查看更多>>摘要：Background: Foodborne outbreaks of Shigella flexneri infection are uncommon in the UK. In November 2019, the United Kingdom Health Security Agency investigated an outbreak of S. flexneri associated with a fast-food restaurant in London. Methods: Epidemiological investigations included case ascertainment and interviewing suspected cases using enhanced surveillance questionnaires. Whole-genome sequencing (WGS) was used for characterisation of human isolates. Environmental investigations included a review of food safety processes at the implicated restaurant, administration of exposure questionnaires and stool sampling of staff. Results: Between November 2019 and February 2020,17 cases were confirmed as part of the outbreak by WGS in London. Among these, 15 were linked to the implicated restaurant. A review of the food safety processes at the restaurant was satisfactory. Despite initial suboptimal coverage of stool screening of staff, all staff members working at the restaurant during the sampling period were screened and an asymptomatic food handler tested positive for S.flexneri with the outbreak WGS profile. The individual underwent microbiological clearance, and no further cases were reported. It was not possible to confirm the direction of transmission for the community cases or the staff member. Conclusion: We report an outbreak of S. flexneri in a fast-food restaurant in London with previous inspection ratings indicating good compliance with food safety and hygiene standards. WGS was crucial in identifying cases linked to the outbreak. This outbreak highlights the importance of prompt testing of food handlers in outbreaks suspected to be associated with food businesses. Crown Copyright (c) 2022 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. All rights reserved.
查看更多>>摘要：Objectives: Growing evidence has associated solid/polluted fuel (PF) burning with higher risks of acute respiratory infection (ARI) among under-five children. However, higher usage of PF contributed to up -surge communal air pollution, which may further aggravate ARI. Instead, women empowerment may mitigate the risk of ARI by shifting towards cleaner fuels. This study aimed to estimate the mitigating impact of community-level women empowerment on ARI among under-five children in Pakistan. In addition, the study also aimed to explore the mitigating impact pathway of empowered women community. Study design: A cross-sectional study design was used to collect data under 2018 Pakistan Demographic and Health Survey. Methods: Retrieved data used in the analysis comprised 12,295 surviving under-five children suffering from cough coinciding with short and rapid breathing and fever from 561 communities. Because of hierarchical structure of the data, two-level mixed-effects logistic regression was used to compute un-biased odds ratios. Results: Approximately 58% of total households used PF as a primary fuel, and PF usage by more than 50% of households led to 129 polluted communities. About 19% of children suffered from symptoms of ARI within 2 weeks preceding the survey. After adjusting for individual, household and communal attributes, the odds of suffering from ARI were 1.156 times higher among children from polluted households than their counterparts. The odds of ARI were aggravated to 1.333 for highly polluted communities. Women empowerment mitigated the risk of ARI by odds of 0.708 and 0.671 at individual level and communal levels, respectively. After shifting towards cleaner fuels, highly women empowered community-mitigated ARI risk by odds of 0.765. Conclusions: Under-five children of highly polluted communities were at higher risk of ARI, while highly women empowered communities mitigated the risk by shifting towards cleaner fuels. We suggest interventional efforts towards empowering poor women in mitigating ARI. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Al-Oraibi, A.Hassan, O.Chattopadhyay, KaushikNellums, L. B....
11页
查看更多>>摘要：Objectives: Alarming rates of non-communicable diseases (NCDs) have been observed in low-and middle-income countries (LMICs) where most refugees reside. There is concern Syrian refugees may experience significant NCD-related health needs, which have significant health implications, including in the context of the COVID-19 pandemic, and which must be addressed by health systems in neighbouring host countries. Although primary studies on this topic exist, there has been no comprehensive synthesis of the existing evidence base. The aim of this systematic review and meta-analysis was to synthesise evidence on the prevalence of NCDs among Syrian refugees residing in neighbouring host countries. Study design: This was a systematic review and meta-analysis. Methods: The review was carried out in line with PRISMA guidelines (PROSPERO CRD420201970430). MEDLINE, CINAHL, EMBASE and PubMed databases were searched from 1 January 2011 to 1 November 2021. Peer-reviewed studies reporting prevalence data on the five most common NCDs among adult Syrian refugees living in Turkey, Lebanon or Jordan were included. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Meta-analysis was carried out to estimate the pooled prevalence of these NCDs in community and primary care settings. Results: A total of 466 citations were identified, 18 of which were included, representing 237,723 Syrian refugees. In community settings, the prevalence of hypertension, diabetes mellitus type II, cardiovascular diseases, chronic respiratory diseases and arthritis was 24% (95% confidence interval: 17-32), 12% (8-15), 5% (3-7), 4% (3-5) and 11% (7-14), respectively. The prevalence of hypertension 35% (33-36) and diabetes mellitus type II 48% (24-72) were significantly higher in primary care settings. Conclusion: The findings demonstrate a high prevalence of NCDs among Syrian refugees. Evidence-based preventive and management interventions for NCDs are needed in this context to address acute health needs during the COVID-19 pandemic and the longer-term health burden of NCDs. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
查看更多>>摘要：Objectives: The objective of this study was to assess the population prevalence of SARS-CoV-2 and changes in the prevalence in the adult general population in Estonia during the 1st year of COVID-19 epidemic. Study design: This was a population-based nationwide sequential/consecutive cross-sectional study. Methods: Using standardised methodology (population-based, random stratified sampling), 11 cross-sectional studies were conducted from April 2020 to February 2021. Data from nasopharyngeal testing and questionnaires were used to estimate the SARS-CoV-2 RNA prevalence and factors associated with test positivity. Results: Between April 23, 2020, and February 2, 2021, results were available from 34,915 individuals and 27,870 samples from 11 consecutive studies. The percentage of people testing positive for SARS-CoV-2 decreased from 0.27% (95% confidence interval [CI] = 0.10%-0.59%) in April to 0.04% (95% CI = 0.00%-0.22%) by the end of May and remained very low (0.01%, 95% CI = 0.00%-0.17%) until the end of August, followed by an increase since November (0.37%, 95% CI = 0.18%-0.68%) that escalated to 2.69% (95% CI = 2.08%-2.69%) in January 2021. In addition to substantial change in time, an increasing number of household members (for one additional odds ratio [OR] = 1.15, 95% CI = 1.02-1.29), reporting current symptoms of COVID-19 (OR = 2.21, 95% CI = 1.59-3.09) and completing questionnaire in the Russian language (OR 1.85, 95% CI 1.15-2.99) were associated with increased odds for SARS-CoV-2 RNA positivity. Conclusions: SARS-CoV-2 population prevalence needs to be carefully monitored as vaccine programmes are rolled out to inform containment decisions. (C) 2022 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
Lampl, B. M. J.Lang, M.Jochem, C.Leitzmann, M. F....
7页
查看更多>>摘要：Objectives: In Germany, deaths of SARS-CoV-2-positive persons are reported as 'death related to SARSCoV-2/COVID-19' to the Robert Koch Institute, Germany's main infectious disease institution. In 177 COVID-19-associated deaths reported in Regensburg, Germany, from October 2020 to January 2021, we investigated how deaths following SARS-CoV-2 infection were reported and whether cases with a death attributed to SARS-CoV-2 (COVID-19 death [CD]) differed from cases with a reported death from other causes (non-COVID-19 death [NCD]). Study design: This was an observational retrospective cohort study. Methods: We analysed descriptive data on the numbers of cases, deaths, age, sex, symptoms and hospitalizations. We calculated odds ratios (ORs) with 95% confidence intervals (95% CIs) and performed Chisquared/Fisher's exact test for categorical variables and the Wilcoxon rank-sum test for comparison of medians. Results: Deaths attributed to COVID-19 occurred primarily in elderly patients. The mortality rate and the case fatality ratio (CFR) increased with age. The median age and the prevalence of risk factors were similar between CD and NCD. Respiratory symptoms and pneumonia at the time of diagnosis were associated with death reported as CD. The odds of CD attribution in cases hospitalized because of COVID19 were 6-fold higher than the odds of NCD (OR: 6.00; 95% CI: 1.32 to 27.22). Conclusions: Respiratory symptoms/pneumonia at the time of diagnosis and hospitalization due to COVID-19 were associated with attributing a death to COVID-19. Numbers of COVID deaths need to be interpreted with caution. Criteria that facilitate attributing the cause of death among SARS-CoV-2 cases more uniformly could make these figures more comparable. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
查看更多>>摘要：Objectives: This study aimed to understand how politics, economics, and public health restrictions affected each other during the COVID-19 pandemic. Methods: We use seemingly unrelated regressions on a monthly data set of government approval ratings, the stringency index, the time-dependent reproduction number (R), and unemployment, allowing the residuals in each regression to be correlated with each other. We also conduct sensitivity tests using weekly data and the growth in polls. Results: The study covers 27 European countries from April 2020 to April 2021. A unit increase in the R and COVID-19 cases per million increases the stringency index by 23.742 and 4.207, respectively; a unit increase in stringency boosts the incumbent's popularity by 0.384; the poll positively affects the stringency index; stringency has negative effects on the R; and the poll and stringency index have opposite effects on unemployment. Conclusion: Political and economic pressures did not hinder the government from introducing stronger measures. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
查看更多>>摘要：Objective: This study aimed to systematically clarify attitudes and influencing factors of the public toward COVID-19 vaccination for children or adolescents. Study design: This was a scoping review. Methods: This scoping review screened, included, sorted, and analyzed relevant studies on COVID-19 vaccination for children or adolescents before December 31, 2021, in databases, including PubMed, Elsevier, Web of Science, Cochrane Library, and Wiley. Results: A total of 34 studies were included. The results showed that the public's acceptance rate toward COVID-19 vaccination for children or adolescents ranged from 4.9% (southeast Nigerian mothers) to 91% (Brazilian parents). Parents' or adolescents' age, gender, education level, and cognition and behavior characteristics for the vaccines were the central factors affecting vaccination. The vaccine's safety, effectiveness, and potential side-effects were the main reasons affecting vaccination. Conclusions: Realizing current public attitudes of COVID-19 vaccination for adolescents or children can effectively develop intervention measures and control the pandemic as soon as possible through herd immunity. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
查看更多>>摘要：Objectives: In 2015, the Republic of Georgia initiated a National Hepatitis C Elimination Program, with a goal of 90% reduction in prevalence of chronic hepatitis C virus (HCV) infections by 2020. In this article, we explore the impact of the COVID-19 pandemic on the 2020 hepatitis C cascade of care in Georgia. Study design: Retrospective analytic study. Methods: We used a national screening registry that includes hospitals, blood banks, antenatal clinics, harm reduction sites, and other programs and services to collect data on hepatitis C screening. A separate national treatment database was used to collect data on viremia and diagnostic testing, treatment initiation, and outcome including testing for and achieving sustained virologic response (SVR). We used these databases to create hepatitis C care cascades for 2020 and 2019. Bivariate associations for demographic characteristics and screening locations per year and care cascade comparisons were assessed using a chi-squared test. Results: In 2020 compared to 2019, the total number of persons screened for HCV antibodies decreased by 25% (from 975,416 to 726,735), 59% fewer people with viremic infection were treated for HCV infection (3188 vs. 7868), 46% fewer achieved SVR (1345 vs. 2495), a significantly smaller percentage of persons with viremic infection initiated treatment for HCV (59% vs. 62%), while the percentage of persons who achieved SVR (99.2% vs. 99.3%) remained stable. Conclusions: The COVID-19 pandemic had a negative impact on the hepatitis C elimination program in Georgia. To ensure Georgia reaches its elimination goals, mitigating unintended consequences of delayed diagnosis and treatment of hepatitis C due to the COVID-19 pandemic are paramount. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
查看更多>>摘要：Objectives: Case definitions are vital in a pandemic to effectively identify, isolate, and contact trace, particularly where testing is slow, scant, or not available. While case definitions have been developed in the COVID-19 pandemic, their diagnostic properties have not been adequately assessed. This study's objective is to determine the diagnostic properties of local and World Health Organization (WHO) COVID-19 case definitions in the large metropolitan area of Mexico City. Methods: We calculated the diagnostic properties of five COVID-19 definitions (three of the Mexican government and two of the WHO) using open data of suspected COVID-19 cases in Mexico City from March 24th, 2020, until May 15th, 2021. Results: All 2,564,782 people included in the analysis met the WHO suspected case definition (sensi-tivity: 100%, specificity: 0%). The WHO probable case definition was met by 1.2%, while the first and second Mexican suspected case had sensitivities of 61% and specificities of 61% and 67%, respectively. Confirmed case by epidemiological contact had a low sensitivity (32%) but slightly higher specificity (81%). Conclusions: Case definitions should maximize sensitivity, especially in a high-transmission area such as Mexico City. The WHO suspected case definition has the potential for detecting most symptomatic cases. We underline the need for routine evaluation of case definitions as new evidence arises to maximize their usefulness. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
da Silva, D. C. G.Barreto da Cunha, M. de SaSantana, A. de Oliveirados Santos Alves, A. M....
10页
查看更多>>摘要：Objectives: This systematic review study and meta-analysis sought to estimate the prevalence of malnutrition and nutritional deficiencies in children with cerebral palsy (CP). Study design: This is a systematic review and meta-analysis. Methods: The systematic review was conducted according to the PRISMA guidelines. The articles were chosen using the PubMed, Embase, Scopus, Web of Science, Cochrane Library, SciELO, and Lilacs databases and the bibliographical reference lists of the articles. No limitations were placed on the time of publication, but the articles had to include children from 0 to 18 years old with CP who presented the prevalence of malnutrition and nutritional deficiencies. The methodological quality of the articles was assessed using the verification list for analytical cross-sectional studies, the Newcastle-Ottawa scale, and the Cochrane Collaboration tool for randomized studies. The meta-analysis of proportions was conducted based on the prevalence data for malnutrition or nutritional deficiencies. The study is registered in PROSPERO under CRD number 42020175068. Results: Sixty-seven articles (N = 453,804) published between 1986 and 2019 were included. Most of the articles presented a low risk of bias and no publication was excluded for quality reasons. The most widely used anthropometric index for diagnosing nutritional status was weight-to-age and the estimated prevalence of malnutrition was 40% (95% CI = 28.0-53.0). Nutrient deficiency was investigated by nine publications, with hypocalcemia and reduced serum concentrations of zinc, copper, and vitamin D being reported the most. Conclusions: We found a high rate of malnutrition in the population in this review, moreover, we suggest that some nutritional deficiencies are associated with food deficit and that the socio-economic and age factors of these children may relate with the poor nutritional outcome. This makes monitoring and personalized nutritional management necessary, in accordance with the characteristics and particularities of children with CP. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
NSTL
Elsevier