Epidemiolgia (Basel, Switzerland)最新文献

{"title":"Diabetes Mortality in the Post-Pandemic Era: What Recent Global Burden of Disease Data Reveals About COVID-19's Lasting Impact.","authors":"Kaustubh Wagh, Gerardo Chowell","doi":"10.3390/epidemiologia7030077","DOIUrl":"10.3390/epidemiologia7030077","url":null,"abstract":"<p><p>The COVID-19 pandemic disrupted diabetes care globally and created a complex bidirectional health crisis. Recent forecasting efforts using pre-pandemic data projected substantial increases in diabetes mortality through 2030, raising concerns about achieving Sustainable Development Goal (SDG) 3.4. However, these projections did not account for pandemic-related disruptions to health systems and chronic disease management. The newly released Global Burden of Disease (GBD) 2023 data, covering the pandemic period through 2023, now provide a comprehensive empirical reference for assessing COVID-19's observed impact on diabetes trends. This perspective adopts a forecast reconciliation and interpretation approach by examining counterfactual pre-pandemic diabetes mortality projections alongside GBD 2023 data, thereby shedding light on how pandemic-era mortality diverged from pre-pandemic trajectories. Critically, we note that insulin-dependent diabetes mellitus (IDDM, Type 1) and non-insulin-dependent diabetes mellitus (NIDDM, Type 2) have distinct etiologies and pandemic vulnerabilities, a distinction this article addresses. The evidence is striking: by 2023, global diabetes deaths had already exceeded 2.0 million per year, surpassing the 2030 upper forecast bound of 1.91 million, seven years ahead of the forecast horizon. NIDDM was the primary driver, with deaths crossing 1.9 million per year in 2023. These findings underscore the urgent need to strengthen diabetes prevention and management strategies as the world recovers from the pandemic-era disruptions in health systems and chronic disease care.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320929","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":"COVID-19 and Interacting Public Health Threats in Europe During 2020-2025: A Narrative Review.","authors":"Christos Ntais, Ioanna P Chatziprodromidou","doi":"10.3390/epidemiologia7030078","DOIUrl":"10.3390/epidemiologia7030078","url":null,"abstract":"<p><p>Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020-2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320944","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":"Molecular Detection of Dengue and Malaria Parasites in Field-Collected Mosquitoes from Meta, Colombia: Implications for Vector-Borne Disease Surveillance.","authors":"Carolina Hernández, David Martinez, Marcela Montilla, Marina González-Robayo, Norma Pavas-Escobar, Plutarco Urbano, Omar Cantillo-Barraza, Davinzon Martínez, Catalina Ariza, Luz Helena Patiño, Juan David Ramírez, Liliana Sánchez-Lerma","doi":"10.3390/epidemiologia7030076","DOIUrl":"10.3390/epidemiologia7030076","url":null,"abstract":"<p><strong>Background/objectives: </strong>Vector-borne diseases (VBDs) remain a major global public health challenge, particularly in tropical and subtropical regions. In eastern Colombia, the department of Meta reports a high incidence of arboviral infections such as dengue, as well as parasitic diseases including malaria and leishmaniasis. This study aimed to conduct baseline entomological surveillance and molecular screening of Diptera vectors to detect the circulation of arboviruses and parasitic pathogens in two municipalities of Meta, Fuente de Oro and Vista Hermosa.</p><p><strong>Methods: </strong>Adult mosquitoes and sand flies were collected in both municipalities and identified primarily at the genus level, with <i>Anopheles</i> specimens identified to species level. A total of 790 insects were collected, of which 780 were processed in 148 pools and 10 were analyzed individually. Molecular detection of pathogens was performed using PCR and RT-PCR to screen for dengue virus (DENV) serotypes, Zika virus (ZIKV), Chikungunya virus (CHIKV), Oropouche virus (OROV), <i>Plasmodium</i> spp., and <i>Leishmania</i> spp.</p><p><strong>Results: </strong>DENV was detected in 34.8% (55/158) of the processed pools, with DENV-1 identified as the most prevalent serotype. <i>Culex</i> was the most abundant genus overall, particularly in Fuente de Oro, while <i>Aedes</i> predominated in Vista Hermosa. MIR estimates indicated higher molecular detection likelihood in <i>Aedes</i> compared with <i>Culex</i>. <i>Plasmodium vivax</i> and <i>P. falciparum</i> were detected in pools of <i>Anopheles darlingi</i> and <i>Anopheles rangeli</i>, respectively. No molecular evidence of <i>Leishmania</i> DNA was detected in <i>Lutzomyia</i> specimens, and no positive detections were observed for ZIKV, CHIKV, or OROV.</p><p><strong>Conclusions: </strong>The molecular detection of DENV and <i>Plasmodium</i> spp. in field-collected vectors provides valuable baseline evidence of pathogen circulation in Meta, Colombia. While the findings do not imply vector competence, they highlight the importance of sustained entomological surveillance to inform integrated vector control strategies and guide future studies incorporating species-level identification and longitudinal sampling in endemic regions.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320954","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":"Machine Learning for Coronary Heart Disease Prediction: Comparative Analysis of Framingham and Cleveland Subset of the UCI Dataset with SHAP-Based Interpretability.","authors":"Shreyas Raman, Devansh Thakkar, Jacques Calixte, Rahul Kumar, Kyle Sporn, Kiran Marla, Divyam Goel, Rhea Gopali, Nitin Chetla, Saif Pasha, Nikitha Ravisankar, Ryung Lee, Ciprian Ionita","doi":"10.3390/epidemiologia7030075","DOIUrl":"10.3390/epidemiologia7030075","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, with coronary artery disease (CAD), also known as ischemic heart disease (IHD), responsible for approximately 13% of global deaths in 2021. Studies applying machine learning (ML) and deep learning (DL) to heart disease classification have demonstrated promising results in risk prediction and feature extraction.</p><p><strong>Background/objectives: </strong>In this study, we develop an AI/ML framework to predict and classify ischemic heart disease risk using publicly available datasets, the Framingham Heart Study and the Cleveland subset of the UCI Heart Disease dataset, along with explanations for how predictions were made by a process called SHAP (SHapley Additive exPlanations).</p><p><strong>Methods: </strong>We implemented a leakage-controlled machine learning pipeline that included data cleaning, stratified 80/20 train-test splitting, training-fold-only feature scaling and class balancing, 5-fold hyperparameter tuning, SHAP interpretability, and Brier score-based calibration assessment. Logistic regression, random forest, K-nearest neighbors, XGBoost, and a feedforward neural network were evaluated on the Framingham dataset and the Cleveland subset of the UCI Heart Disease dataset. Performance was assessed using accuracy, precision, recall, F1-score, Matthews correlation coefficient, AUROC, and Brier score.</p><p><strong>Results: </strong>After leakage-controlled evaluation, Framingham performance was more modest than in the preliminary analysis. Logistic regression achieved the highest AUROC on the Framingham dataset (0.7234), while random forest achieved the lowest Brier score (0.1750), and the feedforward neural network achieved the highest accuracy (0.7719). On the Cleveland subset, logistic regression achieved the strongest threshold-based performance (accuracy 0.8667, precision 0.8571, recall 0.8571, F1-score 0.8571, MCC 0.7321), whereas K-nearest neighbors achieved the highest AUROC (0.9531) and lowest Brier score (0.0942). SHAP highlighted systolic blood pressure, smoking status, and hypertension as influential predictors (Framingham) and number of major vessels, chest pain type, thallium stress-test result (thal; normal, fixed defect, or reversible defect), and age (Cleveland) as top predictors.</p><p><strong>Conclusions: </strong>Optimal model performance is dataset-dependent, and SHAP enhances clinical interpretability. Broader access to high-quality, de-identified medical data could accelerate reproducible ML research in cardiology.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320890","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":"Is Excess Mortality Returning to Pre-Pandemic Levels? A Multi-Model Stochastic Approach for COVID-19: The Spanish Case.","authors":"Julio Ibáñez-Soriano, Francisco G Morillas-Jurado","doi":"10.3390/epidemiologia7030074","DOIUrl":"10.3390/epidemiologia7030074","url":null,"abstract":"<p><strong>Introduction: </strong>This study quantifies excess mortality in Spain during and after the COVID-19 pandemic and assesses whether mortality levels are returning to pre-pandemic patterns.</p><p><strong>Methods: </strong>Expected mortality was estimated using stochastic forecasting models calibrated on pre-pandemic data (1990-2019) and compared with observed mortality over the period 2020-2023. The analysis relies on a multi-model framework including the Lee-Carter, Cairns-Blake-Dowd, and age-period-cohort models.</p><p><strong>Results: </strong>The results show a substantial excess mortality during the pandemic years, with the proportion of ages exhibiting punctual excess mortality increasing from around 65% before the pandemic to approximately 85% during 2020-2022. Excess mortality declined sharply in 2023, when indicators returned to levels comparable to those observed prior to COVID-19, suggesting a transition toward near-normal mortality. The Lee-Carter model showed superior short-term performance in detecting abrupt mortality deviations, while APC and CBD models captured longer-term structural patterns.</p><p><strong>Conclusions: </strong>These findings highlight the usefulness of multi-model stochastic approaches for monitoring excess mortality and assessing recovery trajectories following major epidemiological shocks.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320892","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":"Burnout and Insomnia Among Greek Physicians Affiliated with the Athens Medical Association After the Acute Phase of the COVID-19 Pandemic: Prevalence and Contributing Factors.","authors":"Dimosthenis Akrivakis, Dimitrios Lamprinos, Maria Patatoukou, Stavroula Alevizou, Georgios Zoumpoulis, Theodoros Pouletidis, Paraskevi Deligiorgi, Panagiotis Georgakopoulos, Evangelos Oikonomou, Gerasimos Siasos, Kostas A Papavassiliou, Christos Damaskos, Georgios Rachiotis, Dimitrios Schizas, Georgios Marinos","doi":"10.3390/epidemiologia7030073","DOIUrl":"10.3390/epidemiologia7030073","url":null,"abstract":"<p><p><b>Background:</b> The COVID-19 pandemic has been a global crisis, affecting healthcare systems and professionals worldwide. This study investigates the prevalence and factors associated with burnout and insomnia among Greek physicians affiliated with the Athens Medical Association after the acute phase of the COVID-19 pandemic. <b>Methods:</b> Data were collected through an anonymous online survey distributed to active physician members of the Athens Medical Association between 15 June 2023 and 15 July 2023. Burnout was assessed using the Maslach Burnout Inventory (MBI), and insomnia was assessed using the Athens Insomnia Scale (AIS). Descriptive, unadjusted, and multivariable analyses were performed. <b>Results:</b> A total of 1023 physicians participated. Insomnia (AIS ≥ 6) affected 83.0% of the participants. Based on standard MBI cut-offs, 52.4% had high emotional exhaustion, 35.9% had high depersonalization, and 39.2% had low personal accomplishment. In multivariable logistic regression, older age was significantly associated with lower odds of insomnia, while public-sector employment and high concern about future career consequences were associated with higher odds. In multiple linear regression models, a higher AIS total score was significantly associated with higher emotional exhaustion and depersonalization and with lower personal accomplishment. <b>Conclusions:</b> These findings suggest high rates of insomnia and burnout in this physician sample. Greater insomnia was significantly associated with less favorable scores across all three burnout dimensions. Younger age, public-sector employment, and higher concern about future career consequences were associated with insomnia. These findings should be interpreted as associations, rather than causal effects.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13298319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320963","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":"Assessment of Population Immunity to Enteric Hepatitis Viruses in the Population of Belgrade.","authors":"Anna Yurievna Popova, Alesia Yuryevna Olkhovskaya, Luka Dragačević, Yulia Vladimirovna Ostankova, Svetlana Alexandrovna Egorova, Alexander Nikolaevich Schemelev, Darya Tsibulskaya, Ekaterina Vladimirovna Anufrieva, Anastasiya Romanovna Ivanova, Irina Victorovna Drozd, Ojuna Bayarovna Zhimbaeva, Branko Beronja, Jelena Protić, Ekaterina Mikhailovna Danilova, Angelica Marsovna Milichkina, Valeri Andreevich Ivanov, Oleg Vladimirovich Kotsar, Edward S Ramsay, Vyacheslav Yurievich Smolensky, Areg Artemovich Totolian","doi":"10.3390/epidemiologia7030072","DOIUrl":"10.3390/epidemiologia7030072","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis A (HA) and E (HE) represent a significant global health burden. Despite the development of effective vaccines against hepatitis A virus (HAV) and hepatitis E virus (HEV), outbreaks of acute HA and HE continue to occur worldwide. This study aimed to assess the seroprevalence of anti-HAV and anti-HEV IgG antibodies (Abs) in the population of Belgrade and to analyze their association with socio-demographic and clinical factors.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted on a sample of 2533 healthy volunteers in Serbia in May 2024. Participation was voluntary and web-based, leading to an overrepresentation of women and middle-aged adults, while children were underrepresented. Due to this non-probabilistic recruitment, the absolute seroprevalence estimates have limited generalizability to the entire population of Belgrade. Serum samples were tested for anti-HAV and anti-HEV IgG using commercial ELISA kits. The anti-HEV estimate is based on a single ELISA without confirmatory testing and should be interpreted with this limitation in mind. Statistical analysis included confidence interval estimation, chi-square tests, and Spearman's correlation.</p><p><strong>Results: </strong>Overall seroprevalence was 20.5% (95% CI: 18.9-22.1) for anti-HAV and 22.6% (95% CI: 21.0-24.3) for anti-HEV. A strong, non-linear increase in anti-HAV seroprevalence with age was observed, rising sharply from 2.8% in the 18-29 group to 78.3% in those aged 70+. Anti-HEV seroprevalence also featured a significant positive correlation with age (rs = 0.99, <i>p</i> < 0.0001), increasing from 4.2% in children (1-17 years) to 49.2% in the 70+ group. Men had significantly higher anti-HAV seroprevalence than women (23.1% vs. 19.3%, <i>p</i> = 0.029). Individuals with a history of surgical interventions or blood transfusions had significantly higher odds of being anti-HEV positive (OR = 1.41, <i>p</i> = 0.0005). Vaccination coverage against HAV was low (1.8%), and Abs were detected in only 28.6% of vaccinated individuals.</p><p><strong>Conclusions: </strong>This study suggests high HEV seroprevalence and an age-polarized HAV seroprevalence in Serbia, indicating a significant shift in the epidemiological landscape while acknowledging the sampling and assay limitations stated above. The findings underscore a growing population susceptible to HAV and highlight the need for reinforced vaccination strategies, improved diagnostics, and targeted public health interventions.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038336","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":"Influence of Both La Nina and Island Isolation During COVID-19 on the Epidemiology of Infectious Diseases in New Caledonia.","authors":"Pierre-Henri Moury, Ann-Claire Gourinat, Maria Suveges, Méryl Delrieu, Myrielle Dupont-Rouzeyrol, Christophe Menkes, Nathanaëlle Soler, Cécile Cazorla, Antoine Biron, Antoine Flahault, Morgan Mangeas, Nicolas Ray","doi":"10.3390/epidemiologia7030070","DOIUrl":"10.3390/epidemiologia7030070","url":null,"abstract":"<p><p><i>Background and Objectives</i>: New Caledonia, an archipelago in the South Pacific, experienced an unprecedented conjunction of prolonged border closure during the COVID-19 pandemic (2020 to 2022) and marked influence of the El Niño/Southern Oscillation (ENSO). This context provided a unique opportunity to explore how environmental drivers, island isolation, and socio-demographic factors interact to shape infectious disease dynamics. This study aimed to assess the respective and combined effects of climatic variability, travel restrictions, and socio-demographic factors on the dynamics of four priority infectious diseases. <i>Materials and Methods</i>: We retrospectively analysed data from 2017 to 2023 on four infectious diseases: leptospirosis, dengue, influenza, and hepatitis A (HAV). Satellite precipitation data and the Multivariate El Niño/Southern Oscillation Index (MEI) were used. Socio-demographic and economic variables were gathered. Statistical analyses employed descriptive analysis and Generalized Additive Mixed Models to evaluate the associations between climatic events, travel restrictions, and disease circulation using the communal level as a random effect and time (daily) as a spline effect. <i>Results</i>: We analysed 878 cases of leptospirosis, 165 of HAV, 6607 of influenza, and 7377 dengue cases. Influenza was associated with rainfall before lockdown (Odds Ratio (OR) 0.7, Confidence interval 95%, (CI95%), (0.6-0.8)) and disappeared during lockdown but resurged post-reopening losing its meteorological association. Dengue epidemics declined, coinciding with the <i>Wolbachia</i> program and border closure, and were associated with lower MEI (OR 0.78, CI95% (0.6-1) during the 2017 to 2020 period. HAV cases were correlated with the MEI (OR: 1.8, CI95% (1-3.3)). Leptospirosis cases were associated with cumulative rainfall (OR 1.12 (1.1-1.2)) and lower education (OR 1.04, CI95% (1-1.1)) and decreased with water supply (OR 0.7, CI95% (0.5-0.8)). <i>Conclusions</i>: Our findings highlight how climatic conditions, mobility restrictions, and socio-environmental inequities differentially shape infectious disease risks in island ecosystems. These results reinforce the need for integrated One Health surveillance that jointly addresses environmental change, social vulnerability, and infectious disease prevention.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038351","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":"Age-Related Differences in Dietary Intake and Nutritional Status Among Older Adults in Croatia: Results from a National Food Consumption Survey.","authors":"Lidija Šoher, Daniela Čačić Kenjerić, Martina Pavlić, Dunja Ćosić, Ana Ilić, Ivana Rumbak, Jasna Pucarin-Cvetković, Darja Sokolić","doi":"10.3390/epidemiologia7030071","DOIUrl":"10.3390/epidemiologia7030071","url":null,"abstract":"<p><strong>Background/objectives: </strong>Understanding nutrient intake and diet quality in older adults is essential for promoting healthy ageing and quality of life. The aim of the study was to assess dietary intake and nutritional status in two age groups of older adults in Croatia (65-74 years and ≥75 years).</p><p><strong>Methods: </strong>A total of 786 participants aged 65 and older were included in this cross-sectional study. Data from the National food consumption survey (OC/EFSA/DATA/2017/01), based on the EU Menu methodology, were used. Data collection included a general questionnaire, the International Physical Activity Questionnaire, two 24-h recalls or food diaries, and anthropometric measurements. The effects of body mass index and physical activity level on dietary intake were analysed using a general linear model.</p><p><strong>Results: </strong>21.5% of older adults in Croatia had a normal weight, while 78.5% of were classified as overweight or obese. Significant differences were recorded in energy and macronutrient intake between the two age groups. Body mass index was significantly associated with energy (kcal/day), fat intake (g/day), and intake of the meat, poultry, fish and eggs food group in the 65-74 year age group. In the ≥75 year age group, physical activity level showed an effect on energy, carbohydrates, and milk and dairy product intake. Intake of nutrient-dense foods and fluids was below recommendations in both observed groups.</p><p><strong>Conclusions: </strong>The study results, based on a representative sample, provide the first overview of the nutritional status of older adults in Croatia. These findings offer a foundation for public health initiatives and further research on the nutritional status of the older population in Croatia.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038368","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":"How Is Lebanon's Progress Towards Measles Elimination? Review of Surveillance Performance Indicators, 2013-2024.","authors":"Lina Chaito, Pawel Stefanoff, Hawraa Sweidan, May Younes, Mona Albuaini, Nada Ghosn","doi":"10.3390/epidemiologia7030069","DOIUrl":"10.3390/epidemiologia7030069","url":null,"abstract":"<p><strong>Background: </strong>Lebanon adopted the World Health Organization (WHO)'s regional strategic plan (2012-2020) to achieve measles elimination. We aimed to analyze WHO measles surveillance performance indicators to identify areas for improvement.</p><p><strong>Methods: </strong>We reviewed suspected measles and rubella cases notified to the national epidemiological surveillance program between January 2013 and December 2024. A suspected case was defined as any patient with a febrile maculopapular rash or considered clinically compatible by physicians. We assessed notification rates of discarded non-measles/rubella suspected cases, timeliness of investigations within 48 h, completeness of case investigations (demographic and vaccination data), and proportion of cases tested for measles/rubella. Mean proportions and standard deviations were calculated across years and provinces.</p><p><strong>Results: </strong>A total of 6581 suspected cases were reported, predominantly from hospitals (66%). Outbreaks occurred in 2013 (<i>n</i> = 1760), 2018-2019 (<i>n</i> = 1984) and 2023-2024 (<i>n</i> = 346). Outside outbreak years, the notification rate ranged between 0.7 and 1.8 per 100,000 population. Timely investigation was achieved in 72% (±30%) of cases, while adequate investigation reached 52% (±19%). Laboratory testing was performed in 62% (±16%) of cases.</p><p><strong>Conclusions: </strong>Surveillance in Lebanon showed suboptimal sensitivity, a high proportion of hospitalized cases, and variability in completeness of epidemiological and laboratory investigations. Strengthening outpatient reporting and continuous training of healthcare professionals are essential to improve surveillance performance.</p>","PeriodicalId":72944,"journal":{"name":"Epidemiolgia (Basel, Switzerland)","volume":"7 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038298","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}