Public Health最新文献

{"title":"A prediction model for virologic failure in adolescents living with HIV in Uganda: Findings from the Suubi+Adherence study","authors":"Samuel Kizito ,&nbsp;Fred M. Ssewamala ,&nbsp;Torsten B. Neilands ,&nbsp;Proscovia Nabunya ,&nbsp;Phionah Namatovu ,&nbsp;Josephine Nabayinda ,&nbsp;Mary M. McKay ,&nbsp;Kimberly J. Johnson ,&nbsp;Ross Brownson","doi":"10.1016/j.puhe.2025.105753","DOIUrl":"10.1016/j.puhe.2025.105753","url":null,"abstract":"<div><h3>Objectives</h3><div>Adolescents living with HIV (ALHIV) have low viral suppression levels, with 1 in 3 ALHIV experiencing virologic failure, calling for more efforts to reverse these trends. We developed and validated a model that predicts the risk of virologic failure (VF) among ALHIV.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We used baseline data from 702 ALHIV enrolled in the <em>Suubi + Adherence</em> cluster-randomized clinical trial. Participants were aged 10–16 years, living with HIV and aware of their HIV status, and are living with a family. We developed a risk-prediction model for VF (viral load of ≥200 copies/mL) using sociodemographic, behavioral, psychological, economic, and treatment-related factors. LASSO logistic regression using 10-fold cross-validation with bootstrapping was used to select the predictors for the final model. Model performance was assessed by determining the discrimination using the area under the curve and calibration by drawing a calibration plot.</div></div><div><h3>Results</h3><div>Using a lambda value of 0.007, the final model had 24 predictors (and interaction terms). The predictors included the participants' age, sex, work status, stigma, depressive symptoms, adherence self-efficacy, HIV knowledge, duration with HIV, time spent on ART, communication with the caregiver, family cohesion, social support, orphanhood status, number of people in the household, HIV disclosure, years spent at the current residence, and household asset ownership. The model predicted VF with AUC of 73.8 (95 % CI: 68.3–78.0) and calibration slope of 0.985.</div></div><div><h3>Conclusions</h3><div>We developed and validated a model to predict the risk of virologic failure among ALHIV in Uganda, demonstrating its potential utility in identifying individuals at elevated risk for VF. Future models could be refined by incorporating clinical characteristics such as CD4 count to further improve predictive accuracy.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105753"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood factors and their impact on COVID-19 vaccine acceptance in older adults across Europe","authors":"Tine Bovil ,&nbsp;Lasse Lybecker Scheel-Hincke ,&nbsp;Linda Juel Ahrenfeldt ,&nbsp;Karen Andersen-Ranberg","doi":"10.1016/j.puhe.2025.105740","DOIUrl":"10.1016/j.puhe.2025.105740","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigates how childhood factors, including early vaccinations and socio-demographic variables, influence COVID-19 vaccine acceptance among older adults across Europe.</div></div><div><h3>Study Design</h3><div>Longitudinal panel study using data from the SHARE survey across 27 European countries.</div></div><div><h3>Methods</h3><div>We analyzed responses from 43,790 participants aged 50+ who took part in both the SHARELIFE (waves 3 or 7) and the second SHARE Corona Survey. Childhood factors examined included early vaccinations, socioeconomic status (SES), health, and cognition. Additional variables were region, sex, and birth cohort. Multivariate logistic regression models were used to assess associations between these factors and COVID-19 vaccine acceptance, adjusting for household wealth, chronic diseases, education, and household composition.</div></div><div><h3>Results</h3><div>Overall, 84.9 % of participants reported accepting the COVID-19 vaccine. Childhood vaccinations were significantly associated with higher odds of vaccine acceptance (OR: 1.65, 95 % CI: 1.39–1.96). Females (OR: 0.92, 95 % CI: 0.86–0.99), younger cohorts (born after 1956: OR: 0.61, 95 % CI: 0.53–0.71), and individuals from disadvantaged childhood SES backgrounds (OR: 0.85, 95 % CI: 0.77–0.94), were less likely to accept the vaccine. Regional differences were evident, with Eastern Europe showing the lowest acceptance rates (OR: 0.34, 95 % CI: 0.31–0.38). Low childhood cognition was also associated with a lower vaccine acceptance (OR: 0.72, 95 % CI: 0.72–0.89).</div></div><div><h3>Conclusions</h3><div>Childhood factors, including early vaccinations and socio-demographic variables, significantly influence COVID-19 vaccine acceptance in older Europeans. Interventions should focus on reducing disparities, enhancing trust in healthcare systems, and promoting early vaccination and parental engagement to foster long-term positive attitudes toward immunization.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105740"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating COVID-19 cases reported across prisons in England from 2020 to 2023: Is enhanced address matching a game-changer for surveillance?","authors":"Adedoyin Tinuoya ,&nbsp;Alex Allen ,&nbsp;Christopher Rawlinson ,&nbsp;Nurin Iwani Binti Abdul Aziz ,&nbsp;Bryony Cook ,&nbsp;Andrew Woods ,&nbsp;Gavin Dabrera ,&nbsp;Ian Evans ,&nbsp;Steve Willner ,&nbsp;Elise Tessier","doi":"10.1016/j.puhe.2025.105748","DOIUrl":"10.1016/j.puhe.2025.105748","url":null,"abstract":"<div><h3>Objectives</h3><div>Gathering real-time surveillance data on infectious diseases in prisons can be challenging, and can contribute to health inequalities, including poorer health outcomes and increased risk of transmission. This study assessed the reliability of the address-matching method developed by the UK Security Health Agency (UKHSA) in detecting COVID-19 cases in prisons across England.</div></div><div><h3>Study design</h3><div>Retrospective descriptive study.</div></div><div><h3>Methods</h3><div>The retrospective descriptive study compared data from the UKHSA prison line list generated using the enhanced address-matching enrichment procedure with pseudonymized line list data from the Ministry of Justice (MOJ) in selected English prisons between March 2020 and January 2023. Cases were compared at the regional and prison levels to examine the consistency of positive episode counts over time, and by prison. The study included 104 prisons and excluded young offenders' institutions.</div></div><div><h3>Results</h3><div>Overall, the comparison showed both MOJ and UKHSA COVID-19 prison episodes were very closely aligned in 2020 and 2021 with generally over ninety percent agreement in most prisons, the close alignment remained consistent overall and at regional levels until January 2022, coinciding with the arrival of the Omicron variant and shortly thereafter the relaxation in testing aligning with the governments living with COVID-19 plan when differences in case counts became more noticeable.</div></div><div><h3>Conclusion</h3><div>The enhanced address matching method is reliable in identifying COVID-19 prison episodes and could be adapted for active and timely surveillance of other infectious diseases, and in other settings beyond prisons. This can facilitate better and evidence-based policies for planning and intervention during public health outbreaks.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105748"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction models for patients with recurrent diabetic foot ulcers: A systematic review","authors":"Zitong Zhou ,&nbsp;Yu Jia ,&nbsp;Hong Yan,&nbsp;Jialan Xu,&nbsp;Siyu Wang,&nbsp;Jun Wen","doi":"10.1016/j.puhe.2025.105744","DOIUrl":"10.1016/j.puhe.2025.105744","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically review published studies on risk prediction models for patients with recurrent diabetic foot ulcers.</div></div><div><h3>Study design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Database, China Science and Technology Journal Database (VIP), PubMed, Web of Science, the Cochrane Library and Embase were searched from inception to November 5, 2023. Data from selected studies were extracted, including author, country, participants, study design, data source, sample size, outcome definition, predictors, model development and performance. The Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist was used to assess the risk of bias and applicability.</div></div><div><h3>Results</h3><div>A total of 677 studies were retrieved, and after a screening process, eight predictive models from eight studies were included in this review. The studies utilized logistic regression, COX regression, and machine learning methods to develop risk prediction models for diabetic foot ulcer recurrence. The rate of diabetic foot ulcer recurrence was 20 %–41 %. The most commonly used predictors were HbA1c and DM duration. the reported area under the curve (AUC) ranged from 0.690 to 0.937. All studies were found to be at high risk of bias, mainly due to problems with outcome measures and poor reporting of analytic domains. the studies were not found to be at high risk of bias, mainly due to problems with outcome measures and poor reporting of analytic domains.</div></div><div><h3>Conclusions</h3><div>Although the performance of the diabetic foot ulcer recurrence prediction models included in the studies was decent, all of them were found to be at high risk of bias according to the PROBAST checklist. Future studies should focus on developing new models with larger samples, rigorous study designs, and multicenter external validation.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105744"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of hepatitis E in Latin America and the Caribbean: A systematic review and meta-analysis","authors":"Mariana Cavalheiro Magri ,&nbsp;Caroline Manchiero ,&nbsp;Bianca Peixoto Dantas ,&nbsp;Wanderley Marques Bernardo ,&nbsp;Edson Abdala ,&nbsp;Fátima Mitiko Tengan","doi":"10.1016/j.puhe.2025.105745","DOIUrl":"10.1016/j.puhe.2025.105745","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the prevalence of hepatitis E virus (HEV) infection by the presence of anti-HEV IgG antibodies in Latin America and the Caribbean (LAC).</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Systematic searches were conducted in the Medline, Lilacs and Embase databases, selecting 81 studies comprising 38,951 individuals in accordance with the PRISMA Statement. Analyses were performed by using the random-effects model. Data analysis considered study cohort and geographic location.</div></div><div><h3>Results</h3><div>The prevalence of hepatitis E in LAC ranged from 0 % to 36 % and the overall prevalence was 9.0 %, with important heterogeneity (<em>I</em>² = 97.3 %). Meta-analysis of subgroups showed prevalence of hepatitis E of 9.0 % in the general population, 6.0 % in blood donors, 9.0 % in rural population, 21.0 % in occupational exposure to pigs, 9.0 % in pregnant women, 7.0 % in immunocompromised individuals, 12.0 % in individuals with chronic liver disease and 9.0 % in individuals with acute hepatitis. According to geographic location, the prevalence of hepatitis E was 7.0 % in Argentina, 16.0 % in Bolivia, 7.0 % in Brazil, 17.0 % in Colombia and 24.0 % in Cuba. The generated funnel plot appeared asymmetric, with evidence of bias according to Egger (p = 0.000) and Begg (p = 0.003) tests. In the analysis, which included only studies with a quality score &gt;5, the prevalence of hepatitis E was 8.0 %. When analysing studies with sample sizes greater than 200 and 500, we identified prevalences of 8.0 % and 7.0 %, respectively.</div></div><div><h3>Conclusions</h3><div>The information obtained in this review warns about the current consolidated prevalence of hepatitis E in LAC, which can be a tool for planning prevention strategies.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105745"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic equity in Aotearoa New Zealand's COVID-19 response: A descriptive epidemiological study","authors":"S. Jefferies ,&nbsp;C. Gilkison ,&nbsp;P. Duff ,&nbsp;C. Grey ,&nbsp;N. French ,&nbsp;H. Carr ,&nbsp;P. Priest ,&nbsp;S. Crengle","doi":"10.1016/j.puhe.2025.105732","DOIUrl":"10.1016/j.puhe.2025.105732","url":null,"abstract":"<div><h3>Objectives</h3><div>Aotearoa New Zealand employed one of the most stringent public health pandemic responses internationally. We investigated whether ethnic health equity was achieved in the response and outcomes, from COVID-19 elimination in June 2020 through to Omicron-response easing, including international border reopening, in 2022.</div></div><div><h3>Study design</h3><div>Descriptive epidemiology study.</div></div><div><h3>Methods</h3><div>All COVID-19 cases, patients tested for SARS-CoV-2 and people vaccinated against COVID-19 between 9 June 2020 and 13 April 2022 were examined over three response periods: by demographic features and COVID-19 outcomes, transmission and vaccination patterns, time-to-vaccination and testing rates.</div></div><div><h3>Results</h3><div>There were 15,693 cases per 100,000, 138·7 hospitalisations per 100,000, and 9·8 deaths per 100,000 people. Pacific peoples and Indigenous Māori had, respectively, 9·3 to 35-fold and 1·5 to 8·3-fold higher risk of COVID-19, 5·1-fold and 2·6-fold higher age-standardised risk of hospitalisation and 9-fold and 4-fold higher age-standardised risk of death, than European or Other. Māori and Pacific peoples had lower vaccination coverage at critical points in the response, and slower access to vaccination (Adjusted Time Ratios for two doses 1·32 (95% CI 1·31–1·32) and 1·14 (1·14–1·14), respectively), than European or Other. Testing rates remained high, especially among Māori and Pacific peoples.</div></div><div><h3>Conclusions</h3><div>Despite achieving a low overall burden of disease by international comparisons, the multi-faceted New Zealand response did not prevent stark ethnic inequities in access to vaccination and COVID-19 outcomes. Policies which address disparities in upstream determinants, early vaccine programme planning and implementation with high-risk communities, and prioritisation that addresses systematic ethnic disadvantage and promotes health equity in response decisions is recommended.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105732"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the introduction of universal access to free nicotine replacement therapy on the process and outcome of stop smoking services in Ireland","authors":"Peter Naughton ,&nbsp;Aishling Sheridan ,&nbsp;Paul Kavanagh","doi":"10.1016/j.puhe.2025.105758","DOIUrl":"10.1016/j.puhe.2025.105758","url":null,"abstract":"<div><h3>Objectives</h3><div>Smoking remains a leading cause of preventable death, disproportionately affecting individuals in lower socio-economic groups. The effectiveness of nicotine replacement therapy (NRT) as a smoking cessation aid is well established; however, cost may act as a barrier to access. The aim of this study was to evaluate the impact of introducing universal NRT access on NRT uptake and smoking cessation.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Individuals were followed for twelve weeks following a quit attempt. Changes in NRT use and self-reported quit status were compared between service users before (January 2021–February 2023) and after (March 2023–December 2023) the introduction of fully subsidised NRT.</div></div><div><h3>Results</h3><div>The total number of participants was 19,717. There was a significant increase in NRT uptake among services users after the introduction of universal NRT access (59 % vs 40 %, p &lt; 0.001) and higher quit rates at four (41 % vs 29 %, p &lt; 0.001) and twelve (29 % vs 20 %, p &lt; 0.001) weeks. NRT was significantly associated with smoking cessation at twelve (aOR 5.41, 95 % CI 4.99–5.86) weeks.</div></div><div><h3>Conclusions</h3><div>This study confirms the effectiveness of NRT in a real world context and illustrates the benefits of universal access to this life saving medicine. Overcoming barriers to effective stop smoking care will be key to achieving tobacco endgame, especially for the most disadvantaged population groups. These findings support an urgent call for international policy makers to promote universal access to NRT as a central pillar of tobacco control efforts.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"244 ","pages":"Article 105758"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Difference-in-Differences Investigation Tool (DiD IT) for quantifying local outbreaks","authors":"Roger Morbey ,&nbsp;Andre Charlett ,&nbsp;Dan Todkill ,&nbsp;Alex J. Elliot","doi":"10.1016/j.puhe.2025.105735","DOIUrl":"10.1016/j.puhe.2025.105735","url":null,"abstract":"<div><h3>Objectives</h3><div>The Difference-in-Differences Investigation Tool (‘DiD IT’) is a new tool used to estimate the impact of local threats to public health in England. ‘DiD IT’ is part of a daily all hazards syndromic surveillance service. We present a validation of the ‘DiD IT’ tool, using synthetic injects to assess how well it can estimate small, localised increases in the number of people presenting to health care. Furthermore, we assess how control settings within ‘DiD IT’ affect it's performance.</div></div><div><h3>Study design</h3><div>Validation Study</div></div><div><h3>Methods</h3><div>‘DiD IT’ was validated across ten different syndromic indicators, chosen to cover a range of data volumes and potential public health threats. Injects were added across different times of year and days of week, including public holidays. Also, different size of injects were created, including some with an impact spread to neighbouring locations or spread over several days. The control settings within ‘DiD IT’ were tested by varying the control location and periods, using, for example a ‘washout period’ or excluding nearest neighbours. Performance was measured by comparing the estimates for excess counts produced by ‘DiD IT’ with the actual synthetic injects added.</div></div><div><h3>Results</h3><div>‘DiD IT’ was able to provide a positive estimate in 99.8 % of trials, with a mean absolute error of 1.50. However, confidence intervals for the central estimate could not be produced in 42.5 % of trials. Furthermore, the 95 % confidence intervals for the central estimates only included the actual inject count within 62.8 % of the intervals. Unsurprising, mean errors were slightly higher when synthetic injects were not concentrated in one location on one day but were spread across neighbouring areas or days. Selecting longer control periods and using more locations as controls tended to lower the errors slightly. Including a washout period or excluding neighbouring locations from the controls did not improve performance.</div></div><div><h3>Conclusions</h3><div>We have shown that ‘DiD IT’ is accurate for assessing the impact of local incidents but that further work is needed to improve the how the uncertainty of these estimates are communicated to users.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105735"},"PeriodicalIF":3.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of metabolic risk factors prior to the onset of cardiovascular disease in patients with newly diagnosed diabetes","authors":"Zhe Zhang ,&nbsp;Zhouzheng Tu ,&nbsp;Shuohua Chen ,&nbsp;Guodong Wang ,&nbsp;Pengfei Xia ,&nbsp;Jinchi Xie ,&nbsp;Juanjuan Li ,&nbsp;Yu Yuan ,&nbsp;Junxiang Chen ,&nbsp;Yanbo Zhang ,&nbsp;Yanfeng Zhou ,&nbsp;Tingting Geng ,&nbsp;Gang Liu ,&nbsp;Shouling Wu ,&nbsp;An Pan","doi":"10.1016/j.puhe.2025.105734","DOIUrl":"10.1016/j.puhe.2025.105734","url":null,"abstract":"<div><h3>Objectives</h3><div>Many studies have demonstrated that multiple metabolic risk factors (MRFs) predict cardiovascular disease (CVD) in patients with diabetes, but changes in these markers before CVD onset are not well characterized. We aimed to explore the trajectories of various MRFs before the occurrence of CVD in patients with newly diagnosed diabetes.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>We selected 21,798 patients with newly diagnosed diabetes from seven cycles in the Kailuan cohort. MRFs were measured at two-year intervals prior to CVD diagnosis. We used the mixed effects models to construct trajectories for 16 MRFs respectively.</div></div><div><h3>Results</h3><div>During up to 15 years of follow-up, a total of 2,105 CVD events occurred. Participants who developed CVD had more adverse levels of most MRFs at baseline and during follow-up than those who did not develop CVD. Before CVD diagnosis, fasting plasma glucose, insulin resistance, pulse pressure, heart rate, liver function, and inflammatory biomarkers showed linear increases, while insulin sensitivity, lipids profiles, obesity indices, and diastolic blood pressure showed linear decreases. Systolic blood pressure, as one of the most important components in predicting CVD, showed a quadratic increase.</div></div><div><h3>Conclusions</h3><div>In patients with newly diagnosed diabetes, unfavorable levels of MRFs were present before CVD developed. Key MRFs, including the TyG index, VAI, SBP, and pulse pressure, progressively increased over time and remained higher compared to non-CVD populations. This highlights the need for early prevention to reduce the burden of cardiovascular complications in diabetes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105734"},"PeriodicalIF":3.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiology of asthma and its attributable risk factors from 1990 to 2021: A systematic analysis based on the Global Burden of Disease Study 2021 and Mendelian Randomization Studies","authors":"Ying-qi Hang ,&nbsp;Xiang Piao ,&nbsp;Jie Wu ,&nbsp;Qian-wen Jiang ,&nbsp;Yue Han","doi":"10.1016/j.puhe.2025.105731","DOIUrl":"10.1016/j.puhe.2025.105731","url":null,"abstract":"<div><h3>Objectives</h3><div>Asthma is a commonly occurring condition due to chronic inflammation of the lower respiratory tract. This study aims to assess the global burden of asthma from 1990 to 2021 and the mortality trends caused by specific risk factors.</div></div><div><h3>Study design</h3><div>Systematic analysis based on the Global Burden of Disease Study 2021 and Mendelian Randomization studies.</div></div><div><h3>Methods</h3><div>Based on a global asthma scale spanning from 1990 to 2021, we performed a secondary analysis to explore the incidence, mortality, and disability-adjusted life-years (DALYs), along with risk factors for asthma. Mendelian randomization (MR) analyses were performed to verify the results.</div></div><div><h3>Results</h3><div>In 2021, there were 41,555,628 incident cases of asthma worldwide. Cases of asthma decreased by 0.09 % (95 % uncertainty interval [UI]: 0.12,0.06) from 1990 to 2021. Over the past three decades, asthma-associated deaths increased from 374,377 (95 % UI: 304,600–492,653) to 436,192 (95 % UI: 357,795–555,604). The global incidence rate decreased from 736.99 (95 % UI: 615.03–905.18) to 516.70 (95 % UI: 425.36–646.13) per 100,000 population; the asthma-associated mortality rate decreased from 9.64 (95 % UI: 7.76–12.80) to 5.20 (95 % UI: 4.27–6.59) per 100,000 population. Age-specific incidence and prevalence rates peaked in individuals under nine years old. The prevalence and incidence rates of asthma were relatively higher in individuals in countries with higher Socio-demographic Index (SDI); however, mortality and DALYs rates of individuals with asthma showed a reverse trend. Globally, occupational asthmagens, body mass index, smoking, and air pollution were key risk factors for asthma-associated mortality and DALYs in 2021. MR analyses further confirmed the strongly related correlation between body mass index, occupational asthmagens and asthma.</div></div><div><h3>Conclusions</h3><div>Although a mild decrease in total incidence cases of asthma was observed from 1990 to 2021, asthma has still continued to pose a life-threatening burden worldwide overall. Generally, asthma frequently occurred at younger ages and is more prevalent in high-SDI countries, indicating that specific periodic and regional features exist. Improved understanding of the epidemiology of asthma could facilitate future interventions to better manage the disease globally and support future investigation on the diagnosis and treatment of asthma.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"243 ","pages":"Article 105731"},"PeriodicalIF":3.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}