Epidemiolgia (Basel, Switzerland)最新文献

{"title":"From Conquests to Epidemics in 18th-Century South America: A Reflection on Social Resilience and Reconstruction: Review of the Literature.","authors":"Jorge Hugo Villafañe","doi":"10.3390/epidemiologia5040049","DOIUrl":"10.3390/epidemiologia5040049","url":null,"abstract":"<p><strong>Background/objectives: </strong>This narrative review examines resilience and social reconstruction strategies implemented during the 1742-1743 plague along the Royal Road between Buenos Aires and Lima. The study explores how colonial authorities managed the epidemic and its long-term effects, providing insights into historical crisis management and public health governance.</p><p><strong>Methods: </strong>A systematic analysis of primary and secondary historical records was conducted to identify public health measures, such as quarantines, hospital construction, and administrative reforms. Sources were retrieved from archives and databases, focusing on resilience strategies and institutional responses to the epidemic.</p><p><strong>Results: </strong>The findings highlight key public health interventions designed to contain the epidemic and mitigate its impacts. These included the establishment of quarantines, the construction of temporary hospitals, and administrative adaptations. Religious practices, such as novenas and community prayers, complemented institutional responses. The study underscores the role of colonial governance in adapting under epidemic pressures, illustrating an emergent institutional resilience.</p><p><strong>Conclusions: </strong>The 1742-1743 plague along the Royal Road serves as a case study for understanding the intersection of health crises and institutional adaptability. The review emphasizes the importance of coordinated public health measures and governance in addressing pandemics, offering lessons on resilience and social reconstruction applicable to contemporary health crises. This historical perspective enriches current discussions on crisis management and public health policy.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"706-714"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711815","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":"A Two-Country Questionnaire Study of Biomedical Student Opinions Regarding Online Teaching During COVID-19.","authors":"Irena Ognjanovic, Irina Yakushina, Elena Shustikova, Maria Mikerova, Vladimir Reshetnikov, Sara Mijailovic, Jelena Nedeljkovic, Dragan Milovanovic, Ljiljana Tasic, Vladimir Jakovljevic, Tamara Nikolic Turnic","doi":"10.3390/epidemiologia5040048","DOIUrl":"10.3390/epidemiologia5040048","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare the opinions of biomedical students from Russia and Central Serbia about learning methods in the time of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This is a comparative questionnaire study that used the validated questionnaire tool eMedQ, conducted via the online platform Anketolog.ru from February to May 2022 at Sechenov University and the University of Kragujevac in the same period. At Sechenov University, 694 students took part in the survey, while at the University of Kragujevac, the total number of participants was 209. The eMedQ questionnaire, in Russian and Serbian, consists of 45 closed-ended questions with 7 domains: demographic characteristics, experience with online teaching, education process (teaching organization), aspects of mental functioning, clinical skills, technical aspects, and quality of life.</p><p><strong>Results: </strong>During the COVID-19 lockdown, in Serbian and Russian biomedical faculties, we observed the high flexibility of Russian students with greater experience when it comes to online education before the pandemic compared to students from Serbia. Also, the Russian students declared that they were strongly motivated to achieve clinical skills and to learn, while a larger number of Serbian students reported disrupted mental functioning and learning problems.</p><p><strong>Conclusions: </strong>At the time of isolation, at Serbian and Russian biomedical faculties, we noticed the higher flexibility of Russian students with more experience than students from Serbia. Also, the Russian students declared that they were strongly motivated both to acquire clinical skills and to learn, while a larger number of Serbian students reported reduced mental functioning and learning problems.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"692-705"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711689","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":"Big Epidemiology: The Birth, Life, Death, and Resurgence of Diseases on a Global Timescale.","authors":"Nicola Luigi Bragazzi, Thorsten Lehr","doi":"10.3390/epidemiologia5040047","DOIUrl":"10.3390/epidemiologia5040047","url":null,"abstract":"<p><p>Big Epidemiology represents an innovative framework that extends the interdisciplinary approach of Big History to understand disease patterns, causes, and effects across human history on a global scale. This comprehensive methodology integrates epidemiology, genetics, environmental science, sociology, history, and data science to address contemporary and future public health challenges through a broad historical and societal lens. The foundational research agenda involves mapping the historical occurrence of diseases and their impact on societies over time, utilizing archeological findings, biological data, and historical records. By analyzing skeletal remains, ancient DNA, and artifacts, researchers can trace the origins and spread of diseases, such as <i>Yersinia pestis</i> in the Black Death. Historical documents, including chronicles and medical treatises, provide contextual narratives and quantitative data on past disease outbreaks, societal responses, and disruptions. Modern genetic studies reveal the evolution and migration patterns of pathogens and human adaptations to diseases, offering insights into co-evolutionary dynamics. This integrative approach allows for temporal and spatial mapping of disease patterns, linking them to social upheavals, population changes, and economic transformations. Big Epidemiology also examines the roles of environmental changes and socioeconomic factors in disease emergence and re-emergence, incorporating climate science, urban development, and economic history to inform public health strategies. The framework reviews historical and contemporary policy responses to pandemics, aiming to enhance future global health governance. By addressing ethical, legal, and societal implications, Big Epidemiology seeks to ensure responsible and effective epidemiological research and interventions. This approach aims to profoundly impact how we understand, prevent, and respond to diseases, leveraging historical perspectives to enrich modern scientific inquiry and global public health strategies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"669-691"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711706","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":"Cycle Threshold Values of SARS-CoV-2 RT-PCR during Outbreaks in Nursing Homes: A Retrospective Cohort Study.","authors":"Juan Carlos Gascó-Laborda, Maria Gil-Fortuño, Maria Dolores Tirado-Balaguer, Noemi Meseguer-Ferrer, Oihana Sabalza-Baztán, Óscar Pérez-Olaso, Iris Gómez-Alfaro, Sandrine Poujois-Gisbert, Noelia Hernández-Pérez, Lledó Lluch-Bacas, Viorica Rusen, Alberto Arnedo-Pena, Juan Bautista Bellido-Blasco","doi":"10.3390/epidemiologia5040046","DOIUrl":"https://doi.org/10.3390/epidemiologia5040046","url":null,"abstract":"<p><p>Backgound/Objectives: Cycle threshold (Ct) values of SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests are associated with infectivity and viral load, and they could be an aid in forecasting the evolution of SARS-CoV-2 outbreaks. The objective was to know the Ct values related to the incidence and reinfection of SARS-CoV-2 in successive outbreaks, which took place in nursing homes in Castellon (Spain) during 2020-2022, and to test its usefulness as an instrument of epidemic surveillance in nursing homes.</p><p><strong>Methods: </strong>a retrospective cohort design with Poisson regression and multinomial logistic regression were used.</p><p><strong>Results: </strong>We studied four nursing home SARS-CoV-2 outbreaks, and the average infection rate, reinfection rate, and case fatality were 72.7%, 19.9%, and 5.5%, respectively; 98.9% of residents were vaccinated with three doses of a mRNA SARS-CoV-2 vaccine. Ct values for first infections and reinfections were 27.1 ± 6.6 and 31.9 ± 5.4 (<i>p</i> = 0.000). Considering Ct values ≥ 30 versus <30, residents with reinfections had Ct values higher than residents with a first infection, an adjusted relative risk of 1.66 (95% Confidence interval 1.10-2.51). A sensitivity analysis confirmed these results.</p><p><strong>Conclusions: </strong>Reinfection and SARS-CoV-2 vaccination (hybrid immunity) could protect against severe disease better than vaccination alone. High Ct values suggest lower transmission and severity. Its value can be useful for surveillance and forecasting future SARS-CoV-2 epidemics.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"658-668"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514091","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":"Resilience, Anger, and Insomnia in Nurses after the End of the Pandemic Crisis.","authors":"Argyro Pachi, Aspasia Panagiotou, Nikolaos Soultanis, Maria Ivanidou, Maria Manta, Christos Sikaras, Ioannis Ilias, Athanasios Tselebis","doi":"10.3390/epidemiologia5040045","DOIUrl":"https://doi.org/10.3390/epidemiologia5040045","url":null,"abstract":"<p><strong>Introduction: </strong>Nurses seem to be persistently experiencing intense psychological repercussions, even after the official conclusion of the COVID-19 pandemic. In this cross-sectional study conducted after the end of the pandemic crisis, from 1 June 2023 to 30 June 2023, we evaluated the levels and explored the associations between anger, insomnia, and resilience among Greek nurses.</p><p><strong>Methods: </strong>A total of 441 nurses participated in an online survey and were invited to state their work experience, gender, and age and to complete the self-report measures of the Dimensions of Anger Reactions-5 (DAR-5), the Athens Insomnia Scale (AIS), and the Brief Resilience Scale (BRS).</p><p><strong>Results: </strong>Overall, 62.1% of the participants presented with positive scores on the AIS, and 41.5% displayed positive values on the DAR-5 scale, whereas 24.9% demonstrated scores indicative of low resilience on the BRS. A regression analysis revealed that 23.5% of the variance in the AIS scores can be attributed to the DAR-5 scores and 3% to the BRS scores. A mediation analysis confirmed the protective role of resilience, contributing as a negative mediator in the DAR-5 and AIS relationship.</p><p><strong>Conclusions: </strong>Screening for insomnia symptoms and anger issues among nurses after the end of the pandemic and implementing appropriate interventions is considered imperative to avoid long-term health consequences.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"643-657"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514101","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":"Socio-Economic and Health Literacy Inequalities as Determinants of Women's Knowledge about Their Reproductive System: A Cross-Sectional Study.","authors":"Viktória Prémusz, Kálmán András Kovács, Eszter Skriba, Zoltán Tándor, Gábor Szmatona, Olívia Dózsa-Juhász","doi":"10.3390/epidemiologia5040044","DOIUrl":"https://doi.org/10.3390/epidemiologia5040044","url":null,"abstract":"<p><strong>Background/objectives: </strong>To support women's informed decisions and reproductive self-care, confident reproductive health-related knowledge is needed, supported by adequate health literacy (HL). No corresponding survey has been carried out in Hungary on inequalities to provide information addressing education.</p><p><strong>Materials and methods: </strong>In the current cross-sectional online survey, 301 women of reproductive age (27.16 ± 0.36 years) were asked with the Hungarian versions of validated and standardised questionnaires about reproductive knowledge on hormones, ovulation, menstrual cycle, pregnancy signs and birth control (Knowledge of Female Body Scale-KFB), and HL (Brief Health Literacy Screening Tool-BRIEF). Spearman correlation and multivariable linear regression analyses were utilised, with a significance level set at <i>p</i> < 0.05. IBM SPSS version 28.0 (IBM SPSS, Armonk, NY, USA: IBM Corp.) and G*Power (version 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) software. The STROBE checklist was followed. The Clinical Trial Registry Nr. is NCT06146673.</p><p><strong>Results: </strong>The KFB composite score was high (20.01 ± 2.33); 86.374% had \"high knowledge\". Still, lacking information was identified for the mechanisms of certain contraceptive methods and early physical signs of pregnancy. A significant difference was also found in the KFB scores in the case of higher age (<i>p</i> = 0.019), higher education level (<i>p</i> = 0.018) and previous live birth (<i>p</i> = 0.028). A positive correlation was found between KFB and HL (<i>p</i> < 0.001), education (<i>p</i> = 0.005), and age (<i>p</i> = 0.021). A multiple regression analysis (R² = 0.087, <i>p</i> < 0.001) indicated that both HL (<i>p</i> < 0.001) and age (<i>p</i> = 0.003) are potential positive predictors of adequate reproductive knowledge, whereas induced abortion (<i>p</i> = 0.013) might serve as an inverse predictor.</p><p><strong>Conclusions: </strong>Inequalities in women's knowledge about their reproductive system and HL were found, and it was significantly the lowest in their highest conception probability age. Therefore, in addition to targeted education, HL also needs improvement.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 4","pages":"627-642"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514102","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":"Alcohol Consumption and Cancer Risk: Two Sample Mendelian Randomization.","authors":"Yongho Jee, Mikyung Ryu, Jae-Woong Sull","doi":"10.3390/epidemiologia5030043","DOIUrl":"10.3390/epidemiologia5030043","url":null,"abstract":"<p><p>Although numerous observational studies have reported on the association between alcohol consumption and cancer, insufficient studies have estimated the causality. Our study evaluated the causal relationship between various types of cancer according to the frequency of drinking and the amount of alcohol consumed. The research data were obtained from the publicly available MR-Base platform. The frequency and amount of drinking were selected as the exposure, and 16 cancer types were selected as the outcome. Two-sample summary data Mendelian randomization (2SMR) was conducted to examine the causality between alcohol consumption and cancer type. Additionally, for cancers suspected of pleiotropy, outliers were removed and re-analyzed through radial MR. The MR results using the inverse variance weighted (IVW) method were different before and after removing outliers. The biggest differences were found for esophageal cancer and biliary tract cancer. For esophageal cancer, after removing outliers (rs13102973, rs540606, rs650558), the OR (95% CI) was 3.44 (1.19-9.89), which was statistically significant (<i>p</i> = 0.02172). Even in biliary tract cancer, after removing outliers (rs13231886, rs58905411), the OR (95% CI) was 3.86 (0.89-16.859), which was of borderline statistical significance (<i>p</i> = 0.07223). The strongest association was found for esophageal cancer. For other cancers, the evidence was not sufficient to draw conclusions. More research is needed to understand the causality between drinking and cancer.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 3","pages":"618-626"},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302466","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":"Conceptualization of Depression among Medical Students and Its Differences during Medical Education.","authors":"Santi Arana-Ballestar, Ricardo Campos-Ródenas, Beatriz Olaya, Javier Santabárbara","doi":"10.3390/epidemiologia5030042","DOIUrl":"10.3390/epidemiologia5030042","url":null,"abstract":"<p><p>The definition of mental disorders has been traditionally a matter of discussion, and it has relevant implications in research and healthcare. Our aim was to explore the conceptualization medical students have of depression and to determine differences across academic years. The Maudsley Attitudes Questionnaire was adapted through a double translation, double back-translation and a preliminary validation, obtaining a Spanish edition. All students of the Faculty of Medicine of the University of Zaragoza and doctors who graduated from this University in 2020 were invited to answer the online questionnaire, and we received 222 answers (response rate: 15.2%). The results were compared by years and levels of education using an ANOVA. The social realist, behavioral, biological, cognitive and psychodynamic models were the most endorsed. The psychodynamic and nihilist models were less embraced by students in later educational years. These students also reported greater confidence in their understanding of depression and of its biological, cognitive and behavioral models. In conclusion, the conceptualization of depression among medical students is complex and multidimensional, and appears to be similar across different years of education. In later years, we found less support for the psychodynamic model, increased confidence in psychiatry and greater ease in handling the concepts of its leading models.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 3","pages":"605-617"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302477","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":"Occupational Health Problems among Cambodian Dentists: A Cross-Sectional Study.","authors":"Rodrigo Mariño, Rithvitou Horn, Moniroth Seat, Konitha Hong, Sokpheakta Hen","doi":"10.3390/epidemiologia5030041","DOIUrl":"10.3390/epidemiologia5030041","url":null,"abstract":"<p><p>Dental practitioners, as part of their work, are exposed to a variety of hazards. This highlights the ongoing need for attention to occupational health in the dental field. A cross-sectional study was organised to investigate the range, prevalence, and associated factors for occupational health problems related to dental practice among Cambodian dentists. Participants underwent a face-to-face interview to explore dentists work-related health problems; 106 Cambodian dentists participated in this study, of which 68.9% were male. Ages ranged from 29 to 71 years, averaging 36.1 years, with the majority (77.4%) in the 29-40 age group. They had 5 to 18 years of practice experience, and worked an average of 52.2 h per week. Commonly reported health issues included back pain (88.7%), headaches (81.1%), shoulder pain (78.3%), arm/hand pain (57.5%), and eye problems (48.1%). Additionally, 38.7% of participants felt stressed and 19.8% depressed. Some reported suicidal thoughts and taking medication for depression. Despite these challenges, 91.5% enjoyed practicing dentistry. These findings highlight the need for interventions and strategies to address the physical and mental well-being of Cambodian dentists. By addressing these issues, steps can be taken to enhance the working conditions and professional satisfaction of dental professionals, ultimately benefiting both the practitioners and their patients.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 3","pages":"592-604"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302479","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 Mortality Due to Stroke in South America between 1990 and 2019.","authors":"Alexandre Castelo Branco Araujo, Orivaldo Florencio de Souza, Filomena Euridice Carvalho de Alencar, Betina Bolina Kersanach, Victor Lopes Feitosa, Julia Silva Cesar Mozzer, Vinicius Andreata Brandão, Gabriel Marim Roni, Carlos Bandeira de Mello Monteiro, Luiz Carlos de Abreu","doi":"10.3390/epidemiologia5030040","DOIUrl":"10.3390/epidemiologia5030040","url":null,"abstract":"<p><p>Stroke is the second leading cause of death and disability in Latin America; however, few epidemiological studies have been conducted in South America. An observational study was conducted to analyze trends in stroke mortality in South American (SA) countries. Age-standardized mortality rates and proportional mortality due to stroke in the populations of SA countries between 1990 and 2019 were assessed by extracting data from the Global Burden of Disease 2019 study. Joinpoint regression models were employed to identify trends in the annual percentage change in mortality rates for each segment. Considering the data collected over the 30 years that were studied, the age-standardized stroke mortality trend decreased in Argentina (-1.6%), Uruguay (-0.6%), Brazil (-0.5%), Guyana (-0.5%), and Bolivia (-0.4%), while Venezuela (+1.6%) and Suriname (+1.0%) showed an increasing trend. The proportional stroke mortality trend decreased in Argentina (-1.7%), Paraguay (-0.9%), Uruguay (-0.7%), Guyana (-0.7%), Brazil (-0.5%), and Chile (-0.5%), whereas Bolivia (+1.0%), Suriname (+0.6%), and Peru (+0.4%) exhibited an increasing trend. The trends in stroke mortality between 1990 and 2019 demonstrated considerable variability. While most SA countries experienced significant decreases in stroke mortality trends, Venezuela and Suriname showed increases in age-standardized mortality rates, and Bolivia, Suriname, and Peru exhibited increases in proportional mortality rates. No decreasing stroke mortality trend was observed in the segment after the last joinpoint, highlighting the need for improvement in prevention and treatment.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"5 3","pages":"581-591"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302482","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}