Effective Public Health Interventions Research Articles

Monitoring ESBL-Escherichia coli in Swiss wastewater between November 2021 and November 2022: insights into population carriage.

Antimicrobial resistance (AMR) is a global health threat and is commonly monitored in clinical settings, given its association with the risk of antimicrobial-resistant infections. Nevertheless, tracking AMR within a community proves challenging due to the substantial sample size required for a representative population, along with high associated costs and privacy concerns. By investigating high resolution temporal and geographic trends in extended-spectrum beta-lactamase producing Escherichia coli in wastewater, we provide an alternative approach to monitor AMR dynamics, distinct from the conventional clinical settings focus. Through this approach, we develop a mechanistic model, shedding light on the relationship between wastewater indicators and AMR carriage in the population. This perspective contributes valuable insights into trends of AMR carriage, emphasizing the importance of wastewater surveillance in informing effective public health interventions.

Implementation of mathematics model in public health: Albanian case study

This article presents a detailed examination of the application of the Susceptible-Infected-Recovered (SIR) mathematical model in analyzing the COVID-19 pandemic in Albania. The study integrates the SIR model with real-world data, including vaccination rates and population statistics, to simulate the dynamics of the pandemic over a specified period. Our focus is on the comparison between the model's predictions and the actual epidemiological data from Albania, considering reported cases, recoveries, and fatalities. The simulation results are visualized through graphical representations, offering insights into the epidemic's progression and the effectiveness of public health interventions. This study also provides a projection for the year 2024, emphasizing the evolving nature of the pandemic and the role of mathematical modeling in public health decision-making. The comparison highlights the strengths and limitations of using the SIR model in real-world scenarios and underscores the importance of adaptive strategies in public health planning. This case study serves as an example of the critical role of mathematical models in understanding and managing public health crises.

Temporal Trends in Syphilis Epidemiology in the UAE: A Five-Year Retrospective Analysis (2018-2022)

Objectives This study examined the frequency and dynamics of syphilis in the United Arab Emirates (UAE) between 2018 and 2022. Recognizing the significance of understanding syphilis trends, this study intends to conduct further research on sexually transmitted diseases in the context of the UAE. Methods This was a retrospective cross-sectional study. This study focused on patients who underwent syphilis screening between January 2018 and December 2022. Cases were classified as conclusive only if they passed the first screening and subsequent confirmatory tests. Results The findings demonstrate that Syphilis frequency varied throughout the UAE during the study period. Demographic trends and sex variations were discovered, providing insight into how syphilis patterns change. Additionally, this study identified a broad spectrum of clinical manifestations, confirming the complexity of the disease. It was also noted that males had a higher frequency of syphilis than females. Conclusion Understanding the complexity of the frequency of syphilis is critical for developing effective public health interventions. Variations in frequency, demographic trends, sex disparities, and clinical manifestations indicate the need for personalized preventive and control measures. This study provides important information that may be utilized to motivate focused initiatives to address the difficulties associated with syphilis in the UAE, thus enhancing overall public health.

Unravelling The Complexities of Cervical Cancer: A Comprehensive Exploration

Cervical cancer (CC) ranks as the second most common cause of cancer-related deaths among women aged 20-39, resulting in ten premature deaths weekly. CC affects women worldwide as the most common form of genital cancer, with approximately 500,000 new cases diagnosed annually. Besides the risk of death, CC can lead to increased morbidity, causing symptoms like pain, haemorrhage, and kidney failure. These complications pose significant challenges to treatment, particularly in areas with limited healthcare access. Immune dysregulation and chronic inflammation further contribute to CC pathogenesis, creating a pro-carcinogenic microenvironment through immune cell recruitment, cytokine release, and inflammatory responses triggered by persistent HPV infection. Moreover, understanding the socio-economic determinants influencing the prevalence of CC and promoting awareness can contribute to effective public health interventions. Research endeavours in these domains are vital to reduce the burden of CC, enhance early detection, and ultimately save lives. This review covers recent research on CC global epidemiology, intricate pathogenesis insights, protein-based HPV vaccines, and diverse treatment modalities, including recurrent cases. Molecular markers indicating prognosis and the role of artificial intelligence. The review will briefly highlight preventive strategies, offering a comprehensive overview of crucial research areas in CC.

Changes in Use of Hepatitis C Direct-Acting Antivirals After Access Restrictions Were Eased by State Medicaid Programs

Direct-acting antivirals (DAAs) are safe and highly effective for curing hepatitis C virus (HCV) infection, but their high cost led certain state Medicaid programs to impose coverage restrictions. Since 2015, many of these restrictions have been lifted voluntarily in response to advocacy or because of litigation. To estimate how the prescribing of DAAs to Medicaid patients changed after states eased access restrictions. This modified difference-in-differences analysis of 39 state Medicaid programs included Medicaid beneficiaries who were prescribed a DAA from January 1, 2015, to December 31, 2019. DAA coverage restrictions were measured based on a series of cross-sectional assessments performed from 2014 through 2022 by the US National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation. Calendar quarter when states eased or eliminated 3 types of DAA coverage restrictions: limiting treatment to patients with severe liver disease, restricting use among patients with active substance use, and requiring prescriptions to be written by or in consultation with specialists. States with none of these restrictions at baseline were excluded. Quarterly number of HCV DAA treatment courses per 100 000 Medicaid beneficiaries. Of 39 states, 7 (18%) eliminated coverage restrictions, 25 (64%) eased restrictions, and 7 (18%) maintained the same restrictions from 2015 to 2019. During this period, the average quarterly use of DAAs increased from 669 to 3601 treatment courses per 100 000 Medicaid beneficiaries. After states eased or eliminated restrictions, the use of DAAs increased by 966 (95% CI, 409-1523) treatment courses per 100 000 Medicaid beneficiaries each quarter compared with states that did not ease or eliminate restrictions. The results of this study suggest that there was greater use of DAAs after states relaxed coverage restrictions related to liver disease severity, sobriety, or prescriber specialty. Further reductions or elimination of these rules may improve access to a highly effective public health intervention for patients with HCV.

Assessing risk perceptions that contribute to tetanus toxoid maternal vaccine hesitancy in Kilifi County, Kenya

Background Vaccination is one of the most effective public health interventions today. However, a growing number of people perceive vaccines as unsafe and unnecessary. Methods We used a mixed method research in which we administered a quantitative survey to men and women of reproductive age, held Focus Group Discussions (FGDs) with expectant mothers, and interviewed Key Informants (KI) to understand maternal vaccine hesitancy within a rural setting of Kilifi County, Kenya. Results Of the 104 people surveyed, 70% of the participants were aware of the vaccine that expectant women receive, with 26% stating that they know people in their community who have refused or were hesitant to take maternal vaccination. Reasons for refusals include religion and rumours that have spread in the community that the tetanus toxoid vaccine was a family planning method. Stockout of the vaccine was identified as one of the healthcare factors affecting vaccine uptake. Healthcare workers were the most trusted source for information about maternal vaccines. Conclusion Dissemination of accurate information and continuous engagement with community members can build trust and confidence in maternal vaccines.

Rapid identification of SARS-CoV-2 strains via isothermal enzymatic recombinase amplification and nanopore sequencing.

Surveillance of the SARS-CoV-2 genome has become a crucial technique in the management of COVID-19, aiding the pandemic response and supporting effective public health interventions. Typically, whole-genomic sequencing is used along with PCR-based target enrichment techniques to identify SARS-CoV-2 variants, which is a complicated and time-consuming process that requires central laboratory facilities. Thus, there is an urgent need to develop rapid and cost-effective tools for precise on-site detection and identification of SARS-CoV-2 strains. In this study, we demonstrate the rapid diagnosis of COVID-19 and identification of SARS-CoV-2 variants by amplification and sequencing of the entire SARS-CoV-2 S gene using isothermal enzymatic recombinase amplification combined with the advanced Oxford nanopore sequencing technique. The entire procedure, from sampling to sequencing, takes less than 8 hours and can be performed with limited resources. The newly developed method has noteworthy implications for examining the transmission dynamics of the virus, detecting novel genetic variants, and assessing the effect of mutations on diagnostic approaches, antiviral treatments, and vaccines.

Through the eyes of community health workers: what was needed to increase COVID-19 vaccine uptake in the Missouri Southeast region.

Public health emergencies, such as the COVID-19 pandemic, elucidate the strengths, weaknesses, and significant gaps in infrastructure, compatibility and consistency in communication systems, as well as the quality of collaborative relationships, and provider and workforce capacity. They also expose longstanding patterns of mistrust in the government and healthcare systems, and inadequacy in socio-economic infrastructures. These issues resulted in higher COVID-19 infection and mortality rates, and lower vaccination rates in many rural counties across the nation, including Missouri. In response to these challenges, the COVID-19 Response Network was formed in the Southeast corner of the state. The Network was a community-academic partnership that brought together community and faith-based leaders, academicians, healthcare providers and administrators, public health practitioners, and pharmacists to facilitate collaboration on education and outreach efforts aimed at reducing vaccine inequity in the 16-county project area. Importantly, the Network also included Community Health Workers (CHWs) who worked with these different agencies and organizations and were at the heart of implementing Network activities. The intent of this study was to assess their perspectives on the factors that influenced community engagement and communication strategies, and increased vaccine uptake in rural Missouri. Qualitative methods, including in-depth interviews, were used to explore the professional and personal experiences of CHWs working at the grassroots level during an ongoing pandemic. Narrative analysis revealed effective communication and engagement strategies for increasing vaccine uptake in rural communities. For instance, fear-based messaging was perceived as coercive and met with resistance. In contrast, messages that shared personal experiences and catered to the human need to protect their loved ones were more effective. Trust in the source of information was critical. This study highlights the significance of exploring and leveraging the capacities of trusted community members like CHWs to increase the effectiveness of public health interventions in rural communities.

Assessment of hypercholesterolemia prevalence and its demographic variations in the Republic of Kazakhstan

Hypercholesterolemia is a major risk factor for cardiovascular disease, the leading cause of death in Kazakhstan. Understanding its prevalence is vital for effective public health planning and interventions. This study aimed to assess the scale of hypercholesterolemia in the Republic of Kazakhstan and to identify differences among distinct population groups. A cross-sectional study involving 6720 participants (a nationally representative survey.) aged 18–69 was conducted from October 2021 to May 2022 across all 17 regions of Kazakhstan. The magnitude of hypercholesterolemia was 43.5%. Cholesterol levels were determined through blood biochemical analysis. Age, sex, geographic location, and ethnicity served as covariates. The majority of participants (65.49%) were from urban areas with an almost equal gender distribution (50.07% male and 49.93% female). The predominant age groups were 18–29 years (25.71%) and 30–39 years (25.12%), and 65.09% identified as Kazakh. The prevalence increased with age, with the 60–69 age group showing the highest rate at 71.14%. Women had slightly higher rates than men. Geographical differences were evident, with regions like Astana city and Almaty region showing significant disparities. Kazakhs had a lower rate compared to other ethnicities. Age, region, and BMI were significant predictors for hypercholesterolemia in both binary and multivariate logistic regression analyses. The study revealed a significant prevalence of hypercholesterolemia in Kazakhstan, with increasing age as a major determinant. Women, especially those over 50, and certain regions showed higher cholesterol levels. The disparities observed across regions and ethnicities suggest the need for targeted public health interventions to address this pressing health concern.

Abstract 842: Maize consumption and circulating aflatoxin B1 levels in Mexican adults

Abstract Objective: To estimate the impact of maize consumption on aflatoxin B1 [AFB1] levels, a potent carcinogen, in Mexican adults living in south and eastern Mexico. Methods: Study participants were women and men ≥40 years of age living in five high hepatocellular carcinoma burden states who participated in Mexico’s 2018 National Health and Nutrition Survey, a stratified, multi-stage, and cluster survey probability sampling household survey that is representative of the Mexican population. We estimated the consumption of maize intake in grams per day using a previously validated semi-quantitative food frequency questionnaire with a time reference of the previous seven days. We determined circulating AFB1-albumin lysine adduct [AFB1-lys] levels in serum using liquid chromatography. Guided by subject-matter knowledge we fit multivariable linear regression models that considered the survey design and included age, sex, residence, ethnicity, education, socioeconomic status, and foods known to be contaminated with aflatoxins including peanuts, rice, dried chili, milk, and cheese. Results: Among the 915 participants, median maize consumption was 307 grams per day [Q1-Q3: 165 - 554]. Maize tortillas contributed 80% of the total maize consumption. The median maize tortillas consumption was 252 grams per day [Q1-Q3: 120 - 462], approximately 8 tortillas per day. Prevalence of AFB1-lys detection was 92% and median levels were 0.127 pg/µL [Q1-Q3: 0.052 - 0.449]. After adjusting for factors that may affect aflatoxin levels, for every 100 grams of maize consumption AFB1-lys levels were 7.4% [β: 0.071, 95% CI: 0.030 - 0.112] higher. And for every tortilla consumed [30 g of maize], we observed a 2.0% [β: 0.020, 95% CI: 0.006 - 0.034] higher level of circulating AFB1-lys. Conclusion: These findings indicate that maize and maize tortillas may be an important source of AFB1 exposure in the Mexican population. Mexico requires effective public health interventions to mitigate exposure to AFB1. Citation Format: Martin Lajous, Obed Solis-Martinez, Adriana Monge, John Groopman, Katherine A. McGlynn, Martin Romero, Carolina Batis, Hector Lamadrid-Figeuroa, Horacio Riojas-Rodriguez. Maize consumption and circulating aflatoxin B1 levels in Mexican adults [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 842.

A Retrospective Analysis of Salmonella Isolates across 11 Animal Species (1982-1999) Led to the First Identification of Chromosomally Encoded blaSCO-1 in the USA.

Antimicrobial resistance (AMR) in non-typhoidal Salmonella is a pressing public health concern in the United States, necessitating continuous surveillance. We conducted a retrospective analysis of 251 Salmonella isolates from 11 animal species recovered between 1982 and 1999, utilizing serotyping, antimicrobial susceptibility testing, and whole-genome sequencing (WGS). Phenotypic resistance was observed in 101 isolates, with S. Typhimurium, S. Dublin, S. Agona, and S. Muenster prevailing among 36 identified serovars. Notably, resistance to 12 of 17 antibiotics was detected, with ampicillin being most prevalent (79/251). We identified 38 resistance genes, primarily mediating aminoglycoside (n = 13) and β-lactamase (n = 6) resistance. Plasmid analysis unveiled nine distinct plasmids associated with AMR genes in these isolates. Chromosomally encoded blaSCO-1 was present in three S. Typhimurium and two S. Muenster isolates from equine samples, conferring resistance to amoxicillin/clavulanic acid. Phylogenetic analysis revealed three distinct clusters for these five isolates, indicating evolutionary divergence. This study represents the first report of blaSCO-1 in the USA, and our recovered isolates harboring this gene as early as 1989 precede those of all other reports. The enigmatic nature of blaSCO-1 prompts further research into its function. Our findings highlight the urgency of addressing antimicrobial resistance in Salmonella for effective public health interventions.

The effect of public health interventions on COVID-19 incidence in Queensland, Australia: a spatial cluster analysis

Background Using SaTScan™ Geographical Information Systems (GIS), spatial cluster analysis was used to examine spatial trends and identify high-risk clusters of Coronavirus 2019 (COVID-19) incidence in response to changing levels of public health intervention phases including international and state border closures, statewide vaccination coverage, and masking requirements. Methods Changes in COVID-19 incidence were mapped at the statistical area 2 (SA2) level using a GIS and spatial cluster analysis was performed using SaTScan™ to identify most-likely clusters (MLCs) during intervention phases. Results Over the study period, significant high-risk clusters were identified in Brisbane city (relative risk = 30.83), the southeast region (RR = 1.71) and moving to Far North Queensland (FNQ) (RR = 2.64). For masking levels, cluster locations were similar, with MLC in phase 1 in the southeast region (RR = 2.56) spreading to FNQ in phase 2 (RR = 2.22) and phase 3 (RR = 2.64). All p values <.0001. Conclusions Movement restrictions in the form of state and international border closures were highly effective in delaying the introduction of COVID-19 into Queensland, with very low levels of transmission prior to border reopening while mandatory masking may have played a role in decreasing transmission through behavioural changes. Early clusters were in highly populated regions, as restrictions eased clusters were identified in regions more likely to be rural or remote, with higher numbers of Indigenous people, lower vaccination coverage or lower socioeconomic status.

Determinants of Change in Physical Activity in Children During the Transition from Elementary to High School.

Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school. Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th through 11th grades in 2010 - 2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age. As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years. Interventions should target multiple domains of influences that may vary by age.

Spatiotemporal distribution of climate-sensitive disease incidences in ethiopia: a longitudinal retrospective analysis of Malaria, Meningitis, Cholera, Dysentery, Leishmaniasis and Dengue fever between 2010 and 2022/2023

BackgroundUnderstanding the temporal and geographic distribution of disease incidences is crucial for effective public health planning and intervention strategies. This study presents a comprehensive analysis of the spatiotemporal distribution of disease incidences in Ethiopia, focusing on six major diseases: Malaria, Meningitis, Cholera and Dysentery, over the period from 2010 to 2022, whereas Dengue Fever and Leishmaniasis from 2018 to 2023.MethodsUsing data from Ethiopian public health institute: public health emergency management (PHEM), and Ministry of Health, we examined the occurrence and spread of each disease across different regions of Ethiopia. Spatial mapping and time series analysis were employed to identify hotspots, trends, and seasonal variations in disease incidence.ResultsThe findings reveal distinct patterns for each disease, with varying cases and temporal dynamics. Monthly wise, Malaria exhibits a cyclical pattern with a peak during the rainy and humid season, while Dysentery, Meningitis and Cholera displays intermittent incidences. Dysentery cases show a consistent presence throughout the years, while Meningitis remains relatively low in frequency but poses a potential threat due to its severity. Dengue fever predominantly occurs in the eastern parts of Ethiopia. A significant surge in reported incident cases occurred during the years 2010 to 2013, primarily concentrated in the Amhara, Sidama, Oromia, Dire Dawa, and Benishangul-Gumuz regions.ConclusionsThis study helps to a better understanding of disease epidemiology in Ethiopia and can serve as a foundation for evidence-based decision-making in disease prevention and control. By recognizing the patterns and seasonal changes associated with each disease, health authorities can implement proactive measures to mitigate the impact of outbreaks and safeguard public health in the region.

The prevalence of vulvovaginal symptoms in Japanese women of reproductive and perimenopausal ages: A cross-sectional study across generations.

This cross-sectional study evaluated vaginal health and hygiene practices among reproductive and perimenopausal women in Japan using an online-based questionnaire. The questionnaire included 11 well-structured questions concerning vulvovaginal symptoms and hygiene care practices. Participants' responses were anonymized and analyzed descriptively. The relationships of age, family income, occupation, and childbearing with women's concerns regarding vaginal or vulvar problems were analyzed by chi-square tests. About 80% of women in their 20s to 50s in Japan reported experiencing vulvovaginal symptoms. Women in their 40s had significantly fewer symptoms than women in their 20s (p = 0.04), and women in their 50s had significantly fewer symptoms than all other age groups (20s, 30s, and 40s) (p < 0.001). Among symptomatic women, 77.5% did not discuss their symptoms with anyone else and only 10% visited doctors. About 12.5% of women reported taking special care of their vagina or vulva regularly, whereas 38.2% expressed a desire to try some form of care but had not yet done so. Of the women who did not take special care of their vagina or vulva, 46.2% lacked knowledge about proper care, 42.2% did not want to spend money on care, 30.5% did not want to discuss care with others, and 21.3% were psychologically reluctant. Determination of the prevalence of vulvovaginal symptoms among Japanese women can enhance understanding of this prevalent condition and its impact on women's health. These findings may help formulate effective public health interventions and promote better hygienic practices, thus improving the well-being of women in Japan.

Investigating the Relationship Between Hypertension and Obesity in Schoolchildren From Lower-Middle Socioeconomic Strata in Urban Mumbai.

Background In light of escalating rates of childhood obesity, understanding the gender-specific correlation between body mass index (BMI) and hypertension has become crucial for effective public health interventions. This study investigates the interplay between BMI and hypertension among school-aged children, with a particular emphasis on gender stratification to identify distinct trends. Methodology A cross-sectional study was conducted with a diverse sample of 702 schoolchildren aged 5-16 years from a lower-middle-income school in urban Mumbai. This cohort consisted of 491 boys and 211 girls within the gender subset. BMI was calculated using height and weight measurements, while blood pressure readings determined hypertension prevalence. The children were categorized based on the Indian Academy of Pediatrics (IAP) growth chart BMI calculations and blood pressure percentiles. SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA) was used for data analysis. Data were analyzed using the chi-square test, with p-values <0.05 deemed significant. Results The overall prevalence of overweight was 16.52%, with 15.89% in boys and 18.10% in girls, revealing no significant gender difference (p = 0.487). In terms of obesity, the overall prevalence was 10.83%, with 10.99% in boys and 10.34% in girls, revealing no significant gender difference (p = 0.823). The prevalence of pre-hypertension was 7%, exhibiting a significantly higher prevalence in high BMI males (overweight and obese) versus non-high BMI males (normal and underweight) (p < 0.001); however, no such difference was observed in females (p = 0.289). The prevalence of hypertension was 15.95% with a significantly higher prevalence in high BMI males (overweight and obese) versus non-high BMI males (normal and underweight) (p < 0.001) and high BMI females (overweight and obese) versus non-high BMI females (normal and underweight) (p < 0.001). Hypertension was significantly higher in children with high BMI (overweight and obese) compared to their non-high BMI (normal and underweight) counterparts. Conclusions In lower-middle socioeconomic strata schoolchildren in urban Mumbai, the prevalence of obesity and hypertension was alarmingly high, attributed to shifting lifestyles and unhealthy dietary habits. Hypertension rates were notably elevated among overweight and obese individuals compared to normal and underweight individuals. More than a third of both boys and girls with obesity were diagnosed with hypertension, emphasizing a concerning surge in hypertension cases among children. Prioritizing age-specific blood pressure assessments can facilitate early identification and timely interventions.

Chronic Disease Prevalence in the US: Sociodemographic and Geographic Variations by Zip Code Tabulation Area.

We examined the geographic distribution and sociodemographic and economic characteristics of chronic disease prevalence in the US. Understanding disease prevalence and its impact on communities is crucial for effective public health interventions. Data came from the American Community Survey, the American Hospital Association Survey, and the Centers for Disease Control and Prevention's PLACES. We used quartile thresholds for 10 chronic diseases to assess chronic disease prevalence by Zip Code Tabulation Areas (ZCTAs). ZCTAs were scored from 0 to 20 based on their chronic disease prevalence quartile. Three prevalence categories were established: least prevalent (score ≤6), moderately prevalent (score 7-13), and highest prevalence (score ≥14). Community characteristics were compared across categories and spatial analyses to identify clusters of ZCTAs with high disease prevalence. Our study showed a high prevalence of chronic disease in the southeastern region of the US. Populations in ZCTAs with the highest prevalence showed significantly greater socioeconomic disadvantages (ie, lower household income, lower home value, lower educational attainment, and higher uninsured rates) and barriers to health care access (lower percentage of car ownership and longer travel distances to hospital-based intensive care units, emergency departments, federally qualified health centers, and pharmacies) compared with ZCTAs with the lowest prevalence. Socioeconomic disparities and health care access should be addressed in communities with high chronic disease prevalence. Carefully directed resource allocation and interventions are necessary to reduce the effects of chronic disease on these communities. Policy makers and clinicians should prioritize efforts to reduce chronic disease prevalence and improve the overall health and well-being of affected communities throughout the US.

Oral Potentially Malignant Disorders and Oral Cancer in Saudi Arabia: An Epidemiological Review of the Literature.

Background: Oral potentially malignant disorders (OPMDs) are a group of chronic oral mucosal diseases associated with an increased risk of malignant transformation. Multiple studies have investigated the prevalence of these conditions in multiple regions; however, there are limited data about the prevalence of OPMDs in the Kingdom of Saudi Arabia (KSA). This paper aims to review the prevalence of OPMDs in the KSA, to ensure better understanding of the population risk and propose a more standardised approach to the diagnosis and management of this group across the KSA. In addition, this review will discuss the prevalence of oral cancer in the KSA, considering independent risk factors for oral cancer development. Methods: Electronic databases including PubMed, Medline, Medscape, ScienceDirect, StatPearls, BMC Oral Health and the Cochrane Library were searched with the keywords "Oral Potentially Malignant Disorders"; "Saudi Arabia"; and "Oral Cancer". Identified articles were reviewed independently by 2 reviewers against defined inclusion and exclusion criteria. Results: 16 studies were included in this review. The prevalence of OPMDs in KSA varies significantly depending on age, gender, social habits, background disease and dental status. Conclusions: This review highlights the need for up-to-date data on the prevalence, distribution, and characteristics of OPMDs in KSA. The diverse prevalence rates and distinct characteristics of various OPMDs emphasise the necessity for targeted preventive measures. As the data on OPMDs in KSA remains limited, future research efforts should prioritise the establishment of comprehensive epidemiological studies to inform effective public health interventions in this region.

From neighborhood contexts to human behaviors: Cellphone-based place visitation data contribute to estimating neighborhood-level depression prevalence in the United States

The elucidation of neighborhood-level mental illness is pivotal to effective community need assessment and public health interventions. However, aggregating individual behaviors linked to mental health at the neighborhood level has proven to be a challenge. In this study, we collected place visitation data from extensive mobile phone records as a proxy measure of health behaviors to investigate whether and how the place visitation data can contribute to improving the estimation of nationwide neighborhood-level depression prevalence. Using nationwide place visitation data from 2019, we measured eight types of health behaviors at the neighborhood level in the United States, including positive and negative health behaviors (PNHB) and health service utilization behaviors (HSUB). The study revealed that visitations to different types of places of interest (POI) (i.e., fitness visitation, drinking place (alcoholic beverages) visitation, pharmacy visitation, general hospital visitation, and specialty hospital visitation) were significantly associated with neighborhood-level depression. Incorporating cellphone-based place visitation data (i.e., the proxy of health behaviors) into the models enhanced modeling fitness, with the model that included neighborhood context variables exhibiting the strongest fitness, followed by PNHB, POI features, and HSUB variables. These improvements are greater in models for self-reported mental health status compared to depression. The model fitness exhibits spatial differences, with smaller differences between actual and predicted values in urban areas (2.834) compared to rural areas (2.956) and the Midwest (2.212) compared to other regions. Overall, this study represents the first nationwide investigation of the role of cellphone-based place visitation data in estimating neighborhood-level depression prevalence. It expands a novel conceptual framework for explicating neighborhood-level depression prevalence by incorporating neighborhood-level health behaviors.

The relationship between climate change, globalization and non-communicable diseases in Africa: A systematic review.

Climate change and non-communicable diseases (NCDs) are considered the 21st Century's major health and development challenges. Both pose a disproportionate burden on low- and middle-income countries that are unprepared to cope with their synergistic effects. These two challenges pose risks for achieving many of the sustainable development goals (SDGs) and are both impacted by globalization through different pathways. While there are important insights on how climate change and or globalization impact NCDs in the general literature, comprehensive research that explores the influence of climate change and or globalization on NCDs is limited, particularly in the context of Africa. This review documents the pathways through which climate change and or globalization influence NCDs in Africa. We conducted a comprehensive literature search in eight electronic databases-Web of Science, PubMed, Scopus, Global Health Library, Science Direct, Medline, ProQuest, and Google Scholar. A total of 13864 studies were identified. Studies that were identified from more than one of the databases were automatically removed as duplicates (n = 9649). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 27 studies were eventually included in the final review. We found that the impacts of climate change and or globalization on NCDs act through three potential pathways: reduction in food production and nutrition, urbanization and transformation of food systems. Our review contributes to the existing literature by providing insights into the impact of climate change and or globalization on human health. We believe that our findings will help enlighten policy makers working on these pathways to facilitate the development of effective policy and public health interventions to mitigate the effects of climate change and globalization on the rising burden of NCDs and goal 3 of the SDG, in particular.