Analytical Epidemiological Studies Research Articles

Laboratory-confirmed respiratory viral infection triggers for acute myocardial infarction and stroke: Systematic review protocol.

Cardiovascular disease contributes substantially to global mortality and morbidity. Respiratory tract infections, particularly influenza, may trigger an increase in the short-term risk of acute myocardial infarction (AMI) and stroke. Recent studies have also linked this risk to other respiratory viruses, including respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the pathogen-specific relative contributions, the strength of their associations, and overall public health significance are poorly understood. Assuming causal links, understanding, quantifying, and comparing the effects of different pathogens as triggering factors for acute cardiovascular events is critical to guide future research and prevention. Our aim is to conduct a systematic review to examine the relative effects of laboratory-confirmed respiratory virus infections as triggers for acute myocardial infarction and stroke. We will conduct a comprehensive search of Ovid MEDLINE, PubMed, Ovid Embase, Cochrane Library Central Register of Controlled Trials, and Web of Science, from inception to the end of March 2024. Studies capturing respiratory viral infection(s) using laboratory-confirmatory methods, incidence of AMI or stroke (ischaemic or haemorrhagic), and those involving human participants in any country, will be assessed for eligibility. We will include the following analytical epidemiological study types: randomised controlled trials, cohort and case-control studies, self-controlled case series, and case-crossover designs. We will not impose restrictions on the date, language, study population, geographical region, or sample size, to minimise the risk of introducing biases. Search results will be screened for eligibility by two independent reviewers, and discrepancies resolved by consensus and/or arbitration by a third reviewer. We will assess the risk of bias among the included studies by adopting the Cochrane Collaboration tools for randomised and non-randomised studies. The overall quality of studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We will examine sources of heterogeneity, and if studies are sufficiently homogeneous, a meta-analysis will be conducted to calculate the pooled effect sizes. Reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42024494997.

Association between COVID-19 Vaccination (ChAdOx1-S) and Thromboembolic, Thrombocytopenic, Hemorrhagic Events: A Systematic Review and Meta-analysis of Analytical Epidemiological Studies.

We conducted a systematic review of analytical epidemiological studies to assess the association between ChAdOx1-S vaccination and thromboembolic, thrombocytopenic, and hemorrhagic events. We searched Medline, Embase, Google Scholar, WHO-COVID-19 database, and medRxiv for studies evaluating the association between ChAdOx1-S and vascular events. Primary outcomes of interest were cerebral venous sinus thrombosis, peripheral venous thrombosis (PVT), and thrombocytopenia. Two independent reviewers screened for eligible studies, extracted data, and assessed the risk of bias. The DerSimonian-Laird random effects model was used to pool the incidence rate ratios (IRRs) separately for the first and second doses. Heterogeneity was assessed using I2 statistics. Twenty studies were included, of which 11 were self-controlled case series, and nine were cohort studies (254 million participants). Pooling of 17 studies showed a higher risk of cerebrovascular thrombosis (IRR = 3.5, 95% CI = 2.2-5.4, I2 = 79%), PVT (IRR = 2.0, 95% CI = 1.1-3.5, I2 = 95%) and thrombocytopenia (IRR = 1.6, 95% CI = 1.4-1.9, I2 = 93%) among those who received ChAdOx1-S vaccination as compared to controls. No increased risk was seen after the second dose or for secondary outcomes. There is moderate-to-high certainty of the evidence for the increased risk of cerebral venous sinus thrombosis, PVT, and thrombocytopenia following the first dose of the ChAdOx1-S vaccine. Systematic Review Registration: PROSPERO CRD42022372768.

#1650 Synergistic effects of mineral bone disorder (MBD) markers and iron metabolism markers on QT prolongation in maintenance haemodialysis patients

Abstract Background and Aims Prolonged QT interval is known to be common in maintenance haemodialysis (HD) patients, and QT prolongation is a risk for the development of fatal arrhythmias and cardiovascular complications. Previously, we showed that low Ca and low or high P before dialysis were associated with QT prolongation in HD patients. In this study, we aimed to investigate the effect of abnormalities in MBD markers such as Ca and P on QT time when added to abnormalities in markers of iron metabolism, a known cardiac prognostic factor due to abnormal energy metabolism in the myocardium. Method A cross-sectional study was conducted on adult maintenance HD patients enrolled in the 2020 Japanese Society for Dialysis Therapy Annual Survey. Patients with dialysis frequency less than 3 times per week and patients with absent serum Ca, serum P, transferrin saturation (TSAT), serum ferritin, and QTc were excluded. After describing patient characteristics, an analytical-epidemiological study was conducted with serum Ca, P, TSAT, and serum ferritin as exposure and QTc >500 msec as outcome. Exposure was defined as cut off values for Ca, P, TSAT, and serum ferritin of 8.4/10, 3.5/6, 20/40, and 100/300, respectively according to JSDT guideline. Adjusted variables in the multivariate analysis were age, gender, history of dialysis, BMI, and presence or absence of diabetes, previous cardiovascular disease, P adsorption medication, vitamin D analogue use, calcimimetics use. Missing values were addressed using Multiple Imputation by Chained Equations. All analyses were performed using STATA 18.0. The significance level was set at 5%. Results 169 705 patients were analysed. Among all subjects, 65.6% were male, mean age was 69.7 years (standard deviation (SD) 12.4), 50.6% had comorbid diabetes, 24.1% had previous cardiovascular disease, and mean serum Ca and P levels were 8.6 mg/dL (SD 0.7) and 5.2 mg/dL (SD 35.8), respectively. The mean QTc was 452 msec (SD 37.9). In multivariate analysis, the increased risk of QT prolongation in the low Ca, low P, and high P categories was further increased with low TSAT and cancelled with high TSAT (Table). In contrast, no such effect was appeared for ferritin. Conclusion The present study suggests that the association between lower serum Ca and lower and higher serum P levels and QTc prolongation in maintenance haemodialysis patients may be enhanced at low TSAT levels and weakened at normal and high TSAT levels.

Persistent Global Burden of Stunting Among Children

Introduction: Childhood stunting is a critical indicator of chronic undernutrition, reflecting global challenges in poverty, food security, and health care, with variability highlighting the multifaceted nature of nutritional well-being. Objective: This study aims to provide a comprehensive overview of the global prevalence and trends of childhood stunting, elucidating the interplay of factors influencing its dynamics. Methods: A systematic review and analysis of epidemiological studies, meta-analyses, and health reports were conducted to compile a detailed table on the worldwide prevalence and trends of childhood stunting. Results: The collected data reveal a significant global burden of stunting, with notable disparities across regions, socioeconomic statuses, and age groups. Findings show a persistent high prevalence in regions like northwest Ethiopia and varied trends, with some areas achieving reductions in stunting rates due to effective interventions, while others witness stagnation or increases. Key associations were identified between stunting and factors such as low birth weight, socioeconomic status, and maternal health. The synthesis of recent studies indicates a critical ongoing public health challenge, particularly in Asia and Africa, where a significant proportion of children under five remain stunted. Discussion: The study underscores the complex interplay of demographic, socioeconomic, and environmental factors influencing stunting, highlighting the essential role of targeted and multifaceted public health interventions in mitigating this pervasive issue. Conclusion: Addressing childhood stunting necessitates a global commitment to integrated, evidence-based strategies focusing on the nutritional, health, and socio-economic determinants to ensure the well-being and growth of children worldwide.

Childhood maltreatment, parenting style and anxiety in Chinese youths: A case-control study

BackgroundAlthough evidence in supporting the associations between childhood maltreatment (CM), parenting style and anxiety in children and adolescents exists, few high-quality analytical epidemiological studies which focusing on clinically diagnosed anxiety disorders (AD) had been published. ObjectiveThe aim of this study was to further corroborate the associations between CM, parenting style, and AD in a large representative sample of Chinese children and adolescents. Participants and settingStudy subjects were derived from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a population-based cross-sectional program. MethodsIndividually matched case-control study design was adopted. Univariate and multivariate conditional binary logistic regression models were used to estimate the associations between CM, parenting style and AD. Dose-response trends were estimated using the Cochran-Armitage Chi-square test. A series of stratified analyses were conducted to explore effect modification on exposure-outcome association by some important features. ResultsTotally we screened out 202 cases and 404 matched controls, with an age mean of 14.43 years. Conditional logistic regression models revealed that EA and a higher level of parental over-protection were significantly associated with increased risk of AD, with adjusted ORs of 3.39 (95 % CI: 2.07–5.56) and 1.93 (95 % CI: 1.28–2.90). Stratified analysis identified noticeable effect modification by sex, age, and whether the only child in the family. ConclusionsMajor findings of this study suggested that children and adolescents who had experienced EA or raised up by over-protective parents are at increased risk of AD. Targeted intervention measures should be developed and implemented for these high-risk youths.

Comparison of Different Green Space Measures and Their Impact on Dementia Cases in South Korea: A Spatial Panel Analysis

Dementia has become a profound public health problem due to the number of patients increasing every year. Previous studies have reported that environmental factors, including greenness, may influence the development and progression of dementia. Studies have found that exposure to green space is associated with a lower incidence of dementia. However, many definitions of green space exist, and the effects of its use may differ with the type of green space. Therefore, two types of green space measures were considered in this study to assess the differences in their impact on the prevalence of dementia among females and males. This study used five years of data (2017–2021) from 235 districts in South Korea. The two green space measures used were open space density and normalized difference vegetation index (NDVI), which were derived from satellite images. The analysis utilized a combination of traditional and spatial panel analyses to account for the spatial and temporal effects of independent variables on dementia prevalence. The spatial autocorrelation results revealed that both measures of greenness were spatially correlated with dementia prevalence. The spatial panel regression results revealed a significant positive association between NDVI and dementia prevalence, and open space had a negative association with dementia prevalence in both genders. The difference in the findings can serve as the basis for further research when choosing a greenspace measure, as it affects the analysis results, depending on the objective of the study. This study adds to the knowledge regarding improving dementia studies and the application of spatial panel analysis in epidemiological studies.

Exploring the Insomnia-Ischemic Stroke Nexus: A Comprehensive Review.

Background: This study investigates the relationship between sleep patterns and ischemic stroke beyond the predominant focus on obstructive sleep apnea. Through a systematic review of the existing literature, we aim to elucidate the connections between insomnia, sleep duration, cardiovascular factors, and ischemic stroke onset. Methods: We searched databases, including MEDLINE, SciELO, Scopus, and Science Direct, using an adapted PICO framework. Using a search strategy with MeSH words, keywords, and expressions related to insomnia and stroke, we included clinical trials and analytical observational epidemiological studies, comprising cohort, case-control, and cross-sectional studies. Results: Following the initial search, we identified 984 records, with 779 titles and abstracts screened for eligibility after removing duplicates. From these, 63 full-text articles, including 5 in the data synthesis, were reviewed. Our findings highlight a significant correlation between poor sleep quality, extreme sleep durations, and a heightened risk of ischemic stroke, along with established cardiovascular risk factors, such as hypertension, hyperlipidemia, obesity, and diabetes. Conclusions: This systematic review offers a comprehensive analysis of ischemic stroke prevalence and its association with cardiovascular factors, such as hypertension, hyperlipidemia, obesity, and diabetes. It suggests that poor sleep quality and extreme sleep durations, particularly long ones, are linked to a heightened risk of ischemic stroke.

Global Burden of Pancreatic Cancer Attributable to High Body-Mass Index in 204 Countries and Territories, 1990-2019.

(1) Background: This study aimed to assess the global burden of pancreatic cancer attributable to a high BMI in 1990-2019. (2) Methods: An ecological study was carried out. Data about deaths and Disability-Adjusted Life Years (DALYs) for pancreatic cancer were extracted from the Global Burden of Disease (GBD) study. The age-standardized rates (ASRs, per 100,000) were presented. In order to determine trends of pancreatic cancer burden, joinpoint regression analysis was used to calculate the average annual percent change (AAPC). (3) Results: The highest ASRs of DALYs of pancreatic cancer were found in the United Arab Emirates (47.5 per 100,000), followed by countries with about 25.0 per 100,000 (such as Hungary, Czechia, and Montenegro). From 1990 to 2019, the ASRs of deaths and DALYs of pancreatic cancer attributable to a high BMI significantly increased (p < 0.001) for both sexes in all ages, and across all SDI quintiles and all GBD regions. The highest fraction of DALYs attributable to a high BMI was found in the United States of America and China (equally about 15.0%), followed by the Russian Federation, India, Germany, and Brazil (about 5.0%, equally). (4) Conclusions: Further analytical epidemiological studies are necessary to elucidate the relationship between pancreatic cancer and a high BMI.

GLAUCOMA EPIDEMIOLOGICAL SITUATION IN THE FERGANA VALLEY: REGIONAL CHALLENGES

The aim of the research was to organize and conduct a prospective analytical epidemiological study to determine the prevalence of glaucoma in the Andijan region of the Fergana Valley.

Spatial analysis in epidemiological studies of dengue: A systematic review and meta-analysis

Background: Dengue is a serious tropical disease caused by the mosquito-borne dengue virus (DENV). Over the last 50 years, the incidence of dengue fever (DF) and dengue fever and dengue hemorrhagic fever (DHF) worldwide has increased by 50-fold and 2.5 billion people currently live in dengue-endemic regions. This study reports a systematic review and meta-analysis of different types of applications offered by spatial analysis in epidemiological studies of dengue. Materials and methods: A comprehensive literature search of Web of Science, SCOPUS, Google Scholar, and PubMed were conducted up to December 2023. A total of three sub-sections, namely spatial analysis of points, spatial analysis of area data, and software programs used for spatial analysis of dengue cases, will be presented in this review. Results: It was found that spatial analysis can effectively support the study of dengue fever and dengue hemorrhagic fever such as to investigate spatial patterns, hotspot, spatial clustering, the spread, transmission of dengue fever and dengue hemorrhagic fever and it’s affecting factors. Conclusion: applications of spatial analysis can provide important information and contribute to development of effective measurements to control and prevent the dengue fever and dengue hemorrhagic fever transmission. Finding in this study provide an insight into how to use different techniques in the study of dengue fever and dengue hemorrhagic fever.

Epidemiological study of pediatric ACL injuries

ACL rupture in children is a serious injury that exposes the knee to meniscal damage and then, in the medium term, to osteoarthritis. The incidence of this type of injury has been rising steadily since the 1990s with the everincreasing practice of "pivotal" sports such as football, basketball, handball, rugby and gymnastics. The aim was to study the characteristics of the population of subjects affected and to identify risk factors for meniscus and cartilage damage. This was a retrospective, descriptive and analytical epidemiological study of 80 children who had consulted an orthopaedic clinic for an ACL rupture. At the orthopaedic consultation centre at Haguenau Hospital, from March 2014 to November 2022, with an average age of 13.8 years. Diagnosis was based on questioning, clinical examination and MRI as paraclinical examinations. The 15 parameters analysed were as follows: age at the time of the initial trauma, sex, corrected body mass index (BMI), side, type of sport practised, sporting level, Tegner score, circumstances of the causal trauma, time to consultation, time to MRI, attempt at functional treatment, time to surgery, associated meniscal lesions. The age at the time of surgery, and at the end the operative report. There is still a debate on the optimal treatment of ACL ruptures. Most surgeons who specialise in this area support early surgery, with the aim of preventing secondary damage and returning to the previous level of physical activity as quickly as possible. Of the 80 cases, 88.75% were treated surgically and 11.25% functionally, with a median corrected BMI of 19.7. 41.25% of cases had associated meniscal lesions. The 3 most frequently practised sports were handball, rugby and football. We also found a close relationship between meniscal injury and corrected BMI. Our results are in line with the literature, which is in favour of early repair of the anterior cruciate ligament in adolescent athletes, especially those with a BMI.

Association between perceived stress and history of intimate partner violence throughout life and during the COVID-19 pandemic.

Intimate Partner Violence (IPV) is a significant public health issue, characterized by being a highly stressful experience for its victims. The relationship between IPV and stress creates a harmful cycle with broad health implications, affecting individuals and society at large. Despite its significance, there's a noticeable lack of research on this topic, especially regarding IPV throughout one's life and during the pandemic. To verify the association between perceived stress and the history of intimate partner violence throughout life and during the COVID-19 pandemic. Analytical cross-sectional epidemiological study with a sample of 1,086 women. Sociodemographic information and violence history, assessed using the World Health Organization Violence Against Women (WHO VAW STUDY), along with perceived stress measured by the short version of the Perceived Stress Scale (PSS), were collected. The sampling process unfolded through multiple stages. For bivariate analyses, the t-test and ANOVA were performed, whereas for multivariate analyses simple and multiple linear regression were performed. The software Stata® version 15.1 and R® were used. Women who reported having suffered intimate partner violence throughout their lives had higher means of stress (18.49), with an average increase of 4 points without adjustments and 3.5 points after adjustments for sociodemographic variables. Similarly, during the COVID-19 pandemic (19.01), stress increased by an average of 3.3 points, which was reduced to 2.8 points after adjustments. The results indicate an association between intimate partner violence and an increase in women's perceived stress, both throughout life and during the pandemic. The importance of preventive approaches, promoting gender equality and preventing IPV from the early stages of life is highlighted. In addition, they underscore the urgency of evidence-based interventions of a comprehensive nature to deal with this complex issue in a careful and effective manner. The cross-sectional nature of this study limits the inference of causality, and an additional limitation is acknowledged concerning information bias. This bias relates to the multifaceted issues surrounding the concept of violence, potentially influencing the accuracy of participants' information and complicating the measurement of violence.

Risk Assessment of Esophageal Cancer Prevalence in North East India

Background: The North East (NE) India region has a quite distinct gene pool with over 160 scheduled tribes and 400 other sub-tribal populations. This region is the fourth contributor to the gene pool of the Indian sub-continent, which has associations with Tibeto-Burman speakers and Austro-Asiatic speakers settled in East and NE-India with Asian ties. Methods: Literature search and studies have shown that in India, notwithstanding the lack of data on population coverage, there exists no such evidence for a decline in age-standardized mortality rates in cancer and the number of deaths mostly in individuals less than 70 years. Results: Analytical epidemiological studies using molecular markers are currently the need of NEIndia for prognostication of cancers in this region, which are quite different from the rest of India, such as esophageal cancer, lung cancer in females, stomach cancer, and nasopharyngeal cancers. In addition, there is a dire need for translational research in NE-India, as for cancer survival, it is not always feasible to generalize the current international guidelines for cancer to the population of NEIndia so that high survival rates are achieved just like the rest of India and high-income rich countries. Factors, such as difference in incidence rate, socioeconomic factors, tumor biology and availability of resource in this region, determine the survival rates. Conclusion: In this review, various factors involved in the high cancer burden in this region are discussed, particularly focusing on the genetic basis.

THE EPIDEMIOLOGICAL ANALYSIS OF YEARLQ DYNAMICS OF COVID-19 MORBIDITY IN THE DISTRICTS OF BAKU CITY

The article presents the results of an analytical epidemiological study of the incidence of COVID-19 among the population (including children and adults, men and women) of Baku and its regions for 2021. The purpose of the study is to conduct an epidemiological analysis of the annual dynamics of the incidence of COVID-19 in the districts of Baku. The material for the study was the absolute incidence of COVID-19, which were subject to analytical and statistical processing in the course of descriptive and analytical epidemiological studies. A comparative epidemiological analysis of the incidence of COVID-19 in the districts of Baku was carried out among the total population, including children and adults, as well as women and men, depending on age groups and the month of detection. Intensive per 1000 people (‰) and extensive (%) rates of incidence of COVID-19 were calculated among the specified populations. The results of an analytical epidemiological study made it possible to establish a risk group for the incidence of COVID-19 among the population of the districts of Baku. The risk group by age was the adult population, by gender women, among the children's population by age - 5-13 years. As a risk factor for the season, the autumnwinter seasonality of the incidence of COVID-19 was established. As a result of a prospective epidemiological analysis of the epidemiological situation for COVID-19, areas of high, medium and low risk were identified depending on the incidence of COVID-19 in Baku in 2021.

Temporal trends and geographic variations in mortality rates from tobacco and firearms in the United States

We explored temporal trends and geographic variations in United States of America (US) mortality rates from smoking and firearms from 1999 to 2019. To do so, we used the publicly available Centers for Disease Control and Prevention (CDC) Wide Ranging Online Data for Epidemiologic Research (WONDER) with Multiple Cause of Death files from 1999 to 2019. Using age-specific rates and ArcGIS Pro Advanced software for Optimized Hot Spot Analyses from Esri, we generated maps of statistically significant spatial clusters with 90–99% confidence intervals with the Getis-Ord Gi* statistic for mortality from smoking-related causes and firearms.These data show temporal trends and geographic variations in mortality from smoking and firearms in the US. Smoking and firearm-related mortality from assault and suicide increased throughout the US and clustered in the Southeast. Firearm-related suicide also clustered in the continental West and Alaska. These descriptive data generate many hypotheses which are testable in analytic epidemiologic studies designed a priori to do so. The trends suggest smoking and firearm-related causes pose particular challenges to the Southeast and firearms also to the West and Alaska. These data may aid clinicians and public health authorities to implement evidence-based smoking avoidance and cessation programs as well as address firearm mortality, with particular attention to the areas of highest risks. As has been the case with cigarettes, individual behavior changes as well as societal changes are likely to be needed to achieve decreases in premature mortality.

Clinical and Epidemiological Characteristics of COVID-19 in Persons Living with HIV Complicated by Tuberculosis

Relevance. At present, three infections – HIV infection, tuberculosis, and COVID-19 - are spreading simultaneously in the world. Of great practical importance is the assessment of clinical and epidemiological features of COVID-19 in HIV-infected patients with tuberculosis, COVID-19. Aim. To study the risk of COVID-19 disease and identify clinical and epidemiological features in and population of patients with HIV infection complicated by tuberculosis in comparison with patients with HIV infection and the population without these diseases.Materials and methods. Since 13.03.2020 by 31.12.2021 in the Kemerovo Region-Kuzbass, a continuous prospective analytical epidemiological study of the case-control type was performed. Of those with COVID-19, two observation groups were formed: group I (HIV +), group II (HIV/TB) and comparison group III (persons without either HIV or tuberculosis). All patients underwent: determination of SARS-CoV-2 RNA, standard examination methods in accordance with the temporary methodological recommendations «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)», relevant at the time of treatment.Results. The incidence of COVID-19 among patients with HIV infection complicated by tuberculosis exceeded the incidence of COVID-19 among HIV-infected by 14%. There were no gender differences between patients I (HIV +) and II (HIV/TB) groups. In the comparison group, the incidence of COVID-19 was 1.26 times higher in women compared to men. COVID-19 disease in patients with co-infection (HIV/TB) was predominantly mild. Viral pneumonia developed 1.86 times less often, oxygenotherapy was required only in 18.75% of cases, which is 2.5 times lower than in group I (HIV +) and 2.47 times less than in the comparison group (III). In labeled pairs, clinical symptoms of COVID-19 in all groups occurred with the same frequency. Metabolic disorders were evident in all groups. Co-infected patients (HIV/TB) had higher levels of D-dimer, ESR, total bilirubin.Conclusion. Active tuberculosis in HIV-infected people is a factor that increases the risk of COVID-19 disease without affecting the severity of the infectious process.

Real-life evaluation of incidence and clinical outcomes of COVID-19 among healthcare workers during pre-vaccination and post-vaccination periods: A cross-sectional impact study.

We aimed to evaluate the prevalence and clinical outcomes of COVID-19 in healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods. In addition, we determined factors associated with the development of COVID-19 after vaccination. In this analytical cross-sectional epidemiological study, HCWs who were vaccinated between January 14, 2021, and March 21, 2021, were included. HCWs were followed up for 105 days after the 2 doses of CoronaVac. Pre-vaccination and post-vaccination periods were compared. A total of 1,000 HCWs were included, 576 patients (57.6%) were male, and the mean age was 33.2 ± 9.6 years. In the last 3 months during the pre-vaccination period, 187 patients had COVID-19, and the cumulative incidence of COVID-19 was 18.7%. Six of these patients were hospitalized. Severe disease was observed in three patients. In the first 3 months post-vaccination period, COVID-19 was detected in 50 patients, and the cumulative incidence of the disease was determined to be 6.1%. Hospitalization and severe disease were not detected. Age (p = 0.29), sex (OR = 1.5, p = 0.16), smoking (OR = 1.29, p = 0.43), and underlying diseases (OR = 1.6, p = 0.26) were not associated with post-vaccination COVID-19. A history of COVID-19 significantly reduced the likelihood of the development of post-vaccination COVID-19 in multivariate analysis (p = 0.002, OR = 0.16, 95% CI = 0.05-0.51). CoronaVac significantly reduces the risk of SARS-CoV-2 infection and alleviates the severity of COVID-19 in the early period. Additionally, HCWs who have been infected and vaccinated with CoronaVac are less likely to be reinfected with COVID-19.

The epidemic process of a new coronavirus infection among medical workers in the context of V.D. Belyakov’s theory of self-regulation of parasitic systems

BACKGROUND: The epidemic process of COVID-19, during the analyzed time interval (20202022), like any parasitic system, had a cyclic course, which corresponded to the main provisions of the theory of V.D. Belyakov on the self-regulation of parasitic systems. At the same time, cyclic changes in the clinical and epidemiological characteristics of the infection occurred in the general population and among its cohorts, including employees of medical organizations. The study of the clinical and epidemiological features of COVID-19 in medical workers at various stages of the pandemic is an important area of scientific research that allows the quick adjustment of preventive and antiepidemic measures for reducing the impact of biological factors on the epidemic process.&#x0D; AIM: This study determines the clinical and epidemiological features of COVID-19 in medical workers, considering the phase transformations of the pathogen, and assesses the effectiveness of individual antiepidemic measures at different stages of the pandemic.&#x0D; MATERIALS AND METHODS: The reporting forms General information about patients with positive COVID-19, General information about patients with community-acquired pneumonia with positive COVID-19 (497 units of information), 2176 cards of epidemiological investigation of COVID-19 cases among employees of 3 municipalities were analyzed. Epidemiological and statistical research methods were used.&#x0D; RESULTS: When studying the epidemic process of a new coronavirus infection among medical workers, there was a decrease in the incidence of COVID-19 and the proportion of severe clinical forms of infection and foci during the pathogen reservation phase that corresponded to the appearance of a new genetic variant. During the epidemic spread phase of the pathogen, the largest number of recurrent disease cases was recorded, and disease cases were among those previously vaccinated against this infection. The coefficient and index of focality and the average duration of the existence of the focus in this phase were higher than in the previous one. Among the factors that negatively affected the epidemic were shortcomings in implementing antiepidemic measures, violations in the flow of technological processes, crowding, and lack of working space. As the number of vaccinated and recovered COVID-19 medical workers increased, the nature of the clinical manifestations of the infection changed regarding an increase in the proportion of mild (erased) forms, and a number of characteristics of the epidemic process also changed regarding the frequency of foci formation with multiple diseases.&#x0D; CONCLUSIONS: The conducted analytical epidemiological study confirms the universal nature of the main provisions of the theory of V.D. Belyakov about the self-regulation of parasitic systems at the population level. It also allows us to explain the individual characteristics of the epidemic process among specific cohorts, in particular medical workers, considering the phasic nature of the epidemic, the influence of pathogen and host population transformations, and social and natural factors.

Knowledge and perception attributes about halitosis and its treatment modalities among undergraduate students of dentistry and medicine

Background: A worldwide halitosis frequency of 10% - 30% is a common oral health complaint. Bad breath is described as a persistent condition in which a person's oral emissions are unpleasant or disagreeable. It not only hinders the person's ability to go about their routine activities, but also causes them shame and lowers their self-esteem, which in turn lowers their overall quality of life. Objective: The purpose of this study is to investigate how students majoring in dentistry and medicine see their own halitosis. Methodology: The students inducted in Bachelors in Medicine &amp; Bachelors in Surgery (MBBS), and Bachelors in Dental Surgery (BDS) programs at various Teaching Institutes in Rawalpindi participated in this descriptive cross-sectional analytical epidemiological study. Around 500 undergraduates were given a self-administered questionnaire. Results: In our study, 96 (22.54%) were male students and 330 (77.46%) were female students respectively. 62 (64.6%) male and 255 (77.3%) female students from a variety of disciplines were familiar with the term ‘Halitosis’. 29 students (6.8%) said that halitosis had a mild impact, 189 students (44.36%) said that it had a moderate effect whereas 206 students (48.35%) rendered it as a major severe significant factor affecting their social life deleteriously.

Factors associated with yellow fever vaccine failure: A systematic literature review.

Considering that vaccination with yellow fever vaccine (YFV) is the most important method to prevent and control yellow fever (YF), this study synthesized evidence on factors associated with YFV failure. A systematic review (SR) was performed in the PubMed, Cochrane CENTRAL, Embase, and LILACS databases up to November 2019. Observational and experimental analytical epidemiological studies that analyzed the failure of YFV were included. This review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and meta-Analyses. A total of 1,466 articles were identified after searching the databases of which 46 were included in the qualitative analysis after applying the elegibility criteria. Our findings indicated that YFV confers protective immunity in different age groups; when produced by different producers; when administered simultaneously with a range of other vaccines; when used as fractional doses and when used with prophylactic and immunosuppressive therapies. It failed to produce a protective response in some pregnant women, children under two years of age, children with Kwashiorkor and when long periods of time have passed after vaccination. For individuals with human immunodeficiency virus (HIV), the results were divergent. The results of this SR revealed the factors associated with the failure of the YFV, and the results can support recommendations on vaccination policies, support the safety of health professionals who work directly with immunization in the implementation of the vaccination schedule, in addition to guiding future research and enhance the credibility of YFV in the prevention of a serious disease such as YF.