.5), overestimation of the mean difference was moderate at high power (≥80%): relative bias was &lt;1.13, about 65% of estimates were roughly accurate (between 0.75 and 1.25 of the true value), and sign errors were virtually absent. In contrast, at low power (&lt;30%), overestimation was strong (relative bias &gt;1.78), and almost no estimates were roughly accurate. Sign errors became noticeably prevalent only at very low levels of power (&lt;10%). In all situations, the relative bias had a lower magnitude than the type M error.</div></div><div><h3>Conclusion</h3><div>Low-power statistically significant results may consist entirely of magnitude errors, sign errors, and type 1 errors with high risk of strong overestimation (double effect). Readers should beware positive results from low-power analyses.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023223","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":"Spatial distribution and multilevel analysis of full vaccination coverage among children aged 12–23 months in Democratic Republic of Congo","authors":"Nigussie Adam Birhan ,&nbsp;Abebew Aklog Asmare ,&nbsp;Kefale Tilahun Getahun ,&nbsp;Gedif Mulat Alemayehu ,&nbsp;Zelalem Meraf Wolde ,&nbsp;Denekew Bitew Belay","doi":"10.1016/j.gloepi.2026.100256","DOIUrl":"10.1016/j.gloepi.2026.100256","url":null,"abstract":"<div><h3>Background</h3><div>Vaccination is one of the most cost-effective public health interventions for reducing child morbidity and mortality. However, full vaccination coverage remains suboptimal in many low- and middle-income countries, including Democratic Republic Congo (DRC). This study aimed to assess spatial distribution and risk factors of full vaccination coverage among children aged 12–23 months in DRC.</div></div><div><h3>Methods</h3><div>A cross sectional secondary data analysis on 2023/24 DRC Demographic and Health Survey data with a total weighted sample of 3897 children aged 12–23 months was used. Moran's I and Getis-Ord Gi* statistics was used to identify clustering patterns of full vaccination coverage. Multilevel analysis was used to examine factors associated with full vaccination coverage.</div></div><div><h3>Result</h3><div>The prevalence of full vaccination was 14.9% (95% CI: 13.8, 16.0). Moran's I 0.4 (<em>p</em> value = 0.01) indicated spatial clustering of full vaccination coverage. Full vaccination coverage was associated with maternal age 25–34 years (AOR = 1.54, 95% CI: 1.06–2.24), secondary and above education (AOR = 1.84, 95% CI: 1.18–2.88), being married (AOR = 1.55, 95% CI: 1.15–2.09), rich household wealth (AOR = 1.64, 95% CI: 1.06–2.51), 1–7 antenatal care visits (AOR = 2.25, 95% CI: 1.40–3.62), health facility delivery (AOR = 3.34, 95% CI: 1.87–5.97), and rural residence (AOR = 0.59, 95% CI: 0.39–0.89).</div></div><div><h3>Conclusion</h3><div>Full vaccination coverage in DRC is low and unevenly distributed; with cold spots in Mongala, part of Bas Uele and Tshuapa regions. Hence, targeted interventions focusing on identified cold spot areas, improving maternal education, expanding healthcare access, and promoting antenatal care and institutional delivery are essential to increase vaccine coverage.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384656","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":"Comment on “do certain blood groups increase COVID-19 severity and mortality?”","authors":"Prashant Ramdas Kokiwar ,&nbsp;Amit Singh Pawaiya ,&nbsp;Ranjana Roy ,&nbsp;Reenoo Jauhari","doi":"10.1016/j.gloepi.2026.100246","DOIUrl":"10.1016/j.gloepi.2026.100246","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100246"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023152","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":"A temporal network analysis of drug co-prescription during antidepressants and anxiolytics dispensing in the Netherlands from 2018 to 2022","authors":"Aly Lamuri ,&nbsp;Spyros Balafas ,&nbsp;Eelko Hak ,&nbsp;Jens H. Bos ,&nbsp;Frederike Jörg ,&nbsp;Talitha L. Feenstra","doi":"10.1016/j.gloepi.2026.100248","DOIUrl":"10.1016/j.gloepi.2026.100248","url":null,"abstract":"<div><h3>Background:</h3><div>Drug prescription networks (DPNs) model the temporal dynamics of medication co-prescription within a population. Understanding these networks can provide insights into polypharmacy and prescribing behaviors.</div></div><div><h3>Objective:</h3><div>This study assesses the structural characteristics of temporal DPNs derived from daily co-prescriptions of antidepressants, anxiolytics, and other therapeutic drug classes. By analyzing these networks using eigenvector centrality, we identify influential medications and prescribing patterns.</div></div><div><h3>Methods:</h3><div>We utilized the IADB.nl database, including prescriptions from 128 Dutch pharmacies (2018–2022). A cohort of patients prescribed antidepressants/anxiolytics was extracted. Medications were classified using the Anatomical Therapeutic Chemical (ATC) system into 24 therapeutic classes. Time-varying DPNs were constructed as undirected graphs using symmetric daily dose-adjusted co-prescriptions. Eigenvector centrality (<span><math><msub><mrow><mi>c</mi></mrow><mrow><mi>e</mi></mrow></msub></math></span>) quantified relative nodal importance. Weekly-aggregated data included number of dispensing (<span><math><msub><mrow><mi>n</mi></mrow><mrow><mi>c</mi></mrow></msub></math></span>) and eigenvector centrality, which were decomposed using a singular-spectrum approach.</div></div><div><h3>Results:</h3><div>Antidepressants (<span><math><msub><mrow><mi>c</mi></mrow><mrow><mi>e</mi></mrow></msub></math></span>: 0.09, <span><math><msub><mrow><mi>n</mi></mrow><mrow><mi>c</mi></mrow></msub></math></span>: 28,993) and anxiolytics (<span><math><msub><mrow><mi>c</mi></mrow><mrow><mi>e</mi></mrow></msub></math></span>: 0.05, <span><math><msub><mrow><mi>n</mi></mrow><mrow><mi>c</mi></mrow></msub></math></span>: 14,061) had high eigenvector centrality, demonstrating frequent co-prescription. Other ATC groups with high centrality included those for the alimentary tract and metabolism (<span>A01-A16</span>), blood and blood-forming organs (<span>B01-B06</span>), cardiovascular system (<span>C01-C10</span>), respiratory system (<span>R01-R07</span>), and analgesics (<span>N02</span>).</div></div><div><h3>Discussion:</h3><div>DPNs revealed key co-prescription patterns. High-centrality medications highlight potential targets for drug monitoring, such as identifying co-prescription trends that may warrant evaluation for safety, appropriateness, or policy oversight. This approach aids in identifying influential medications and refining prescribing oversight.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023224","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":"Three little pigs and one big bad wolf: The parable of data sharing in epidemiology","authors":"Igor Burstyn","doi":"10.1016/j.gloepi.2026.100259","DOIUrl":"10.1016/j.gloepi.2026.100259","url":null,"abstract":"","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230806","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":"On misconceptions about the Brier score in binary prediction models","authors":"Linard Hoessly","doi":"10.1016/j.gloepi.2025.100242","DOIUrl":"10.1016/j.gloepi.2025.100242","url":null,"abstract":"<div><div>The Brier score is a widely used metric in epidemiological and clinical research for evaluating the accuracy of probabilistic predictions for binary outcomes, such as disease occurrence, treatment response, and screening performance. Despite its popularity, the Brier score is frequently misunderstood, leading to flawed interpretation of prediction models and potentially misguided public health and clinical decisions. This study aims to didactically clarify common misconceptions about realised Brier scores and to provide practical, statistically rigorous guidance for its correct interpretation in epidemiologic and public health prediction models. We analytically examined its statistical properties and conducted simulation studies across diverse scenarios, varying the distribution of true outcome probabilities, prediction accuracy, sample size, and event prevalence. Five prevalent misconceptions were identified, including the mistaken belief that a Brier score of zero indicates a perfect model. Analytic arguments and simulations demonstrated that even perfectly specified models yield non-zero Brier scores under realistic conditions. The Brier score was shown to reflect not only prediction accuracy but also the underlying distribution of true risks and random variation in outcomes. Comparisons across different populations or disease settings can therefore be misleading, and the Brier score does not directly measure calibration. We recommend restricting comparisons to the same population and complementing the Brier score with calibration metrics and measures of clinical or public health utility. Adopting these practices will improve the validity and interpretability of risk prediction in epidemiologic research and enhance decision-making in population health.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100242"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926529","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":"Socioeconomic and regional determinants of optimal antenatal care utilization among women in South and Central Somalia","authors":"Mohamed Abdirahim Omar ,&nbsp;Yahye Sheikh Abdulle Hassan ,&nbsp;Abdirasak Sharif Ali ,&nbsp;Mohamed Mustaf Ahmed","doi":"10.1016/j.gloepi.2025.100239","DOIUrl":"10.1016/j.gloepi.2025.100239","url":null,"abstract":"<div><h3>Background</h3><div>Somalia faces one of the world's highest maternal mortality ratios, and fewer than one in sixteen pregnant women obtain the previously recommended minimum of four antenatal care (ANC) visits. Understanding the drivers of low ANC use is essential for responsive policy. We investigated the prevalence and determinants of optimal ANC use (≥4 visits) among women in South and Central Somalia using nationally representative survey data.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of the 2020 Somali Health and Demographic Survey. The weighted analytic sample comprised 4124 women aged 15–49 years with complete data. Survey-adjusted descriptive statistics characterized ANC use. Bivariate associations and multivariable survey logistic regression identified independent predictors; adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) are reported.</div></div><div><h3>Results</h3><div>Only 5.7 % of women (95 % CI 4.3–7.6) had four or more ANC visits. After adjustment, secondary education (aOR 2.33, 95 % CI 1.01–5.40) and higher education (aOR 5.36, 95 % CI 1.58–18.15) were associated with optimal ANC. Household wealth showed a graded increase, with the richest quintile having nearly 30 times the odds compared with the poorest (aOR 29.66, 95 % CI 8.51–101.27). Home delivery was associated with lower odds of optimal ANC (aOR 0.29, 95 % CI 0.18–0.47). Regional disparities persisted: women in Bay (aOR 4.07, 95 % CI 1.22–13.60) and Galgaduud (aOR 2.74, 95 % CI 1.13–6.64) had higher odds than those in Mudug.</div></div><div><h3>Conclusion</h3><div>Optimal ANC coverage in South and Central Somalia remains critically low. Priorities include reducing financial and geographic barriers to care, strengthening facility-based services, and promoting female education to improve maternal and neonatal outcomes.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100239"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791464","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":"Efficacy of device-measured physical activity on cardiometabolic outcomes among individuals with abnormal glucose tolerance in Ghana: A pilot randomized controlled trial","authors":"Thomas Hormenu ,&nbsp;Ebenezer Oduro Antiri ,&nbsp;Stephen Ocansey ,&nbsp;Eric Awlime-Ableh ,&nbsp;Juliet Elikem Paku ,&nbsp;Edward Wilson Ansah","doi":"10.1016/j.gloepi.2026.100255","DOIUrl":"10.1016/j.gloepi.2026.100255","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal glucose tolerance (AGT) is surging rapidly in sub-Saharan Africa, yet evidence on effective interventions remain limited. Physical activity improves glycemic control, but self-reported measures are prone to bias. Device-based monitoring enables objective assessment and may enhance adherence. This pilot randomized controlled trial assessed the preliminary efficacy of a structured, device-measured physical activity intervention on cardiometabolic outcomes among Ghanaian adults with AGT.</div></div><div><h3>Methods</h3><div>An open-label, parallel-group pilot RCT with blinded outcome assessment randomly assigned 28 adults aged ≥25 years with newly diagnosed AGT who owned smartphones to intervention and control groups. The intervention involved a 12-week structured program prescribing ≥150 min of moderate-intensity or ≥ 75 min of vigorous-intensity activity weekly, tracked via smartphone sensors and mobile health applications. Participants received brief training and were instructed to carry their phones during activity. Controls received basic health education materials and kept activity journals. Primary outcomes included glycemic measures and secondary outcomes comprised anthropometric, bioimpedance, and biochemical markers. Generalized estimating equations were used under an intention-to-treat protocol.</div></div><div><h3>Results</h3><div>Adherence was high, with mean daily moderate-to-vigorous physical activity of 77.4 ± 44.2 min. Group × Time interactions suggested differential changes favouring the intervention group for BMI (β = −2.7 kg/m², 95% CI: −5.2 to −0.1), alkaline phosphatase (β = −24.0 U/L, 95% CI: −47.9 to −0.1), and total protein (β = −12.6 g/L, 95% CI: −23.2 to −2.0). The intervention group was associated with larger within-group changes in HbA1c (−1.2% vs. -0.6%), weight (−4.7 kg vs −0.8 kg), basal metabolic rate (+92.9 vs +66.7 kcal/day), and total body water (+18.5 L vs +16.5 L).</div></div><div><h3>Conclusions</h3><div>Device-based physical activity interventions appear feasible and acceptable among Ghanaian adults with AGT. Preliminary findings suggest potential benefits for body composition and glycemic control, supporting progression to larger trials to confirm efficacy and assess scalability in low-resource settings.</div></div><div><h3>Trial registration</h3><div>This trial is prospectively registered with the Pan African Clinical Trails Registry (PACTR202409492459905).</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"11 ","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147384713","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":"Real-life safety assessment of orally disintegrating desmopressin tablet: Incidence of diagnosed hyponatraemia and other events across three European countries","authors":"Gunnar Johansson ,&nbsp;Jonas Reinold ,&nbsp;Nelly L. Shapero ,&nbsp;Tekla L. Rosell ,&nbsp;Leif A. Jørgensen ,&nbsp;Niklas Koenen ,&nbsp;Christian Frøsig ,&nbsp;Michael Falkenberg ,&nbsp;Lene Holdrup ,&nbsp;Kristian Juul","doi":"10.1016/j.gloepi.2025.100228","DOIUrl":"10.1016/j.gloepi.2025.100228","url":null,"abstract":"<div><h3>Objective</h3><div>This real-life analysis quantifies the incidence rate of diagnosed hyponatraemia in patients treated with a desmopressin Orally Disintegrating Tablet 25–50 μg (ODT) versus patients treated for lower urinary tract symptoms (LUTS) across Sweden, Denmark, and Germany.</div></div><div><h3>Material and methods</h3><div>Claims data and register data from drug registries, hospital records, laboratories, and intensive care units were accessed from the three countries in this imposed Post-Authorisation Safety Study (PASS). The incidence rates of diagnosed hyponatraemia, mortality, major cardiovascular events (MACE), venous thromboembolism (VTE), and acute exacerbation of congestive heart failure (CHF) were calculated using Poisson regression. A sensitivity analysis and subgroup analyses of older adult patients and patients with contraindications were conducted. The <span><span>clinicaltrial.gov</span><svg><path></path></svg></span> number is <span><span>NCT04740645</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>In total, 1,099,545 patients were included in Sweden, Denmark, and Germany. Of these 6745 (0.61 %) were ODT-treated patients, and 1,092,800 (99.39 %) were LUTS-treated patients. The incidence rate of diagnosed hyponatraemia, based on ICD-10 codes, was in the range of 9.04–24.15/1000 patient-years in the ODT cohort and 1.39–4.45/1000 patient-years in the LUTS cohort. Laboratory measured clinically significant hyponatraemia had incidence rates of 139.9 and 33.0/1000 patient-years in the ODT and LUTS cohorts, respectively. The incidence rates of mortality, MACE, and VTE were comparable between groups, with variations in subgroups of patients. Due to different baseline characteristics between the countries, a planned meta-analysis could not be performed.</div></div><div><h3>Conclusion</h3><div>Results from this real-life study does not indicate any added safety concerns related to use of ODT, since increased rate of hyponatraemia is already in the SmPC.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465711","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":"Physical activity patterns and environmental influences: Findings from the Kuwait diabetes epidemiology program","authors":"Victor M. Oguoma ,&nbsp;Mark Daniel ,&nbsp;Ralf-D Schroers ,&nbsp;Mohamed Abu-Farha ,&nbsp;Faisal H. Al-Refaei ,&nbsp;Fahd Al-Mulla ,&nbsp;Neil T. Coffee ,&nbsp;Saad Alsharrah","doi":"10.1016/j.gloepi.2025.100232","DOIUrl":"10.1016/j.gloepi.2025.100232","url":null,"abstract":"<div><h3>Background</h3><div>Insufficient physical activity (PA) is the fourth leading risk factor for cardiometabolic disease. This study assessed in Kuwait adults the spatial clustering of PA; relationships between PA, climatic factors and built environmental (BE) indicators; and ethnic group differences in PA.</div></div><div><h3>Methods</h3><div>A population-based cross-sectional study was conducted from 2011 to 2014 targeting adults in Kuwait ≥18 years old, using the World Health Organisation (WHO) Global Physical Activity Questionnaire (GPAQ) to assess five domains of physical activity. 2530 participants were classified as physically active or not physically active based on accruing at least 600 MET (min/week). Objectively measured residential-area BE indicators were extracted using the street address location of study participants. Climatic variables expressed as monthly aggregates were acquired from Kuwait's climate stations. Random effects logit analysis was used to assess the relationships between PA, climatic and BE variables.</div></div><div><h3>Results</h3><div>The proportion of physically active respondents was 51.9 % (95 % CI: 49.9, 53.8 %). Insufficient PA was greater in women than men. Suburb-level PA ranged from 21.4 % to 81.9 %. Covariate-adjusted analyses of PA revealed a weak positive association between average temperature aOR = 1.03 (95 %CI: 1.00, 1.06), open space sports ground with synthetic grass (300 m) aOR = 1.28 (95 %CI: 0.88, 1.86), and weighted area road density (100 m) aOR = 1.06 (95 %CI: 0.96, 1.17). A lower odds of PA was apparent for respondents who were currently married (vs never married) aOR = 0.68 (95 %CI: 0.46, 0.99), and for women (vs men) aOR = 0.57 (95 %CI: 0.46, 0.72). A greater odds of PA was apparent for the South/Southeast Asian relative to Arab ethnic group aOR = 1.32 (95 %CI: 1.04, 1.67).</div></div><div><h3>Conclusion</h3><div>This study indicates that half the population in Kuwait did not meet the WHO recommended minimum PA level of at least 600 MET (min/week). Efforts to promote PA in Kuwait should consider addressing gender and ethnic disparities, local environmental factors, and demographic influences such as marital status.</div></div>","PeriodicalId":36311,"journal":{"name":"Global Epidemiology","volume":"10 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576005","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}