Journal of Global Health最新文献

{"title":"A cohort study of the occurrence of post-term births and its association with perinatal mortality in a rural area in Bangladesh.","authors":"U Tin Nu, Jesmin Pervin, Monjur Rahman, Kazi Tamara B Kamal, Shaki Aktar, Fauzia A Huda, Shikha Ganguly, Shams El Arifeen, Lars Åke Persson, Anisur Rahman","doi":"10.7189/jogh.14.04238","DOIUrl":"10.7189/jogh.14.04238","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate the trend of post-term births over time and their association with perinatal mortality based on prospective pregnancy cohorts in a rural area in Bangladesh.</p><p><strong>Methods: </strong>This cohort study included 72 373 singleton births with gestational ages ≥28 weeks recorded by a health and demographic surveillance system from 1990 to 2019 in Matlab, Bangladesh. We expressed the gestational age as X (weeks) + Y (days)/7 weeks, where X indicated complete weeks, and Y presented the number of completed days out of seven days or a week. Using Poisson regression with robust variances, we estimated the population-based proportion of post-term births and assessed the association between gestational age categories and perinatal mortality. We presented results by adjusted relative risk (aRR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Post-term births declined from 5.8% in 1990 to 2.8% in 2019. Perinatal mortality declined from 58 to 27 per 1000 births from 1990 to 2019. Compared to full-term births (39 + 0/7 to 40 + 6/7 weeks), the aRRs of perinatal mortality were 1.39 for late-term (41 + 0/7 to 41 + 6/7 weeks) and 1.93 for post-term (≥42 + 0/7 weeks) births. The population-attributable fraction of perinatal mortality was 15% for births at ≥41 + 0/7 weeks out of the total perinatal deaths occurring at ≥39 gestation weeks.</p><p><strong>Conclusions: </strong>In this rural setting in Bangladesh, we observed a decline in post-term birth proportions from 1990 to 2019. We found increased perinatal mortality when pregnancy continued beyond 40 + 6/7 weeks of gestation. This implies that planning the management of pregnant women approaching the post-term period may be needed to further improve perinatal health outcomes.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04238"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between perceived olfactory dysfunction and all-cause mortality in Chinese adults: A prospective community-based study.","authors":"Zhicheng Zhang, Yesong Liu, Yaqi Li, Tingting Geng, Shuohua Chen, Shouling Wu, Xiang Gao","doi":"10.7189/jogh.14.04237","DOIUrl":"10.7189/jogh.14.04237","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction has been suggested to be associated with all-cause mortality. Yet, there is a lack of large-scale cohorts to study this relationship.</p><p><strong>Methods: </strong>Using data from the Kailuan cohort, we assessed 97 327 Chinese adults for perceived olfactory dysfunction at baseline and gathered mortality data from government records. We used Cox proportional hazards regression models to analyse the risk of all-cause mortality associated with perceived olfactory dysfunction, yielding hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment for multiple potential confounders.</p><p><strong>Results: </strong>Over a median follow-up of 6.4-year, we recorded a total of 3903 deaths. Individuals reporting perceived olfactory dysfunction had a higher risk of mortality (adjusted HR = 1.42; 95% CI = 1.02-2.00) compared to those without the dysfunction. In sensitivity analyses, we found similar results after excluding participants with pre-existing obesity, cardiovascular diseases, those younger than 50 years old, individuals diagnosed with cancer or stroke during follow-up, and those who died within two years of follow-up.</p><p><strong>Conclusions: </strong>Perceived olfactory dysfunction was associated with a high risk of all-cause mortality among Chinese adults. Our study is limited by failure to include a national-representative sample and misclassification of exposure assessment due to use of a subjective question to assess olfactory dysfunction. Further studies with objective are warranted to replicate our findings and understand the underlying mechanisms.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04237"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body fat variation and redistribution across different stages of life measured by dual-energy x-ray absorptiometry.","authors":"Hongbo Dong, Hong Cheng, Jingfan Xiong, Li Liu, Yiwen Huang, Xinying Shan, Hongmin Fan, Xi Wang, Xia Wang, Pei Xiao, Fangfang Chen, Jie Mi","doi":"10.7189/jogh.14.04247","DOIUrl":"10.7189/jogh.14.04247","url":null,"abstract":"<p><strong>Background: </strong>The global obesity epidemic of all ages has increased the demand for accurate management of body fat in each stage of life. The primary aim of this study was to provide reference centiles of body fat indices for Chinese children and adults and compare those with ethnicities from USA using dual-energy x-ray absorptiometry (DXA).</p><p><strong>Methods: </strong>The samples were drawn from two nationwide cross-sectional surveys of China Body Composition Life-course Study (2013-2023) and the US National Health and Nutrition Examination Survey (2011-2018). Age- and sex-specific centile curves were generated for a set of fat measurements, including total fat mass (FM), fat mass index (FMI), body fat percentage (BF%), trunk-to-leg fat ratio (TLR), android-to-gynoid fat ratio (AGR) and visceral-to-subcutaneous fat ratio (VSR), using the general additive model for location scale and shape method.</p><p><strong>Results: </strong>The age-related variations from childhood to adulthood were generally similar among Chinese, Non-Hispanic Whites, Non-Hispanic Blacks and Mexican American population, with distinct levels across races and ethnicities. For whole-body fat (FM, FMI, and BF%), Mexican American population consistently presented the highest levels before 40 years old, followed by Non-Hispanic White, Non-Hispanic Black and Chinese individuals. For central fats indices, although the TLR and AGR levels in Chinese males were second to Mexican American counterparts in most stages of life, the VSR was much higher in Chinese than other races and ethnicities from eight years old.</p><p><strong>Conclusions: </strong>DXA-based centiles for body fat quantity and distribution in Chinese population aged 3-60 years old were presented, and their differences with other race and ethnicity were noted across periods from early childhood to middle adulthood. Our findings will promote age-, sex- and ethnic-specific assessment of life-course body fat and obesity-related risks in clinical practice.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04247"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity in the level of dementia literacy among community doctors in China: A latent profile analysis.","authors":"Shuxian Qiu, Mei Zhao, Haifeng Zhang, Tao Li, Weihong Kuang, Sha Liu, Yongan Sun, Mingwei Wang, Hengge Xie, Enyan Yu, Xin Yu, Huali Wang","doi":"10.7189/jogh.14.04161","DOIUrl":"10.7189/jogh.14.04161","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the heterogeneity of community doctors based on their knowledge of dementia and the potential factors associated with their dementia literacy.</p><p><strong>Methods: </strong>A total of 1288 community doctors completed the Alzheimer disease knowledge scale (ADKS) in a cross-sectional study conducted between December 2021 and January 2022. We used latent class analysis (LCA) to explore potential clusters based on responses to the ADKS. Multivariate multinomial logistic regression analysis was performed to evaluate the associations between potential risk factors and the knowledge of community doctors.</p><p><strong>Results: </strong>Community doctors were divided into four clusters according to their knowledge structure (Akaike information criterion (AIC) = 35672.83, Bayesian information criterion (BIC) = 36307.63, adjusted BIC (aBIC) = 35916.91, entropy = 0.814): the severity-focused subgroup (n = 269), the physical issues-focused group (n = 370), the knowledge uncertainty group (n = 191), and the general-focused group (n = 458). Age, education level, type of practice, and professional title were associated with the knowledge structure of Alzheimer's disease (AD). In addition, the perception that patients seek care in community health centres for physical reasons and community doctors' failure to manage patients with recently identified cognitive impairment were associated with the structures of the ADKS among community doctors (P < 0.05).</p><p><strong>Conclusions: </strong>There is heterogeneity in the level of AD knowledge among community doctors and their demographic characteristics, perceptions, and practices. Further efforts are needed to optimise the knowledge structure of dementia among community health care professionals.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04161"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing social norms for adolescent timing and spacing of pregnancy in low and middle-income countries: Developing a global research agenda.","authors":"Jasmine Uysal, Anvita Dixit, Catherine Green, Marilyn Akinola, Bryan Shaw, Rebecka Lundgren","doi":"10.7189/jogh.14.04206","DOIUrl":"10.7189/jogh.14.04206","url":null,"abstract":"<p><strong>Background: </strong>Social norms shape adolescent sexual and reproductive health behaviours contributing to contraceptive and pregnancy outcomes. No global research agendas exist to guide research on adolescent social norms shifting in low- and middle-income countries (LMICs). We developed a social norms research agenda to improve adolescent healthy timing and spacing of pregnancy in LMICs.</p><p><strong>Methods: </strong>We adapted and applied the Child Health and Nutrition Research Initiative (CHNRI) method. A group of researchers guided the process, and consulted with diverse experts to develop a list of 21 research questions for global stakeholders to score via an online survey. Survey participants scored each research question according to four criteria (fills key gap, feasible, impactful, equitable). Research priority scores (RPS) and average expert agreement (AEA) statistics were calculated for each question and analysed overall and by stakeholder region and profession.</p><p><strong>Results: </strong>We received 185 survey responses. Participants were, on average, 44 years old, 64% were women, 70% were from LMICs and 47% were implementers. The RPS ranged from 52 to 81% (74% median) and the AEA ranged from 49 to 70% (58% median). Nearly 70% of stakeholders gave the same score to each of the top five research questions. The top five research priorities focused on effective norm-shifting interventions (NSIs) strategies, processes and indicators to NSIs, and NSI adaptation and scale-up.</p><p><strong>Conclusions: </strong>Using a collaborative and rigorous process with diverse representation from LMICs and implementers, we reached consensus on five priority research questions to guide future adolescent social norms research to improve healthy timing and spacing of pregnancy in LMICs.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04206"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergies and dis-synergies between universal health coverage and global health security: A case study of Cambodia.","authors":"Lo Yan Esabelle Yam, Pheak Chhoun, Di Liang, Jiayan Huang, Siyan Yi","doi":"10.7189/jogh.14.04218","DOIUrl":"10.7189/jogh.14.04218","url":null,"abstract":"<p><strong>Background: </strong>After the coronavirus disease 2019 (COVID-19) pandemic, the global community's increased focus on pandemic preparedness has driven efforts such as the Pandemic Treaty proposed by the World Health Organization (WHO) and the Pandemic Fund managed by the World Bank. While these initiatives will enhance countries' capabilities in pandemic preparedness, synergies could be achieved by exploring the intersections between universal health coverage (UHC) and global health security (GHS). This is particularly relevant for developing countries like Cambodia. As it transitions to higher income status and reduces its reliance on external funding, the synergistic development of UHC and GHS will help Cambodia maximise health investment and align with its population health goals. We aimed to identify synergies and dis-synergies between UHC and GHS and recommend implementations that the government can consider moving forward.</p><p><strong>Methods: </strong>We conducted a rapid review of policy documents based on the World Health Organization (WHO) Health System Framework and undertook consultations with key stakeholders in Cambodia.</p><p><strong>Results: </strong>Our findings show the synergies between the two agendas in Cambodia resulted from having a central coordinating authority through the Ministry of Health (MoH), an extensive primary care network, and intersecting human resources that drive both UHC and GHS. We also identified potential dis-synergies such as vertical programmes and funding sources, inadequate regulation and engagement of the private sector, and underutilisation of information and data. Recommendations include cross-consultations between departments within the MoH when developing policies in GHC or UHC, and training programmes to increase awareness of the synergies between UHC and GHS.</p><p><strong>Conclusions: </strong>Our findings reinforce those of previous case studies in Bangladesh, Ethiopia, and Ghana, offering recommendations for building resilient health systems by integrating UHC and GHS.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04218"},"PeriodicalIF":4.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in casemix, acute interventions, discharge destinations and mortality of patients with traumatic brain injury between Europe and India.","authors":"Deepak Gupta, Ranjit D Singh, Rick Jg Vreeburg, Jeroen Tjm van Dijck, Hugo F den Boogert, Kaveri Sharma, Kokkula Praneeth, David B Clarke, Fiona E Lecky, Andrew Ir Maas, Virendra Deo Sinha, Godard Cw de Ruiter, Wilco C Peul, Thomas A van Essen","doi":"10.7189/jogh.14.04227","DOIUrl":"10.7189/jogh.14.04227","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a major global health problem that disproportionally affects low- and middle-income countries. The needs for patients with TBI therefore may differ between levels of national development. We aimed to describe differences in epidemiology and acute care provision of TBI between India and Europe.</p><p><strong>Methods: </strong>We used data from two prospective observational registry studies - the Collaborative Indian NeuroTrauma Effectiveness Research in TBI (CINTER-TBI) and the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI), which included TBI patients with an indication for brain CT-scan presenting to 65 centres across Europe and Israel and two trauma centres in India. We performed descriptive analyses of demographic, injury, and treatment characteristics and used random-effects logistic regression with covariate adjustment to examine the likelihood of acute neurosurgical interventions and in-hospital mortality.</p><p><strong>Results: </strong>We included 22 849 patients from CENTER-TBI and 3904 from CINTER-TBI. The median age in Europe was 55 years (IQR = 32-76) compared to 27 years (IQR = 18-40) in India. The most common cause of TBI in Europe were falls (n = 12150 (53%), while traffic incidents predominated in India (n = 2130 (55%)). The proportion of patients with severe TBI was higher in India (n = 867 (22%)) than in Europe (n = 1661 (7%). Professional pre-hospital care involving ambulance service was utilised by three-fourths (n = 17203 (75%)) of European and less than a one-tenth (n = 224 (6%)) of Indian patients in our sample. Patients with severe TBI were more likely to undergo surgical contusion/haematoma evacuation in India compared to Europe (OR = 2.0; 95% CI = 1.7-2.5) and Indian patients had higher odds of undergoing intracranial pressure monitor placement (OR = 2.3; 95% CI = 2.0-2.7). A primary decompressive craniectomy was likewise more often performed in the Indian cohort (OR = 5.1; 95% CI = 3.5-7.5). Discharge destinations in Europe included rehabilitation centres (n = 1261 (6%)) or nursing homes (n = 1208 (5%)), which was rarely the case in India (n = 13 (0%) and n = 9 (0%), respectively).</p><p><strong>Conclusions: </strong>Substantial disparities between India and Europe exist along the neurotrauma care chain, with both systems being likely to face unique features and challenges in the future.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04227"},"PeriodicalIF":4.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global incidence and risk factors for glaucoma: A systematic review and meta-analysis of prospective studies.","authors":"Shiyi Shan, Jing Wu, Jin Cao, Yan Feng, Jiali Zhou, Zeyu Luo, Peige Song, Igor Rudan","doi":"10.7189/jogh.14.04252","DOIUrl":"10.7189/jogh.14.04252","url":null,"abstract":"<p><strong>Background: </strong>This study aims to estimate global incidence and assess risk factors for glaucoma subtypes.</p><p><strong>Methods: </strong>The literature search was performed in three English (PubMed, Embase, MEDLINE) and three Chinese (China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database) databases to identify prospective studies on glaucoma incidence between 1 January 1990 and 29 November 2022. We used a multilevel mixed-effects meta-regression to estimate the age- and sex-specific incidence rate of primary open-angle glaucoma (POAG). The global and regional incidence rate of POAG in 2022 were respectively estimated. The annual cumulative incidence (ACI) of POAG and primary angle-closure glaucoma (PACG), and risk factors for POAG were pooled using a random-effects meta-analysis, respectively. The heterogeneity of the included articles was tested using the Q statistic and measured by I² index. Publication bias was detected by funnel plots, Egger's regression test, and Begg's rank correlation test.</p><p><strong>Results: </strong>A total of 9050 articles were identified in literature search, and 50 articles provided incidence data of glaucoma subtypes. In 2022, the global incidence rate of POAG was 23.46 (95% confidence interval (CI) = 15.68-32.91) per 10 000 person-years among 40-79 years. An increase from 5.51 (95% CI = 1.63-11.12) per 10 000 person-years in 40-44 years to 64.36 (95% CI = 49.82-80.70) per 10 000 person-years in 75-79 years was noted between the year 1990 and 2019. Across sociodemographic index (SDI) and World Health Organization (WHO) regions, the incidence rate was the highest in low SDI region and Africa, respectively. The pooled ACI of POAG was 0.21% (95% CI = 0.13%-0.30%). Six risk factors for POAG were identified, including intraocular pressure (IOP) treatment (meta-odds ratio (OR) = 3.69; 95% CI = 2.64-5.15), a family history of glaucoma (meta-OR = 2.49; 95% CI = 1.92-3.24), myopia (meta-OR = 2.08; 95% CI = 1.59-2.70), elevated IOP (meta-OR = 1.13; 95% CI = 1.11-1.15), advanced age (meta-OR = 1.07; 95% CI = 1.05-1.08), male (female: meta-OR = 0.76; 95% CI = 0.66-0.88). The pooled ACI of PACG was 0.05% (95% CI = 0.00%-0.16%).</p><p><strong>Conclusions: </strong>Significant disparities existed in incidence rates for glaucoma across geographic regions and age groups. Further research is needed to understand which risk factors drive glaucoma incidence in different socioeconomic strata for tailored health policy on preventing glaucoma.</p><p><strong>Registration: </strong>This study is registered with PROSPERO (number CRD42023434203).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04252"},"PeriodicalIF":5.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low antiviral uptake of nirmatrelvir/ritonavir and molnupiravir in adult patients with COVID-19 in Taiwan in 2022.","authors":"Fu-Der Wang, Phung-Anh Nguyen, David Lee, Bulent Taysi, Florence Lefebvre d'Hellencourt, Julia Spinardi, Phan Thanh Phuc, Whitney Burton, Yu-Hui Chang, Nguyen Thi Kim Hien, Shiue-Ming Lin, Yang Chieh, Moe H Kyaw, Jason C Hsu","doi":"10.7189/jogh.14.05032","DOIUrl":"10.7189/jogh.14.05032","url":null,"abstract":"<p><strong>Background: </strong>Antivirals are effective in reducing hospitalisation and death in mild-to-moderate coronavirus 2019 (COVID-19) patients. We estimated the antiviral uptake of nirmatrelvir/ritonavir and molnupiravir in adult patients with a syndrome coronavirus 2 (SARS-CoV-2) infection during the Emergency Use Authorization (EUA) period in Taiwan.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in Taiwan between January 2022 and December 2022. Patients aged ≥18 years with a SARS-CoV-2 infection were included from the Taipei Medical University Clinical Research Database (TMUCRD) and stratified in three risk groups according to World Health Organization criteria.</p><p><strong>Results: </strong>In total, 96 398 COVID-19 patients (mean age 46.7 ± 17.7 years, 45.8% male) were included. Of these patients 69.8% were classified as low risk, 29.8% as moderate risk, and 0.4% as high risk for progression to severe COVID-19. Nirmatrelvir/ritonavir was prescribed in 5.1% of the COVID-19 patients (low risk = 1.0%, moderate risk = 14.3%, high risk = 17.6%). Molnupiravir was prescribed in 1.9% of the COVID-19 patients (low risk = 0.1%, moderate risk = 5.8%, high risk = 6.9%).</p><p><strong>Conclusions: </strong>Nirmatrelvir/ritonavir and molnupiravir were poorly used in the treatment of adult COVID-19 patients in Taiwan during the pandemic in 2022, especially in moderate-to-high risk groups for progression to severe COVID-19.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05032"},"PeriodicalIF":5.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory viruses associated with severe acute respiratory infection in children aged <5 years at a tertiary care hospital in Delhi, India during 2013-15.","authors":"Satinder Aneja, Varinder Singh, Venkatesh Vinayak Narayan, Mayuri Gohain, Avinash Choudekar, Bharti Gaur, Katherine Roguski DeBord, Brett Whitaker, Anand Krishnan, Shobha Broor, Siddhartha Saha, A Danielle Iuliano","doi":"10.7189/jogh.14.04230","DOIUrl":"10.7189/jogh.14.04230","url":null,"abstract":"<p><strong>Background: </strong>With the increased availability of licensed vaccines for respiratory viruses such as severe acute respiratory syndrome coronavirus 2, respiratory syncytial virus (RSV), and influenza virus, a better understanding of the viral aetiology of severe acute respiratory infections (SARI) among children could help in optimising the use of these vaccines. We conducted a study among children aged <5 years hospitalised with SARI at a tertiary care children's hospital in north India and tested for common respiratory pathogens.</p><p><strong>Methods: </strong>We randomly enrolled eligible SARI cases aged <5 years from August 2013 to July 2015. SARI cases were defined as either <7-day history of fever with cough or in children aged eight days to three months, a physician diagnosis of acute lower respiratory infection requiring hospitalisation. We also enrolled an age-group matched control without any acute illness in a 2:1 ratio from the outpatient clinic within 24 hours of case enrolment. Nasopharyngeal and/or oropharyngeal swabs were collected and tested using TaqMan Array Cards, a real-time reverse transcription polymerase chain reaction-based multi-pathogen testing platform for selected respiratory viruses among the enrolled cases and controls. We compared the prevalence of each pathogen among cases and controls using the χ² (χ²) or Fisher exact test (P < 0.05). We used logistic regression to estimate adjusted odds ratios (aORs) which were then used to calculate aetiologic fractions (EFs).</p><p><strong>Results: </strong>We enrolled 840 cases and 419 outpatient controls. Almost half of the individuals in the whole sample were aged <6 months (n = 521, 41.4%). Females made up 33.7% of cases and 37.2% of controls. Viral detections were more common among cases (69%, 95% confidence interval (CI) = 66, 73) compared to controls (33%; 95% CI = 29, 38) (P < 0.01). RSV (n = 257, 31%; 95% CI = 28, 34%) was the most common virus detected among cases. Influenza A was detected among 24 (3%; 95% CI = 2, 4%), and influenza B among 5 (1%; 95% CI = 0, 1%) cases. The association between the virus and SARI was strongest for RSV (aOR = 23; 95% CI = 12, 47; EF = 96%). Antivirals were administered to 1% of SARI cases while 78% received antibiotics.</p><p><strong>Conclusions: </strong>Using a multi-pathogen molecular detection method, we detected respiratory viruses among more than two-thirds of children aged <5 years admitted with SARI in the Delhi tertiary care children's hospital. The guidelines for preventing and managing SARI cases among children could be optimised further with the improved availability of antivirals and vaccines.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04230"},"PeriodicalIF":4.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}