Frontiers in epidemiology最新文献

{"title":"Identifying and resolving ethical challenges related to the enrollment of black individuals with chronic kidney disease in U.S. health registries and clinical research: a qualitative study.","authors":"Henry Asante Antwi, Adaeze Aroh, Deidra Crews, Rodney Elliot, Nicole Huillca, C Daniel Mullins, Mehar Sandhu, Abdou Simon Senghor","doi":"10.3389/fepid.2026.1753620","DOIUrl":"https://doi.org/10.3389/fepid.2026.1753620","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) disproportionately impacts Black individuals. This disparity, coupled with historical and ongoing injustices in medical research, raises significant ethical concerns that may hinder participation in health registries and clinical research, which are critical for advancing patient-centered kidney care. This study sought to identify key ethical challenges from the perspective of Black individuals with CKD to enhance their meaningful and equitable engagement.</p><p><strong>Methods: </strong>We employed a qualitative approach guided by a pragmatist bioethical framework. We conducted three virtual town hall meetings with a sample of 24 self-identified Black adults with CKD and their caregivers, recruited from the Baltimore Metropolitan Area. Data were analyzed using thematic analysis. To ensure rigor, we employed intercoder reliability checks and member-checking with participants and a Community Advisory Board.</p><p><strong>Results: </strong>Six primary ethical areas emerged: (1) lack of transparent communication, (2) distrust in the research enterprise, (3) experiences of stigmatization and discrimination, (4) cultural insensitivity, (5) lack of respect and civility, and (6) potential harm from poor-quality staff. Participants proposed and prioritized actionable solutions, including implementing mandatory transparent communication policies, enhancing community-engaged outreach, enforcing anti-discrimination legislation, providing cultural competency training for staff, and establishing rigorous quality control measures with patient input.</p><p><strong>Conclusion: </strong>Addressing these multi-faceted ethical challenges through targeted, trust-building strategies is essential to enhance the participation of Black individuals in health registries and clinical studies. This, in turn, can lead to more equitable representation in kidney research and more generalizable findings to reduce CKD disparities.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1753620"},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898318","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":"Adverse drug events in hospitalized COVID-19 patients: a pharmacovigilance perspective on ICU management and fentanyl exposure.","authors":"Michele Ferreira Murgel, Marcel de Souza Borges Quintana, Roberta Olmo Pinheiro, Vítor Santos da Silva, Cláudia Luciana Dos Santos Moura, Vanessa da Gama Oliveira, Cláudia Maria Valete Rosalino, Gilberto Marcelo Sperandio da Silva","doi":"10.3389/fepid.2026.1770145","DOIUrl":"10.3389/fepid.2026.1770145","url":null,"abstract":"<p><strong>Background: </strong>Pharmacovigilance is the science and practice aimed at detecting, assessing, understanding, and preventing adverse drug events (ADEs). During the COVID-19 pandemic, a wide range of medications - suchasantivirals, corticosteroids, anticoagulants, immunomodulators, and sedatives - were used during respiratorysupport. Reports of hepatotoxicity, cardiotoxicity, renal impairment, and neurological effects underscored the need for systematic safety monitoring. Since 2012, our research group has been monitoring the clinical use of various prescriptions at the National Institute of Infectious Diseases in Brazil. In this study, we aimed to evaluate factors associated with adverse drug events in hospitalized COVID-19 patients,with emphasis on ICU management practices, polypharmacy and fentanyl exposure.</p><p><strong>Methods: </strong>This observational study was conducted between March and September 2021 and included patients with a positive molecular test for SARS-CoV-2. Sociodemographic characteristics, including age, sex, educational level, and family income, as well as medical history such as hypertension, diabetes, obesity, dyslipidemia, fever, cough, dyspnea, and anosmia, were collected. Clinical data on hospitalizations, commonly prescribed medications, length of stay in intensive care units, vaccination status, oxygen supplementation, type of respiratory support, deaths, and oxygen saturation were also recorded. All adverse reactions were classified using a validated algorithm and standard terminology, and patients were followed until discharge or death. Data were initially collected on paper forms and subsequently entered into an electronic data capture platform. Associations between patient characteristics, treatments, and adverse reactions were analyzed using Poisson regression, with statistical significance set at <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Among 113 patients, 110 experienced at least one adverse event, totaling 411 events. The mean age was 56.5 years; 54.9% were male, 53.1% had hypertension, 28.3% had diabetes, 22.2% had received at least one vaccine dose, and 17.7% died. Higher rates of adverse events were observed among intubated patients and those who received fentanyl, which is commonly used during the intubation process.</p><p><strong>Conclusions: </strong>In this study, intubation and fentanyl use were associated with higher rates of ADEs. These findings should be interpreted cautiously given the severity of illness, ICU sedation practices, and the possibility of confounding by indication. Therefore, active pharmacovigilance strategies may contribute to improved medication safety in critically ill populations.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1770145"},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876442","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":"High prevalence of human coronaviruses in rural and urban Ghana in the post-COVID-19 era.","authors":"Elvis Suatey Lomotey, Martin Montiel-Ruiz, Daniel Adjei Odumang, Elizabeth Obeng-Aboagye, Florence Biamah Amakye, Joseph Annan Hayford, Bernard Aniakwo Logonia, Katharina Röltgen, Irene Owusu Donkor","doi":"10.3389/fepid.2026.1874054","DOIUrl":"10.3389/fepid.2026.1874054","url":null,"abstract":"<p><p>The prevalence and distribution of endemic human coronaviruses (HCoVs) in Ghana remain poorly characterized, particularly in the post-COVID-19 pandemic era. We conducted a cross-sectional molecular and serological survey of 1,000 individuals from five rural and five urban communities in Ghana to assess the prevalence of HCoVs. Reverse transcriptase real-time PCR (RT-qPCR) assays targeted SARS-CoV-2, HCoV-OC43, HCoV-HKU1, HCoV-NL63, and HCoV-229E, while serological assays evaluated IgG antibody responses against SARS-CoV-2, SARS-CoV-1, MERS-CoV, HCoV-OC43, HCoV-HKU1, HCoV-NL63, and HCoV-229E Spike proteins. A broad pan-coronavirus RT-qPCR assay detected HCoV RNA in 6.7% of participants, with SARS-CoV-2 as the most frequent, followed by HCoV-229E, HCoV-HKU1, and HCoV-OC43; HCoV-NL63 was not detected. Serological analyses revealed widespread exposure to SARS-CoV-2, HCoV-OC43, HCoV-229E, and HCoV-HKU1, with a low seroprevalence for HCoV-NL63. Our findings demonstrate ongoing co-circulation of multiple HCoVs in both rural and urban settings in Ghana post Covid-19, suggesting sustained community transmission, increased potential for co-infection, and the need for continued surveillance of endemic and emerging respiratory viruses. The data provides rare insights into the epidemiology of HCoVs in West Africa.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1874054"},"PeriodicalIF":2.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815106","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 impact of body mass index on health service utilization among pilgrims: a comprehensive analysis.","authors":"Fahad Alamri, Reem Hasan, Areej Alshamrani, Lamis Al Abdulatif, Jumanah Alhazmi, Mariyyah Alburayh, Abrar Alkhashi, Hala Aljishi, Ahmed ElGanainy, Sami M Alsaedi, Ayman Banjar","doi":"10.3389/fepid.2026.1769947","DOIUrl":"10.3389/fepid.2026.1769947","url":null,"abstract":"<p><strong>Background: </strong>Body Mass Index (BMI), a measure based on weight and height, is a key indicator for assessing health status and the risk of chronic diseases such as hypertension, diabetes, and cancer. Both ends of the BMI distribution have been associated with greater healthcare utilization, with prior evidence in general populations suggesting a non-linear (U-shaped) association in which underweight and obese individuals use more healthcare services than those with normal weight. This relationship is particularly important during mass gatherings like the Hajj pilgrimage, where overcrowding, extreme heat, and physical exertion can amplify health risks. This study aimed to investigate how variations in BMI influence clinic visits, hospital stays, and diagnoses among pilgrims during Hajj.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 4,000 pilgrims randomly selected from the official Hajj registry during the 2024 (1445 H) season. BMI was modelled as a categorical variable (<18.5, 18.5-24.9, 25-29.9, and ≥30 kg/m²), with the normal-weight category as the reference, allowing detection of non-linear (U-shaped) associations. Outcomes were clinic visit (yes/no), hospital admission (yes/no), and primary diagnosis, all collected using a standardized data collection form. Crude and adjusted odds ratios (cOR, aOR) with 95% confidence intervals and exact p-values were estimated using multiple logistic regression, adjusting simultaneously for age, gender, education, WHO region, marital status, employment, and smoking.</p><p><strong>Results: </strong>Underweight (BMI <18.5) and obese (BMI ≥30) pilgrims reported higher rates of clinic visits (9% and 10%, respectively) and higher rates of hospital admission than normal-weight and overweight pilgrims, confirming a U-shaped association between BMI and healthcare utilization. The most frequent diagnoses were heat-related illnesses (75% of admissions among underweight, 76% among obese), followed by chronic-disease follow-up, particularly at BMI extremes. In the adjusted analyses, WHO region and employment status remained significantly associated with clinic visits, with lower odds among pilgrims from South-East Asia and higher odds among unemployed individuals with BMI <18.5.</p><p><strong>Conclusion: </strong>Both low and high BMI are linked to greater healthcare utilization during Hajj. Implementing targeted risk assessments, pre-travel health education, and culturally adapted healthcare services for BMI extremes may reduce acute healthcare demand during mass gatherings.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1769947"},"PeriodicalIF":2.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815051","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":"Mixed-strain infection and heteroresistance in drug-resistant tuberculosis: insights from a whole-genome sequencing pilot.","authors":"Mandlenkosi Manika, Lindiwe Modest Faye, Ntandazo Dlatu, Mojisola Clara Hosu, Teke Apalata","doi":"10.3389/fepid.2026.1813571","DOIUrl":"https://doi.org/10.3389/fepid.2026.1813571","url":null,"abstract":"<p><strong>Background: </strong>Mixed-strain <i>Mycobacterium tuberculosis</i> (<i>M.</i> tuberculosis; Mtb) infections and heteroresistance are increasingly recognized as under-detected contributors to drug resistance dynamics. In high-burden rural settings such as the Eastern Cape, these genomic features may reflect both within-host diversity and ongoing transmission. However, their epidemiological and clinical implications remain incompletely understood, particularly in contexts with high HIV co-infection.</p><p><strong>Methods: </strong>We conducted an exploratory whole-genome sequencing (WGS) analysis of 28 drug-resistant <i>M.</i> tuberculosis isolates obtained through routine diagnostic workflows. Mixed-strain candidacy was defined using a composite genomic criterion, including multi-lineage assignments, ≥2 heteroallelic variants [allele frequency (AF): 0.10-0.90], or heteroresistance across multiple drug classes. A Random Forest (RF) model with Leave-One-Out Cross-Validation (LOOCV) was used as a feature-prioritization tool to identify genomic characteristics associated with mixed-strain candidacy. Given the limited sample size, analyses were designed to generate hypotheses rather than support causal inference. Clinical and epidemiological metadata, including HIV status and treatment outcomes, were not available.</p><p><strong>Results: </strong>Lineage 4 (46%) and Lineage 2 (43%) predominated, with 10.7% of isolates classified as probable mixed-strain candidates. Heteroallelic variants were most frequently observed in <i>fabG1/inhA</i> and <i>rpoB</i>, with a median AF of 0.22, consistent with subclonal diversity and possible within-host microevolution. Additional heteroallelic variants were identified in non-resistance-associated genes, suggesting broader genomic heterogeneity. The RF model demonstrated high discriminatory performance (AUC = 1.00), although this likely reflects the small sample size and should be interpreted cautiously. Feature importance analysis identified heteroresistance burden as the most prominent predictor of mixed-strain candidacy.</p><p><strong>Conclusion: </strong>This pilot study provides preliminary genomic evidence of mixed-strain infection and heteroresistance in a high-burden rural setting. While these findings highlight the potential role of subclonal diversity in shaping resistance patterns, their clinical and epidemiological relevance remains uncertain due to the absence of patient-level data and limited sample size. Future studies integrating genomic, clinical, and epidemiological data in larger cohorts and incorporating benchmarking against established tools are required to validate these findings and clarify their implications for tuberculosis control.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1813571"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802502","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":"Sociodemographic determinants and prevalence of metabolic risk factors and the metabolic syndrome among women aged 20-49 in kirinyaga county, Kenya.","authors":"Umotho Kinya Mbae, Florence Kyallo, Dorothy Othoo, Zipporah Ndungu, Beatrice N Kiage Mokua, Vincent Were","doi":"10.3389/fepid.2026.1807836","DOIUrl":"https://doi.org/10.3389/fepid.2026.1807836","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, Noncommunicable diseases (NCDs) contribute to 75% of all deaths. The precursors to the development of NCDs include the metabolic syndrome (MetS) and key metabolic risk factors outlined by the World Health Organisation, including overweight/obesity, raised blood pressure, hyperglycemia, and hyperlipidemia. Women in Kirinyaga County in Kenya have the highest prevalence of overweight and obesity at 64.6%, and hypertension at 20%, as per the 2022 Kenyan Demographic Health survey; however, data on MetS, hyperglycemia, and hyperlipidemia in Kirinyaga is scarce. Therefore, this study aimed to determine the relationship between sociodemographic determinants and the prevalence of metabolic risk factors and the metabolic syndrome among women aged 20-49 years in Kirinyaga County, Kenya.</p><p><strong>Methods: </strong>A cross-sectional study design was employed, and multi-stage sampling was used to select 425 women aged 20-49 years in Kirinyaga County, Kenya. Data were collected on sociodemographic determinants and anthropometric and biochemical measurements. Data analysis was conducted using STATA version 17, frequencies, proportions and binary logistic regression. A total of 425 women participated in the study.</p><p><strong>Results: </strong>The prevalence of MetS was 46.4%; 68.87% were obese or overweight; central obesity, measured by waist circumference, was 79.3%, and by waist-hip ratio, 51.06%. Diabetes was at 8.56%, elevated blood pressure at 22.6%, elevated triglycerides at 17.2%, Low HDL-C at 68.6%, and elevated cholesterol at 7.5%. The primary determinants of metabolic health were wealth and age. Increasing age (<i>p</i> > 0.05) elevated the odds of having all risk factors for NCDs and metabolic syndrome, except low HDL cholesterol. Women in the highest wealth quintile had increased odds of obesity (AOR = 1.83, <i>p</i> = 0.036), elevated triglycerides (AOR = 2.22, <i>p</i> = 0.035), and metabolic syndrome (AOR = 1.79, <i>p</i> = 0.040). However, being a student reduced the odds of metabolic syndrome (AOR = 0.24, <i>p</i> = 0.047). Hormonal contraceptive use, on one hand, was associated with reductions in hypertension (AOR = 0.32, <i>p</i> < 0.001), but was a significant risk factor for low HDL cholesterol (AOR = 2.08, <i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>The study reveals a high prevalence of both metabolic syndrome and metabolic risk factors linked to noncommunicable diseases, mainly driven by ageing, multi-parity, and economic affluence. Public health interventions need to focus on wealth-associated lifestyle behaviours.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1807836"},"PeriodicalIF":2.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802448","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":"Editorial: Mapping the unseen: advancements and innovations in spatial epidemiology for disease dynamics and public health interventions.","authors":"Wei Wang, Pengpeng Ye","doi":"10.3389/fepid.2026.1934467","DOIUrl":"https://doi.org/10.3389/fepid.2026.1934467","url":null,"abstract":"","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1934467"},"PeriodicalIF":2.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765400","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":"Dynamic trajectories in visual function and fall risk in older adults.","authors":"Alan Y Huang, Riaz Qureshi, Ali G Hamedani","doi":"10.3389/fepid.2026.1910165","DOIUrl":"10.3389/fepid.2026.1910165","url":null,"abstract":"<p><strong>Purpose: </strong>Visual impairment is associated with falls in older adults, but whether changes in vision alter this risk is unclear.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries aged ≥65 years. Distance acuity, near acuity, and contrast sensitivity were measured in 2022 and 2023. Change from 2022-2023 was calculated and categorized as stable (to ±0.1 logMAR), improving, or worsening. Using multivariable survey-weighted logistic regression, we compared the following fall-related outcomes in 2024: any fall in the last month, any fall in the last year, or multiple falls in the last year.</p><p><strong>Results: </strong>Among 6,327 eligible participants, distance acuity trends from 2022-2023 were stable in 50.3%, improved in 19.5%, and worsened in 30.2%. Similar patterns were observed for near acuity and contrast sensitivity. Worsening distance acuity was associated with higher odds of a fall in the past year (aOR 1.44, 95% CI 1.03-2.02), and worsening near acuity was associated with higher odds of a fall in the last month (aOR 1.44, 95% CI 1.3-2.02). Improvements in distance acuity, near acuity, and contrast sensitivity from 2022-23 were not associated with lower odds of falls in 2024.</p><p><strong>Conclusions: </strong>Worsening vision is associated with an increased risk of falls, but improving vision does not appear to reduce this risk. These findings suggest that while efforts to improve vision may not prevent falls, preventing a decline in visual function may help to reduce fall risk.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1910165"},"PeriodicalIF":2.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708617","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":"High prevalence of Q fever among patients clinically diagnosed with brucellosis in a Kenyan pastoralist community.","authors":"Esther Lemarkoko, Pauline Gitonga, Stanley Kang'ethe, Aggrey Keya, Luciano Wairungu, Ryan Musasia, Brian Ogoti, Richard Bowen","doi":"10.3389/fepid.2026.1824266","DOIUrl":"10.3389/fepid.2026.1824266","url":null,"abstract":"<p><p><i>Coxiella burnetii</i> is a zoonotic bacterial agent responsible for Q fever in both humans and animals. Ruminants are the most common livestock species associated with Q fever infections in humans. The disease presentation in humans range from asymptomatic, non-specific symptoms to fatal illness. In Kenya, no healthcare indicators seek to clinically diagnose and report Q fever because there are no readily available diagnostic technologies. We conducted a prospective observational study with paired serological sampling leveraging on the existing equipment in the Kajiado County referral laboratory to demonstrate antibodies to <i>Coxiella burnetii</i> in sera of febrile patients presenting with Brucella-like symptoms using the indirect immunofluorescent assay (IFA) and a fluorescent microscope provided for diagnosis of tuberculosis. A total of 100 paired blood samples were obtained from consenting and assenting study subjects. A pilot-tested questionnaire was used to collect patient's socio-demographic information, knowledge of Q fever disease, and community practices that put them at risk of exposure. <i>Coxiella burnetii</i> phase I (IgG) and phase II (IgM) antibodies were characterized, while Brucella spp. IgG antibodies were demonstrated using an indirect enzyme-linked immunosorbent assay (iELISA) and febrile Brucella agglutination test (FBAT). The overall seroprevalence of <i>C. burnetii</i> IgG and IgM antibodies was 49% and 27%, respectively, compared to only 13% reactivity with Brucella ELISA. Q fever prevalence substantially exceeded that of brucellosis in patients presenting with brucellosis-like symptoms in this pastoral community, suggesting a substantial burden of undiagnosed Q fever.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1824266"},"PeriodicalIF":2.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708671","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 military employment associated with the risk of cognitive impairment in older adult? Evidence from China.","authors":"Ren-Ping Gu, Wen-Bao Liu, Xiang-Dong Peng, Ai-Yong Zhu","doi":"10.3389/fepid.2026.1873441","DOIUrl":"10.3389/fepid.2026.1873441","url":null,"abstract":"<p><strong>Background: </strong>It remains unknown whether a link exists between military employment and alterations in cognitive function later in life.</p><p><strong>Aim: </strong>To examine the association between military employment and cognitive impairment in adults.</p><p><strong>Methods: </strong>Chinese Longitudinal Healthy Longevity Survey data from 2018 were retrospectively analyzed. The participants included Chinese military veterans and non-veterans aged ≥65 years. Veteran status was defined according to the self-reported prior service as uniformed military personnel in the armed forces. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination. Nearest neighbor caliper matching without replacement was conducted to generate matched pairs. Binary logistic regression models were used to examine the association between military employment and cognitive impairment in the matched cohort, with adjustments for age, sex, education level, marital status, current smoking status, and chronic disease history. To assess the robustness of the findings, sensitivity analyses were conducted by defining cognitive impairment according to higher education-specific cut-off values.</p><p><strong>Results: </strong>Data from 102 matched pairs were analyzed. The logistic regression analyses demonstrated that military employment was not significantly associated with the risk of cognitive impairment (odds ratio (OR) [95% confidence interval (CI)]: 0.61 [0.24-1.55). The sensitivity analyses yielded similar results.</p><p><strong>Conclusions: </strong>There was no evidence to suggest military employment affected the risk of cognitive impairment later in life in this Chinese cohort. Nevertheless, owing to the high prevalence of impaired cognition among Chinese veterans, it remains an important health condition requiring further study.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1873441"},"PeriodicalIF":2.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686896","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}