Frontiers in epidemiology最新文献

{"title":"Density of tobacco retail outlets around school in Lao People's Democratic Republic 2024: a geospatial analysis.","authors":"Shweta Kulkarni, Thanh Cong Bui, Phonepadith Xangsayarath, Khatthanaphone Phangdouangsy, Chanthavy Soulaphy, Khanittha Sengdara, Sydney Martinez, Amanda Janitz, Summer G Frank-Pearce, Laura A Beebe","doi":"10.3389/fepid.2026.1817143","DOIUrl":"10.3389/fepid.2026.1817143","url":null,"abstract":"<p><strong>Introduction: </strong>Exposure to tobacco advertising at tobacco retail outlets (TROs) is associated with smoking initiation among youth. There is limited geospatial evidence on the density of TROs in Lao People's Democratic Republic (PDR), a country with high prevalence of tobacco smoking. This study examined the density and proximity of TROs around schools in two urban districts and one rural district of Vientiane Capital, Lao PDR, using geographic information systems.</p><p><strong>Methods: </strong>We audited 233 TROs around 27 schools between January 19 and February 18, 2024. TROs were mapped within 250 m and 500 m buffers in two urban districts (Chanthabuly and Sissatanak), and 500 m and 1,000 m buffers in one rural district (Naxaithong). Buffer analysis and network analysis estimated TRO density and median walking distances between TROs and schools. We used the Kruskal-Wallis test to determine if TRO density varied significantly in urban districts within two buffers and the chi-square test to examine differences in TRO characteristics based on proximity to schools.</p><p><strong>Results: </strong>TRO density was defined as the number of TROs mapped within a 250 m radius of urban schools and those mapped within 1,000 m radius of rural schools. TRO density was higher within the buffer of 250-500 m in Chanthabuly (median = 12), followed by Sissatanak (median = 3) (<i>p</i> = 0.01). Comparing the two urban districts, the median distance between TROs and schools within the buffer of 250-500 m was significantly less in Sissatanak compared to Chanthabuly (<i>p</i> = 0.04). The shortest distance between an urban school and any TRO (i) without age verification signage was 21.58 m, (ii) with outside cigarette advertisements was 9.95 m, and (iii) selling \"single\" cigarettes was 311.36 m. In the rural district, the TRO density was higher within 500-1,000 m (median = 2) compared to within 500 m (median = 0.5).</p><p><strong>Conclusion: </strong>Within the context of the Lao PDR, our study provides the first geospatial evidence of tobacco retail outlet density in both urban and rural districts of Vientiane Capital, revealing a substantially higher concentration of outlets in urban districts.We also quantified walking distances between schools and outlets violating tobacco control measures, including lack of age verification signage and outdoor cigarette advertising. These findings suggest that stricter regulation of tobacco retail outlets could strengthen tobacco control policy implementation in Lao PDR.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1817143"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267013","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":"Challenges and pitfalls in analyzing, reporting, and interpreting health effects related to occupational and environmental exposures.","authors":"Glinda S Cooper, Martha Powers, Krista Christensen, Suril S Mehta, Ruth M Lunn","doi":"10.3389/fepid.2026.1817746","DOIUrl":"10.3389/fepid.2026.1817746","url":null,"abstract":"<p><p>Occupational and environmental epidemiology play a vital role in efforts to reduce preventable forms of disease and premature mortality worldwide by evaluating disease risk in relation to exposure sources, routes, and levels in a variety of industrial and community settings. There are considerable challenges in measuring these exposures due to wide variations in intensity, frequency, and duration. Because exposure levels and conditions often vary by site, comparing results across studies is also difficult. In this paper, we address these challenges and provide suggestions pertaining to the design, analysis, and reporting of individual studies as well as systemic reviews and meta-analyses. Key recommendations include reporting specific exposure levels within a study population and including quantitative bias assessment to address the impact of exposure measurement error on results within and across studies. These recommendations can improve the reporting quality and utility of occupational and environmental epidemiology, thereby strengthening its role in risk assessment.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1817746"},"PeriodicalIF":2.9,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254737","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":"An epidemiological assessment of the distribution and sociodemographic burden of chronic diseases: a focus on hypertension, diabetes, and cardiovascular conditions.","authors":"Chidimma Evangeline Oliobi, Dawit Getnet Ayele, Knowledge Chinhamu, Temesgen Zewotir, Retius Chifurira","doi":"10.3389/fepid.2026.1715893","DOIUrl":"10.3389/fepid.2026.1715893","url":null,"abstract":"<p><strong>Background: </strong>Chronic diseases remain a major contributor to morbidity and mortality worldwide. Understanding the sociodemographic and behavioral factors associated with these conditions, as well as potential effect modification across population subgroups, is essential for developing targeted prevention strategies.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of nationally representative survey data to examine the associations between sociodemographic and behavioral factors and hypertension, diabetes, and cardiovascular disease (CVD). Survey-weighted multivariable logistic regression models were fitted for each outcome. Restricted cubic splines were used to assess the non-linearity of age. An age × gender interaction term was evaluated, and predicted probabilities were estimated to visualize effect modification. The issue of missing data was addressed using multiple imputation (five imputations). Model discrimination and calibration were assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots.</p><p><strong>Results: </strong>Advancing age was strongly associated with higher odds of all three conditions. Significant age × gender interactions were observed for diabetes and CVD, indicating steeper age-related increases in risk among males compared with females. In contrast, age-related increases in hypertension were similar across genders. Sociodemographic and behavioral factors such as income and BMI were independently associated with cardiometabolic outcomes. Model discrimination was good for hypertension (AUC = 0.80), diabetes (AUC = 0.77), and CVD (AUC = 0.83), with adequate calibration across risk deciles. Sensitivity analyses yielded consistent findings.</p><p><strong>Conclusions: </strong>Cardiometabolic risk is strongly associated with age and sociodemographic and behavioral factors, with important gender differences in age-related trajectories for diabetes and CVD. These findings underscore the importance of accounting for interaction effects in epidemiologic analyses and support age- and gender-tailored prevention strategies at the population level.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1715893"},"PeriodicalIF":2.9,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13236920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201217","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":"Detecting comorbidity patterns in rare disease patients with machine learning.","authors":"Benjamin Mark Connor, Claire Hill, Lu Bai, Amy Jayne McKnight, Anna Jurek-Loughrey","doi":"10.3389/fepid.2026.1765678","DOIUrl":"10.3389/fepid.2026.1765678","url":null,"abstract":"<p><strong>Introduction: </strong>Whilst individually rare, affecting only a small percentage of the population, rare diseases as a whole impact around 6% of the global population (with this number likely an underestimate). Rare diseases are often complex, with specific challenges in diagnosis, management, and treatment due to limited knowledge and research. Rare disease patients have been shown to have more comorbidities compared to those without a rare disease diagnosis. Studying comorbidities in patients with rare diseases is particularly important as these patients may exhibit unique patterns of multiple diseases which are not well understood. Understanding these comorbidity patterns can lead to insights into the etiology and progression of rare diseases, potentially identifying new therapeutic targets and improving clinical management strategies. Additionally, studying comorbidities can help in predicting complications, improving the quality of life of patients, and offering a more comprehensive approach to health care for those affected by rare diseases.</p><p><strong>Methods: </strong>A machine learning based method known as hierarchical clustering was applied to diagnosis data from the UK Biobank to study comorbidity patterns in patients with rare diseases. The results were then compared with patterns detected for the general population.</p><p><strong>Results: </strong>Twelve clusters were identified for the rare disease group, and 14 for the no rare disease group.</p><p><strong>Discussion: </strong>Unique comorbidity patterns were observed for individuals with and without a rare disease diagnosis, highlighting potential priorities for intervention to improve both disease management and patient care.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1765678"},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977666","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":"Seasonal variations in hospital admissions and case-fatality of ischemic stroke: a nationwide analysis of >4.2 million cases in Germany.","authors":"Omar Hahad, Simon-Noah Hakim-Meibodi, Seyed Hamed Rastguye Haghi, Sasan Faridi, Andreas Daiber, Alexandra Schneider, Kathrin Wolf, Nikolaos Nikolaou, Volker H Schmitt, Philipp Lurz, Christine Espinola-Klein, Yafang Cheng, Andrea Pozzer, Jos Lelieveld, Thomas Münzel, Daniel Wollschläger, Lukas Hobohm, Karsten Keller","doi":"10.3389/fepid.2026.1750089","DOIUrl":"10.3389/fepid.2026.1750089","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke is a leading cause of global morbidity and mortality, with seasonal variations potentially influencing both outcomes. While previous studies have suggested a pronounced association of the cold months with increased stroke morbidity and mortality, the evidence remains limited and inconsistent. This study aimed to assess seasonal variations in ischemic stroke hospital admissions and in-hospital case-fatality and complications in Germany over an 18-year period.</p><p><strong>Methods: </strong>This nationwide retrospective analysis included all hospitalizations for ischemic stroke in Germany from 2005 to 2022, using data from the Federal Statistical Office. Patients were categorized by season of hospital admission (winter, spring, summer, autumn). Multivariable logistic regression models were used to assess the association between season and in-hospital case-fatality, adjusting for age, sex, and comorbidities.</p><p><strong>Results: </strong>A total of 4,236,789 ischemic stroke hospitalizations were analyzed. No statistically significant seasonal variation in stroke hospitalization was observed. However, in-hospital case-fatality was significantly higher in winter (7.4%) compared to summer (6.6%, <i>p</i> < 0.001). This seasonal association was independent of patient age, sex, and comorbidities [adjusted odds ratio (OR): 1.140, 95% confidence interval (CI): 1.128-1.152; <i>p</i> < 0.001]. Similar trends were observed in both men (adjusted OR: 1.122, 95% CI: 1.103-1.141; <i>p</i> < 0.001) and women (adjusted OR: 1.112, 95% CI: 1.096-1.128; <i>p</i> < 0.001), without substantial sex-specific differences.</p><p><strong>Conclusion: </strong>While ischemic stroke hospital admissions remained stable across seasons, in-hospital case-fatality was significantly increased during winter compared to summer. These findings highlight the need for targeted seasonal prevention and management strategies. Further research is needed to explore underlying mechanisms and evaluate potential interventions to mitigate excess winter case-fatality among stroke patients.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1750089"},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965754","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":"Malaria antibody responses augment surveillance in low-transmission settings in the Upper River Region, the Gambia.","authors":"Rihana A Aydin, Thomas Keller, Edgard D Dabira, Nuredin Mohammed, Annette Erhart, Chris Drakeley, Umberto D'Alessandro, Gillian Stresman","doi":"10.3389/fepid.2026.1816934","DOIUrl":"10.3389/fepid.2026.1816934","url":null,"abstract":"<p><strong>Introduction: </strong>In low-transmission malaria settings, routine surveillance often fails to detect asymptomatic infections in partially immune populations. P(Detect), defined as the proportion of infections captured by surveillance systems, serves as a proxy for both population immunity and surveillance completeness. We evaluated whether antibody responses to <i>Plasmodium falciparum</i> antigens could classify low vs. high P(Detect) populations and identify surveillance blind spots.</p><p><strong>Methods: </strong>We analyzed data from 5,300 seropositive individuals across 32 villages in The Gambia following mass drug administration. Random forest classification models were used to predict low vs. high P(Detect) groups based on antibody responses to 19 <i>P. falciparum</i> antigens. Analyses were stratified by transmission intensity (<5% and <10% PCR prevalence). Model performance was assessed using precision-recall area under the curve (PR AUC) in held-out test data, and permutation-based variable importance identified key predictive antigens.</p><p><strong>Results: </strong>Models demonstrated strong discrimination between detectability groups, with PR AUCs of 0.92-0.93 in the <5% stratum and 0.89-0.90 in the <10% stratum using a reduced 8-antigen panel. PfSEA, PfMSP1-19, gSG6, and Etramp4.Ag2 were consistently important predictors, though rankings varied by transmission context. Individual antigen models outperformed combined immune score approaches.</p><p><strong>Discussion: </strong>Antibody profiles can identify populations where surveillance underestimates transmission due to immunity. Integrating serological data into surveillance systems may improve detection of hidden reservoirs and support more targeted malaria elimination strategies.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1816934"},"PeriodicalIF":2.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846578","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":"Global prevalence and predictors of depression and anxiety in patients with liver cirrhosis: a systematic review and meta-analysis.","authors":"Omar Abureesh, Araek Al-Shraideh, Joelle Sleiman, Chloe Lahoud, Brendan Plann-Curley, Liliane Deeb","doi":"10.3389/fepid.2026.1740227","DOIUrl":"10.3389/fepid.2026.1740227","url":null,"abstract":"<p><strong>Background: </strong>Liver cirrhosis is a complex disorder that affects nearly 122 million patients worldwide. This study synthesizes global prevalence estimates of depression and anxiety among patients with cirrhosis, together with associated risk factors and geographic distribution.</p><p><strong>Method: </strong>An electronic search was conducted on Medline, Embase, Cochrane Central and Web of Science databases. Results were then filtered according to the inclusion criteria over two stagesData from eligible studies were extracted into a standardized spreadsheet, which was then subjected to analysis and evidence synthesis.</p><p><strong>Results: </strong>Our search yielded 23 articles from countries all over the world describing 979,113 patients.The pooled prevalence was 0.37 [95% C.I. 0.29-0.46, <i>p</i> = 0.01] for depression and of 0.53 [95% C.I. 0.33-0.73, <i>p</i> < 0.010] for anxiety, in cirrhotic patients, however, high heterogeneity was noted. Meta-regression was performed to assess the ability of demographic factors (Ager, Sex), and etiological factors to predict depression in cirrhotic patients. Age, alcoholism, and viral etiologies, were linked to depression incidence. Advancing age was associated with increased depression prevalence among cirrhosis patients (<i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Depression and anxiety substantially impair quality of life in patients with cirrhosis, but their diagnosis remains limited and under-investigated. Standardizing depression and anxiety screening for cirrhosis patients can improve their outcomes and quality of life significantly.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1740227"},"PeriodicalIF":2.9,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824331","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":"Behavioral symptoms of dementia and psychotropic use during the COVID-19 pandemic.","authors":"Jung Min Yoon, Kwame Kissi-Twum, Alison M Trinkoff, T Joseph Mattingly","doi":"10.3389/fepid.2026.1746012","DOIUrl":"10.3389/fepid.2026.1746012","url":null,"abstract":"<p><strong>Background: </strong>As nursing home settings and their residents were severely affected by the COVID-19 pandemic, changes in care practices along with increased social isolation during the pandemic may have increased the prevalence of behavioral and psychological symptoms of dementia (BPSD) and psychotropic medication use in nursing homes.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional study using 2019 and 2020 Minimum Data Set from nursing homes in New York, Utah, and Colorado. The primary outcome was a composite BPSD measure, defined as two or more symptoms among depression, wandering, rejection of care, hallucinations, delusions, or verbal/physical behavioral symptoms. Secondary outcomes included neuropsychiatric sub-syndromes and psychotropic use.</p><p><strong>Results: </strong>From 2019 to 2020, the prevalence of two or more BPSDs increased from 19.0% (95% CI, 18.8-19.2) to 20.2% (95% CI, 20.0-20.5). Increases in BPSD were largely driven by depressive symptoms, which increased by 63%, from 17.4% (95%CI, 17.1-17.6) in 2019 to 28.3% (95%CI, 28.0-28.5) in 2020. Whereas, the prevalence of psychosis-related symptoms changed minimally, from 5.6% (95%CI, 5.5-5.8) to 5.7% (95%CI, 5.5-5.8), and agitation-related symptoms decreased from 30.0% (95%CI, 29.8-30.3) in 2019 to 29.6% (95%CI, 29.4-30.0) in 2020. Antipsychotic and sedative use decreased while antidepressant and antianxiety use remained steady.</p><p><strong>Discussion: </strong>In this study of nursing home residents, the prevalence of BPSD was higher during the COVID-19 pandemic, primarily driven by increased depressive symptoms. These findings underscore the need to strengthen depression screening and mental health support for nursing home residents during public health emergencies such as pandemics.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1746012"},"PeriodicalIF":2.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790952","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":"Hearing loss and incident dementia over 8 years in Black and White older adults: the Atherosclerosis Risk in Communities Neurocognitive Study.","authors":"Jennifer A Deal, John J Shin, Kening Jiang, A Richey Sharrett, Josef Coresh, Rebecca F Gottesman, David S Knopman, Thomas Mosley, Keenan A Walker, Frank R Lin, Nicholas S Reed","doi":"10.3389/fepid.2026.1798451","DOIUrl":"10.3389/fepid.2026.1798451","url":null,"abstract":"<p><strong>Objective: </strong>We investigated potential racial disparities in the effects of audiometric hearing loss and its treatment on dementia and mortality among 3,602 older adults aged 68-89 years, 22% of whom were self-identified Black race.</p><p><strong>Methods: </strong>Adjudicated all-cause dementia was determined using neurocognitive test data, proxy reports, and surveillance of hospital records and death certificates. Audiometric hearing loss, defined as the better-ear averaged pure-tone threshold (0.5-4 kHz), was categorized using clinical cutpoints. Multivariable-adjusted Cox proportional hazards models included hearing loss-race interaction terms.</p><p><strong>Results: </strong>Dementia risk associated with moderate-to-severe hearing loss did not differ by race [Black participants: hazard ratio (HR): 1.66; 95% confidence interval (CI): 1.05, 2.61; White participants: HR: 1.71; 95% CI: 1.16, 2.51; <i>P</i>-interaction = 0.92]. However, moderate-to-severe hearing loss was associated with a 2.3-fold increase in mortality among Black participants only (95% CI: 1.17, 4.60).</p><p><strong>Conclusions: </strong>Our findings emphasize the importance of including minoritized populations in hearing treatment research to build an evidence base for policy development and clinical decision-making. Hearing loss affects the health of both Black and White Americans. Racial disparities in hearing healthcare should be addressed to advance health equity for all older adults.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1798451"},"PeriodicalIF":2.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790946","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":"Epidemiology of hepatitis A in Saudi Arabia: a retrospective analysis of Ministry of Health surveillance and yearbook data, 2006-2023.","authors":"Ibrahim G Alghamdi","doi":"10.3389/fepid.2026.1717102","DOIUrl":"10.3389/fepid.2026.1717102","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the epidemiology of hepatitis A virus (HAV) infection in Saudi Arabia from 2006 to 2023, focusing on temporal, demographic, and geographic variations in incidence. The aim was to characterize long-term national trends and identify high-risk subgroups to inform prevention strategies.</p><p><strong>Methods: </strong>National HAV surveillance data were obtained from the Saudi Ministry of Health Statistical Yearbooks. Crude incidence rates (CIRs) were calculated using mid-year population estimates. Temporal trends were assessed via Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Regional differences were analyzed with negative binomial regression using Riyadh as the reference. Group comparisons employed nonparametric tests, with statistical significance set at <i>α</i>=0.05.</p><p><strong>Results: </strong>Between 2006 and 2023, 9,820 HAV cases were reported (mean 546/year). National CIR declined from 11.1 per 100,000 in 2006 to 0.48 in 2023, with an AAPC of -19.5% (95% CI -24.2 to -14.4; <i>p</i> < 0.001). Children aged 5-14 years bore the highest burden (53.5% of cases). Significant regional heterogeneity was observed, with persistently higher CIRs in Najran and Qurayyat, while urban centers showed lower, stable rates. Negative binomial regression identified higher adjusted risks in Qurayyat (IRR 2.89) and Najran (IRR 2.52). Saudis initially showed higher incidence than non-Saudis, but rates converged by 2023. Males consistently outnumbered females (ratio ∼1.6).</p><p><strong>Conclusion: </strong>HAV incidence in Saudi Arabia has markedly declined over the past two decades, reflecting improved sanitation and public health measures. This decline may, in part, reflect the impact of the national hepatitis A vaccination program introduced in 2008. However, age-, region-, and nationality-specific disparities remain, underscoring the need for geographically tailored interventions and consideration of targeted vaccination strategies to sustain progress and prevent resurgence.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"6 ","pages":"1717102"},"PeriodicalIF":2.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693762","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}