Annual Prevalence Rates Research Articles

INFLUENCE OF POPLITEUS MUSCLE MANIPULATION AND QUADRICEPS STRENGTHENING ON ANTERIOR KNEE PAIN IN RUNNERS

Background: Anterior knee pain is prevalent among young athletes, with sports-related injuries accounting for 25–30% of cases. Patellofemoral pain syndrome (PFPS) contributes to up to 40% of knee disorders, with annual prevalence rates reported at 22.7% in the general population and 28.9% in adolescents. Among runners, the incidence of PFPS ranges from 37% to 56%. Objective: The popliteus muscle is primarily associated with anterior knee pain but may also influence posterior knee discomfort. This study aims to investigate the effects of soft tissue manipulation of the popliteus muscle combined with quadriceps strengthening exercises on anterior knee pain in athletic runners, addressing a gap in the literature regarding the interaction between these muscle groups. Methods: In this experimental study, 30 subjects with non-traumatic anterior knee pain were recruited. Baseline assessments included quadriceps strength and pain levels. Participants then underwent six sessions of popliteus manipulation alongside quadriceps strengthening exercises. Post-intervention, all parameters were reassessed. Results: A significant reduction in knee pain (P < 0.005) was observed after the six-week intervention, with more pronounced improvements in Group A compared to Group B. Conclusion: The results suggest that incorporating popliteus soft tissue manipulation can effectively reduce anterior knee pain while strengthening the quadriceps enhances muscle function. These findings support the integration of popliteus manipulation into treatment protocols for athletes experiencing anterior knee pain.

Fraction of Cancer Attributable to Carcinogenic Drugs in Korea from 2015 to 2030.

This study aims to estimate and project the Population Attributable Fraction (PAF) of cancer incidence and death due to carcinogenic drug use in Korea from 2015 to 2030, to estimate the degree of cancer prevention from exposure to carcinogenic drugs in Korea. Selected carcinogenic drugs were immunosuppressive and antineoplastic drugs classified as group I by the International Agency for Research on Cancer (IARC). Systematic review and meta-analyses were conducted to estimate the relative risk (RR) of cancer associated with carcinogenic drug use. Age was standardized using the annual prevalence rate of the National Health Insurance Service sample cohort (NHIS-NSC) from 2002 to 2013 to calculate the standardized prevalence rate of carcinogenic drug use each year. The PAF of specific cancer incidence and death were calculated using Levin's formula and Monte Carlo methods. The prevalence rates were extrapolated to estimate the trend of PAF from 2015 to 2030. In 2015, carcinogenic drugs attributed to 0.003% and 0.002% among the causes of cancer incidence and death in Korea. However, carcinogenic drugs attributed to 1.1% among the causes of both cancer incidence and death in patients with clinical indications of carcinogenic drugs. The PAF in patients with clinical indications of carcinogenic drugs were significantly high and expected to increase rapidly over time. Since these drugs are listed as essential by the World Health Organization (WHO), and may be difficult to replace, a surveillance system on susceptible populations using group I carcinogenic drugs must be discussed and implemented.

A meta-analysis of the prevalence of work-related musculoskeletal disorders among rehabilitation therapists

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in rehabilitation therapists. Methods: In September 2023, the computer searched Chinese and English databases such as CNKI database, Wanfang Data Knowledge Service Platform, VIP Chinese Science and Technology Journal Database, Chinese Biomedical Literature Database, PubMed, Cochrane Library, Web of Science, Embase database, etc. The retrieval time was from the establishment of the database to September 2023. Musculoskeletal disorders, rehabilitation therapists were selected as search terms, and the author, publication time, prevalence rate, and study type were analyzed. The Agency for Healthcare Research and Quality (AHRQ) tool and The Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the literature. Stata 15.0 software was used for meta-analysis. Results: A total of 28 literatures were included, including 8039 rehabilitation therapists. Meta-analysis showed that the overall prevalence rate of WMSDs among rehabilitation therapists was 72% (95%CI: 64%-80%). The top 3 annual prevalence rates were lower back (51%, 95%CI: 38%-64%), neck (42%, 95%CI: 30%-54%) and shoulder (32%, 95%CI: 23%-41%). The top 3 weekly prevalence rates were lower back (47%, 95%CI: 28%-65%), neck (35%, 95%CI: 14%-55%) and back (30%, 95% CI: 17%-44%) . Conclusion: The higher prevalence of WMSDs in rehabilitation therapists, especially in the lower back, neck, shoulder and back, may be related to the prolonged stouching posture and the continuous or repeated exertion of the upper limbs.

Trends in the incidence and prevalence of cirrhosis in Manitoba, Canada: A population-based study (2010-2019)

Introduction and objectivesThe burden of chronic liver disease and cirrhosis continues to increase in North America. We sought to estimate the incidence and prevalence of cirrhosis in Manitoba, Canada over time and assess changes in trends between 2010-2019. Material and methodsWe performed a population-based study using Manitoba administrative health care data, and two validated case-finding algorithms. Annual incidence and prevalence rates were estimated using a generalized linear model with generalized estimating equations, adjusting for age and sex. Changes in estimates were tested using linear trend regression models. ResultsTwo algorithms estimated the number of prevalent cirrhosis to be 16,140 and 29,943 respectively. The age- and sex-adjusted incidence rates increased over the study (from 149 to 264 cases per 100,000 population in 2010, to 177 to 388 cases per 100,000 population in 2019). Cirrhosis incidence increased annually by 2-6 %, with the largest increase (6-8 % 95 % CI 7-9 %, p <0.0001) in those aged 18-44 years. Irrespective of the algorithm used, females consistently exhibited higher cirrhosis incidence and prevalence compared to males over time (P <0.0001). Prevalence demonstrated an upward trend among all age groups over time for both algorithms (P < 0.0001). ConclusionsThis population-based study highlights concerning temporal trends in cirrhosis, characterized by rising annual incidence and prevalence estimates, particularly among young adults and females. These findings underscore the urgent need for comprehensive strategies that encompass prevention, early detection, and the delivery of high-quality healthcare and public health initiatives to effectively tackle this escalating health burden.

Prevalence of Multimorbidity and Chronic Diseases in citizens of the Métis Nation of Ontario

Objective and ApproachPopulation-based analyses of Métis health in Canada are limited. The Métis are a distinct Indigenous people with both First Nation and Euro-Settler ancestry. This study aimed to examine multimorbidity in the Métis Nation of Ontario (MNO) citizens from 2009 to 2019. Registered MNO citizens were linked to Ontario’s administrative health data. An existing data algorithm identified individuals with multimorbidity (2+ chronic conditions) among MNO citizens and the Ontario population aged 18+. Annual prevalence rates of multimorbidity were calculated and rates in the latest year were compared across income quintiles, age, and sex. Results &amp; ConclusionThe prevalence of multimorbidity increased in MNO citizens from 49.2 per 100 (CI: 48.1-50.2) in 2009 to 61.0 per 100 (CI: 59.9-62.1) in 2018. A consistently higher prevalence rate was seen in MNO citizens compared to non-MNO citizens across the entire period. Female MNO citizens had a higher prevalence of multimorbidity compared to males. The prevalence of multimorbidity increased with age in MNO citizens from 40.5 per 100 (CI: 39.1-41.8) in those aged 18 to 44 years up to 91.6 per 100 (CI: 88.4-98.0) in those aged 65 years and older. An income gradient was evident with MNO citizens in the highest income quintile having the lowest prevalence of multimorbidity (57.1 per 100) compared to those in the lowest income quintile (66.3 per 100). ImplicationsUnderstanding the burden of multimorbidity in MNO citizens is essential for the MNO to guide program and policy planning, as well as support decision-making related to resource allocation.

CLINICOHISTOPATHOLOGICAL STUDY OF TESTICULAR TUMOURS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG

Objective: The purpose of this research was to describe the clinical and histopathological characteristics of testicular tumours at Hasan Sadikin General Hospital (RSHS) between 2017-2021. Material &amp; Methods: This research was a cross-sectional descriptive study examining the clinical and histopathological profiles of testicular tumours. The secondary data sources included medical records from the Department of Urology, Anatomic Pathology, Medical Records, and Hospital Information System (SIRS). The collected data covered age, ethnicity, clinical symptoms, site, stage, annual prevalence rate, and analyzed using Microsoft Excel. Results: There were 42 patients who had primary testicular tumour. The highest prevalence of testicular tumours at RSHS was in 2019 consist of 12(29%) patients and the lowest in 2020 were 6(14%) patients. Most patients were &gt;35 years old amounting 19(45%) patients, Sundanese ethnicity were 29(69%) patients, and testicular enlargement revealed in 27(64%) patients. Majority patients were in stage 0/IB 36(86%) patients and occurred in unilateral testis which 34(80%) patients, with 3(7%) patients metastasized. The most common histopathological type was seminoma 18(43%) cases followed by prepubertal-type yolk sac tumour 9(21%) patients. Seminomas, and the fibroma-thecoma group were mostly in patients over 35 years old, while prepubertal-type yolk sac tumour was more commonly in children under 15 years old. Conclusion: Prevalence of testicular tumours increased from 2017 to 2019, then started to decrease in 2020. Histopathologically, seminoma was the most common type. These tumours were most commonly found in older individuals (&gt;35 YO) and unilateral, diagnosed in stage 0/IB, and were mostly presented with enlargement of testis. Keywords: Testicular tumours, clinical features, histopathology

Epidemiology and prognostic nomogram for invasive breast cancer aged 85 years and older in the USA

The available data on epidemiology and prognostic factors of female patients with breast cancer aged 85 years and older in the USA are limited, especially regarding molecular-level heterogeneity. Relevant data were extracted from the surveillance, epidemiology, and end-result database. The incidence rate and the annual prevalence rate were determined. The annual percent change (APC) of incidence was measured to determine the gradual trends or changes in rates. A visual nomogram was constructed to predict the 3-year overall survival (OS). The Kaplan–Meier method and log-rank test were performed for survival analysis. In total, 18,137 female patients with invasive breast cancer aged 85 years and older were included. Among these patients, patients with HR+/HER2− accounted for 68.7%, followed by HR−/HER2− (9.3%), HR+/HER2+ (7.4%), and HR−/HER2+ (3.1%). The overall incidence rate among this population was 181.82 (95% CI 179.18–184.49) per 100,000 women. This decreased from 184.73 to 177.71 per 100,000 women from 2010 to 2019, with an APC of − 1.0 (95% CI − 1.8 to − 0.1, P = 0.036). The incidence rate varied across receptor subtypes and races and was higher in patients with HR+/HER2− or the black population. The most common treatment regime was breast-conserving surgery. Approximately 29.2% of all patients were categorized as receiving no treatment. A nomogram for predicting 3-year overall survival was constructed, with a consistency index of 0.71. Furthermore, the calibration curves showed consistency. In this study, we have presented the epidemiological data of invasive breast cancer in females aged 85 years and older in the USA. The developed predictive nomogram can effectively identify patients with poor survival.

Work-related musculoskeletal disorders and associated factors among weavers working in Bahir Dar City, Northwest Ethiopia: cross-sectional study design

BackgroundWork-related musculoskeletal disorders are one of the most common public health problems throughout the world. It is a major cause of occupational injury, illness, and disability that leads to an increased rate of sick leave, financial costs for both individuals and society and the health care system. Weavers are among the populations exposed to musculoskeletal disorders due to a lack of occupational safety, health services, and poor working conditions. Yet, little is known about WMSD among weavers in Africa particularly in Ethiopia. Thus, this study aimed to assess the prevalence and associated factors of work-related musculoskeletal disorders among weavers.MethodA multi-centered institutional-based cross-sectional study was conducted in Bahir Dar City, Ethiopia among 424 weavers with a response rate of 97.7%. Participants were recruited randomly after proportional allocation was done for each institution and face-to-face interviews were employed to collect data using a well-structured questionnaire adopted from the Nordic musculoskeletal questionnaire and different literature. The data were entered into Epidata and analyzed using SPSS version (Choobineh A, Lahmi M, Shahnavaz H, Khani Jazani R, Hosseini M. Int J Occup Saf Ergon, 10:157–68, 2004). Variables with a P-value < 0.25 in the bivariate logistic regression were entered into a multivariable logistic regression model. Finally, variables with an AOR, a 95% confidence interval, and a P-value of < 0.05 were reported.ResultThe annual prevalence rate of work-related musculoskeletal disorders among weavers was 76.3% [CI = 72.2 to 80.2%]. Longer working hours [AOR = 3.48, CI = (1.96–6.21)] lack of back support during sitting [AOR = 2.50 (1.293–4.480)], having repetitive movement in weaving [AOR = 4.11(2.029–8.324)], attaining awkward posture [AOR = 3.37(1.875–6.059)] and job stress [AOR = 4.37(2.447–7.816)] was significantly associated with work-related musculoskeletal disorders.ConclusionsThis study revealed a high prevalence of WMSDs among weavers. Our study findings reported that longer working hours, lack of back support during sitting, having repetitive movement in weaving attaining awkward posture, and having job stress were significantly associated with work-related musculoskeletal disorders.

Charting the Course: Insights into Neuroendocrine Tumor Dynamics in the United States.

To explore changing trends and characteristics in neuroendocrine tumors (NETs) epidemiology, focusing on demographics, clinical aspects, and survival, including the impact of social determinants of health (SDOH) on outcomes. The escalating incidence and prevalence of NETs underscore the pressing need for updated epidemiologic data to reveal the evolving landscape of this condition. Access to current information is imperative for informing clinical strategies and public health initiatives targeting NETs. A retrospective, population-based study analyzed NET patient data from 1975 to 2020, using the Surveillance, Epidemiology, and End Results (SEER 8, 12, 18) program. We calculated annual age-adjusted incidence, prevalence, and 5-year overall survival (OS) rates. Survival trends from 2000 to 2019 were examined, employing the Fine-Gray model to evaluate cancer-specific mortality. NETs' age-adjusted incidence rate quadrupled from 1.5 per 100,000 in 1975 to 6.0 per 100,000 in 2020. A decline in incidence occurred from 6.8 per 100,000 in 2019 to 6.0 per 100,000 in 2020. All-cause survival multivariable analysis demonstrated high grade (HR: 2.95, 95% CI: 2.63-3.09, P<0.001), single patients (HR: 1.49, 95% CI: 1.45-1.54, P<0.001), and Black patients (HR: 1.17, 95% CI:1.13-1.22, P<0.001) all had worse survival than their controls. In conclusion, our study shows a steady increase in NETs incidence until 2019, with a decline in 2020. Understanding the reasons behind this trend is vital for improved management and public health planning. Further research should focus on the factors driving these changes to enhance our understanding of NET epidemiology.

Trends in the prevalence and incidence of Crohn’s disease in Japan and the United States

PurposeThis study is to describe patient demographic characteristics and estimate annual prevalence and incidence rates of Crohn’s disease (CD) in Japan and the United States (US).MethodsTwo large employment-based healthcare claims databases (Japan Medical Data Center [JMDC] in Japan and Merative MarketScan [Merative] in the US) were used to identify patients with CD from 2010 to 2019. Cases were confirmed using an algorithm based on diagnostic with/without treatment codes. The Merative population was used for sex and age standardization of annual prevalence and incidence rates estimated from the JMDC.ResultsPatients with CD were generally younger in Japan than in the US at diagnosis (mean 33.6 vs. 39.4 years) and 71.5% were male versus 45.1% in the US. Annual prevalence per 100,000 population increased substantially in both countries, from 34.2 in 2010 to 54.5 in 2019 in Japan (standardized) and 163.3 to 224.2 in the US. Prevalence rates increased in both males and females in all age groups between 6 and < 65 years. Annual incidence rate per 100,000 person-years was almost fourfold higher in the US than Japan (21.0 vs. 5.5 [standardized] in 2019) but remained stable in both countries over time in both sexes and in all age groups.ConclusionThe epidemiology of CD differs between Japan and the US. Research to understand the basis of these differences could help to identify at-risk groups in each country, and guide implementation of preventive measures.

Changing trends in Japanese spotted fever epidemiology in Shimane, Japan: A two-decade retrospective study with emphasis on the COVID-19 pandemic era

IntroductionThe objective of this study is to evaluate the epidemiological characteristics of Japanese Spotted Fever (JSF) cases reported through the National Epidemiological Surveillance of Infectious Disease (NESID) system in Shimane Prefecture, Japan, from 2000 to 2022, encompassing the periods before and during the COVID-19 pandemic period. MethodsA retrospective analysis was conducted on JSF cases reported to the NESID system in Shimane Prefecture between 2000 and 2022. Population data were obtained from the Statistical Information of Shimane. Poisson regression analysis was employed to examine the relationship between the annual prevalence rate of JSF and the COVID-19 pandemic. ResultsA total of 301 JSF cases were analyzed during the study period. Even the pre-COVID-19 pandemic period, a gradual and significant increase in the prevalence rate was observed (prevalence rate = 1.03, 95% CI: 1.01–1.05; p = 0.01), and a rapid increase was noted since 2020 (prevalence rate = 1.57, 95% CI: 1.39–1.78; p < 0.01). The slope during the pre-COVID-19 pandemic period was estimated to have significantly increased (p < 0.01). ConclusionsOur findings suggest that while the prevalence rate of JSF had exhibited a slight increase in the years preceding the COVID-19 pandemic, it demonstrated a more significant increase following the pandemic in Shimane Prefecture. JSF has increased since 2020 and may be linked to COVID-19 pandemic. The COVID-19 pandemic has had a substantial impact on global health, underscoring the importance of investigating the prevalence of specific infectious diseases and other health-related indicators to accurately assess the pandemic's impact.

Use of polygenic and clinical risk scores in wide spectrum congenital heart malformations: a diagnostic and therapeutic perspective

Worldwide, congenital heart defects (CHDs) are a leading cause of mortality and morbidity. Globally, the annual prevalence rate of CHDs is about 1.5 million. It is one of the most common life-threatening congenital malformations, with a visible difference between high-income countries (HICs) and developing countries. This difference may be attributed to the diagnostic facilities and interventions.1 Moreover, the use of genetic and clinical risk scores is less studied in this field compared to other diagnostic and therapeutic approaches. Thus, we comprehensively review the available literature on adult and pediatric syndromic or non-syndromic CHDs and propose limitations and future directions in this field. Risk factors for this fatal disease include genetic and environmental factors.2,3 Risk stratification based on prenatal diagnosis with genetic counseling has shown better clinical outcomes. The modified World Health Organization (mWHO) guidelines are among the first proposed for risk stratification based on clinical scores.4 The combination of polygenic risk scores (PRS) and clinical risk evaluation has been adopted in various populations as better diagnostic and therapeutic approaches for various diseases, including coronary artery disease,5 diabetes,6 obesity,7 and cancers.8,9 However, unlike these diseases, polygenic risk scores are rarely used for the genetic diagnosis of CHD patients. The clinical utility of polygenic risk scores for CHDs is still in the early stages and requires validation studies in different cohorts. Incorporating PRS into the clinical setting may improve CHD diagnosis and therapeutic strategies.10 Recently, an initial attempt was made to determine the clinical utility of polygenic risk scores in a large dataset of the European cohort. Data from this study suggested a high potential for PRS in distinguishing between clinical phenotypes (mild, moderate, and severe) of congenital heart malformations.11 Furthermore, this hypothesis was tested in patients with transposition of the great arteries (TGA) to assess the utility of risk stratification after arterial switch operation. The cumulative risk score was computed for single nucleotide polymorphisms (SNPs) that reached the threshold statistical significance of p&lt;1×10−5 in the initial analysis. Combined clinical and polygenic risk scores showed improved risk stratification in mild, moderate, and severe TGA phenotypes.12 Similarly, in another European cohort, the risk allele frequency was higher in the diseased group compared to the control group. However, statistical analysis suggested a non-significant association with p&gt;0.05. Interestingly, combined risk scores constructed for selected SNPs showed a significant association with the disease with a p-value of 0.002. This evidence further supports the hypothesis that the cumulative effect of polymorphisms has better diagnostic and therapeutic efficacy than individual SNPs.13 There are certain limitations to its clinical use. Firstly, social stigma and lack of awareness regarding this disease are major hurdles. Secondly, there is a need to recruit a large number of samples from different populations to validate the clinical utility of PRS. Additionally, a lack of resources in developing countries also contributes to fatal outcomes. We recommend conducting large cohort studies in different ethnic groups to predict better risk associations, develop better therapeutic strategies, and formulate management guidelines.

An individual-based model for direct and indirect transmission of chronic wasting disease in free-ranging white-tailed deer

Chronic wasting disease (CWD) is an infectious prion disease that infects members of the Cervidae family (i.e., deer) resulting in widespread ecological, economic, and recreational ramifications. We introduce a spatially explicit individual-based model (IBM) that integrates individual deer movement and behavior with population and disease dynamics to forecast CWD in populations of free-ranging white-tailed deer (Odocoileus virginianus). We use a Susceptible-Exposed-Infectious-Dead (S-E-I-D) epidemiological framework to explore spatiotemporal dynamics of CWD within an agriculturally dominated area in Michigan, USA. The IBM results closely mimicked documented short- and long-term dynamics of white-tailed deer populations and CWD in the Midwestern, USA. We applied pattern-oriented modeling using annual apparent CWD prevalence rates reported by Midwestern state wildlife agencies to validate the disease model. The introduction of a single infected deer to the modeled landscape (93 km2) led to an outbreak of CWD in 100 out of 350 model simulations (29 %); prevalence never exceeded 1.47 % for repetitions where the outbreak ended. For the 100 simulations where disease persisted, the deer population declined by 87 % by year 50 following initial introduction of CWD. Mean (±SD) prevalence after 5, 10, 25, and 50 years was 1.1 % (±1.0 %), 3.4 % (±3.3 %), 46.5 % (±18.8 %), and 51.8 % (±18.1 %), respectively, which highly correlated (r = 0.99) with annual CWD prevalence reported in Wisconsin white-tailed deer populations for years 1–21 post initial detection. Combined with a global sensitivity analysis, the IBM indicated that prevalence of CWD at year 20 was most sensitive to harvest rate of yearling and adult female deer and least sensitive to prion shedding rate, prion half-life, and deer group numbers, indicating that deer population parameters were more influential than disease parameters on CWD dynamics. Our IBM serves as a tool to explore and better understand indirect and direct transmission of CWD within free-ranging cervid populations. Users of this model can adjust parameter values to explore how interactions among individual deer and between deer and their environment affect CWD dynamics. This IBM also serves as a framework for applying and assessing spatially and temporally explicit management scenarios.

Prevalence of occupational injuries and associated factors among workers of textile and garment factories during the era of COVID-19 pandemic in mekelle city, Northern Ethiopia: A cross-sectional study.

Occupational injury is any personal injury that can lead to disease, disability, or death due to accidents sustained by workers while performing their work. The present study aimed to determine the prevalence of occupational injuries and associated factors among workers of textile and garment factories in Mekelle City, Northern Ethiopia during the era of COVID-19. A cross-ectional study was conducted among 348 Textile and Garment factories in Mekelle City, Northern Ethiopia on September and October 2020. Data were collected using a semi-structured face-to-face interview questionnaire by trained data collectors and supervisors. Occupational injury was assessed by a yes/no question "Have you had any injury related to your occupation in the last 12 months?."Epi Data version 3.1 was used to enter data and Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. A multivariable logistic regression model was used to determine the independent determinants of occupational injury, and variables with p < 0.05 were considered as statistically significant. The annual prevalence rate of occupational injury among textile and garment factories was 27.8% (95% confidence interval [CI] = 23.2-32.9%). Factors like being a male (AOR = 3.65; 95% CI = 1.92-6.92), job satisfaction (AOR = 0.22; 95% CI = 0.11-0.43), sleeping disorder (AOR = 3.47; 95% CI = 1.91-6.32), job stress (AOR = 2.62; 95% CI = 1.44-4.73), and safety and health training (AOR = 0.40; 95% CI = 0.22-0.74) were significantly associated with the occurrence of occupational injury. Expectedly, lockdown during COVID-19 could lead to absenteeism and reduced prevalence of occupational injuries as the outcome of this study.

Global, regional and national burdens of reproduction-related congenital birth defects, 1990-2019.

Reproduction-related congenital birth defects (RCBDs), including Klinefelter syndrome (KS), Turner syndrome (TS), and urogenital congenital anomalies (UCA), can lead to severe physical and psychosocial disorders. The global impact of RCBDs on children and adults is unknown, which limits high-quality development of populations and increases in life expectancy per capita. Annual incidence rates, prevalence rates (PR), and disability-adjusted life year (DALY) rates were collected for KS, TS, and UCA for 204 countries and territories, including at birth, for children younger than 1 year, and age-standardized (AS) for all ages. Linear regression was used to calculate their estimated annual percentage changes (EAPCs). Finally, the relationships between EAPCs of each indicator and sociodemographic index (SDI) was investigated using Pearson correlation analysis. Globally, the age-standardized prevalence rate (ASPR) trend is decreasing in KS and TS and increasing in UCA. The DALY rates for children younger than 1 year were on a downward trend in KS and UCA, while they were still rising for TS. The AS-DALY rates were all on a downward trend in KS, TS, and UCA. The DALY rates of KS, TS and UCA were found higher in high-income countries in North America. In addition, the burdens of TS and UCA went down with increasing SDI, whereas the burden of KS increased with increasing SDI. The global burdens of RCBDs have decreased since 1990. This finding can help policymakers implement cost-effective interventions to reduce the burdens of RCBDs.

Prevalence Trend and Clinical Profile of Leprosy Among the Indigenous Penan Community in Rural Baram, Sarawak, Malaysia: A Retrospective Study.

In Malaysia, despite achieving leprosy-elimination status in 1994, leprosy remains a public health issue among the indigenous Penan community in Sarawak. This study aimed to determine the prevalence trend and clinical profile of leprosy among the Penans in rural Baram, Sarawak, Malaysia. A retrospective records review was conducted on 10-year (2008-2018) time trend of annual prevalence rate and 5-year (2013-2018) Penan leprosy patient clinical profile. Out of the 257 new cases of leprosy reported in Sarawak, 42.8% were Penans, and 72.7% were from Baram. The annual Penan ethnic-specific prevalence rate ranged from 2.08 to 35.5/10 000. Forty-six cases were analyzed for clinical profile: There were more males, active case detection, and multibacillary leprosy. The prevalence trend of leprosy among the Penans in rural Baram exceeded recommended elimination targets. Majority of the cases were detected through active case detection, but cases were detected late. Interventions are needed to improve early diagnosis and detection to achieve elimination of leprosy.

Kidney Failure Attributed to Focal Segmental Glomerulosclerosis: A USRDS Retrospective Cohort Study of Epidemiology, Treatment Modalities, and Economic Burden

Rationale & ObjectiveThis study describes the epidemiology, characteristics, and clinical outcomes of patients with focal segmental glomerulosclerosis (FSGS)-attributed kidney failure in the US Renal Data System (USRDS) during 2008-2018, and healthcare resource utilization and costs among those with Medicare-linked data. Study DesignRetrospective cohort study Setting & PopulationPatients with FSGS-attributed kidney failure in the USRDS OutcomesPrevalence/incidence, clinical/demographic characteristics, time to kidney transplant/death, healthcare resource utilization, direct healthcare costs Analytical ApproachPatients with FSGS as the primary cause of kidney failure were followed from USRDS registration (index date) until death/data end. Prevalence/incidence were calculated per 1,000,000 US persons. Patient characteristics at index and treatment modalities during follow-up were described. Time to kidney transplant/death was assessed with Kaplan-Meier and competing risk analyses. Healthcare resource utilization and costs were reported among patients with 1 year Medicare Part A+B coverage post-index, including (Medicare Coverage subgroup) or excluding (1-year Medicare Coverage subgroup) those who died. ResultsThe FSGS cohort and Medicare Coverage and 1-year Medicare Coverage subgroups included 25,699, 6,340, and 5,575 patients, respectively. Mean annual period prevalence and incidence rates of FSGS-attributed kidney failure were 87.6 and 7.5 per 1,000,000 US persons, respectively. Initial treatment for most patients was in-center hemodialysis (72.1%), while 7.3% received kidney transplant. Accounting for competing risk of death, Year 1 and 5 kidney transplant rates were 15% and 34%, respectively. In the Medicare Coverage and 1-year Medicare Coverage subgroups, 76.6% and 74.2%, respectively, required inpatient admission, 69.9% and 67.3% visited the emergency room, and mean monthly healthcare costs were $6,752 and $5,575 in the year post-index. LimitationsDrug costs may be underestimated as Medicare Part D coverage was not required; kidney acquisition costs were not available. ConclusionsFSGS-attributed kidney failure is associated with substantial clinical and economic burdens, prompting the need for novel therapies for FSGS to delay kidney failure.

The Need to Consider Pro-Active Treatment for Cerebral Artery Conditional Blood Velocity Determined By Transcranial Doppler Ultrasonography (TCD) in Sickle Cell Disease (SCD)

Introduction Cerebral artery peak systolic blood velocity (PSV) or timed average mean of the maximum blood velocity (TAMMV) determined by TCD in children of age 2-16 years with SCD is normal (NV) if TAMMV &amp;lt;170 cm/sec or PSV &amp;lt;200 cm/sec; abnormal (AV) if TAMMV &amp;gt; 200cm/s or PSV &amp;gt; 250 cm/sec; and conditional (CV) if TAMMV is 170-199cm/sec or PSV 200-249 cm/sec. Internal carotid (ICA) or middle cerebral (MCA) artery AV is associated with a stroke risk of 10% /year, CV a risk of 3-4% /year [Adams et al. Long-Term stroke risk in children with SCD screened with TCD. Ann Neurol 1997; 42: 699-704]. Blood transfusion or hydroxycarbamide is used to treat AV, but active treatment is currently not considered the standard of care for conditional velocity, although it could progress to abnormal values. ObjectiveTo evaluate the need for pro-active treatment of cerebral artery conditional blood velocity in children of age 2-16 years with SCD. Methods Following IRB approval and informed consent/assent, 308 children with SCD (126 girls and 182 boys, age 2-16 years) had TCD to determine PSV (n=193) or TAMMV (n=115) in the MCA, ICA and anterior cerebral arteries (ACA). This design was to make the research findings relevant to hospitals with TCD equipment that measure either PSV or TAMMV. Exclusion criteria were blood transfusion in the previous 4 months, therapy with hydroxycarbamide, omega-3 fatty acids or other agents that affect the severity of SCD, pregnancy, breast feeding, chronic disorders unrelated to SCD (such as diabetes mellitus) and stroke. Children with AV were started on a blood transfusion program. Those with conditional PSV were randomized in a 2:1 ratio to receive either standard care of SCD and active treatment with omega-3 fatty acids and potassium thiocyanate, or standard care only. After 3 months, measurement of PSV in the ICA, MCA and ACA was repeated. Study data were analysed with the Statistical Package for Social Sciences version 23 (IBM, USA). ResultsIn the TAMMV cohort of 115 children, 96 (84%) had NV, 7 (6%) AV, and 12 (10%) CV. Figure 1 shows the cumulative frequency of TAMMV in the MCA where most AV and CV occurred. In the PSV cohort of 193 children, 150 (77.7%) had NV, 7 (3.6%) AV, and 36 (18.7%) CV. There were no significant differences in gender or age distribution between the PSV and TAMMV cohorts. Altogether, cerebral artery blood velocity was normal in 246/308 children (80%), abnormal in 14 (4.5%) and conditional in 48 (15.5%). The PSV in 21 patients randomized to active treatment of conditional blood velocity or standard SCD care are shown in Table 1. After 3 months, PSV reduced to normal (&amp;lt;200cm/sec) in a significantly higher proportion (11/14 or 79%) of children on active treatment compared with 3/7 (43%) on standard care only, p = 0.04. Change in the right MCA median PSV showed a significant difference of 54cm/sec between children on active treatment who had a reduction from 201.5 cm/sec to 169.5 cm/s, and the standard care group with a rise from 184cm/s to 206 cm/sec (p = 0.018). One of 7 patients on standard care (14%) but none of 14 on active treatment (0%) had progression of PSV from conditional to abnormal. Reduction in conditional velocity following active treatment has been reported from other studies [Lagunju et al, Pediatr Blood Cancer 2015;62:1587-91; Estepp et al. Br J Haematol 2021;194:463-8]. Although not statistically significant, pre/post-treatment median steady state Hb level in actively treated patients showed an upward trend [6.8/7.3g/dl]; and the median platelet count a downward trend: 278/235 x10 9/l. The standard care group had opposite, but also not significant, trends: 7.45/7.0 g/dl, 224/261 x10 9/l. Discussion and Conclusion The 15.5% prevalence of conditional velocity translates to 15,500 /100,000 children born annually with SCD in our country, or 46,500 worldwide, of whom 1,860 (4%) may have stroke. If 14% of CV progress to AV, that is 6,510/year globally. If all are not treated, a reality in resource-limited places, any number up to 651 (10%) may develop stroke. The annual incidence, cumulative prevalence and progression rates of CV, and the significant difference in the proportion that revert to NV on active treatment compared to standard care only, suggest that there is need to consider CV for active treatment. This will prevent the cumulation of more than 1,860 children who develop stroke every year with its health, psychosocial and economic burden to the patients, their families and society.

Deficiencies in the Recognition and Reporting of Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus; A Hungarian Nationwide Analysis.

Objectives: Recognition of chronic kidney disease (CKD) is crucial in type 2 diabetes mellitus (T2DM). We conducted a nationwide epidemiological study to evaluate T2DM-associated CKD in Hungary between 2016 and 2020. Methods: Annual incidence and prevalence rates of registered CKD amongst all pharmacologically treated T2DM patients were analyzed in different age-groups by the central database of the Hungarian Health Insurance Fund Management. Statistical methods included Poisson regression, Bonferroni test, Chi-square test. Results: We found 499,029 T2DM patients and 48,902 CKD patients in 2016, and 586,075 T2DM patients and 38,347 CKD patients in 2020. The majority of all prevalent T2DM and CKD patients were older (aged 60-69years: 34.1% and 25.8%; ≥70years: 36.1% and 64.4%, respectively). The annual incidence of T2DM and incidence rates of CKD in T2DM decreased in 2017-2020 (p < 0.001). The annual prevalence of T2DM increased (p < 0.01), the prevalence rates of CKD in T2DM were low and decreased from 9.8% to 6.5% in 2016-2020 (p < 0.001). Conclusion: Incidence and prevalence of T2DM-associated CKD decreased significantly in Hungary in 2016-2020. Lower prevalence rates of CKD may suggest under-recognition and/or under-reporting.

Prevalence of Australians exposed to potentially cardiotoxic cancer medicines: a population-based cohort study

Cardiovascular disease (CVD) and cancer are leading causes of death and people with cancer are at higher risk of developing CVD than the general population. Many cancer medicines have cardiotoxic effects but the size of the population exposed to these potentially cardiotoxic medicines is not known. We aimed to determine the prevalence of exposure to potentially cardiotoxic cancer medicines in Australia. We identified potentially cardiotoxic systemic cancer medicines through searching the literature and registered product information documents. We conducted a retrospective cohort study of Australians dispensed potentially cardiotoxic cancer medicines between 2005 and 2021, calculating age-standardised annual prevalence rates of people alive with exposure to a potentially cardiotoxic medicine during or prior to each year of the study period. We identified 108,175 people dispensed at least one potentially cardiotoxic cancer medicine; median age, 64 (IQR: 52-74); 57% female. Overall prevalence increased from 49 (95%CI: 48.7-49.3)/10,000 to 232 (95%CI: 231.4-232.6)/10,000 over the study period; 61 (95%CI: 60.5-61.5)/10,000 to 293 (95%CI: 292.1-293.9)/10,000 for females; and 39 (95%CI: 38.6-39.4)/10,000 to 169 (95%CI: 168.3-169.7)/10,000 for males. People alive five years following first exposure increased from 29 (95%CI: 28.8-29.2)/10,000 to 134 (95%CI: 133.6-134.4)/10,000; and from 22 (95%CI: 21.8-22.2)/10,000 to 76 (95%CI: 75.7-76.3)/10,000 for those alive at least 10 years following first exposure. Most people were exposed to only one potentially cardiotoxic medicine, rates of which increased from 39 (95%CI: 38.7-39.3)/10,000 in 2005 to 131 (95%CI: 130.6-131.4)/10,000 in2021. The number of people exposed to efficacious yet potentially cardiotoxic cancer medicines in Australia is growing. Our findings can support the development of service planning and create awareness about the magnitude of cancer treatment-related cardiotoxicities. NHMRC Centre for Research Excellence in Medicines Intelligence, Cancer Institute NSW Early Career Fellowship.