Frontiers in epidemiology最新文献

{"title":"Genetic and biomarker modulation of arterial stiffness change in the SardiNIA population cohort","authors":"N. Asefa, O. Meirelles, Edward Lakatta, E. Fiorillo, A. Scuteri, F. Cucca, Michele Marongiu, A. Delitala, D. Schlessinger, L. Launer","doi":"10.3389/fepid.2023.1295209","DOIUrl":"https://doi.org/10.3389/fepid.2023.1295209","url":null,"abstract":"Arterial stiffness (AS), quantified by pulse wave velocity (PWV), arises due to impaired arterial elastic tissue and smooth muscle dysfunction. We aimed to examine the longitudinal association of genetic, lipid and inflammation biomarkers with PWV and how these associations may change with aging.We utilized genotype and four time-point biomarker data from the SardiNIA cohort [n = 6,301; mean baseline age 43.3 (SD 17.3); 58% females]. To investigate the association of PWV with genetic variants, lipid, and inflammation biomarkers, we employed linear mixed modeling, using age as the time scale. Biomarkers exhibiting significant longitudinal associations were categorized into tertiles and individuals within the second tertile or those with heterozygous alleles were excluded, leaving a cohort of 2,000 individuals. This cohort was further divided into four risk groups: low genetic and low biomarker (L-L), low genetic and high biomarker (L-H), high genetic and low biomarker (H-L), and high genetic and high biomarker risk (H-H). Subsequent analyses focused on these risk groups to assess their association to PWV with time.Using the complete dataset, we found a significant longitudinal association of total cholesterol (TC), triglycerides (TG), fibrinogen (FGN), and total white blood cell count (TWBC) with PWV, all with p < 3.33 × 10−3. After grouping, individuals with homogeneous risk alleles of SNP rs3742207 and high baseline TG levels (H-H group) exhibited a 1.39-fold higher PWV (m/s) (95% CI, 1.17–1.64, p = 1.21 × 10−4) compared to the L-L group. Similarly, individuals in the H-H group of rs3742207-TWBC combination showed 1.75 times higher PWV (95% CI, 1.48–0.2.07, p = 1.01 × 10−10) compared to the L-L group. Similar patterns were observed for groups based on SNP rs7152623-TWBC risk. Furthermore, these associations became more pronounced with increasing age (p < 3.33 × 10−3).The longitudinal association of TG and TWBC biomarkers with PWV varied by SNPs rs3742207 and rs7152623 genotype. Further studies are warranted to investigate the function of genetics, lipids, and inflammation biomarkers on PWV change.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"31 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of asymptomatic cytomegalovirus (CMV) infection in newborns in northeast Florida","authors":"R. Alissa, Nizar Maraqa, Patty D. Williams, Jennifer A. Hipp, Sfurti Nath, Nicole S. Torres, Tiffany Lee, Amr Matoq, Mobeen Rathore","doi":"10.3389/fepid.2023.1270374","DOIUrl":"https://doi.org/10.3389/fepid.2023.1270374","url":null,"abstract":"Congenital cytomegalovirus (CMV) infection is the leading cause of hearing loss and neurocognitive delay among children. Affected infants may be asymptomatic at birth and even pass their universal hearing screen. Early identification of CMV-infected infants will allow earlier detection, evaluation and management. The prevalence of congenital CMV infection in the developed world varies geographically from 0.6% to 0.7% of all deliveries and certain regions are at higher risk. The prevalence of congenital CMV is unknown for our region.The purpose of this study was to determine the prevalence of CMV infection among the neonatal population at an urban, tertiary hospital in northeast Florida which serves a large population of patients with low socioeconomic status to assess if universal screening program for congenital asymptomatic CMV infection can be determined.The study was submitted and approved by our Institutional Review Board. We tested the urine for CMV infection in 100 asymptomatic newborns (>32 weeks gestational age and >1,750 g weight at the time of delivery) delivered between June 2016 and July 2017.Urine CMV was tested on 100 infants. One infant had a positive urine NAAT for CMV, making the prevalence of congenital CMV infection among asymptomatic newborns in our hospitals' population 1%.CMV prevalence in our setting of an urban, tertiary hospital is relatively consistent with the national average of all congenital CMV infections. A policy of universal screening for congenital CMV may be necessary.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"59 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal carriage and genetic characteristics of carbapenem-resistant enterobacterales among adults from four provinces of China","authors":"Yuanyuan Li, Lan Ma, Xinying Ding, Rong Zhang","doi":"10.3389/fepid.2023.1304324","DOIUrl":"https://doi.org/10.3389/fepid.2023.1304324","url":null,"abstract":"Carbapenem-resistant Enterobacterales (CRE) is a global concern. This study investigated the prevalence of fecal colonization carriage and clonal dissemination of CRE among population in four provinces of China. A total of 685 stool samples were collected from four provinces in China. Among these samples, 141 and 544 were obtained from healthy and hospitalized individuals, respectively. The overall fecal carriage rate was 9.6% (65/685) with 4.26% (95% CI: 0.9–7.6) in healthy individuals and 10.84% (95% CI: 8.2–13.5) in hospitalized patients. The highest prevalence was in Henan province (18.35%, 95% CI: 9%–18.7%). Sixty-six CRE isolates were identified in Escherichia coli (56.06%, 37/66), Klebsiella (15.15%, 10/66), Citrobacter (13.63%, 9/66), Enterobacter (12.12%, 8/66), and Atlantibacter (1.51%, 1/66). All CRE strains carried carbapenemase genes and multiple antibiotics resistance genes, blaNDM−5 (77.27%, 51/66) was the most common carbapenemase gene, followed by blaNDM−1 (19.69%, 13/66). Antibiotic resistance genes, including blaIMP−4, and the colistin colistin resistance (mcr-1) gene were also identified. All CRE isolates belonged to different sequence types (STs). ST206 (36.84%, 14/38) in E. coli and ST2270 (60%, 6/10) in Klebsiella were significantly dominant clones. The results indicated the prevalence of CRE fecal carriage among adults of China, mostly blaNDM-producing E coli, which pose significant challenges for clinical management. Screening for CRE colonization is necessary to control infection.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"34 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139388678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A community health promotion project: Amazing Race for Heart Health","authors":"Jessica A. Reese, Carla Guy, Halana Jay, T. Ali, Elisa T. Lee, Ying Zhang","doi":"10.3389/fepid.2023.1278672","DOIUrl":"https://doi.org/10.3389/fepid.2023.1278672","url":null,"abstract":"American Indians have higher rates of cardiovascular disease (CVD), likely due to disproportionate burden of diabetes and limited access to widespread CVD prevention programs such as Honoring the Gift of Heart Health (HGHH), a 10-week CVD risk factor awareness curriculum. Due to its length, HGHH may be difficult to complete; therefore, we aimed to evaluate a shortened CVD risk factor awareness program based on the HGHH educational materials for American Indians residing in southwest Oklahoma, entitled “The Amazing Race for Heart Health.”We conducted an interventional study where each participant served as their own control (n = 61), with pre- and post-intervention measurements. We included American Indians from seven tribal nations in southwest Oklahoma. At two interventional meetings we used educational materials and activities from HGHH focusing on nutrition, cholesterol, diabetes, hypertension, physical activity, and heart attack warning signs. McNemar's test was used to determine the effectiveness of the intervention on raising CVD risk factor awareness.When comparing the pre- and post-survey responses, the percentage of correct responses either stayed the same or increased. Knowledge improved in 11/25 (44%, p < 0.05) domains including the difference between good and bad cholesterol and types of physical activity that can prevent CVD. When considering diabetes, knowledge increased regarding the interaction between diabetes and cholesterol in the association with CVD.These results demonstrate that the “Amazing Race for Heart Health,” a shortened CVD risk factor educational program based on the HGHH educational materials, was effective at increasing awareness regarding CVD risk factors.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"15 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Greedy knot selection algorithm for restricted cubic spline regression","authors":"J. Arnes, Alexander Hapfelmeier, Alexander Horsch, Tonje Braaten","doi":"10.3389/fepid.2023.1283705","DOIUrl":"https://doi.org/10.3389/fepid.2023.1283705","url":null,"abstract":"Non-linear regression modeling is common in epidemiology for prediction purposes or estimating relationships between predictor and response variables. Restricted cubic spline (RCS) regression is one such method, for example, highly relevant to Cox proportional hazard regression model analysis. RCS regression uses third-order polynomials joined at knot points to model non-linear relationships. The standard approach is to place knots by a regular sequence of quantiles between the outer boundaries. A regression curve can easily be fitted to the sample using a relatively high number of knots. The problem is then overfitting, where a regression model has a good fit to the given sample but does not generalize well to other samples. A low knot count is thus preferred. However, the standard knot selection process can lead to underperformance in the sparser regions of the predictor variable, especially when using a low number of knots. It can also lead to overfitting in the denser regions. We present a simple greedy search algorithm using a backward method for knot selection that shows reduced prediction error and Bayesian information criterion scores compared to the standard knot selection process in simulation experiments. We have implemented the algorithm as part of an open-source R-package, knutar.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"16 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139172797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A stronger association of depression with rheumatoid arthritis in presence of obesity and hypertriglyceridemia.","authors":"Grayden Shand, Daniel T Fuller, Leon Lufkin, Carly Lovelett, Nabendu Pal, Sumona Mondal, Shantanu Sur","doi":"10.3389/fepid.2023.1216497","DOIUrl":"10.3389/fepid.2023.1216497","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is an autoimmune disorder characterized by chronic and systemic inflammation. Recent research underscores the role of chronic inflammation in multiple common RA comorbidities such as depression, obesity, and cardiovascular diseases (CVDs), suggesting a potential overlap of the pathogenic mechanisms for RA. However, it is not well understood how the coexistence of these comorbid conditions impacts the risk of RA and whether any such association relates to body's inflammatory state.</p><p><strong>Methods: </strong>We used data from the 2007-2010 United States National Health and Nutrition Examination Survey (NHANES) database and compared RA prevalence between subsamples with the presence of any two conditions among depression, obesity, and hypertriglyceridemia (HTG). Each subsample was further divided into three categories based on the serum level of the inflammatory marker C-reactive protein (CRP) and analyzed for statistically significant differences using three-way <i>χ</i>² tests of independence.</p><p><strong>Results: </strong>The study was conducted on 4,136 patients who fulfilled the inclusion criteria (representing 163,540,241 individuals after adjustment for sampling weights). Rates of depression, obesity, and HTG were found to be significantly higher (<i>P</i> < 0.001) among the subjects with RA compared with the control population with no arthritis. The presence of depression along with obesity or HTG showed a noticeably higher RA prevalence but such an association was not observed for the combination of obesity and HTG. The synergistic effect of HTG with depression was found to be most prominent at a medium CRP level (1-3 mg/L), while for obesity, the effect was observed across all CRP levels examined. These findings were further confirmed by the three-way <i>χ</i>² test for independence.</p><p><strong>Conclusions: </strong>The presence of obesity or HTG in subjects suffering from depression might pose an increased risk of RA. Inflammatory mechanisms potentially play an important underlying role as suggested by the strong dependency of the association to CRP level. Identification of synergistic associations between RA risk conditions could provide useful information to predict the development and progress of RA.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"3 ","pages":"1216497"},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061446","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":"Tracking SARS-CoV-2 seropositivity in rural communities using blood-fed mosquitoes: a proof-of-concept study.","authors":"Benjamin J Krajacich, Djibril Samaké, Adama Dao, Moussa Diallo, Zana Lamissa Sanogo, Alpha Seydou Yaro, Amatigue Zeguime, Josué Poudiougo, Kadiatou Cissé, Mamadou Traoré, Alassane Dit Assitoun, Roy Faiman, Irfan Zaidi, John Woodford, Patrick E Duffy, Tovi Lehmann","doi":"10.3389/fepid.2023.1243691","DOIUrl":"10.3389/fepid.2023.1243691","url":null,"abstract":"<p><strong>Background: </strong>The spread of SARS-CoV-2 cannot be well monitored and understood in areas without capacity for effective disease surveillance. Countries with a young population will have disproportionately large numbers of asymptomatic or pauci-symptomatic infections, further hindering detection of infection. Sero-surveillance on a country-wide scale by trained medical professionals may be limited in a resource-limited setting such as Mali. Novel ways of broadly sampling the human population in a non-invasive method would allow for large-scale surveillance at a reduced cost.</p><p><strong>Approach: </strong>Here we evaluate the collection of naturally blood-fed mosquitoes to test for human anti-SARS-CoV-2 antibodies in the laboratory and at five field locations in Mali.</p><p><strong>Results: </strong>Immunoglobulin-G antibodies to multiple SARS-CoV-2 antigens were readily detected in mosquito bloodmeals by bead-based immunoassay through at least 10 h after feeding [mean sensitivity of 0.92 (95% CI 0.78-1) and mean specificity of 0.98 (95% CI 0.88-1)], indicating that most blood-fed mosquitoes collected indoors during early morning hours (and likely to have fed the previous night) are viable samples for analysis. We found that reactivity to four SARS-CoV-2 antigens rose during the pandemic from pre-pandemic levels. The crude seropositivity of blood sampled via mosquitoes was 6.3% in October and November 2020 across all sites, and increased to 25.1% overall by February 2021, with the most urban site reaching 46.7%, consistent with independent venous blood-based sero-surveillance estimates.</p><p><strong>Conclusions: </strong>We have demonstrated that using mosquito bloodmeals, country-wide sero-surveillance of human diseases (both vector-borne and non-vector-borne) is possible in areas where human-biting mosquitoes are common, offering an informative, cost-effective, and non-invasive sampling option.</p>","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"3 ","pages":"1243691"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061448","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":"State-level public health preparedness indices as predictors of COVID-19 mortality outcomes: results from the United States of America in 2020","authors":"Matthew R. Boyce","doi":"10.3389/fepid.2023.1229718","DOIUrl":"https://doi.org/10.3389/fepid.2023.1229718","url":null,"abstract":"This study evaluates associations between state-level preparedness indices and reported COVID-19-related mortality outcomes in all 50 states and the District of Columbia in the United States of America during three distinct time periods throughout the first year of the COVID-19 pandemic. State-level preparedness data for the year 2019 were gathered from the National Health Security Preparedness and Trust for America's Health Indices, and COVID-19-related mortality data for March–December 2020 (i.e., excess mortality and reported COVID-19 mortality rates) were collected in May 2022. Linear regression analyses were conducted to examine associations during three distinct time periods. Statistically significant positive associations were observed between both indices and reported COVID-19 mortality rates during the first time period. A statistically significant negative association was observed between one preparedness index and excess mortality during the second time period. No other significant associations existed for the outcomes or time periods considered in this analysis. These results demonstrate that state-level preparedness indices were not well attuned to COVID-19-related mortality outcomes during the first year of the pandemic. This suggests that current measures of state-level preparedness may be underinclusive and require a reconceptualization to improve their utility for public health practice.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139008220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of treatment interruption among patients on anti-tuberculosis treatment in Nekemte public healthcare facilities, Oromia, Western Ethiopia","authors":"Robsan Gudeta Getachew, Tadesse Tolossa, Z. Teklemariam, Angefa Ayele, H. S. Roba","doi":"10.3389/fepid.2023.1234865","DOIUrl":"https://doi.org/10.3389/fepid.2023.1234865","url":null,"abstract":"Tuberculosis treatment interruption increases the risk of poor treatment outcomes and the occurrence of drug resistant Tuberculosis. However, data on the incidence and predictors of tuberculosis treatment interruption are still scarce in Ethiopia, as well as in the study area. Therefore, this study aimed to assess the incidence and predictors of treatment interruption among patients on tuberculosis treatment in Nekemte public healthcare facilities, Oromia region, Western Ethiopia, from July 1, 2017, to June 30, 2021.A retrospective cohort study design was conducted among 800 patients enrolled in anti-tuberculosis treatment during the study period. Data were collected from patient cards who were enrolled in treatment from July 1, 2017 to June 30, 2021. Epidata version 3.2 was used for data entry, and STATA version 14 was used for analysis. A multivariable Cox regression model with a 95% confidence interval (CI) and adjusted hazard ratio (AHR) was used to identify the significant predictors at a p value < 0.05. Finally, the log likelihood ratio, and a Cox-Snell residual graph was used to check the adequacy of the model.A total of 800 patients were followed for a median time of 2.3 (95% CI: 2.20–2.36) months, and with a maximum follow-up time of 11.7 months. The overall incidence rate of treatment interruption was 27.4 per 1000 (95% CI: 22.8–32.8) person-month observations. Age 18–34 years (AHR = 1.8, 95% CI: 1.02–3.18), male (AHR = 1.63, 95% CI: 1.1–2.42), rural residence (AHR = 3, 95% CI: 1.98–4.64), presence of comorbidity (AHR = 10, 95% CI: 5.47–18.27) and lack of treatment supporters on the treatment follow-up (AHR = 2.82, 95% CI: 1.9–4.41) were found to be significant predictors of treatment interruption.A high incidence rate of interruption was observed among TB patients in public health facilities in Nekemte town. Health facilities should provide supportive care for patients with co-morbidities and consider interventions that target middle-aged patients from rural areas that reduce treatment interruptions.","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138603061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic algorithms for post-discharge readmission and mortality among mother-infant dyads: an observational study protocol","authors":"M. Wiens, J. Trawin, Yashodani Pillay, Vuong Nguyen, C. Komugisha, N. Kenya-Mugisha, Angella Namala, L. Bebell, J. Ansermino, N. Kissoon, Beth Payne, M. Vidler, Astrid Christoffersen-Deb, Pascal M. Lavoie, J. Ngonzi","doi":"10.3389/fepid.2023.1233323","DOIUrl":"https://doi.org/10.3389/fepid.2023.1233323","url":null,"abstract":"In low-income country settings, the first six weeks after birth remain a critical period of vulnerability for both mother and newborn. Despite recommendations for routine follow-up after delivery and facility discharge, few mothers and newborns receive guideline recommended care during this period. Prediction modelling of post-delivery outcomes has the potential to improve outcomes for both mother and newborn by identifying high-risk dyads, improving risk communication, and informing a patient-centered approach to postnatal care interventions. This study aims to derive post-discharge risk prediction algorithms that identify mother-newborn dyads who are at risk of re-admission or death in the first six weeks after delivery at a health facility.This prospective observational study will enroll 7,000 mother-newborn dyads from two regional referral hospitals in southwestern and eastern Uganda. Women and adolescent girls aged 12 and above delivering singletons and twins at the study hospitals will be eligible to participate. Candidate predictor variables will be collected prospectively by research nurses. Outcomes will be captured six weeks following delivery through a follow-up phone call, or an in-person visit if not reachable by phone. Two separate sets of prediction models will be built, one set of models for newborn outcomes and one set for maternal outcomes. Derivation of models will be based on optimization of the area under the receiver operator curve (AUROC) and specificity using an elastic net regression modelling approach. Internal validation will be conducted using 10-fold cross-validation. Our focus will be on the development of parsimonious models (5–10 predictor variables) with high sensitivity (>80%). AUROC, sensitivity, and specificity will be reported for each model, along with positive and negative predictive values.The current recommendations for routine postnatal care are largely absent of benefit to most mothers and newborns due to poor adherence. Data-driven improvements to postnatal care can facilitate a more patient-centered approach to such care. Increasing digitization of facility care across low-income settings can further facilitate the integration of prediction algorithms as decision support tools for routine care, leading to improved quality and efficiency. Such strategies are urgently required to improve newborn and maternal postnatal outcomes. https://clinicaltrials.gov/, identifier (NCT05730387).","PeriodicalId":73083,"journal":{"name":"Frontiers in epidemiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139210889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}