Epidemiolgia (Basel, Switzerland)最新文献

{"title":"Perceived Readiness and Ability to Socially Distance During the Early COVID-19 Epidemic in a U.S. Metropolitan Area: Implications for Local Public Health Preparedness.","authors":"Emmanuel K Tetteh, Julia D López, Collin McGovern, Gifty Aboagye-Mensah, Elvin H Geng, Virginia R McKay","doi":"10.3390/epidemiologia7020048","DOIUrl":"https://doi.org/10.3390/epidemiologia7020048","url":null,"abstract":"<p><strong>Background/objectives: </strong>Nonpharmaceutical interventions such as social distancing and face mask use were central to controlling infectious disease transmission during the early phases of the COVID-19 pandemic, particularly when vaccines and treatments were limited or unevenly available. Although public health strategies emphasized individual compliance, adherence varied widely. Empirical evidence remains limited regarding how individuals integrate influences across individual, interpersonal, and community levels when assessing their ability and readiness to socially distance. This study examined how residents evaluated, prioritized, and experienced multi-level factors shaping perceived ability and readiness to practice social distancing during the early phase of the COVID-19 epidemic.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey of adults (≥18 years) residing in St. Louis City and St. Louis County, Missouri, between April and July 2020. Participants selected and ranked individual/interpersonal and community-level factors influencing social distancing and provided open-ended explanations of their choices. Quantitative data were analyzed descriptively to assess selection frequency and ranking priority. Qualitative responses were analyzed using iterative thematic coding to examine how participants interpreted and combined these factors.</p><p><strong>Results: </strong>The analytic sample included 1692 respondents. At the individual/interpersonal level, family and friends' distancing behavior (58.9%), desire for in-person interaction (52.4%), and personal risk of COVID-19 (48.9%) were frequently selected, while personal risk, caring for others, and ability to work from home were most often ranked as the highest priority. At the community level, others' distancing in public spaces (66.2%), availability of COVID-19 testing (58.9%), and businesses' ability to ensure distancing and sanitation (57.2%) were most frequently selected, with epidemic severity, testing availability, and treatment availability ranked as most influential. Qualitative findings indicated that respondents experienced these influences as interconnected, integrating personal and relational risk, local epidemic conditions, healthcare access, visible community norms, and employer policies.</p><p><strong>Conclusions: </strong>Perceived ability and readiness to practice social distancing emerge from interdependent social and structural conditions rather than isolated individual motivations. Public health responses to emerging infectious diseases may be more effective when individual-level guidance is complemented by accessible testing and treatment, supportive workplace policies, and community environments that visibly reinforce protective behaviors.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholecystectomy in the Pediatric Population-What Has Changed in Recent Decades? Insight from a Tertiary Pediatric Referral Center.","authors":"Tal Weiss, Yael Dreznik, Dragan Kravarusic, Samah Hayek","doi":"10.3390/epidemiologia7020047","DOIUrl":"https://doi.org/10.3390/epidemiologia7020047","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic cholelithiasis is the leading indication for pediatric cholecystectomy. While historically linked to hemolytic disorders, non-hemolytic gallbladder disease in children has become increasingly common in recent decades.</p><p><strong>Objective: </strong>The objective of this study was to describe the distribution and temporal trends of indications for cholecystectomy among children (ages ≤ 19 years) undergoing surgery at a tertiary pediatric center in Israel and to compare clinical presentation between hemolysis-related and non-hemolysis-related cases.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study of all pediatric patients who underwent cholecystectomy at Schneider Children's Medical Center between 2011 and 2024. Patients with congenital biliary tract anomalies or biliary tract neoplasms were excluded.</p><p><strong>Results: </strong>A total of 199 cholecystectomies were performed (median age 13.4 years). Hemolysis-related cholelithiasis accounted for 34.2% of cases; five patients (2.5%) had gallbladder polyps or other benign lesions, while the remaining patients had non-hemolysis-related cholelithiasis. No cases of biliary dyskinesia were identified. The proportion of non-hemolysis-related cholecystectomies remained stable over time. Among symptomatic patients, the rate of choledocholithiasis was significantly higher in the hemolysis-related group compared to the non-hemolysis group (27% vs. 7.9%, <i>p</i> = 0.004). No statistically significant association was observed between obesity and increased disease severity or adverse outcomes.</p><p><strong>Conclusion: </strong>Unlike trends reported in some Western countries, the number of cholecystectomies performed for non-hemolysis-related cholelithiasis in our single-center cohort did not increase over time. Hemolysis-related disease remains a leading indication for pediatric cholecystectomy. Prophylactic surgery may help prevent biliary complications in this group while symptomatic patients have substantial complication rates.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Socio-Political and Economic Factors and COVID-19 Vaccination Uptake: US-Mexico Border Study.","authors":"Komla Koumi, Soyoung Jeon, Yu-Feng Lee","doi":"10.3390/epidemiologia7020045","DOIUrl":"https://doi.org/10.3390/epidemiologia7020045","url":null,"abstract":"<p><strong>Background/objectives: </strong>The implementation of COVID-19 vaccination in the United States has revealed substantial disparities driven by geography, socioeconomic conditions, and political ideology. This study examines the association between these factors and COVID-19 vaccination uptake across 360 counties in four U.S.-Mexico border states, characterized by distinct socio-political traits.</p><p><strong>Methods: </strong>Using county-level data, this study employed multivariable regression analysis and GIS mapping to assess the effects of income, education, employment, age, race, ethnicity, occupation, metropolitan status, border status, and political affiliation on Dose 1, Dose 2, and booster vaccination rates.</p><p><strong>Results: </strong>The analysis showed that Dose 1 vaccination rates were significantly higher in border counties and metropolitan areas. Democratic population share and per capita income were positively associated with vaccination uptake. Dose 2 vaccination rates exhibited patterns similar to those observed for Dose 1. Booster vaccination rates were positively associated with Democratic affiliation, the proportion of the population with at least a high school education, and the share of individuals aged 65 years and older. In contrast, unemployment rates were negatively associated with booster uptake. Racial and ethnic composition was also associated with vaccination outcomes: higher Black population shares were associated with lower Dose 1 vaccination rates, whereas higher Native American population shares were associated with higher vaccination rates. Booster uptake was higher with larger shares of the Asian population but slightly lower with larger shares of the White population.</p><p><strong>Conclusions: </strong>COVID-19 vaccination uptake in U.S.-Mexico border counties was associated with a complex interaction of geographic, socioeconomic, demographic, and political factors. These findings underscore the importance of targeted, context-specific public health strategies to reduce vaccination disparities and improve booster coverage in border regions.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Urinary Tract Symptoms (LUTSs) in Elite Female and Male Athletes: Prevalence and Impact on Performance-A Cross-Sectional Study Using the STROBE-SIIS (Sports Injury and Illness Surveillance) Reporting Guidelines.","authors":"Beth McCullough, Thomas Fallon, Neil Heron","doi":"10.3390/epidemiologia7020046","DOIUrl":"https://doi.org/10.3390/epidemiologia7020046","url":null,"abstract":"<p><p><b>Introduction:</b> Lower urinary tract symptoms (LUTSs), including urinary incontinence (UI), are common problems present in the general population. However, these symptoms have also been seen in young, elite-level athletes, especially females, including those who are nulliparous. This preliminary study aimed to report on the prevalence of LUTSs within an elite athletic population, including both males and females, within the UK high-performance system (the Sports Institute of Northern Ireland) and a women's elite cycling team, while also investigating the link between LUTSs and specific training and sporting activities. <b>Methods:</b> A cross-sectional study of elite athletes in the Sports Institute of Northern Ireland (SINI) and a women's professional cycling team, using an online questionnaire, was conducted to investigate the prevalence of LUTSs and UI and their impact on quality of life (QOL) among both male and female elite athletes. The authors used the STROBE-SIIS guidelines to produce separate electronic questionnaires for male and female athletes. This is a preliminary pilot study due to the small sample size. <b>Results:</b> Ten male athletes completed the IPPS questionnaire, reporting a median score of 5.5/35. Meanwhile, 18 female athletes completed the Athlete Female LUTS (A-FLUTS) questionnaire and reported a median score of 6/44. Female athletes had a higher prevalence of UI in the last four weeks (66.7%) compared to male athletes (20%). Of the 28 athletes, 7 were explosive/sprint athletes, and 21 were endurance athletes. Explosive/sprint athletes (71.4%) appeared to have a higher prevalence of UI in the last four weeks compared to endurance athletes (42.9%). Athletes self-managed these UI symptoms through a variety of methods, including reducing fluid intake, which could impact their athletic performance. This is a preliminary pilot study and-despite its small size-it defines a methodology and shows some important results that encourage research to be carried out on a larger sample size. <b>Conclusions:</b> The reported QOL impact and potential impact on health and athletic performance highlight the need for better management and treatment protocols, including the need to screen for urinary symptoms in the pre-season medical.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices of the Mexican Population Regarding the Disposal of Medications: A Cross-Sectional Study.","authors":"Raymundo Escutia-Gutiérrez, Igor Martin Ramos-Herrera, Anahí Dreser-Mansilla, Nelson Bruno de Almeida-Cunha","doi":"10.3390/epidemiologia7020044","DOIUrl":"https://doi.org/10.3390/epidemiologia7020044","url":null,"abstract":"<p><strong>Background and objectives: </strong>The improper disposal of expired and unused medications (EUM) poses significant environmental and health risks. Discarding EUM in household trash or drains leads to accidental poisoning, illegal trade, and ecosystem contamination. These persistent compounds often resist wastewater treatment, disrupting ecological balance and contributing to antimicrobial resistance, thereby increasing morbidity and mortality rates. This study aims to analyze the knowledge, attitudes and practices (KAP) and related factors of the Mexican population regarding the disposal of EUM.</p><p><strong>Methods: </strong>A cross-sectional, descriptive, and correlational study was conducted via an online survey of adults (18+) from October 2021 to October 2024.</p><p><strong>Results: </strong>Among 6080 participants (95.4% aged 18-59; 65.8% women), a medium level of KAP was observed. Notably, 51.5% did not use specialized disposal containers, only 15.5% knew container locations, and 30.5% correctly identified expiration dates. Significant associations emerged: lower education levels correlated with poorer disposal knowledge, while health-related backgrounds and postgraduate studies linked to positive attitudes and adequate practices. Ordinal logistic regression revealed that being elderly, belonging to a high socioeconomic class, having lower education levels, and lacking health-related studies were significantly associated with poor KAP regarding EUM disposal.</p><p><strong>Conclusions: </strong>Inadequate pharmaceutical disposal in Mexico compromises environmental and public health. Addressing this requires reinforced regulations, professionalized pharmacies, and a comprehensive approach to bridge knowledge gaps. Integrating digital tools-like real-time mapping and QR labeling-with accessible take-back schemes is vital in mitigating hazards and uphold the One Health triad.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Clinical Scores and Cardiac Troponin I with 30-Day Mortality in Patients with Spontaneous Intracerebral Hemorrhage.","authors":"Nina Mihic, Ivan Cavar, Jelena Sulic, Katarina Vukojevic, Mirela Mabic, Sandra Lakicevic, Ante Kvesic","doi":"10.3390/epidemiologia7020043","DOIUrl":"10.3390/epidemiologia7020043","url":null,"abstract":"<p><strong>Background/objectives: </strong>Spontaneous intracerebral hemorrhage (sICH) is a particularly severe subtype of stroke, characterized by high rates of mortality and long-term disability, for which robust prognostic markers are still lacking. The aim of this study was to assess the relationship of the ICH score, the National Institutes of Health Stroke Scale (NIHSS) score, and serum high-sensitivity cardiac troponin I (hs-cTnI) levels with 30-day mortality in patients with sICH.</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study enrolling 100 consecutive patients diagnosed with sICH based on neuroimaging findings. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed.</p><p><strong>Results: </strong>Patients who died were older and had significantly higher ICH and NIHSS scores, lower Glasgow Coma Scale (GCS) scores, larger hematoma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared to survivors. Serum hs-cTnI concentrations were significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, higher ICH score, NIHSS score, and hs-cTnI level were associated with mortality, whereas multivariate analysis identified the GCS score, hematoma volume, and IVH score as significant independent factors related to fatal outcome.</p><p><strong>Conclusions: </strong>Individual components of the ICH score may provide useful information on outcomes in patients with sICH. Higher serum hs-cTnI levels were associated with 30-day mortality but were not independent predictors. These markers may assist in patient monitoring and support established clinical procedures in therapeutic decision-making. Nevertheless, larger multicenter studies are needed to further clarify their clinical implications in sICH management.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling Place-Based Effects at Scale: A Multiscale Geographically Weighted Regression of Food Deserts and Cardiovascular Risk in Chile.","authors":"Francisco Vergara-Perucich, Leslie Landaeta-Díaz, Carlos Aguirre-Nuñez","doi":"10.3390/epidemiologia7020042","DOIUrl":"10.3390/epidemiologia7020042","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cardiovascular diseases (CVD) in Chile are profoundly shaped by place-based determinants of diet. This study examines the association between food deserts-areas with structurally limited access to nutritious, affordable food-and population-level cardiovascular risk across Chile's three largest metropolitan areas (Santiago, Valparaíso, Concepción).</p><p><strong>Methods: </strong>We constructed a geospatial food desert index combining OpenStreetMap-derived retail accessibility with census information, and linked it to georeferenced cardiovascular health records. To overcome the limitations of global models that assume spatial stationarity, we applied Multiscale Geographically Weighted Regression (MGWR) to allow coefficients to vary across space and to recover variable-specific process scales.</p><p><strong>Results: </strong>The MGWR results indicate pronounced spatial non-stationarity in the food desert-CVD association. The relationship is predominantly positive across Gran Valparaíso, predominantly negative in Gran Concepción, and highly mixed within Gran Santiago, evidencing divergent local mechanisms rather than a single national pattern.</p><p><strong>Conclusions: </strong>The observed heterogeneity undermines \"one-size-fits-all\" national interventions and supports place-sensitive, equity-oriented strategies. Policy implications include territorially tailored food-retail regulation and primary-care outreach, co-designed with local actors, with MGWR providing a critical analytic basis for actionable, context-specific public health planning.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Serum Status and Associated Factors Among Women with Cervical Lesions.","authors":"Zinhle Simelane, Likhona S Masika, Charles B Businge, Zizipho Z A Mbulawa","doi":"10.3390/epidemiologia7020040","DOIUrl":"10.3390/epidemiologia7020040","url":null,"abstract":"<p><strong>Background/objectives: </strong>Vitamin D plays a role in cellular regulation and immune processes relevant to cervical carcinogenesis, yet data on vitamin D status and its determinants in high-burden settings such as South Africa remain scarce. This paper therefore describes the prevalence of vitamin D deficiency, insufficiency, and sufficiency, and explores associated factors among women with cervical lesions.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among 103 women aged 18-81 years. Women were referred to Nelson Mandela Academic Hospital due to cervical cancer, high-grade squamous intraepithelial lesions (HSILs), or atypical squamous cells-cannot exclude HSIL, or low-grade squamous intraepithelial lesions, or atypical squamous cells of undetermined significance. The total serum 25(OH)D (D₂ + D₃) was quantified using the MAGLUMI 25-OH Vitamin D chemiluminescent immunoassay kit on the MAGLUMI X3 Fully Automatic Chemiluminescence Immunoassay Analyzer (Snibe Diagnostic, Shenzhen New Industries Biomedical Engineering Co., Ltd., Shenzhen, China). Serum vitamin D was categorized according to the Endocrine Society Task Force guidelines.</p><p><strong>Results: </strong>Vitamin D insufficiency was observed in 46.60% of participants and deficiency in 26.21% while only 27.18% had sufficient levels. Overall, vitamin D deficiency or insufficiency was more common than sufficiency (72.82%; 27.18%, <i>p</i> < 0.0001). Among HIV-positive women, 78.26% had vitamin D deficiency or insufficiency compared with 63.33% of HIV-negative women; however, this difference was not statistically significant. Vitamin D deficiency was most prevalent in women with healthy body mass index (BMI, 46.40%) values and decreased significantly with increasing BMI values (<i>p</i> = 0.008).</p><p><strong>Conclusions: </strong>Vitamin D deficiency and insufficiency were common among women with cervical lesions in this rural South African population. Associations with BMI suggest context-specific influences on vitamin D status. Owing to the study's cross-sectional design and lack of normal cervical cytology participants, the findings are descriptive and exploratory, underscoring the need for longitudinal and comparative research to better define the role of vitamin D in cervical disease.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Tuberculosis Incidence and Mortality in South Africa and Bulgaria (2000-2023): The Impact of Income, Poverty, Unemployment, and Universal Health Coverage.","authors":"Siyabonga Kave, Joana Simeonova, Antoniya Yanakieva, Alexandrina Vodenitcharova, Denisha Govender, Yandisa Sikweyiya, Nelisiwe Khuzwayo","doi":"10.3390/epidemiologia7020039","DOIUrl":"10.3390/epidemiologia7020039","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a major global public health challenge, with substantial variation across countries. South Africa has one of the highest TB incidence and mortality rates globally, while Bulgaria, a low-incidence country, faces a persistent TB burden among vulnerable populations.</p><p><strong>Objectives: </strong>To compare national trends in TB incidence and mortality in South Africa and Bulgaria from 2000 to 2023 and explore associations with selected socioeconomic indicators and health system coverage.</p><p><strong>Methods: </strong>An ecological, descriptive, analytical study used national-level data from the WHO, World Bank, and official statistics. TB trends were analyzed alongside income, poverty, unemployment, and Universal Health Coverage indicators. Time series measures and Pearson correlation were used descriptively to summarize co-variation over time.</p><p><strong>Results: </strong>Between 2000 and 2023, TB incidence declined by approximately 44% in the Republic of South Africa and 69% in Bulgaria. In both countries, TB incidence co-varied strongly with unemployment (RSA: r = 0.805; BG: r = 0.723). In Bulgaria, TB incidence was also strongly negatively associated with GDP per capita (r = -0.910), whereas no significant association with GDP was observed in South Africa. These findings indicate that TB trends co-varied more closely with labour market conditions in both contexts, while broader economic growth co-occurred with declining TB incidence only in Bulgaria.</p><p><strong>Conclusions: </strong>TB trends co-occurred with changes in socioeconomic conditions and health system coverage, with differing patterns across contexts. Findings highlight the relevance of equity-oriented, context-specific TB control strategies integrated with social and economic policies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Treatment of Type 2 Diabetes and Hypothyroidism: Impact of Oral Semaglutide and Levothyroxine on Cardiometabolic and Thyroid Parameters: A 6-Month Comparative Study.","authors":"Dana-Mihaela Tilici, Ruxandra-Mihaela Costinescu, Diana Loreta Paun, Daniela Stegaru, Beatrice Mihaela Grecu, Mirona Costea, Cristian Guja","doi":"10.3390/epidemiologia7020041","DOIUrl":"10.3390/epidemiologia7020041","url":null,"abstract":"<p><strong>Background/objectives: </strong>Type 2 diabetes (T2DM) and hypothyroidism often coexist, worsening cardiometabolic risk. Oral semaglutide and levothyroxine each improve metabolic parameters, but the effect of combined therapy is understudied. This study aimed to evaluate whether oral semaglutide administered concomitant with levothyroxine provides additive benefits on lipid profile, glycemic control, and body weight in patients with both conditions.</p><p><strong>Methods: </strong>This prospective comparative observational study assessed a total of 210 patients who were enrolled (70 per group) with a 6-month follow-up. Group A (T2DM and hypothyroidism) received semaglutide and levothyroxine, group B (hypothyroidism only) received levothyroxine, and group C (T2DM only) received oral semaglutide. Lipid profile, glycemic profile (HbA1c), thyroid profile, and anthropometric parameters were comparable across groups at baseline and after 6 months.</p><p><strong>Results: </strong>Group A demonstrated significant improvements in lipid parameters: LDL-cholesterol decreased by 12.7%, HDL increased by 9.0%, and triglycerides decreased by 6.7% (all comparisons <i>p</i> < 0.001 unless otherwise specified). In contrast, group B experienced worsening lipid profiles (LDL increased by 11.0%, HDL decreased by 0.5%, and triglycerides increased by 9.1%), while group C showed modest changes (LDL increased by 4.5%). Glycemic control improved among diabetic patients, with HbA1c declining by 7.7% in group A and 12.6% in group C. Body mass index (BMI) decreased in groups A (4.9%) and C (6.0%).</p><p><strong>Conclusions: </strong>The concurrent administration of oral semaglutide and levothyroxine produces additive cardiometabolic advantages in individuals with T2DM and hypothyroidism. These findings suggest that combined treatment may optimize metabolic outcomes in this particularly high-risk population.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}