Epidemiological Burden Research Articles

Epidemiological Analysis of Prostatic Cancer: Incidence, Prevalence, Mortality, and Disability Burden in Middle Eastern Countries

Prostatic cancer is considered the second most common cancer among men worldwide. It has significant geographical variability in its burden. Using data from the Global Burden of Disease (GBD) 2021 database, this review aimed to analyze the epidemiological burden of prostatic cancer in 14 Middle Eastern countries. The data of incidence, prevalence, mortality, and age-standardized disability-adjusted life years (DALYs) were analyzed. Compared to the global average rate of 33.449 per 100,000, our results showed that the Middle East reports a lower average incidence rate of 17.297 per 100,000 population. However, outliers such as Lebanon (64.381 per 100,000) and Turkey (52.166 per 100,000) exhibit a significantly higher burden. Mortality and age-standardized DALYs also highlight disparities, with Lebanon and Turkey recorded a higher values compared to other regional counterparts. Conversely, countries like Oman and Yemen reported the lowest rates, potentially reflecting underdiagnosis or limited healthcare access. The results underscore the importance of enhancing early detection programs, such as prostate-specific antigen (PSA) testing, and addressing modifiable risk factors, including smoking and obesity. By bridging gaps in data and healthcare access, this research highlights critical areas for policy interventions and targeted public health strategies to reduce the burden of prostatic cancer in the region. The findings provide valuable insights to inform regional healthcare planning and resource allocation, contributing to a broader understanding of global prostatic cancer epidemiology.

Synergistic pathogenesis: exploring biofilms, efflux pumps and secretion systems in Acinetobacter baumannii and Staphylococcus aureus.

Antimicrobial resistance (AMR) is a growing global health crisis, particularly among ESKAPE pathogens: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species. Among them, A. baumannii and S. aureus are major contributors to nosocomial infections, with high prevalence in intensive care units and immunocompromised patients. Their ability to resist multiple antibiotic classes complicates treatment strategies, leading to increased morbidity and mortality. Key resistance mechanisms, including biofilm formation, efflux pump activity, and horizontal gene transfer, enhance their survival and persistence. Furthermore, interactions during polymicrobial infections intensify disease severity through synergistic effects that promote both virulence and resistance. The epidemiological burden of these pathogens highlights the urgent need for novel antimicrobial strategies and targeted interventions. This review explores their virulence factors, resistance mechanisms, pathogenic interactions, and clinical implications, emphasizing the necessity of innovative therapeutic approaches to combat their growing threat.

Vascular models of Alzheimer's disease: An overview of recent in vitro models of the blood-brain barrier.

Vascular models of Alzheimer's disease: An overview of recent in vitro models of the blood-brain barrier.

The epidemiological burden of major depressive disorder in women of childbearing age and its relationship with the sociodemographic index: A systematic analysis based on the global burden of disease study from 1990 to 2021.

The epidemiological burden of major depressive disorder in women of childbearing age and its relationship with the sociodemographic index: A systematic analysis based on the global burden of disease study from 1990 to 2021.

Approach from the Public Health of the Global Historical and Clinical and Molecular Diagnóstic of the Cryptococcosis

This review explores the historical background of Cryptococcus, its key virulence factors, molecular diagnostic tools, and emerging trends in cryptococcal research. Fungal pathogens are increasingly recognized as a significant global public health threat, particularly in light of the rising incidence of neglected mycoses. In response to this growing burden, the World Health Organization (WHO) has prioritized fungal diseases as a critical area of concern. Traditionally, Cryptococcus neoformans and Cryptococcus gattii have been classified into four serotypes: A and D for C. neoformans, and B and C for C. gattii. Currently, serotype A is designated as C. neoformans var. grubii, serotype D as C. neoformans var. neoformans, while serotypes B and C are assigned to C. gattii. Cryptococcal infection poses a significant public health challenge globally, particularly in equatorial regions. In this review, we provide a concise overview of the Cryptococcus genome and discuss a range of molecular typing methods used to evaluate the genetic diversity and epidemiological burden of cryptococcal pathogens in environmental and clinical contexts. We also offer a detailed examination of the molecular mechanisms underlying cryptococcal immune reconstitution inflammatory syndrome (IRIS), with a specific focus on cryptococcal meningitis–associated IRIS (CM-IRIS).

A systematic review and meta-analysis of herpes zoster risk in adults with immunocompromised conditions and autoimmune diseases in Asia-Pacific

ABSTRACT Asia-Pacific (APAC) faces an increasing burden of herpes zoster (HZ) over time. The risk of HZ and its complications are increased in immunocompromised (IC) patients and those with autoimmune diseases (AID). Our study aimed to synthesize evidence on the epidemiological burden of HZ and its complications among the general adult population and patients with IC/AID conditions in APAC. Following a systematic literature review, we performed meta-analyses for outcomes where ≥3 studies met the inclusion criteria. Of the 271 articles identified, 75 were included for meta-analysis. We found a high burden of HZ and its complications (i.e., postherpetic neuralgia, HZ ophthalmicus), particularly among individuals with IC/AID conditions in APAC. Patients with IC/AID conditions had significantly increased HZ risk and a higher proportion of HZ recurrence than the general adult population. These findings may inform clinical practice and public health decisions regarding HZ prevention, including HZ vaccination strategies, among the IC/AID population in APAC.

PREVALENCE OF FOOT COMPLICATIONS IN ADMITTED PATIENTS WITH TYPE 2 DIABETES MELLITUS IN A TERTIARY CARE TEACHING HOSPITAL

Background: Diabetic foot is one of the most severe and costly complications of diabetes mellitus, often leading to infections, hospitalization, and limb amputations. The growing prevalence of type 2 diabetes mellitus (T2DM) in developing countries, particularly Pakistan, has made diabetic foot a pressing public health concern. Limited access to foot care services and delayed diagnosis further compound the risk of severe complications. Understanding the epidemiological burden and clinical patterns of diabetic foot complications is crucial for developing targeted preventive strategies. Objective: To assess the prevalence and clinical characteristics of foot complications in patients with type 2 diabetes mellitus admitted to a tertiary care hospital in Karachi, Pakistan. Methods: This descriptive retrospective study included 183 male patients with T2DM aged between 40 and 70 years, admitted to the male general ward. The mean age was 57.87 ± 13.1 years. Data were extracted from hospital records, including foot lesion type, laterality, comorbidities, and surgical interventions. Diabetic foot complications were classified using Amit Jain’s classification. Statistical analysis was performed using SPSS version 29.0. Results: The right foot was affected in 109 patients (59.6%) and the left in 74 (40.4%). Type 1 diabetic foot complications were most prevalent, found in 131 patients (71.6%), followed by type 3 in 37 (20.2%) and type 2 in 15 (8.2%). Wet gangrene was the most frequent pathological lesion (68 cases; 37.2%), followed by abscesses (34 cases; 18.6%) and cellulitis (22 cases; 12.0%). Infected trophic ulcers were reported in 24 patients (13.1%), while 18 (9.8%) had osteomyelitis and 22 (12%) had peripheral arterial disease. Surgical amputation was performed in 147 patients (80.3%). Conclusion: Type 1 diabetic foot complications, particularly wet gangrene, were the most common cause of hospitalization among male patients with T2DM, with a high rate of surgical intervention. These findings underscore the need for early screening, proper foot care education, and accessible multidisciplinary care.

Global, regional, and national burden of visceral leishmaniasis, 1990–2021: findings from the global burden of disease study 2021

BackgroundLeishmaniasis is a vector-borne parasitic disease caused by protozoa of the Leishmania genus; it is transmitted through the bites of infected phlebotomine sandflies. Clinically, it manifests in three primary forms: cutaneous, mucocutaneous, and visceral leishmaniasis (VL). Among these, VL represents the most severe form, characterized by high morbidity and mortality, and poses a considerable public health burden, particularly in endemic regions. This study utilizes data from the Global Burden of Disease (GBD) study 2021 to conduct a comprehensive analysis of the global epidemiological trends and burden of VL from 1990 to 2021, aiming to generate evidence-based insights to inform prevention and control strategies.MethodsUsing GBD 2021 data, this study examined trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of VL across 204 countries and territories, stratified by age, sex, and sociodemographic index (SDI) levels. Average annual percent change (AAPC) was calculated to describe trends in age-standardized rates and indicator counts from 1990 to 2021.ResultsFrom 1990 to 2021, the global age-standardized incidence rate (ASIR; AAPC = −0.25, 95% confidence interval (CI) −0.25, −0.24), age-standardized prevalence rate (ASPR; AAPC = −0.06, 95% CI −0.06, −0.05), age-standardized mortality rate (ASMR; AAPC = −0.03, 95% CI −0.04, −0.02), and DALY rate (AAPC = −2.38, 95% CI −2.44, −2.33) for VL all showed a declining trend. The ASMR was highest among children under 5 years old and decreased progressively with age. VL remains a critical and under-recognized tropical disease in Latin America, the Middle East, Africa, and South Asia.ConclusionsVL disproportionately affects males and presents the highest risk in children under 5 years. Enhanced global collaboration in infectious disease control, with a focus on regions such as Latin America, Africa, the Middle East, and South Asia, is essential to further reduce the burden of VL.Graphical abstract

Epidemiological characteristics and disease burden of bacterial meningitis in hospitalized children in China: a 6-year nationwide retrospective study

Bacterial meningitis is a severe infectious disease. Study of bacterial meningitis of children in recent years are limited. It is unclear whether there have been any changes in the epidemiological characteristics of bacterial meningitis during the years of the COVID-19 pandemic. The purpose of this study was to describe a large, nationwide study of bacterial meningitis in China. We analyzed data of hospitalized patients with bacterial meningitis from 30 hospitals in China from 2016—2021. A total of 16566 episodes of bacterial meningitis were included, of which 13614 episodes (82.18%) occurred in children age under 5-years old. The admission proportion of bacterial meningitis to total hospitalization decreased from 0.24% to 0.16% after COVID -19 pandemic (under COVID -Zero Strategy) (P < .0001). The risk of at least one complication was 26.45% (4382/16566). The three most common complications were hydrocephalus (2351, 14.19%), subdural effusions or empyema (1438, 8.68%), and seizures (794, 4.79%). Ninety-one (0.55%) patients died in hospital. Risks of complications and mortality (0.55%) were related to age under 5 years old (P < .0001). The median length of stay and inpatient expenditures for children with bacterial meningitis were 16 days and 2,697.38 USD.ConclusionsBacterial meningitis mostly occurred in children aged < 5 y. The percentage of 30 tertiary hospitalized children with bacterial meningitis apparently decreased after the COVID-19 pandemic. Ninety-one (0.55%) patients died in the hospital.

Prevalence of Hepatitis C viral infection in Ghana: A systematic review and meta-analysis protocol.

Background Hepatitis C virus (HCV) infection remains a major public health concern for many countries. A recent survey report in Ghana revealed a national HCV prevalence rate of 4.6% in a population of 35 million but with notably higher regional variations ranging from 8.6 to 14.4%. Considering that Ghana is targeting micro-elimination of HCV as part of the STOP Hepatitis C project, it is prudent to estimate the current epidemiological burden of hepatitis C for evidence-based policymaking, public health research, and program direction. An initial search of the literature showed a previous review that spanned from 1995 to 2015. The gap of almost 10 years may not reflect the current burden of hepatitis C in Ghana, hence this review. A systematic literature search will be performed in the major electronic databases and search engines including PubMed, Embase, Web of Science, CINAHL, and African Journals Online (AJOL). There will be a search for articles reporting on the prevalence of hepatitis C in Ghana from 2016 to 2024 in these databases. The protocol is registered with PROSPERO (CRD42024592505).

Epidemiological and economical burden of cholestatic liver disease.

Epidemiological and economical burden of cholestatic liver disease.

Acute pulmonary embolism with and without hemodynamic instability (2003-2022): a Swiss nationwide epidemiologic study.

Data on the epidemiologic burden of acute pulmonary embolism (PE) in Switzerland are unavailable. Knowledge gaps remain on trends in PE-related comorbidities, PE severity, and length of in-hospital stay (LOS) at a nationwide level. To study the epidemiology of acute PE with a focus on overall trends, sex-stratified trends, and trends in patients with (vs without) hemodynamic instability. We used nationwide, patient-level data including all patients aged 15 years or older hospitalized for PE in Switzerland from 2003 to 2022, amounting to N= 180 600. Additionally, we analyzed the Swiss Death Registry for the same period. We estimated the disease-specific age-standardized incidence rates, mortality rates, in-hospital case fatality rates, proportional mortality rates, and LOS. Analyses were stratified by sex and the presence of features of high-risk PE. During the study period, the PE-related incidence rate increased from 0.87 (95% CI: 0.82, 0.92) per 1000 population in 2003 to 1.19 (95% CI: 1.15, 1.24) in 2022. In contrast, a decreasing trend was found for mortality rates (18.7 [95% CI: 16.8, 20.6] per 100 000 population in 2003, 13 [95% CI: 11.7,14.2] in 2022), in-hospital case fatality rate (9.8 [95% CI: 9.1, 10.5] deaths per 100 hospitalized PE patients in 2003, 7.9 [95% CI: 7.4, 8.5] in 2019, subsequent increase during COVID-19 pandemic), and LOS (11 [Q1-Q3: 7-18] days in 2003, 8 [Q1-Q3: 4-16] in 2022). No major sex differences in trends were present. Except for LOS reduction, patients with high-risk features presented with similar trends. The incidence of acute PE in Switzerland increased over the last 20 years. Despite increasing trends in the median age at PE diagnosis, in-hospital case fatality and mortality rates decreased, particularly among patients with high-risk features, and the LOS progressively declined.

Premature Mortality Attributable to Ultraprocessed Food Consumption in 8 Countries.

Premature Mortality Attributable to Ultraprocessed Food Consumption in 8 Countries.

SEROPREVALENCE AND RESEARCH GAPS IN CYTOMEGALOVIRUS STUDIES IN YEMEN: A COMPREHENSIVE REVIEW

Cytomegalovirus is a prevalent virus that poses significant public health challenges, especially in developing countries like Yemen. Despite its widespread occurrence, there is a substantial gap in understanding the true epidemiological burden due to diagnostic limitations and low awareness among healthcare professionals and the general public. This comprehensive review aimed to assess Cytomegalovirus seroprevalence across different regions and population groups in Yemen, critically analyze the diagnostic techniques used, and evaluate awareness levels among key stakeholders. The findings indicated consistently high seroprevalence rates, reaching up to 100% among pregnant women and 99.5% among cancer patients. However, the heavy reliance on serological methods, such as enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay, without the use of molecular techniques, such as polymerase chain reaction, significantly hampers the accurate detection of active infections. Moreover, awareness among healthcare workers and the general population remains critically low, exacerbating the transmission risks. This review identifies critical research gaps, including a lack of molecular epidemiological studies and comprehensive awareness campaigns. Addressing these gaps requires an integrated approach that combines advanced diagnostic methods, enhanced healthcare training, and public education initiatives to mitigate Cytomegalovirus transmission and reduce its impact on health.

Global, regional, and national multiple myeloma burden from 1990 to 2021: a systematic analysis for of the Global Burden of Disease Study 2021

BackgroundMultiple myeloma (MM) is the second most common haematological malignancy worldwide. A comprehensive global analysis of MM based on diverse geographic locations and timeframes is lacking. This study aimed to provide the incidence, mortality rate, and disability-adjusted life years (DALYs) of MM, from 1990 to 2021, focusing on the age structure and temporal trends of the disease burden.MethodsThis study analysed the most recent MM data (1990 to 2021) from 204 countries and territories obtained from the Global Burden of Disease database. MM incidence, age-standardised mortality rate (ASMR), and DALYs were stratified by age, sex, and region to accurately reflect epidemiological trends and disease burden. The correlation between age-standardised rates and social population index was evaluated. To explore the influencing factors of MM, the annual percentage change (APC) and average APC rate (AAPC), as well as their corresponding 95% confidence intervals (UIs), were calculated.ResultsIn 2021, there were approximately 35,000 cases of MM worldwide, with the highest numbers in China and Germany, with 47,003 and 32,010 cases, respectively. In 2021, Europe had the highest ASIR and ASPR, while North America had the highest ASMR and DALYs. Globally, age-standardized ASPR, ASMR, and DALYs all increased between 1990 and 2021. From 1990 to 2021, the number of cases, deaths, and disability-adjusted life-years due to MM were higher in males than in females. The higher the sociodemographic index, the higher the ASPR.ConclusionsThe global prevalence, ASIR, ASMR and DALYs of MM increased, showing significant regional disparities. These findings underscore the need for prevention in specific populations and emphasise the urgent need for new therapies to reduce ASIR and improve patient prognosis.

EARLY DETECTION OF RENAL CYST ON ULTRASONOGRAPHY AND THEIR ASSOCIATED RISK FACTORS

Background: Renal cysts are fluid-filled sacs that develop within or on the kidneys, often detected incidentally during routine ultrasonographic examinations. Although usually benign, renal cysts can be associated with systemic conditions and contribute to renal dysfunction in certain cases. Identifying their prevalence and associated risk factors is essential for early diagnosis and management. Hypertension, diabetes mellitus, and age-related changes have been recognized as potential contributors to renal cyst development, yet their exact epidemiological burden varies across different populations. Objective: To determine the prevalence of renal cysts in patients undergoing ultrasound evaluation and to assess their associated risk factors. Methods: A cross-sectional descriptive study was conducted at the Institute of Kidney Diseases, Peshawar, Pakistan, on 344 patients referred for renal ultrasound. Convenience sampling was applied. Patients of all ages and genders were included, while those with congenital anomalies, unilateral nephrectomy, or kidney transplants were excluded. Data were collected through a pre-structured questionnaire, and statistical analysis was performed using SPSS version 20. Descriptive and inferential statistics, including chi-square tests and binary logistic regression, were applied to determine associations. Results: Renal cysts were present in 23.8% of cases. Simple cysts were the most common type (89%), while complex and other cyst types accounted for 9.6%. Females had a higher prevalence (52.3%) than males (30.3%) (P=0.034). The left kidney was more frequently affected (52%) than the right (34%), with bilateral involvement in 14%. Cyst location was predominantly cortical (84%), followed by medullary (4.8%), renal pelvis (8.5%), and polycystic (1.2%). Solitary cysts were most common (64.6%), while double (8.5%) and multiple cysts (25.6%) were less frequent. Hypertension (P=0.000, OR=2.969) and diabetes mellitus (P=0.007, OR=2.519) were significant risk factors. Conclusion: Simple renal cysts were the most frequently detected type, with a higher prevalence in females. Hypertension, diabetes mellitus, and renal stone history were strongly associated with cyst development. Ultrasound plays a crucial role in early detection, guiding appropriate management to prevent complications such as chronic kidney disease.

Temporal trends, clinical characteristics and prognostic factors analysis of infective endocarditis: a multicenter ambispective cohort study in China

BackgroundThe epidemiological and clinical characteristics of infective endocarditis (IE) in mainland China, particularly following the COVID-19 pandemic, remain insufficiently understood. This study aims to examine temporal trends, clinical features, and factors influencing in-hospital mortality of IE in northern China from 2019 to 2023.MethodsThis multicenter, retrospective study included 961 patients diagnosed with IE between 2019 and 2023 across hospitals in Henan, Shandong, and Tianjin. Data were collected on demographics, comorbidities, COVID-19 status, and treatment modalities. Risk factors for in-hospital mortality were identified using logistic regression and Cox proportional hazards models. The effect of surgical intervention was assessed through propensity score matching.ResultsIn-hospital mortality increased from 7.7% in 2019 to 26.4% in 2023, with an average annual growth of 38% (P = 0.008). The proportion of IE patients aged 65 years and older significantly increased, with this age group exhibiting the highest mortality rate (37.3%) by 2023. Surgical intervention was associated with a 91% reduction in in-hospital mortality (HR 0.09, 95% CI 0.05–0.15, P < 0.001). Independent risk factors for mortality included low left ventricular ejection fraction (LVEF), elevated heart rate (HR), cerebral hemorrhage, the use of vasoactive drugs and the requirement for continuous renal replacement therapy (CRRT).ConclusionIn-hospital mortality due to IE in northern China has risen substantially since 2019, particularly in elderly patients and those with comorbid conditions. There was no significant change in overall per capita hospitalization costs or length of stay. Surgical intervention significantly improved survival outcomes. Additionally, patients who have been infected with COVID-19 twice had an 81.3% increased risk of death. The results of this study provide important data into the epidemiological and medical burden of IE in mainland China since the COVID-19 epidemic.

Postoperative pneumonia in isolated coronary artery bypass grafting: A comprehensive study of epidemiology, etiology, and disease burden from China (2020-2023).

To investigate the epidemiological trends,etiological profiles and disease burden metrics related to postoperative pneumonia following isolated coronary artery bypass grafting (CABG). A retrospective analysis was conducted on data from 518 patients who developed postoperative pneumonia following isolated CABG between January 1, 2020, and November 30, 2023. Postoperative pneumonia occurred at a rate of 11.34% among the cohort (518/4569),which fluctuated by year (P < 0.001). Patients aged 60-80 and over 80 years exhibited significantly higher incidence rates compared to those under 60 years (all P < 0.05) A total of 416 strains were identified, with Gram-negative bacteria accounting for 86.5%, primarily represented by Klebsiella pneumoniae (31.0%), while pseudomonas aeruginosa (21.4%) and stenotrophomonas maltophilia (5.3%) demonstrated an increasing trend in the period of 2022-2023 (both P < 0.05). The proportion of Staphylococcus aureus in the fourth quarter was significant lower than that in the first quarter (4.8% vs 14.4%, P < 0.05). The overall detection rate of multi-drug resistant organisms (MDRO) was 57.7%,with 53.9% for Gram-negative bacteria and 82.1% for Gram-positive bacteria.Late-onset postoperative pneumonia was significantly associated with a higher detection rate of MDRO (63.8% vs 50.3%, P < 0.01). Postoperative pneumonia prolonged median length of postoperative hospital[20.00 (13.00,31.25) days vs 15.50(10.25,19.75) days, P < 0.001] and ICU [9.00(5.00,14.00)days vs 4.00(3.00,11.75) days, P = 0.002] stay, thereby increasing hospitalization costs[￥255592.15 (193384.29, 336337.53) vs ￥180501.02 (154493.58, 220501.03),P < 0.001]. The incidence of severe pneumonia significantly increased in patients infected with MDRO (19.30% vs. 5.51%, P < 0.001) or co-infected (40.00% vs. 9.52%, P < 0.001), leading to marked differences in postoperative hospital stay and hospitalization costs (all P < 0.05). The etiological patterns of postoperative pneumonia following isolated CABG showed temporal variations by year and quarter. MDRO infection and co-infections could significantly exacerbate the disease burden on patients.

Epidemiological disease burden and annual, nationwide health insurance treatment cost of female infertility based on real-world health insurance claims data in Hungary

BackgroundInfertility affects more than 50 million couples worldwide, resulting in a significant burden on individuals and society. Its prevalence ranges from 8–12% among developed countries. The growing number of patients poses an increasing challenge to the healthcare system and its funding. Our quantitative, descriptive, and cross-sectional study aimed to analyze the prevalence and annual nationwide health insurance treatment cost of female infertility in Hungary in 2019.MethodsWe used claims data obtained from the Hungarian National Health Insurance Fund Administration (NHFIA). The number of patients, total and age-specific prevalence, annual health insurance expenditure, and the distribution of costs by age group were evaluated. Infertility was determined according to the World Health Organization International Classification of Diseases codes (N.97.0, N97.1, N97.2, N97.3, N97.4, N97.8, and N97.9) and the utilization of each healthcare service type. During the study descriptive statistics, correlation analysis and t-test were used.ResultsIn 2019, the NHIFA spent a total of 7.2 billion HUF (22.2 million EUR) on female infertility treatment in Hungary (33,151 women in outpatient care). The most significant costs were related to inpatient care (4.1 billion HUF, 12.7 million EUR). The highest number of patients and prevalence (650.4 per 100,000 women) were found in outpatient care. In inpatient care, the prevalence is substantially lower (206.7 per 100,000 women). Regardless of its type, female infertility mainly affects patients in the 30–39 years age group (number of patients: 18,156 women). The average annual health insurance expenditure per capita was 1,083 EUR.ConclusionsReproductive health education, prevention, and medical screening play inevitable roles in the early stages of reproductive life to reduce the risk of infertility and decrease treatment costs.

Epidemiological, economic and humanistic burden of cervical intraepithelial neoplasia in Europe: A systematic literature review.

Epidemiological, economic and humanistic burden of cervical intraepithelial neoplasia in Europe: A systematic literature review.