BMC Public Health最新文献

{"title":"Differential impacts of physical activity volume and intensity on blood lead levels in children and adolescents: a cross-sectional study.","authors":"Shengrong Ouyang, Yan Yin, Yuanyuan Li, Jianxin Wu, Zhuo Liu","doi":"10.1186/s12889-025-23333-8","DOIUrl":"10.1186/s12889-025-23333-8","url":null,"abstract":"<p><strong>Background: </strong>Previous studies on physical activity (PA) and blood lead levels (BLLs) have relied on self-reported data, conflating PA volume and intensity. This study aimed to disentangle their independent effects and test the hypothesis that higher PA volume increases BLLs via environmental lead exposure, while higher PA intensity reduces BLLs through enhanced excretion.</p><p><strong>Methods: </strong>We used data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to quantify PA in 3,249 U.S. children and adolescents (aged 3-19 years) using two metrics based on monitor-independent movement summary units (MIMS): average daily MIMS for volume and peak 60-minute MIMS for intensity. BLLs were natural log-transformed (ln-BLL) for analysis. Weighted multivariable linear regression, general additive models, mediation analysis, and Bayesian kernel machine regression (BKMR) were employed to explore associations.</p><p><strong>Results: </strong>PA volume showed a significant positive association with ln-BLL (β = 0.025, p < 0.001), with a threshold effect at 19,700 MIMS. In contrast, PA intensity exhibited a non-significant negative correlation with BLL (β = -0.027, p = 0.156). Mediation analysis indicated that outdoor time explained 32.8% of the PA volume-BLL association. BKMR revealed cumulative effects of co-exposures on BLL trends. Sex-stratified analyses showed that males had higher BLLs at similar PA volume levels, while females experienced greater reductions in BLLs with increased PA intensity.</p><p><strong>Conclusion: </strong>Our findings support a dual-pathway model: greater PA volume may elevate BLL-particularly in males-while higher intensity may reduce BLL-especially in females. These results underscore the need for PA guidelines that balance volume and intensity, optimize sweat-promoting exercise in low-lead environments, and inform interventions to safeguard the health of children and adolescents against lead exposure.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2049"},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to political violence and health risk behaviors of Palestinian youth.","authors":"Rita T Karam, Wenjing Huang, Umaiyeh Khammash, Peter Glick, Mohammed Shaheen, Ryan Andrew Brown, Sebastian Linnemayr, Salwa Massad","doi":"10.1186/s12889-025-23191-4","DOIUrl":"10.1186/s12889-025-23191-4","url":null,"abstract":"<p><strong>Background: </strong>Exposure to political violence, which pervades many parts of the Middle East and Northern African (MENA) region, is a key potential factor behind the rising rates of risky behaviors among youth, such as drug use, alcohol use, and sexual activity. Theory and empirical work on youth elsewhere suggests that individual characteristics, mental health, and youths' future orientation play a role in such behaviors. It is possible that political violence impacts behavior in part through its effects on these factors, in particular mental health. However, very little is known about the determinants of youth risk behavior in the region. Understanding the determinants will help MENA countries to deal with emerging public health threats as well as risks to youth health and well-being resulting from engagement in risky behavior. We examined determinants of risky behavior among Palestinian youth in the West Bank and East Jerusalem.</p><p><strong>Methods: </strong>We employed structural equation modeling using a 2014 nationally representative data from the Palestinian Youth Health Risk Study to examine the factors associated with engagement of youth ages 18-24 (N = 1449) in risky behaviors.</p><p><strong>Results: </strong>Personal experience of political violence was the strongest direct predictor of engagement in interpersonal violence (β = 0.21, p = 0.00) and substance use (β = 0.21, p = 0.00). With respect to indirect effects, global distress mediates the impact of witnessing and vicariously experiencing violence on the three outcomes. However, no association was found between personally experiencing political violence and global distress. The study also identified several individual characteristics, such as religiosity, that may be protective against risky behavior. Females are less likely to engage in risky behavior than males, despite experiencing higher levels of global distress.</p><p><strong>Conclusions: </strong>The study is the first to use population-based data to test the effects of exposure to political violence on key risky health behaviors of Palestinian youth, a population facing protracted conflict and hardship for which solutions remain elusive. The findings suggest the need for customized interventions to target male and female Palestinians at an early age to develop their coping skills in dealing with violence and distress.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2029"},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of household food insecurity on the use of maternal health services in the Savanes region, Togo: a qualitative study.","authors":"Komlan Kota, Roland Pongou, Marie-Hélène Chomienne","doi":"10.1186/s12889-025-23220-2","DOIUrl":"10.1186/s12889-025-23220-2","url":null,"abstract":"<p><strong>Background: </strong>Food insecurity is a major public health challenge in many parts of the world, especially in sub-Saharan Africa. It affects the health and well-being of vulnerable populations, particularly women of reproductive age in their use of maternal health services. This study explores the impact of food insecurity on the use of maternal health services among Togolese women in the Savanes region, aged between 18 and 49 years.</p><p><strong>Methods: </strong>This qualitative study was carried out using both focus group discussions (FGD) and in-depth interviews (IDI), which were conducted from March 14th to May 20th, 2022 in three different rural areas of the Savanes region in Togo. Firstly, we conducted twelve in-depth interviews with health professionals in three community health centers. In addition, we conducted three FGDs with 8 participants each in three different rural areas. For analysis, all the data collected were transcribed verbatim, and themes were coded using Nvivo14.</p><p><strong>Results: </strong>Household food insecurity is perceived as a significant threat and barrier to maternal healthcare utilization. Women experiencing food insecurity are less likely to seek maternal health services, as their limited financial resources are prioritized for food rather than healthcare. In contexts of poverty where finances are already precarious, food insecurity further diverts funds that could otherwise be used for medical care. As a result food and financial insecurity intersect influencing women's decisions on whether to access maternal health services. Additionally, the majority of participants identified the COVID-19 pandemic as a factor that seriously exacerbated household food insecurity and consequently further reduced access to maternal healthcare in the region. Enhancing women's socio-economic empowerment and promoting food self-sufficiency were highlighted as potential solutions to improve access to maternal healthcare services while ensuring food security.</p><p><strong>Conclusions: </strong>Findings from this study highlight the link between food insecurity and maternal healthcare utilization, emphasizing the need to address food insecurity at its root in programs aiming to improve maternal health. Prioritizing poverty reduction through education, income, women's socioeconomic empowerment and food self-sufficiency is crucial. Hence, intersectorial interventions including prenatal nutrition programs are essential to improving access to maternal healthcare.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2040"},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A budget impact analysis of 15- or 20- valent pneumococcal conjugate vaccine use in all US adults aged 50-64 years old compared to those with high-risk conditions from US payer perspective.","authors":"Nirma Khatri Vadlamudi, Chyongchiou J Lin, Angela R Wateska, Richard K Zimmerman, Kenneth J Smith","doi":"10.1186/s12889-025-22827-9","DOIUrl":"10.1186/s12889-025-22827-9","url":null,"abstract":"<p><strong>Background: </strong>In 2023, the US CDC recommended 20-valent pneumococcal conjugate vaccine (PCV20) or 15-valent pneumococcal conjugate vaccine (PCV15) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults aged 65-years and older and those aged 19-64 years old with chronic conditions. However, there is substantial pneumococcal disease burden in healthy adults aged 50-64 years, particularly in Black adults, who are likely to benefit from vaccination. This study assesses the financial impact of introducing routine PCV15 or PCV20 in US adults aged 50-64 years.</p><p><strong>Objective: </strong>To evaluate the budget impact of introducing PCV20 or PCV15/PPSV23 use in adults aged 50-64 years old compared to vaccinating only those with high-risk conditions for pneumococcal disease.</p><p><strong>Methods: </strong>A budget impact model was developed over a 3-year time horizon to compare PCV20 versus PCV15/PPSV23 from the US payer perspective. Outcomes and costs of pneumococcal disease among US adults aged 50-64 years and those with underlying conditions were projected using a Markov decision model.</p><p><strong>Results: </strong>Incorporating either PCV20 or PCV15/PPSV23 vaccines in routine vaccination programs for adults aged 50-64 years compared to vaccinating only adults with chronic conditions had an incremental budget impact of $6.5 and $9 billion, respectively, over three years. Budgetary impact was sensitive to number of vaccine doses, cost of vaccine per dose, vaccine coverage proportion and pneumococcal treatment cost across the overall population and sub-groups. Routine vaccination of 50-64-year-old age group was more economically favorable in Black adults sub-group analyses.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2042"},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WeCanWork study: well-being of male cancer survivors working physically demanding jobs.","authors":"Natalie V Schwatka, Miranda Dally, Amy Dye-Robinson, Liliana Tenney, Carol E Brown, Madison Goering, Brian Williams, Lee S Newman, Cathy J Bradley","doi":"10.1186/s12889-025-23147-8","DOIUrl":"10.1186/s12889-025-23147-8","url":null,"abstract":"<p><strong>Background: </strong>Male cancer survivors performing physically demanding work have received less attention in the scientific literature compared to other groups. We hypothesized that men newly diagnosed with cancer have better well-being if they have less physically demanding jobs.</p><p><strong>Methods: </strong>Seventy-six male workers completed the NIOSH Worker Well-being Questionnaire (WellBQ) approximately three months after starting cancer treatment. We used descriptive statistics to describe the demographics and worker well-being of the study sample and pooled t-tests to determine whether there were differences between respondents who had more physically demanding work and those with fewer physical demands.</p><p><strong>Results: </strong>Male cancer survivors with physically demanding jobs reported poorer wage (p < 0.001)and benefit (p = 0.04) satisfaction, less autonomy (p = 0.03) and flexibility (p = 0.004), and greater financial insecurity (p = 0.002). They also experienced more negative job attitudes (p = 0.0003), and workplace safety concerns (p < 0.001) and less sleep (p = 0.05), with less support outside of work (p = 0.03) compared to men with less physically demanding jobs.</p><p><strong>Conclusions: </strong>Our study highlights worker well-being differences approximately three months after initiating cancer treatment between men with and without physically demanding jobs. There are opportunities for employers to support worker well-being, specifically those with physically demanding jobs. Additionally, male cancer survivors with physically demanding jobs may need greater support outside of the workplace. Future research with a larger and longitudinal sample of male cancer survivors could inform how to support survivors from diagnosis through treatment and beyond.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2025"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recreational activities and psychological distress during the COVID-19 crisis: a cohort study from Norway.","authors":"Rebecca Dyer Ånensen, Viggo Krüger, William Hazell, Gro Mjeldheim Sandal, Lars Thore Fadnes","doi":"10.1186/s12889-025-22942-7","DOIUrl":"10.1186/s12889-025-22942-7","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the relationship between engaging in recreational activities before the pandemic and levels of psychological distress during the pandemic.</p><p><strong>Methods: </strong>Data from a cohort study (n = 16,212) collected at three time points (April 2020, January 2021, and May 2022) in Bergen, Norway, were analysed via a linear mixed model. Associations between psychological distress and five dimensions of recreational activities were assessed, both at baseline and over time.</p><p><strong>Results: </strong>Regular physical activity before the pandemic was linked to lower psychological distress at baseline, whereas for cultural audience participation, this relationship was inverted. Over time, regular cultural audience participation before the pandemic was associated with a slight reduction in psychological distress. No clear baseline associations or significant changes over time were found for cultural practitioner, social networking, or volunteering/religious activities.</p><p><strong>Conclusions: </strong>These findings suggest that there are links between recreational activities and psychological distress during a crisis, with cultural audience participation possibly reducing distress over time.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2020"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated effect of media use on mothers' vaccination of their children in Sub-Saharan Africa: a quasi-experimental propensity score matching analysis using DHS data.","authors":"Melak Jejaw, Kaleb Assegid Demissie, Getachew Teshale, Demiss Mulatu Geberu, Misganaw Guadie Tiruneh, Asebe Hagos, Nigusu Worku, Endalkachew Dellie, Tesfahun Zemene Tafere","doi":"10.1186/s12889-025-23258-2","DOIUrl":"10.1186/s12889-025-23258-2","url":null,"abstract":"<p><strong>Backround: </strong>Media channels are a primary source of health information for mothers/caregivers to enhance their children's vaccination uptake, particularly in Sub-Saharan Africa, where there is a dearth of health workers. WHO set mass media exposure as a potential strategy to increase vaccination uptake. However, estimating the effect of media exposure on child vaccination using observational studies suffers from problems of selection bias. Thus, this study used the propensity score matching (PSM) analysis to estimate the effect of media exposure on childhood vaccinations.</p><p><strong>Methods: </strong>We used nationally representative demography and health survey data collected from 2019 to 2024 among 23,194 children aged 12-23 months in SSA countries. A total of 23,194 weighted sample were included in the analysis. We employed PSM analysis with the logit model using the psmatch2 command package in STATA to estimate the causal effect of media exposure on women's uptake of child immunization. The Average Treatment Effect (ATE), average treatment effect on the treated (ATT), and the average treatment on the untreated (ATU) represent the overall effect of media exposure on the entire population, among women who had media exposure, and the hypothetical effect if unexposed women had experienced media exposure, respectively. Radius matching with a caliper width of 0.01 was employed to match the groups. The quality of matching was examined statistically and graphically. Sensitivity analysis was done to test the robustness of the PSM estimate using the Mantel-Haenszel test statistics.</p><p><strong>Results: </strong>The overall prevalence of full child vaccination was 61.27% (95% CI (60.64%, 61.89%)) in the treatment group. In the PSM analysis, the ATT values in the treatment and control groups were 0.68 and 0.59, respectively, indicating that the childhood immunization uptake increased by 8.76% because of media exposure. The ATU values in the treatment and control groups were 0.51 and 0.62, respectively. This showed that for the women or caregivers who did not have media exposure, the probability of vaccinating their children would have increased by 10.8% if they had media exposure. The final ATE estimate was 0.0828 among the samples. Quality of matching was good, and the estimates were insensitive to hidden bias.</p><p><strong>Conclusion and recommendations: </strong>This study finding highlighted that policymakers and planners in SSA countries should give great emphasis to further enhancing media exposure coverage for target groups since it has a substantial impact on improving childhood vaccination uptake. Further research is recommended to examine the cause-effect relationship of media exposure on childhood vaccination by including more proximal variables that were not observed in the present study.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2018"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare-seeking pathway and delay analysis of rifampicin-resistant tuberculosis patient in Southwestern China.","authors":"Yunbin Yang, Zichao Li, Liangli Liu, Jinou Chen, Ling Li, Rui Yang, Xing Yang, Lianyong Chen, Haohao Ru, Lin Xu","doi":"10.1186/s12889-025-23288-w","DOIUrl":"10.1186/s12889-025-23288-w","url":null,"abstract":"<p><strong>Objectives: </strong>Rifampicin-resistant tuberculosis (RR-TB) remains a critical health challenge in southwest China. This study investigates healthcare-seeking delays and patient pathways among RR-TB patients in Yunnan province, employing diagram visualization. Aim to explore the accessibility and challenges of medical services for RR-TB.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among RR-TB patients who were enrolled in the Tuberculosis Management Information System (TBMIS) from 2020 to 2022. Data was collected via a face-to-face questionnaire survey to measure the patient pathways and delays of RR-TB patients at different health facility levels. SPSS statistical software was used for descriptive statistics, nonparametric tests, and patient pathway analysis. Sankey diagram, box plot and a heat map were used for data visualization.</p><p><strong>Results: </strong>Sankey diagrams revealed 7 distinct diagnostic pathways, with 49.4% diagnosed after one health facility visit. Over 50% of patients were diagnosed at county level facilities (Level 2), prolonging delays. As the level of health facility increases, the flow of RR-TB patients gradually decreased. Treatment pathways were simple with 4 routes. 92.4% of RR-TB patients enrolled treatment after visiting only one health facility, reflecting shorter treatment delays (median: 5 days). The median total delay was 66 days (Interquartile range: 28 to 155) of RR-TB patients. The diagnostic delay and total delay in lower health facilities was significantly higher than that in higher-levels (P < 0.05).</p><p><strong>Conclusions: </strong>This study visualizes RR-TB healthcare-seeking flows in economically underdeveloped areas of China. Though healthcare access is decent, diagnostic delays are notable, especially at under-resourced facilities. We should pay more attention to and enhance the RR-TB diagnostic capabilities of primary health facilities. While treatment pathways are simple, financial burdens might be a key issue. Reducing these burdens through multi-channel funding and policy support is essential.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2019"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with hypertension in rural areas of Naubatpur block of Patna District in Bihar, India: a population-based cluster cross-sectional study.","authors":"Alok Ranjan, Sanjay Pandey, Santosh Kumar Nirala, Chandramani Singh, Mohit Bhardwaj","doi":"10.1186/s12889-025-23198-x","DOIUrl":"10.1186/s12889-025-23198-x","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a serious public health challenge with varying incidence at the global and national levels. The prevalence of hypertension has been rising in low- and middle-income countries (LMICs) like India. Hypertension, previously considered an urban issue, is increasingly prevalent in rural India, necessitating targeted interventions.</p><p><strong>Objective: </strong>To estimate the prevalence of hypertension, and the various associated factors among the rural population of Naubatpur block of Patna district in Bihar state.</p><p><strong>Methodology: </strong>A population-based, cluster cross-sectional study was conducted among 840 adults, selected randomly using a two-stage cluster sampling method. Data on socio-demographics and economic, anthropometric, family history, lifestyle variables, and awareness were collected using a pre-tested standardized structured questionnaire. Standard WHO procedures were used to measure blood pressure and anthropometric variables. Stata version 17 was used for statistical analyses considering cluster survey data using sampling weights. Bivariate analysis was performed to estimate crude odds ratios (ORs) with 95% confidence intervals. A multivariate logistic regression model was used, taking variables with p-value ≤ 0.20 in bivariate analysis as independent variables and hypertension as dependent variables to estimate adjusted ORs with 95% confidence intervals.</p><p><strong>Results: </strong>The weighted prevalence of hypertension in adults was 24.55% (95% CI: 20.66 - 28.9%) higher than the National Family Health Survey (NFHS-5) data of Bihar. Nearly 25.35% of subjects were classified in the pre-hypertension stage according to JNC VII criteria. Based on three regression models, the odds of having hypertension increased significantly with an increasing trend as age advanced, family history of hypertension, tobacco chewing, Obesity (BMI > 25.5), and salt consumption (> 5gm/day) were found to be significantly associated with the prevalence of hypertension among adult population of rural areas after controlling for all the confounders.</p><p><strong>Conclusions: </strong>The high prevalence of hypertension and pre-hypertension among the adult population residing in the rural area is a serious public health concern. Public health policymakers and professionals need to create awareness, early identification, and prevention programs in rural areas to focus on modifiable behaviors in rural areas to combat the menace of diseases associated with hypertension.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2023"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a syndromic surveillance tool to support the epidemiological investigation into paediatric acute hepatitis of unknown aetiology in England.","authors":"Alex J Elliot, Helen E Hughes, Christopher Bennett, Thomas C Hughes, Kirsty Challen, Conall H Watson, Sema Mandal, Gillian E Smith, Daniel Todkill","doi":"10.1186/s12889-025-23222-0","DOIUrl":"10.1186/s12889-025-23222-0","url":null,"abstract":"<p><strong>Background: </strong>During 2022, a new public health threat emerged when cases of paediatric acute hepatitis of unknown aetiology (HUA) were identified in children aged under 16 years old in the United Kingdom (UK). At the time, the epidemiology and extent of cases was based upon limited and non-standardised reporting from hospitals and liver units. We aimed to adapt existing real-time syndromic surveillance systems to support the epidemiological investigation of cases of HUA presenting to emergency departments (EDs) in England.</p><p><strong>Methods: </strong>Syndromic surveillance is generally based on the collection of patient symptoms or chief complaints, which are collected using automated routines in near real-time. Here, we used an existing ED syndromic surveillance system monitoring daily patient attendances across a network of approximately 150 EDs in England. Clinical diagnosis codes related to the potential symptoms associated with the HUA incident were selected and attendance data monitored retrospectively and prospectively during the incident.</p><p><strong>Results: </strong>From 2 April 2018 to 31 December 2021, there were small sporadic numbers of daily ED attendances for 'liver conditions' in children with no observed secular trends or seasonality across the 1 to 4 and 5 to 14 years age groups. The period 2 April to 29 July was compared across each year included in the analysis. Mean daily HUA attendances during 2018 to 2021 was 0.05 and 0.22 for 1 to 4 and 5 to 14 years respectively, however in 2022 there were 0.26 and 0.42 mean daily attendances. This represented an increase of 377% and 94% in the 1 to 4 and 5 to 14 years age groups, respectively. From June 2022, daily syndromic 'liver condition' attendances appeared to decrease and the rate of increase in cumulative attendances slowed.</p><p><strong>Conclusions: </strong>We demonstrate how syndromic surveillance provided support to the HUA outbreak using an existing syndromic surveillance framework to develop new indicators based on the newly emerging clinical symptoms. The outputs from the syndromic tool matched clinical and epidemiological findings with respect to trends in other HUA-related data, including clinical and laboratory reports, over time. This work demonstrates the potential for syndromic surveillance supporting the epidemiological surveillance of hepatitis and providing a valuable tool for the real-time management of future unknown health threats.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2017"},"PeriodicalIF":3.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}