Risk Of Infectious Diseases Research Articles

Factors Influencing Stunting in Children Toddlers in the Working Area of the Puskesmas Kutambaru in 2023

Background: Stunting is one of the targets of the Sustainable Development Goals (SDGs) which is included in Goal 2, namely to end hunger and various forms of malnutrition by 2030 and achieve food security. The target set is to reduce the stunting rate by 40% by 2025. Stunting is caused by prolonged (chronic) malnutrition and repeated infections. Objective: The aim of this research is to determine and analyze the factors that influence stunting in toddlers in the Kutambaru Health Center working area in 2023. Methodology: This research uses quantitative methods with a cross sectional design and sampling using random sampling. The research population was 297 respondents and the research sample was 75 mothers who had stunted toddlers. This research uses a questionnaire. The research time is December 2023. This research analysis uses Univariate, Bivariate and Multivariate. The statistical tests used are the chi-square test and multiple logistic regression with the Enter method. Results: Research results regarding influencemother's height pvalue= 0.004,birth height pvalue= 0.003,birth weightpvalue= 0.002,Exclusive Breastfeeding pvalue= 0.001, History of infectious disease pvalue= 0.001, and immunization status pvalue= 0.002with Stunting in toddlers. Based on the results of the multiple logistic regression test, the variable that is very influential is Exclusive Breast Milk with an Exp(B) value of 14,594. Conclusion:The conclusion in this study is that there is an influence of maternal height, birth height, birth weight, exclusive breastfeeding, history of infectious disease and immunization status with Stunting.in toddlers in the Kutambaru Community Health Center working area.To be able to reduce the prevalence of stunting in toddlersIt is hoped that cooperation from the Health Service, Community Health Centers, especially health workersto be able to increase health promotion about stunting, the benefits of exclusive breastfeeding, the risk of infectious diseases and the benefits of immunization for children routinely every month.

Effect of Infectious Disease Risk Management on Indoor Environmental Quality in Lecture Rooms: Current Performance and Future Considerations

The global COVID-19 pandemic has resulted in significant and accelerated developments in ventilation practises, where the need to ventilate buildings has been put centre stage. Longer-term ventilation approaches are now more likely to utilise hybrid ventilation strategies to address the challenge of ensuring resilient indoor thermal environments that are carbon neutral while also minimising the risk of long-range airborne infectious spread of viral pathogens. In the short term, there are many existing buildings which may not undergo retrofit for some time, and consequently, risk mitigation strategies have been implemented in these buildings by utilising existing systems. This paper will present an indoor environmental quality evaluation of ten university lecture rooms both before, during and after changes in ventilation management behaviour and systems that were accelerated due to the COVID-19 pandemic. The results indicate a mean reduction in internal carbon dioxide levels of between 46% and 67% when pre-COVID-19 and COVID-19 datasets are compared and between 11% and 62% when pre-COVID-19 and post-COVID-19 datasets are compared. Changes in behaviour and systems have reduced the time spent above thresholds conducive to virus growth by between 8% and 54%, depending on the lecture room. Despite this, a “rebound” can be observed in many rooms, with CO2 levels appearing to be trending toward pre-pandemic levels. This work indicates the effect of behavioural and system changes on ventilation and the potential risk for virus spread. The results indicate a need to retrofit existing lecture rooms with more advanced natural or mechanical systems to ensure consistent indoor environmental quality.

Novel loci and biomedical consequences of iron homoeostasis variation

Iron homoeostasis is tightly regulated, with hepcidin and soluble transferrin receptor (sTfR) playing significant roles. However, the genetic determinants of these traits and the biomedical consequences of iron homoeostasis variation are unclear. In a meta-analysis of 12 cohorts involving 91,675 participants, we found 43 genomic loci associated with either hepcidin or sTfR concentration, of which 15 previously unreported. Mapping to putative genes indicated involvement in iron-trait expression, erythropoiesis, immune response and cellular trafficking. Mendelian randomisation of 292 disease outcomes in 1,492,717 participants revealed associations of iron-related loci and iron status with selected health outcomes across multiple domains. These associations were largely driven by HFE, which was associated with the largest iron variation. Our findings enhance understanding of iron homoeostasis and its biomedical consequences, suggesting that lifelong exposure to higher iron levels is likely associated with lower risk of anaemia-related disorders and higher risk of genitourinary, musculoskeletal, infectious and neoplastic diseases.

Association between self-reported child maltreatment and risk of hospital-treated infectious diseases in middle-aged and older adults: A UK Biobank cohort study.

This study aimed to explore the association between child maltreatment and hospital-treated infectious diseases in middle-aged and older adults. 145,151 participants aged 38-72 years from the UK Biobank between 2006 and 2010 were enrolled and interviewed. Child maltreatment included five types: physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse. Patterns of maltreatment were identified using latent class analysis (LCA). Cox regression was employed to estimate the associations between child maltreatment (number of types, individual types, and patterns) and infectious diseases. Further, we evaluated potential mediators using mediation analysis. Over a median follow-up of 13.4 years, 22,688 participants (12.26 per 1000 person-years) were hospitalized for an infectious disease. Participants reporting any maltreatment had elevated infectious diseases risk (HR 1.18, 95 % CI: 1.15-1.21) than those without maltreatment. A dose-response relationship was observed between the number of maltreatment types and infectious disease (one, HR 1.09 [95 % CI 1.06-1.13]; two, HR 1.17 [95 % CI 1.12-1.23]; three to five, HR 1.48 [95 %CI 1.41-1.55]; Ptrend < 0.001). Each type of maltreatment was associated with increased infectious diseases risk. LCA identified four patterns (low maltreatment, child neglect, child abuse, and poly-maltreatment), with those experiencing poly-maltreatment exhibiting the highest infectious diseases risk (HR 1.51, 95 % CI: 1.43-1.59). The association between child maltreatment and infectious diseases was mediated by C-reactive protein, phenotypic age acceleration, loneliness, psychiatric disorders, and unhealthy lifestyles. Child maltreatment may increase susceptibility to a broad spectrum of infectious diseases in adulthood, highlighting the need for early-life maltreatment prevention policies.

Urbanization and Infectious Disease.

The United Nations currently estimates that over half of the global population has lived in cities since 2017 and that this proportion is continuing to grow, particularly in the Global South. While urbanization is not new, increased population density combined with accelerating rates of (re)emerging and noncommunicable diseases as well as growing economic disparities has created new challenges to human health and well-being. Here, I examine peri-urban communities, peripheral settlements on the edges of urban areas populated by rural people, and argue that these areas are often overlooked, despite becoming increasingly common. Thus, human biologists should move beyond categorizing these spaces as transitional. Using unplanned, peri-urban communities around Lima, Peru as a case study, I detail the complexity of political ecological factors that impact infectious disease risk and rates in peri-urban communities. Using disease mechanisms, I demonstrate the importance of a biocultural approach and a political ecology perspective when investigating infectious disease. I highlight how human biologists and anthropologists are uniquely positioned to explore the heterogeneity of infectious disease patterns and pathways in an increasingly urbanized world.

Severity and risk to inhalation of pathogen-laden aerosol in large public spaces: Insights from fangcang shelter hospitals under multi-location release

The key to strengthening the inherent safety of large public spaces and implementing precise preventive measures lies in clarifying the transmission risks of respiratory infectious diseases based on multiple factors. This work innovatively improves a pathogen inhalation infection risk prediction model and attempts to apply it to a Fangcang Shelter Hospital to investigate the effect of pathogen release location on risk distribution and the role of airflow distribution in risk control mechanisms. The model used in the study improved in resolution and accuracy, shedding light on the airflow distribution mechanisms involved in pathogen transport and risk control, thus providing a quantitatively realistic landscape of the spread of respiratory infectious diseases in large indoor environments. Predictions reveal a significant unevenness in the spatial distribution of infection probabilities within the multi-patient shelter unit, which is further exacerbated by different release locations, and that extreme infection risks can reach 4 to 14 times the average. Additionally, the study noted that the infection probability in the medical staff area due to the long-distance transmission of contaminants can reach as high as 1.72 % and that patients from ward 6# could potentially infect a healthcare worker every four days.

Assessment of harm reduction receipt and infectious diseases outcomes in United States Veterans with opioid use disorder and history of injection drug use

BackgroundInjection drug use (IDU) may lead to negative health outcomes and increased healthcare utilization. In US Veterans (USV) with opioid use disorder (OUD), there is sparse information about healthcare utilization, harm reduction prescription, and outcomes associated with IDU, including severe injection-related infections (SIRI). We assessed psychosocial factors, clinical outcomes, and harm reduction receipt in a cohort of USV with OUD, specifically focusing on persons who inject drugs (PWID).MethodsA retrospective cohort study was performed of USV aged ≥ 18 years with a diagnosis of OUD who presented to the Northport Veterans Affairs Medical Center (Long Island, NY) between 2012 and 2022. Demographics, psychosocial factors, history of human immunodeficiency virus (HIV), hepatitis C virus (HCV) infection, and healthcare utilization were compared by IDU status. Prescription of medications for opioid use disorder, naloxone and pre-exposure prophylaxis (PrEP) for HIV were also compared by IDU status. SIRI episodes and associated sequelae were characterized in USV with IDU.ResultsA total of 502 USV with OUD were included and 216 (43%) were PWID. Mean age was 52.6 years. PWID were more likely to use multiple stimulants (14.4% PWID vs. 7.3% non-PWID, p < 0.011), be hospitalized with an infection (26.4% PWID vs. 12.2% non-PWID, p < 0.001) and had more frequent inpatient admissions (n = 5.5 PWID vs. n = 3.51 non-PWID, p = 0.003). Among PWID, 134 (62%) had a history of HCV infection, 9 (4.2%) had HIV, and 35 (16.2%) had at least one SIRI episode. PWID had a higher frequency of current (51.9% PWID vs. 38.5% non-PWID, p = 0.003) or previous MOUD use (45.8% PWID vs. 31.1% non-PWID, p < 0.001). Overall PrEP receipt in our cohort (0.46% PWID vs. 1.4% non-PWID, p = 0.4) was low.ConclusionsUSV with OUD and a history of IDU had a high prevalence of concurrent stimulant use, HCV, SIRI episodes, and were more likely to be hospitalized than USV with OUD and no history of IDU. Harm reduction strategies such as MOUD or PrEP, can help decrease the risk of infectious diseases, yet PrEP was underutilized in our population regardless of IDU status. USV with OUD would benefit from improved integration of OUD treatment, infectious diseases clinical care and harm reduction interventions.

Vaccine Efficacy and Safety in Patients with Celiac Disease

Celiac disease (CD) is an autoimmune disorder caused by gluten intake in genetically predisposed individuals. This article provides an overview of the available data on the risks of infectious diseases and the mechanisms involved in CD, including a detailed analysis of vaccine efficacy, immunogenicity, and safety. The published articles were retrieved from the PubMed database using the terms “celiac disease,” “efficacy,” “hyposplenism,” “immune response,” “infections,” “immunization,” “immunogenicity,” “safety,” “vaccination,” and “vaccine.” CD can be associated with several autoimmune diseases, including selective immunoglobulin A deficiency (SIgAD), altered mucosal permeability, and hyposplenism. These conditions entail an increased risk of infections, which can be prevented by targeted vaccinations, although specific recommendations on immunization practices for subjects with CD have not been released. Regarding vaccinations, the immune response to the Hepatitis B virus (HBV) vaccine can be impaired in patients with CD; therefore, proposed strategies to elicit and maintain protective specific antibody titers are summarized. For patients with conditions that put them at risk of infections, vaccinations against Pneumococcus and other encapsulated bacteria should be recommended. Based on the available evidence, the Rotavirus vaccine offered to children could be useful in preventing CD in at-risk subjects. Overall, except for the HBV vaccine, vaccine efficacy in patients with CD is comparable to that in the general population, and no safety concerns have arisen.

Not Just an Oxymoron: The Utilitarian's Guide to Antimicrobial Stewardship in Transplant Infectious Diseases.

Solid organ transplant and hematopoietic cell transplant patients face an increased risk of infectious diseases, greater exposure to antibiotics, and heightened risk of multidrug-resistant organisms (MDROs) due to their immunosuppressed state. Antimicrobial stewardship programs (ASP) are essential in reducing the incidence of MDRO by conserving antimicrobial use, minimizing treatment durations, and improving the appropriate use of diagnostic testing. However, the role of ASP in transplant infectious diseases (TID) is still evolving, necessitating greater collaboration between ASP and transplant programs. This collaboration will mitigate infection risks, reduce infection-associated costs, and improve outcomes. This article reviews the key components for implementing ASP in TID, especially for those that are establishing or growing their ASP to include TID, including specific goals, structure and funding, ASP initiatives (including antibiotic allergy delabeling, diagnostic stewardship, and antiviral/antifungal stewardship), metrics, and educational opportunities.

Birth order, daycare attendance, and childhood socioeconomic status in relation to gingivitis: a cross-sectional study in Turkish young adults

AimBirth order, sibship size, breastfeeding, daycare attendance, and delivery method are known to influence the development of gut microbiota and the immune system, affecting the risk of many infectious diseases. This study aims to explore the impact of these factors, along with socioeconomic background and familial factors, on gingivitis and oral hygiene practices in early adulthood among the Turkish population.Materials and methodsPatients were diagnosed using periodontal clinical and radiographic assessments, adhering to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The study included 18-year-old individuals diagnosed with either generalized gingivitis or clinical gingival health. Data collected included sociodemographic factors, birth order, sibship size, delivery methods, breastfeeding duration, daycare attendance, and oral hygiene behaviors. Binary logistic regression was employed to analyze the associations between these factors and the presence of generalized gingivitis.ResultsA total of 178 individuals were evaluated, including 124 with generalized gingivitis and 54 with clinical gingival health. Daycare attendance was significantly associated with gingival health. Among those with gingival health, 55.6% had attended daycare, whereas only 29% of participants with generalized gingivitis had attended daycare. Conversely, 71% of those with generalized gingivitis did not attend daycare, compared to 44.4% in the gingival health group (p = 0.001). Univariate logistic regression identified a significant association between daycare attendance and a reduced risk of generalized gingivitis (Odds Ratio [OR] = 0.327, p = 0.001). Later birth order was associated with a reduced risk of gingivitis (OR = 0.470, p = 0.037). Sibship size, delivery methods, and breastfeeding duration showed no clear associations with gingivitis (p > 0.05).ConclusionsThe findings indicate a potential association between oral health status in adulthood and early childhood exposures, such as daycare attendance and birth order. Further research is necessary to confirm these associations and elucidate the mechanisms involved, even though these factors may contribute to gingival health in early adulthood. These insights may enhance our understanding of how early-life exposures relate to oral health outcomes and suggest that considering such factors could be beneficial in future oral health management strategies.Trial registrationTrial registration is also available at clinicaltrail.gov.Clinical Trials-ID: NCT06240247.Registration Date: 22.01.2024.

Risk Factors for Human Contact with Bats in Northern Tanzania

Background: Environmental changes impact bat–human interactions, heightening concerns of pathogen spillover and highlighting the need to understand human–bat interactions in the context of ecosystems. The objective of this study was to assess factors associated with human contact with bats in communities living near bat roosts in Northern Tanzania. Methods: A cross-sectional survey was used to investigate the factors associated with human contact with bats. Utilizing a standardized questionnaire administered through face-to-face interviews, relevant data were collected from respondents living in or near regions characterized by high bat density. Descriptive analyses followed by bivariate and multivariate analyses were performed to assess the association between the investigated factors and the outcome variable of interest, contact with bats. Results: Data were collected from 325 respondents. Of the respondents, 57.5% (187/325) reported bat contact, and only 4% believed bats can transmit rabies. The following factors were significantly associated with human–bat contact: being unaware that bats can transmit diseases like rabies (AOR = 8.63, CI = 1.04, 71.43, p = 0.045), feeling safe to handle bats with bare hands (AOR = 3.47, CI = 1.71, 7.05, p &lt; 0.001), not washing hands thoroughly after bat bite or scratch (AOR = 2.43, CI = 1.29, 4.59, p = 0.006), using water from ponds, rivers or wells (AOR = 5.58, CI = 3.17, 9.79, p &lt;0.001), age &gt; 45 years (AOR = 1.77, CI = 1.0, 3.14, p = 0.047) and a low level of education (AOR = 5.86, CI = 2.97, 11.57, p &lt;0.001). Conclusion: The study findings highlight the key factors to be targeted when developing strategies aimed at improving the community’s knowledge of the potential risks of zoonotic infectious diseases associated with bats and reducing the likelihood of human–bat contact and the related public health risks in communities living near bat roosting sites in Tanzania.

Migration and infectious disease risk: knowledge and perception among university students in two European countries.

In the past years, migration has increasingly affected the European continent. The concerns of the local population about infection spread by migrants may increase as an unjustified stigma. Our study aimed to assess the knowledge and risk perception of infectious disease associated with migration among university students. Between January and February 2020, we conducted an online survey in Italian and Spanish University students. We collected data on demographics, perception, and knowledge of infectious diseases associated with migration. We performed descriptive and risk factors analysis to assess the association among selected variables. We collected 1,397 answers, 73.16% from Italian students and 26.84% from Spanish students, 34.54% and 38.67% enrolled in healthcare degrees, respectively. We found a statistically significant correlation between the knowledge of infectious diseases and the perception of the infectious risk associated with migration, not confirmed for the area of study. Healthcare students had the best levels of knowledge and perception of the migratory phenomenon, but the higher perception of infectious risk. Exposure to the media coverage about migration was associated with the worst perception of the migratory phenomenon and infectious risk. Our study showed that, despite healthcare students had the best levels of knowledge, they had the highest risk perception of infectious diseases associated with migration. The inclusion of courses on migration medicine in current healthcare curricula and the increase of practical training could help to avoid the development of biased approaches towards migrants among healthcare professionals.

Sex-specific transcriptomic effects of low-dose inorganic arsenic exposure on bone marrow-derived macrophages

Both tissue-resident macrophages and monocytes recruited from the bone marrow that transform into tissue-resident cells play critical roles in mediating homeostasis as well as in the pathology of inflammatory diseases. Inorganic arsenic (iAs) is the most common drinking water contaminant worldwide and represents a major public health concern. There are numerous diseases caused by iAs exposure in which macrophages are involved, including cardiovascular disease, cancer, and increased risk of (respiratory) infectious diseases. Notably, prenatal iAs exposure is also associated with negative birth outcomes and developmental immunotoxicity (DIT) contributing to long-term adverse outcomes of these immune-related diseases. Therefore, understanding the effects of iAs exposure on macrophages, particularly during immune development or tissue injury and inflammation, can help us better grasp the full range of arsenic immunotoxicity and better design therapeutic targets for iAs-induced diseases particularly in exposed populations. In contrast to prior published studies which often only focused on the effect of iAs on mature macrophages after development, in this study, we analyzed the transcriptome of M0-, M1- and M2-polarized male and female murine bone marrow-derived macrophages (BMDMs) which were exposed to iAs during the differentiation phase, as a model to study iAs (developmental) immunotoxicity. We identified differentially expressed genes by iAs in a sex- and stimulation-dependent manner and used bioinformatics tools to predict protein-protein interactions, transcriptional regulatory networks, and associated biological processes. Overall, our data suggest that M1-stimulated, especially female-derived, BMDMs are most susceptible to iAs exposure during differentiation. Most notably, we observed significant downregulation of major proinflammatory transcription factors, like IRF8, and its downstream targets, as well as genes encoding proteins involved in pattern recognition and antigen presentation, such as TLR7, TLR8, and H2-D1, potentially providing causal insight regarding the role of (early-life) arsenic exposure in perturbing immune responses to infectious diseases. We also observed significant downregulation of genes involved in processes crucial to coordinating a proinflammatory response including leukocyte migration, differentiation, and cytokine and chemokine production and response. Finally, we discovered that 24 X-linked genes were dysregulated in iAs-exposed female stimulation groups compared to only 3 across the iAs-exposed male stimulation groups. These findings elucidate the potential mechanisms underlying the sex-differential iAs-associated immune-related disease risk.

Can Massive Religious Festival Celebrations Encourage a Faster Spread of a Pandemic? The Case of COVID-19 in Israel.

This paper attempts to evaluate how massive religious festivalcelebrations can encourage the faster spread of any pandemic according to our problem statement, such as the case of COVID-19. For example, we evaluate Israel's three major religions, namely Judaism, Christianity, and the Islamic festival celebrations, respectively. Firstly, we have the traditional Jewish festivities such asHanukkah, Yom Kippur, Sukkot, and Rosh Hashanah. In the Christian's traditional festivities celebrations, we identified Christmas, Easter Day, and All Saints Day. Finally, the Muslim festivities ofMuharram and the Birthday of theHoly Prophet Mohamad. Thepurpose of thisstudy wasto evaluate if these nine massive religious festival celebrations are the main reasons for the large spread of COVID-19 in Israel directly or indirectly. In fact, we propose a new methodology to evaluate the impact of any massive religious festivalcelebration andthe fast spread of any pandemic everywhere and anytime. The new indicator is entitled "The National Spread Levels of Infectious Diseases Risk from Massive Religious Festivities Index" (National-SLIDRMRF-Index). Finally, the major finding in this research is that any massive religious events can generate an exponential number of COVID-19 cases constantly. Therefore, this research concluded that we urgentlyneed a standardized index to monitor and control the expansion of any pandemic such as COVID-19 among different religious groups in the same country. At the same time, we give different policy recommendations to the Israeli government to constantlykeep major controls and measures ofdifferent religious events inJerusalem.

Preparing for outbreaks of vaccine preventable diseases: why are prisons invisible?

Abstract From 1 March 2023 to 29 February 2024, 30 EU/EEA Member States reported a total of 5 770 cases of measles, 4 864 (84.3%) of which were laboratory-confirmed. Th7e highest number of cases were reported by Romania- at the time of writing, 11,397 confirmed cases, including 12 deaths from 1 January 2023 to 7 April 2024. Measles is a highly infectious disease. The best mitigation is vaccination which is highly effective. Outbreaks in many countries have been driven by decreases in vaccine coverage with a two-dose measles-containing vaccine (MCV), especially evident since the COVID-19 pandemic. In many countries, vulnerable migrant populations, ethnic groups and communities experiencing social deprivation have been over-represented in cases and under-covered by vaccine programmes. We know that prisons contain such populations. Historic seroprevalence studies of prison populations, which themselves are scant, show that prison populations are under-vaccinated. Prisons are a setting that can cause disease amplification. Given these facts, it is perhaps surprising that many countries in Europe cannot provide specific surveillance data on either cases in prisons or vaccine coverage specifically in prison populations. Further, that prisons are not often cited as specific settings for vaccine catch-up programmes in national or regional programmes. This is despite evidence of measles cases and outbreaks historically and currently in several European countries. In the presentation we will ask why this ‘blind spot’ in national and international disease surveillance continues and what Member States could and should do to prevent the risk of mass outbreaks of measles in prisons, causing pressures on justice and health systems and risking wider community outbreaks. Finally, we will reflect on how this experience should alert us to the risk of other infectious diseases going undetected, unprevented, and under-studies in prisons, threatening our collective health security.

Vaccination Coverage among Institutionalized Elderly Population: A Case Study in Cascais, Portugal

Abstract Vaccination stands as a cornerstone of public health, significantly reducing the morbidity and mortality associated with infectious diseases. However, the aging demographic, with declining homeostasis and immunosenescence, presents new challenges. Those residing in nursing homes face heightened risks of infectious diseases due to proximity and interactions with multiple staff members. In Portugal, elderly vaccination against tetanus/diphtheria (Td) is integrated into the National Vaccination Program, with additional official recommendations for pneumococcal (Pn), seasonal influenza, and COVID-19 vaccinations. Specific vaccination campaigns in nursing homes for influenza and COVID-19 are coordinated by Public Health Units. This study aimed to assess the vaccination coverage for these vaccines among the institutionalized elderly in Cascais municipality and evaluate the implementation of official recommendations. A survey of nursing homes in Cascais was conducted, and the vaccination status of residents was assessed through electronic records in February 2024. Statistical analysis was performed. Vaccination status for each vaccine was considered valid if individuals had received at least one dose of Pn13 or Pn23, a Td vaccine dose within the last 10 years, and vaccinations against influenza and COVID-19 within the last 6 months. Among 2189 institutionalized elderly in Cascais, 87% were vaccinated against both influenza and COVID-19, 39% against Td, and 17% against pneumococcal disease. While influenza and COVID-19 vaccination coverage is high, the tetanus/diphtheria vaccination rate is low, and pneumococcal vaccination is very low, despite official recommendations. This population remains at increased risk for preventable diseases. Monitoring vaccination status and implementing targeted vaccination campaigns are crucial for increasing coverage, realizing health and economic benefits and preventing severe diseases. Key messages • Vaccination is essential for safeguarding the health of institutionalized elderly populations. There is a need for targeted interventions to address preventable diseases and protect these individuals. • Monitoring vaccination status and implementing targeted campaigns are critical for increasing coverage and realizing health and economic benefits among elderly populations in nursing homes.

Social ageing can protect against infectious disease in a group-living primate.

The benefits of social living are well established, but sociality also comes with costs, including infectious disease risk. This cost-benefit ratio of sociality is expected to change across individuals' lifespans, which may drive changes in social behaviour with age. To explore this idea, we combine data from a group-living primate for which social ageing has been described with epidemiological models to show that having lower social connectedness when older can protect against the costs of a hypothetical, directly transmitted endemic pathogen. Assuming no age differences in epidemiological characteristics (susceptibility to, severity and duration of infection), older individuals suffered lower infection costs, which was explained largely because they were less connected in their social networks than younger individuals. This benefit of 'social ageing' depended on epidemiological characteristics and was greatest when infection severity increased with age. When infection duration increased with age, social ageing was beneficial only when pathogen transmissibility was low. Older individuals benefited most from having a lower frequency of interactions (strength) and network embeddedness (closeness) and benefited less from having fewer social partners (degree). Our study provides a first examination of the epidemiology of social ageing, demonstrating the potential for pathogens to influence the evolutionary dynamics of social ageing in natural populations.This article is part of the discussion meeting issue 'Understanding age and society using natural populations'.

Combined performance of upper-room UVGI and ceiling-mounted air cleaners for removing active bioaerosol

Upper-room ultraviolet germicidal irradiation (UR-UVGI) and ceiling-mounted air cleaner (CM-AC) technologies contribute to curbing the spread of infectious diseases such as COVID-19. However, there is a lack of detailed studies on the performance differences between these two control technologies for reducing viral concentrations and infection risk in isolation ward environments with different ventilation modes, especially when used alone versus in combination. Therefore, this study performed numerical simulations under three ventilation modes, namely, downward ventilation (DWV), stratum ventilation (SV), and displacement ventilation (DV), by the Eulerian-Lagrangian method combined with the UV inactivation model. The viral disinfection performance of UR-UVGI and CM-AC was parametrically analyzed. The effectiveness of the combined application of these two control technologies in wards was evaluated. The results showed that expanding the irradiation range was more effective in enhancing the UR-UVGI performance with the same total UV flux. When using UR-UVGI only, DWV disinfected better at the same irradiation flux. In CM-AC cases, the viral aerosol removal efficiency was the greatest in DV. UR-UVGI and CM-AC had advantages in active bioaerosol removal in overall and localized indoor spaces, respectively. The combined application was recommended to maximize the air cleanliness. Under the role of UR-UVGI, a high level of disinfection could be achieved using CM-AC with low ventilation rates. When the CM-AC ventilation rate was 150 m3/h and the UV irradiance was 30 μW/cm2, the viral disinfection of DV exceeded 90 %, while that of DWV was also close to 90 %. The findings could provide insights to further lower the transmission risk of infectious diseases.

Assessing the Impact of Frailty on Infection Risk in Older Adults: Prospective Observational Cohort Study.

Infectious diseases are among the leading causes of death and disability and are recognized as a major cause of health loss globally. At the same time, frailty as a geriatric syndrome is a rapidly growing major public health problem. However, few studies have investigated the incidence and risk of infectious diseases in frail older people. Thus, research on frailty and infectious diseases is urgently needed. The purpose of this study was to evaluate the association between frailty and infectious diseases among older adults aged 65 years and older. In this prospective observational cohort study, we have analyzed the infectious disease prevalence outcomes of older adults aged 65 years and older who participated in frailty epidemiological surveys from March 1, 2018, to March 2023 in Dalang Town, Dongguan City, and from March 1, 2020, to March 2023 in Guancheng Street, Dongguan City. This study has an annual on-site follow-up. Incidence data for infectious diseases were collected through the Chinese Disease Control and Prevention Information System-Infectious Disease Monitoring and Public Health Emergency Monitoring System. A project-developed frailty assessment scale was used to assess the frailty status of study participants. We compared the incidence rate ratios (IRR) of each disease across frailty status, age, and gender to determine the associations among frailty, gender, age, and infectious diseases. Cox proportional hazards regression was conducted to identify the effect of frailty on the risk of demographic factors and frailty on the risk of infectious diseases, with estimations of the hazard ratio and 95% CI. A total of 235 cases of 12 infectious diseases were reported during the study period, with an incidence of 906.21/100,000 person-years in the frailty group. In the same age group, the risk of infection was higher in men than women. Frail older adults had a hazard ratio for infectious diseases of 1.50 (95% CI 1.14-1.97) compared with healthy older adults. We obtained the same result after sensitivity analyses. For respiratory tract-transmitted diseases (IRR 1.97, 95% CI 1.44-2.71) and gastrointestinal tract-transmitted diseases (IRR 3.67, 95% CI 1.39-10.74), frail older adults are at risk. Whereas no significant association was found for blood-borne, sexually transmitted, and contact-transmitted diseases (IRR 0.76, 95% CI 0.37-1.45). Our study provides additional evidence that frailty components are significantly associated with infectious diseases. Health care professionals must pay more attention to frailty in infectious disease prevention and control.

Association of modifiable risk factors and infectious diseases among individuals with hypertension: a prospective cohort study

BackgroundA comprehensive assessment of combined modifiable risk factors in relation to infectious diseases among individuals with hypertension is lacking, and the potential mechanisms of these associations remain unclear. To investigate the prospective associations of a combination of lifestyle behaviors and cardiometabolic factors with the risk of infectious diseases among individuals with hypertension and to estimate whether and to what extent blood biomarkers mediate these associations.MethodsThis cohort study included 147,188 participants with hypertension and complete data on modifiable risk factors from the UK Biobank. Health score was constructed from eight modifiable risk factors, including four lifestyle behaviors (diet, physical activity, smoking, and sleep duration) and four cardiometabolic factors (body mass index, blood lipids, blood glucose, and blood pressure). Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the health score and infectious diseases. The mediation analysis was performed to assess the potential intermediation effects of blood biomarkers.ResultsOver a median follow-up of 12.5 years, 27,398 participants with infectious diseases were documented, with 960 respiratory infectious diseases and 7940 digestive infectious diseases. After adjusting for potential confounders, the HR (95% CI) for the highest versus the lowest quartile of health score was 0.64 (0.62, 0.66) for infectious diseases, 0.72 (0.60, 0.86) for respiratory infectious diseases, and 0.66 (0.62, 0.71) for digestive infectious diseases. Stratified factors including duration of hypertension did not modify the associations between the health score and infectious diseases. In addition, biomarkers including inflammation and renal function collectively explained 46.60% of the associations between the combined lifestyle factors and infectious disease risk among individuals with hypertension.Conclusions and relevanceIdeal management of combined modifiable risk factors was associated with lower risks of infectious diseases and might produce profound changes in blood biomarkers among individuals with hypertension. Additionally, specific biomarkers appeared to serve as an intermediate between combined lifestyle factors and infectious diseases. These insights highlighted the important role of a combination of healthy lifestyle and favorable cardiometabolic status in reducing disease burden and facilitated the understanding of biological mechanisms underlying modifiable risk factors with infectious diseases.