Epidemiolgia (Basel, Switzerland)最新文献

{"title":"COVID-19 Seroprevalence in Romania: Insights from a Nationwide Antibody Study.","authors":"Réka Bodea, Toader Septimiu Voidăzan, Lorand Iozsef Ferencz, Zoltán Ábrám","doi":"10.3390/epidemiologia6020026","DOIUrl":"10.3390/epidemiologia6020026","url":null,"abstract":"<p><strong>Background: </strong>Frequency indicators are used by epidemiologists to facilitate public health professionals in estimating the impact of diseases. As of April 2022, Romania had reported 2.8 million confirmed COVID-19 cases to the World Health Organization, equating to a prevalence rate of 13.94%. A more accurate method for assessing the cumulative number of cases is the use of seroprevalence studies. This study retrospectively evaluates infection trends in Romania to enhance understanding of the virus's spread and may support future comparative analyses of public health responses and community-level immunity.</p><p><strong>Methods: </strong>We analyzed 51,533 qualitative test results for high-affinity IgG antibodies targeting the SARS-CoV-2 nucleocapsid protein.</p><p><strong>Results: </strong>The largest proportion of tested individuals (59.4%) was aged 18-49 years. Among all serological tests, 18,980 were positive, corresponding to an adjusted seroprevalence rate of 40%.</p><p><strong>Conclusions: </strong>During the second year of the pandemic, seropositivity rates were highest among young adults, particularly in the western regions, and lowest among children and adolescents. These findings point out variations in exposure across age groups and geographic areas.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487360","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":"Epidemiological and Socioeconomic Disparities in the 1742-1743 Epidemic: A Comparative Analysis of Urban Centers and Indigenous Populations Along the Royal Road.","authors":"Jorge Hugo Villafañe","doi":"10.3390/epidemiologia6020025","DOIUrl":"10.3390/epidemiologia6020025","url":null,"abstract":"<p><strong>Background/objectives: </strong>Epidemics have historically shaped societies, influencing demographic structures, social organization, and economic stability. The 1742-1743 epidemic had a profound impact on populations along the Royal Road (Camino Real), the main colonial corridor between Buenos Aires and Lima. However, its specific demographic and socio-economic effects remain underexplored. This study aims to examine these impacts of the 1742-1743 epidemic through a comparative analysis of urban centers and Indigenous communities.</p><p><strong>Methods: </strong>A historical-comparative approach was employed, analyzing secondary sources including parish records and colonial administrative documents. This study assessed excess mortality and socio-economic consequences across different population groups and settlement types.</p><p><strong>Results: </strong>Mortality rates increased dramatically-up to twelve times the pre-epidemic average in Cordova (Córdoba) and by 45% in Santa Fe-disproportionately affecting Indigenous and enslaved populations. Urban centers experienced severe economic disruption and slow recovery, whereas Indigenous communities and Jesuit missions demonstrated greater resilience. Their communal strategies and early isolation measures contributed to a faster demographic stabilization. Additionally, the epidemic weakened colonial governance in some areas, altering local power structures.</p><p><strong>Conclusions: </strong>The epidemic of 1742-1743 revealed divergent patterns of vulnerability and resilience. Comparative analysis underscores recurring themes in the epidemic response and recovery, drawing relevant parallels with contemporary crises such as COVID-19. Recognizing these historical patterns of adaptation can inform present and future public health strategies. The terminology \"plague\" is used based on contemporary sources and not confirmed clinically.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129596","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 Limb Arthroplasties in Colombia: Projections for 2050 Based on Official Records.","authors":"Yesika Natali Fernández-Ortiz, Jorge Martín Rodríguez-Hernández","doi":"10.3390/epidemiologia6020024","DOIUrl":"10.3390/epidemiologia6020024","url":null,"abstract":"<p><p>Population ageing is driving a growing demand for orthopedic surgical procedures. The rise in chronic conditions such as osteoarthritis significantly contributes to disability among older adults, particularly women, and primarily affects the hip and knee joints, thereby increasing the need for arthroplasties.</p><p><strong>Objective: </strong>To determine the future demand for lower limb arthroplasty procedures among individuals aged 60 and over in Colombia up to 2050, using official public health records and national demographic projections.</p><p><strong>Methods: </strong>This study used an observational longitudinal retrospective design, using a Poisson regression model with official records from the Integrated Social Protection Information System-which consolidates procedures reported by both public and private healthcare service providers-to identify lower limb arthroplasties performed between 2015 and 2023. Population projections from the National Department of Statistics were incorporated to model future demand, accounting for demographic ageing and mortality trends. An additional analysis was conducted by sex and the most prevalent types of arthroplasties.</p><p><strong>Results: </strong>A total of 62,728 procedures took place from 2015 to 2023, with women undergoing approximately twice as many as men. The highest intervention rates occurred in the 65-69 and ≥80 age groups. By 2050, projections indicate the number of procedures will reach 39,270, with 52.7% projected among women.</p><p><strong>Conclusions: </strong>This study reports demographic trends in arthroplasties between 2015 and 2023 and offers insights into the anticipated future burden of lower limb arthroplasties among Colombia's older population.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129597","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":"Studying the Role of Vegetarianism as a Potential Strategy for Cancer Prevention and Treatment, a Bibliometric Analysis.","authors":"Maria Chrysafi, Maria Gialeli, Constantinos Giaginis, Andreas Y Troumbis, Georgios K Vasios","doi":"10.3390/epidemiologia6020023","DOIUrl":"10.3390/epidemiologia6020023","url":null,"abstract":"<p><p>Vegetarianism, as a dietary pattern, is characterized by animal product avoidance and increased consumption of fruits, vegetables, whole grains, and legumes. It has been associated with health benefits, both physical and psychological, and has raised interest as a potential strategy for cancer prevention and treatment, which remains one of the leading causes of morbidity and mortality worldwide, demanding continual exploration of novel approaches.</p><p><strong>Background/objectives: </strong>This study aims to describe trends in scientific publications about the relationship between vegetarianism and cancer and to highlight research gaps using bibliometric analysis.</p><p><strong>Methods: </strong>The methodology includes comprehensive research of three literature databases. After combining and cleaning these data, a final sample of 3427 studies was obtained that was analyzed using the Bibliometrix-R package.</p><p><strong>Results: </strong>The results indicate a continuously growing production of scientific publications. The most impactful sources, authors and their collaborations were identified. Author keywords, their co-occurrence network, and thematic trends were studied.</p><p><strong>Conclusions: </strong>Through synthesizing and critically evaluating insights from the scientific literature, we aim to contribute to the understanding of the potential benefits of vegetarianism in cancer prevention and management. However, due to the complexity of the topic, the results are often contradictory and could be used as a starting point for further research.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129598","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 Congenital Syphilis Incidence and Mortality in Brazil's Southeast Region: A Time-Series Analysis (2008-2022).","authors":"Alexandre Castelo Branco Araujo, Orivaldo Florencio de Souza, Betina Bolina Kersanach, Julia Silva Cesar Mozzer, Victor Lopes Feitosa, Vinicius Andreata Brandão, Filomena Euridice Carvalho de Alencar, Norma Suely Oliveira, Andrea Vasconcellos Batista da Silva, Luiz Carlos de Abreu","doi":"10.3390/epidemiologia6020022","DOIUrl":"10.3390/epidemiologia6020022","url":null,"abstract":"<p><p>Congenital syphilis (CS) is an important infectious cause of miscarriage, stillbirth, and neonatal morbidity and mortality. Despite the advances in diagnosis and treatment, CS continues to challenge health systems with increasing incidence and mortality rates in recent years worldwide. Given this, the present study aims to comparatively analyze the temporal trends in CS incidence and mortality in Brazil's Southeast Region from 2008 to 2022. This is an ecological time-series study using secondary data on congenital syphilis from the states of Espírito Santo, Minas Gerais, Rio de Janeiro, and São Paulo. The data was extracted from the Brazilian Health System Informatics Department. Incidence and mortality rates were calculated per 100,000 live births. Joinpoint regression models were employed to identify trends in annual percentage change and average annual percentage change with 95% confidence intervals. The temporal trend of CS incidence in Brazil's Southeast Region increased 12.8% between 2008 and 2022. Minas Gerais, São Paulo, Espírito Santo, and Rio de Janeiro showed increasing temporal trends of 21.4%, 14.1%, 14.0%, and 10.9%, respectively. The temporal trend of CS mortality in Brazil's Southeast Region rose 11.9% between 2008 and 2022. Minas Gerais, São Paulo, and Rio de Janeiro exhibited increasing mortality temporal trends of 21.9%, 20.8%, and 10.1%, respectively. In contrast, Espírito Santo showed reduced mortality, with no deaths in 2021 and 2022. The temporal trend of CS incidence increased in all states of Brazil's Southeast Region between 2008 and 2022, highlighting the need to reassess control measures. The temporal trend of CS mortality also increased during the same period, except in Espírito Santo. Considering that CS is preventable with adequate prenatal care and low-cost measures, these findings can serve as instruments to support strengthening public health policies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129617","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":"The Global Burden of Multidrug-Resistant Bacteria.","authors":"Andrea Marino, Antonino Maniaci, Mario Lentini, Salvatore Ronsivalle, Giuseppe Nunnari, Salvatore Cocuzza, Federica Maria Parisi, Bruno Cacopardo, Salvatore Lavalle, Luigi La Via","doi":"10.3390/epidemiologia6020021","DOIUrl":"10.3390/epidemiologia6020021","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This narrative review provided a broad synthesis of recent epidemiological trends, priority resistance mechanisms, and public health implications of multidrug-resistant (MDR) bacteria. We focused on the most clinically significant MDR pathogens, regional differences in resistance, and the effectiveness of containment strategies. Our goal was to synthesize current knowledge and propose research directions. <b>Methods:</b> Through comprehensive analysis of epidemiological studies, surveillance reports, clinical trials, and meta-analyses, we present a detailed assessment of the evolving landscape of antimicrobial resistance across both developed and developing nations. The review encompasses data from 187 countries, analyzing over 2500 published studies and reports from major health organizations. <b>Results:</b> Our findings reveal a concerning 43% increase in multidrug-resistant infections globally, with particularly sharp rises in healthcare-associated infections (67% increase) and community-acquired infections (38% increase) in regions with high antibiotic misuse. The analysis specifically focuses on critical pathogens, including methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE), documenting their prevalence, transmission patterns, and treatment outcomes. Economic impact assessments indicate annual global healthcare costs exceeding USD 100 billion due to resistant infections. The review identifies significant gaps in current surveillance systems, particularly in low- and middle-income countries, and proposes standardized approaches for monitoring and containment strategies. We evaluate the effectiveness of various antimicrobial stewardship programs, documenting success rates and implementation challenges across different healthcare settings. <b>Conclusions:</b> The analysis concludes with evidence-based recommendations for policy reforms, research priorities, and international collaboration frameworks necessary to address this growing global health crisis. Our findings highlighted the importance of strengthening stewardship efforts, proposing novel diagnostics and therapeutic interventions, and addressing inequities in access to care and data across different countries.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129600","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":"Access to Blood Glucose Testing in Peru: Who Is Getting Tested?","authors":"Jamee Guerra Valencia, Akram Hernández-Vásquez, Carlos Rojas-Roque, Rodrigo Vargas-Fernández","doi":"10.3390/epidemiologia6020020","DOIUrl":"10.3390/epidemiologia6020020","url":null,"abstract":"<p><strong>Background/objectives: </strong>Significant disparities in access to diabetes screening persist, particularly among populations with limited healthcare access. We aimed to estimate the proportion of overweight-obese Peruvian adults who underwent blood glucose testing (BGT) in the past year and to analyse the socioeconomic and geographic inequalities associated with access to this preventive intervention.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using data from the Demographic and Family Health Survey 2023. We included adults aged 35-70 years diagnosed with overweight or obesity, according to the United States Preventive Services Task Force screening recommendation. We used concentration curves (CC) and concentration indices (CI) to assess socioeconomic inequalities in BGT. BGT was ascertained using a self-reported question, while the wealth index was used as the variable to measure inequality. We also conducted a decomposition analysis to determine the relative contributions of covariates to socioeconomic inequalities in BGT.</p><p><strong>Results: </strong>A total of 9499 individuals were included in the analysis. A pro-rich concentration of BGT uptake was observed in CC and CI (0.2090; <i>p</i> < 0.001). Notably, a 27-point prevalence difference was reported between the lowest and highest wealth index. The decomposition analysis showed that higher education (+64%) and rural areas (+10.6%) were the main contributors to this pro-rich concentration. In contrast, secondary education (-4.7%) and female gender (-3.4%) reduced this pro-rich concentration.</p><p><strong>Conclusions: </strong>The results underscore the need for targeted strategies, such as enhancing healthcare infrastructure and implementing localized screening initiatives, to close the gap and address the burden of undiagnosed diabetes in high-risk populations.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129595","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":"Incidence and Epidemiology of Kidney Infarctions in Germany-A Cohort Study.","authors":"Yannick Rau, Ludwig Matrisch","doi":"10.3390/epidemiologia6020019","DOIUrl":"https://doi.org/10.3390/epidemiologia6020019","url":null,"abstract":"<p><strong>Background/objectives: </strong>The aim of this study was to quantify and analyze the incidence and epidemiology of kidney infarctions between 2012 and 2022 in Germany.</p><p><strong>Methods: </strong>We analyzed and extracted data from the national database of federal health reporting. Incidence rates were calculated and stratified by gender and age. Statistical analysis involved linear regression to assess correlations between incidence, age, and reporting year, with significance determined using F-tests and Student's <i>t</i>-tests.</p><p><strong>Results: </strong>From 2012 to 2022, 7983 cases of kidney infarction (4769 male, 3214 female) were identified. The mean incidence was 8.81 per million per year, higher in males (10.7) than females (6.99). Incidence peaked among individuals aged 50-59 years. A significant decrease in incidence over the study period was observed, particularly among males (-2.49 per million per year) compared to females (-0.87 per million per year). Linear regression showed a significant correlation between incidence and age (F(1,6) = 131, <i>p</i> < 0.001) and a significant overall incidence decrease over time (F(1,9) = 40.5, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study provides the first nationwide epidemiological data on kidney infarction in a Western country. The downward trend, especially among males, may be due to the improved management of risk factors like atherosclerosis and atrial fibrillation, e.g., through an increase in the prescription of direct anticoagulatory agents. Despite the decrease, kidney infarction remain a significant cause of acute kidney injury. Further research is needed to understand these trends and improve preventive strategies.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054241","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":"Racial/Ethnic Disparities in Lung Cancer Surgery Outcomes in the USA.","authors":"Ivana Vasic, Kian C Banks, Julia Wei, Leyda Marrero Morales, Zeuz A Islas, Nathan J Alcasid, Cynthia Susai, Angela Sun, Katemanee Burapachaisri, Ashish R Patel, Simon K Ashiku, Jeffrey B Velotta","doi":"10.3390/epidemiologia6020018","DOIUrl":"https://doi.org/10.3390/epidemiologia6020018","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Sparse data exist identifying racial/ethnic outcome disparities among patients with lung cancer, specifically regarding healthcare utilization patterns, such as emergency department visits and outpatient follow-ups. We aimed to utilize our large, multicenter, and ethnically diverse integrated health system to assess for such disparities among patients undergoing pulmonary resections for lung cancer. <b>Methods</b>: The cohort comprised all patients undergoing pulmonary resections for lung cancer at our integrated health system from 1 January 2016 to 31 December 2020. Outcomes including the length of stay (LOS), 30-day return to the emergency department (30d-ED), 30-day readmission, 30- and 90-day outpatient appointments, and 30- and 90-day overall mortality were compared by race/ethnicity. Multivariable logistic and linear models adjusted for age, sex, body mass index (BMI), Charlson Comorbidity Index scores, procedure approach, neighborhood deprivation index (NDI), cancer stage, receipt of adjuvant chemotherapy, and insurance. <b>Results</b>: Of the 645 included patients, non-Hispanic White patients tended to be older and live in the least deprived neighborhoods. Among each race/ethnicity, the percentage of patients insured by Medicaid was highest among Asian patients. On bivariate analysis, only the outcome of surgical outpatient appointments within 30 days had differing distributions by race/ethnicity with no other significant associations between race/ethnicity and other outcomes; however, multivariable analysis showed Asian patients having lower odds of 30d-ED (adjusted odds ratio 0.51; 95% CI 0.27-0.98) while those with Medicaid insurance had higher odds of 30d-ED (adjusted odds ratio 3.29; 95% CI 1.26-8.59). <b>Conclusions</b>: Despite parity across clinical outcomes, some patient encounter-related differences still exist within our system. To better understand racial/ethnic disparities in care, systems must track such disparities in addition to clinical outcomes.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057968","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":"Co-Infections and Their Prognostic Impact on Melioidosis Mortality: A Systematic Review and Individual Patient Data Meta-Analysis.","authors":"Pakpoom Wongyikul, Wiyada Kwanhian Klangbud, Moragot Chatatikun, Phichayut Phinyo","doi":"10.3390/epidemiologia6020017","DOIUrl":"https://doi.org/10.3390/epidemiologia6020017","url":null,"abstract":"<p><p><b>Objectives</b>: This study aimed to evaluate the prognostic impact of coinfections and other clinical factors on mortality in melioidosis patients, providing a comprehensive analysis through systematic review and meta-analysis. <b>Methods:</b> A systematic search was conducted in PubMed, Embase, Scopus, and other sources for studies published from their inception to August 2023. Studies reporting mortality outcomes in melioidosis patients with and without coinfections were included. Mixed-effects logistic regression models were used to estimate the causal association of each prognostic factor on the outcome. Directed acyclic graphs (DAGs) were used to guide confounding adjustment, and missing data were handled using multiple imputations. <b>Results:</b> A total of 346 studies involving 509 patients were analyzed. Coinfections were observed in 10.8% of patients with tuberculosis and <i>Leptospira</i> spp. being the most common. Disseminated disease significantly increased the odds of death (OR 4.93, 95% CI: 2.14-11.37, <i>p</i> < 0.001). Coinfections were associated with a higher mortality rate, but the association was not statistically significant (OR 2.70, 95% CI: 0.53-13.90, <i>p</i> = 0.172). Sensitivity analyses confirmed the robustness of the findings. Other factors, including diabetes mellitus and agricultural occupation, were evaluated for their associations with mortality. <b>Conclusions:</b> Disseminated melioidosis remains a significant factor influencing prognosis. Although less common, coinfections may contribute to worsen patient outcomes, emphasizing the importance of immediate and accurate diagnosis and comprehensive management.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008841","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}