Health Policy Development Research Articles

Exploratory analysis of COVID-19 propagation using logistic model

Pandemics pose significant threats to social, economic, and public health. The novel coronavirus (COVID-19), which emerged in late 2019, quickly became a global public health crisis due to its high contagion and pathogenicity. Using data from the World Health Organization (WHO), this study applied the Logistic model to analyze the spread patterns of COVID-19 in 16 countries with over 10 million infections from 2020 to 2023. The findings reveal that as of December 31, 2023, global infections exceeded 772 million with over seven million deaths. The USA and China had the highest infection numbers, while Brazil had the highest mortality rate. The study identified three main outbreak patterns: initial, late, and gradual development, reflecting different stages of the pandemic. Countries with earlier outbreaks, such as India, Brazil, the USA, and Argentina, generally had higher mortality rates, while those with later outbreaks, such as China, Pakistan, Japan, and Australia, had lower mortality rates. Significant differences were observed in the duration and speed of the spread, with China showing the shortest average duration and Russia the longest. The Logistic model’s parameter k values revealed policy adjustments, with Australia, Vietnam, and China showing significant changes over time, while the USA, France, and Russia showed less impact on epidemic control. These results provide an important perspective for understanding global pandemic transmission patterns and assessing the effectiveness of quarantine strategies across countries. They also provide a scientific basis for future public health policy and pandemic response development, helping countries to develop more targeted prevention and control strategies according to the characteristics of virus transmission, rationally allocate medical resources, and reduce social harm.

Lifestyle and incidence of hypertension in elderly with obesity

Introduction: Hypertension is one of the main health problems that often occurs in the elderly, especially those who are obese. An unhealthy lifestyle, such as poor diet, lack of physical activity, and smoking habits, can worsen this condition. This study aims to analyze the relationship between lifestyle and the incidence of hypertension in the elderly and obesity, as well as identify the most influential lifestyle factors. Materials and Methods: This study used a cross-sectional design involving 200 randomly selected obese elderly respondents. Data was collected through a structured questionnaire that included information about diet, physical activity, and smoking habits. Blood pressure measurements are taken to determine hypertension status. Statistical analysis was performed using logistic regression. Results: The results of the analysis showed that a diet high in salt and low in fiber, as well as lack of physical activity, was significantly associated with an increased risk of hypertension in obese elderly (p < 0.05). Smoking habits have also been found to be a risk factor that worsens the condition of hypertension. Older people who adopt a healthy lifestyle have a lower risk of developing hypertension. Conclusions: Lifestyle modifications, including increased physical activity and dietary improvements, are important strategies in the prevention and management of hypertension in obese older adults. These findings emphasize the need for health intervention programs that focus on lifestyle changes to improve the quality of life of the elderly. This research provides a basis for the development of more effective health policies in dealing with hypertension in the elderly population

Internet usage elevates elderly obesity: evidence from a difference-in-differences analysis of the broadband China policy

BackgroundThe global aging population is rapidly increasing, which has led to a growing prevalence of obesity among the elderly. Body mass index (BMI) is a crucial measure of obesity and is linked to an increased risk of various chronic diseases. At the same time, the widespread use of the internet and digital technologies has significantly influenced the health behaviors and outcomes of the elderly.ObjectiveThis study aims to examine the causal relationship between internet usage and BMI among the elderly, addressing a gap in existing research and providing evidence for the development of health policies targeted at the elderly population.MethodsUtilizing China’s “Broadband China” strategy as a quasi-natural experiment, we employed a difference-in-differences (DID) approach to analyze panel data from the CHARLS covering the years 2011–2015. By comparing the treatment and control groups before and after the policy’s implementation, we identify causal effects.ResultsOur findings indicate that the “Broadband China” strategy significantly increased BMI among the elderly. The mechanisms underlying this effect include reduced sleep duration, decreased physical activity levels, and worsened mental health. Furthermore, the impact of internet usage on obesity is particularly pronounced among urban residents, those without chronic diseases, and individuals with fewer surviving children.ConclusionsPolicy recommendations include promoting healthy internet usage practices, enhancing community-based activity facilities, and providing comprehensive mental health support to mitigate obesity rates and improve health outcomes among the elderly.

Analysis and contrast of psoriasis disease burden trends in China and globally from 1990 to 2021.

This study aimed to delineate the temporal tendency in the age and gender burden of psoriasis in China, spanning from 1990 to 2021, encompassing metrics such as incidence, prevalence, and disability-adjusted life years (DALYs). Furthermore, it sought to contrast these findings with the global disease burden. It also purposed to assess the impacts of age, time, and birth cohort, as well as to forecast the psoriasis burden in China for the upcoming 15 years. Utilizing open-access data from the Global Burden of Disease (GBD) database spanning 1990 to 2021, this study comprehensively examined the burden of psoriasis in China and globally. In China, a detailed analysis was conducted, emphasizing dimensions such as age, gender, and temporal trends. Join-point regression models were employed to calculate the average annual percentage change (AAPC). Furthermore, age-period-cohort (APC) analyses assessed the effects of age, time, and birth cohort, while an extended autoregressive integrated moving average model (ARIMA model) was used to forecast the psoriasis burden in China from 2022 to 2036. Between 1990 and 2021, China experienced significant changes in its age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY Rate (ASDR). Specifically, the ASIR rose from 48 per 100,000 in 1990 to 60 per 100,000 in 2021. Correspondingly, the ASPR increased from 362 per 100,000 in 1990 to 474 per 100,000 in 2021. Finally, the ASDR also showed an upward trend, climbing from 31 per 100,000 in 1990 to 41 per 100,000 in 2021. The AAPC of the ASIR, ASPR, and ASDR in China was 0.7434%, 0.8765%, and 0.8827%, respectively, significantly outpacing the global AAPC of 0.2204%, 0.2220%, and 0.2426%, respectively. The burden of psoriasis in China varied with age and gender, showing a trend of increasing and then decreasing ASIR, ASPR, and ASDR as age advanced. Women experienced lower incidence and prevalence rates of psoriasis than men. Over time, a delay in peak incidence was observed in both genders. The APC analyses revealed that psoriasis incidence initially increased and then declined with advancing age. Across all age groups, earlier birth cohorts had a relatively lower risk. Projections suggest that the incidence and prevalence of psoriasis in China will continue to rise over the next 15 years. Psoriasis poses a substantial public health challenge in China due to the country's large and increasingly aging populace. Mitigating this burden requires a multifaceted approach, including precise epidemiological research, an enhanced understanding of its socioeconomic determinants, and the development of effective health policies.

Epidemiological and clinical characteristics of craniofacial soft tissue injuries in a plastic emergency department in Xi’an, China: a retrospective study of 22887 patients from 2019 to 2023

ObjectiveThis study aims to describe the epidemiological features of craniofacial soft tissue injuries in a major plastic emergency department in northwest China.MethodsA retrospective review of emergency medical records (2019-2023) was conducted for craniofacial soft tissue injury patients. Demographic and clinical data were collected and analyzed, stratified by age and with consideration of the COVID-19 period.ResultsA total of 22,887 patients with 24,050 craniofacial soft tissue injuries were included. The mean age was 13.46±15.52 years, with a male to female ratio of 1.57. Collisions were the primary cause of injury (86.5%), and contusion and laceration were the most common types of wounds (97.4%). The most frequent injury locations were the forehead (24.4%), chin (13.8%), cheeks (13.0%), and supercilium (12.3%). Peak visiting times were in April, May, June, September, and October during the year, on weekends during the week, and in the afternoon and evening during the day. The average time interval between injury and hospital visit was 6.17±5.68 hours, with a median time of 4 hours. Epidemiological characteristics were also described for different age subgroups (underage [0-17 years], working-age [18-65 years], elderly [≥65 years]) and within each underage subgroup (infant-toddler [0-2 years], preschool [3-5 years], primary school [6-11 years], secondary school [12-17 years]). The COVID-19 pandemic led to a decrease in the frequency of facial injuries and a change in hospital visiting pattern, but had no apparent influence on other epidemiological characteristics.ConclusionsThis study provides a detailed epidemiological description of craniofacial soft tissue injuries in a large single-center retrospective cohort. The findings can contribute to optimizing treatment strategies, resource allocation, and the development of public health policies.

IMPLEMENTAÇÃO DA COMUNICAÇÃO VIRTUAL VIA WHATSAPP EM UMA EQUIPE DE SAÚDE DA FAMÍLIA: UM RELATO DE EXPERIÊNCIA

This article provides an in-depth analysis of the implementation of a virtual health community, mediated through the WhatsApp platform, within the Family Health team 4 at UBS 03 in Itapoã, Brasília-DF. The initiative was designed to overcome critical challenges related to geographical distance, financial constraints, and low adherence to in-person consultations—factors that compromise continuity of care and exacerbate health disparities. Initially, systematic observation identified communication and logistical barriers that hindered users' access to the health unit. Subsequently, the team, through weekly meetings, developed a strategic plan that included defining project objectives, training professionals, and creating a pilot WhatsApp group. This group was later expanded using QR codes, strategically placed on posters, appointment tickets, and other access points to reach a broader audience. The qualitative methodological approach, based on an experience report, enabled data collection through interaction records, evaluation meetings, and participant feedback. The results highlighted a significant improvement in information dissemination, service organization, and the strengthening of ties between the team and the community. Additionally, the project facilitated the segmentation of thematic groups for specific care needs, such as pregnant women, hypertensive patients, diabetics, and others. Despite challenges such as resistance to technology among some professionals and low digital literacy among certain users, training strategies, the establishment of guidelines, and continuous monitoring ensured the project's sustainability. This study underscores the transformative potential of digital technologies in Primary Health Care, demonstrating that well-planned innovations can promote more agile, humanized, and inclusive care, contributing to the development of more equitable health policies.

Brazilian Dialysis Survey 2023.

The annual Brazilian Dialysis Survey (BDS) supports and contributes to the development of national health policies. Objective: To report the 2023 epidemiological data from the BDS of the Brazilian Society of Nephrology (BSN). A survey was carried out in a voluntary sample of Brazilian chronic dialysis centers using an online questionnaire covering clinical and epidemiological aspects of patients on chronic dialysis, and characteristics of dialysis centers. For estimates of prevalence, incidence, and source of payment for dialysis, data were obtained from a random sample of dialysis centers. A total of 37.5% (n = 332) of the centers voluntarily responded to the online questionnaire, and 124 were randomly selected for specific estimates of prevalence and incidence rates. It was estimated that on July 1, 2023, the total number of patients on dialysis was 157,357 and 51,153 started dialysis in 2023. The estimated prevalence and incidence rates of patients per million population (pmp) were 771 and 251, respectively. Of the prevalent patients, 88.2% were on hemodialysis, 8.0% on hemodialfiltration, and 3.8% on peritoneal dialysis. The prevalence of anemia (Hb <10g/dL) was 29% and hyperphosphatemia (P >5.5mg/dL), 30%. There was an increase in the frequency of use of cinacalcet and paricalcitol. The estimated overall crude annual mortality rate was 16.2%. Estimates from a random sample of dialysis facilities show that the absolute number and the prevalence rate of patients on chronic dialysis continue to increase. A growing number of patients were undergoing hemodiafiltration and using cinacalcet and paricalcitol for hyperparathyroidism treatment.

Mental health of adolescents in countries of South-East Asia: A policy review.

Mental health of adolescents in countries of South-East Asia: A policy review.

Culinary Medicine.

The use of food as medicine to treat illness and maintain health has ancient roots across various cultures. Despite significant scientific progress during the past 2 centuries linking diet, the microbiome, and overall health, modern challenges persist due to sociocultural factors, aggressive food marketing, and insufficient nutritional education. However, there is increasing support from health systems, insurers, nonprofits, philanthropic organizations, and government bodies to develop health policies that promote access to high-quality meals for disease prevention and management. Culinary medicine is now incorporated into undergraduate and postgraduate medical education through electives, certifications in culinary and lifestyle medicine, and continuing medical education conferences. There is substantial potential for culinary medicine to enhance patient care across diverse populations and settings, including individual consultations, group visits, schools, farms, and community gardens. Collaborative efforts among stakeholders can advance practical solutions to translate scientific knowledge into effective policy and practice. [Pediatr Ann. 2025;54(3):e83-e87.].

Estimating Hospitalization Incidence for Ischaemic Heart Disease Using National Health Insurance Claims Data

Objectives: The objective of this study is to estimate the hospitalization incidence for ischemic heart disease (IHD) in South Korea using data from the National Health Insurance Service (NHIS). Additionally, the study aims to evaluate the appropriateness of the estimation method by examining the estimated incidence and its distribution across demographic characteristics.Methods: Data were obtained from the NHIS, with a focus on inpatient data to avoid potential overestimation by excluding mild cases. IHD episodes were defined in three stages, with criteria progressively broadened to include secondary diagnoses, related procedures, and medication codes. Using age-standardised rates and stratified demographic variables, detailed IHD incidence rates were derived.Results: The 2021 IHD incidence rate exhibited variation across stages, with the strictest criteria yielding a rate of 117.6 per 100,000 and broader definitions resulting in a rate of 125.1. Increased rates were observed among males, older adults, and low-income groups. Rural areas exhibited elevated incidence rates, reflecting regional disparities in healthcare access. Age-standardised rates enabled consistent comparisons, highlighting critical areas for targeted healthcare resources and preventive programs.Conclusions: Although claims data have limitations, such as excluding out-of-hospital mortalities, the NHIS database offers comprehensive population coverage for reliable long-term monitoring and health policy development. By refining episode definitions and standardising age, this study provides an evidence-based framework for assessing the burden of IHD, informing resource allocation, and guiding prevention strategies in high-risk areas. The findings support the use of IHD incidence rates as a valuable basis for public health planning and resource distribution.

IMPLEMENTAÇÃO DA COMUNICAÇÃO VIRTUAL VIA WHATSAPP EM UMA EQUIPE DE SAÚDE DA FAMÍLIA: UM RELATO DE EXPERIÊNCIA

This article provides an in-depth analysis of the implementation of a virtual health community, mediated through the WhatsApp platform, within the Family Health team 4 at UBS 03 in Itapoã, Brasília-DF. The initiative was designed to overcome critical challenges related to geographical distance, financial constraints, and low adherence to in-person consultations—factors that compromise continuity of care and exacerbate health disparities. Initially, systematic observation identified communication and logistical barriers that hindered users' access to the health unit. Subsequently, the team, through weekly meetings, developed a strategic plan that included defining project objectives, training professionals, and creating a pilot WhatsApp group. This group was later expanded using QR codes, strategically placed on posters, appointment tickets, and other access points to reach a broader audience. The qualitative methodological approach, based on an experience report, enabled data collection through interaction records, evaluation meetings, and participant feedback. The results highlighted a significant improvement in information dissemination, service organization, and the strengthening of ties between the team and the community. Additionally, the project facilitated the segmentation of thematic groups for specific care needs, such as pregnant women, hypertensive patients, diabetics, and others. Despite challenges such as resistance to technology among some professionals and low digital literacy among certain users, training strategies, the establishment of guidelines, and continuous monitoring ensured the project's sustainability. This study underscores the transformative potential of digital technologies in Primary Health Care, demonstrating that well-planned innovations can promote more agile, humanized, and inclusive care, contributing to the development of more equitable health policies.

Systematic Literature Review: The Presence of Microplastics in the Body and their Impact on Human Health

Background - Microplastics have been found in various environments, including water, air and food, increasing the risk of exposure to the human body. The accumulation of microplastics in the body can cause health impacts according to the route of entry into the body. Objective - This study reviews literature on microplastics that accumulate in the human body and their impact on health. Microplastics are small plastic particles that often come from consumer products and environmental pollution, and have been detected in various tissues of the human body. In the human body, microplastics cause oxidative stress conditions, affect the general body system and cause disorders in organ systems including the digestive system, respiratory system, reproductive system, trigger inflammation and potentially have long-term effects on the endocrine and nervous systems. Method - This study presents current evidence on the mechanisms of exposure, distribution of microplastics in organs, and health implications, providing important insights for the development of mitigation strategies and public health policies. The literature review articles obtained were screened with predetermined criteria. After screening, 10 main reference articles were obtained. Result - The results of this study showed that there were 10 articles stating that the presence and form of microplastics in the human body were found, and explained that there were health impacts due to exposure to microplastics on human health. The conclusion that can be drawn from this literature review is that microplastics have a long-term health impact on humans. Microplastics have additive carrier properties that can cause cancer. However, no research has been found on the real impact of microplastics that cause death. Implication - Food and beverage companies and the pharmaceutical industry should increase surveillance of microplastic contamination in their products and invest in more advanced filtration technology to protect consumers. In addition, the government and health sector need to develop mitigation policies and educate the public about the risks of microplastics and encourage innovation in reducing the use of single-use plastics.

Helminth Seropositivity Inversely Correlated with Th1 and Th17 Cytokines and Severe COVID-19

Background/Objectives: The COVID-19 pandemic has significantly impacted global health. However, Africa has reported relatively low numbers of cases and fatalities. Although the pandemic has largely receded, the reasons for its milder course on the African continent have not yet been fully clarified. This study explored the hypothesis that helminth co-infections may have contributed to these observations. Methods: A retrospective cohort study was conducted using 104 plasma samples collected during the third wave of the pandemic in the Ashanti Region of Ghana. Luminex assays were used to measure SARS-CoV-2-specific IgA and IgG, neutralizing antibodies, systemic cytokines and helminth-specific IgG. Results: The results indicated that the highest cumulative seroprevalence of helminths (61.5%) was observed in asymptomatic COVID-19 patients. In comparison, mild and moderate patients had helminth seropositivity rates of 43.8% and 34.5%, respectively, which were 1.4 and 1.8 times lower than those of the asymptomatic group, respectively. Notably, the two severe COVID-19 cases investigated were seronegative for all three of the helminths tested. Strikingly, co-exposure resulted in lower SARS-CoV-2-specific IgA/IgG expression and reduced neutralization potential. However, co-seropositive individuals for helminths and SARS-CoV-2 exhibited a higher expression of Th2 cytokines and IL-10 over Th1 cytokines compared to SARS-CoV-2-positive individuals alone. Conclusion: These data suggest that co-exposure to helminths could mitigate the severity of COVID-19 outcomes by reducing the Th1 and Th17 responses; this highlights the potential protective role of helminthiasis against severe COVID-19. These findings provide valuable insights for the development of public health policies in helminth-endemic regions and underscore the importance of considering helminth co-infections in managing viral infections. It also offers a plausible explanation for the milder disease severity observed in helminth-endemic regions while raising critical considerations regarding vaccine efficacy, as helminth-induced immune modulation may influence the magnitude and quality of vaccine-induced immune responses.

Evaluation of reporting in time-driven activity-based costing studies on cardiovascular diseases: a scoping review.

Aim: This scoping review evaluates the application of the time-driven activity-based costing (TDABC) methodology in cardiovascular disease (CVD) studies. Materials & methods: The evaluation was conducted using the 32-item TDABC Healthcare Consortium Consensus Statement Checklist. A systematic search was performed in Medline, Embase and Scopus in September 2023, including only full-text, peer-reviewed studies reporting the application of TDABC in CVD research. Results: Twenty studies were included in the review. The positive response rate for individual studies ranged from 31 to 81%. The most frequently addressed checklist item was the clear definition of study objectives, while presenting costs per patient included in the analysis was the least reported item. Although 70% of the studies achieved a positive response rate above 50%, adherence to the TDABC checklist remains inconsistent. Conclusion: There is significant room for improvement in the reporting of TDABC methodology in CVD studies. Providing a more comprehensive and standardized description of the methodology would enhance the utility, reproducibility and accuracy of the information generated, supporting the development of evidence-based health policies and improving accountability in healthcare cost assessments.

Association between adverse childhood experiences with chronic kidney diseases in middle-aged and older adults in mainland China

Adverse childhood experiences (ACEs) among middle-aged and elderly individuals may influence the subsequent occurrence of chronic kidney disease (CKD). We aim to investigate the association between ACEs and CKD among the middle-aged and elderly populations in China. The prospective cohort longitudinal study examined baseline data from the China Health and Retirement Longitudinal Study (CHARLS) from June 1 to December 31, 2014. Subsequent follow-up surveys were conducted in 2015, 2018, and 2020. The study population consisted of 4063 participants aged at least 45 years, who had CKD data and information on the 16 complete ACEs indicators included in this study. Utilizing correlation analysis to explore the relationship between CKD and the total score of ACEs, as well as the three dimensions (Conventional ACEs, Expanded ACEs, and New ACEs), along with specific items. The correlation between individual ACEs, disease-related factors, and CKD was examined using binary logistic regression models. Valuable diagnostic factors were then identified through the use of ROC curves. A Cox proportional hazards regression model, with age as the timescale and ACEs groups as covariates, was established to investigate the relationship between age-related CKD occurrence and ACE groups as individuals aged. Among the 4063 participants included in the analysis, in patients with CKD, the male proportion is 85 (64.9%), and the female proportion is 46 (35.1%). Of the participants, 2332 experienced at least two Conventional ACEs, 3786 experienced at least two Expanded ACEs, and 2774 experienced at least one New ACE. Factors influencing the occurrence of CKD in participants included Conventional ACEs 5 (OR 1.742; 95% CI 1.115–2.721; P = 0.015), Conventional ACEs 6 (OR 1.581; 95% CI 1.024–2.442; P = 0.039), Conventional ACEs 9 (OR 2.190; 95% CI 1.288–3.725; P = 0.004), Expanded ACEs 3 (OR 0.195; 95% CI 0.085–0.444; P < 0.001), memory-related disease (OR 3.297; 95% CI 1.140–9.538; P = 0.028), dyslipidemia (OR 2.536; 95% CI 1.521–4.230; P < 0.001), cancer (OR 6.369; 95% CI 2.464–16.461; P < 0.001), chronic lung disease (OR 2.261; 95% CI 1.091–4.684; P = 0.028), and liver disease (OR 3.050; 95% CI 1.432–6.497; P = 0.004). These three models showed significant statistical differences in CKD, the Conventional ACEs, and the New ACEs. In Model 1, 2, and 3, the risk was higher for individuals exposed to the Conventional ACEs group, indicating an increased likelihood of developing CKD, the risk was lower for individuals exposed to the New ACEs group, suggesting a reduced likelihood of developing CKD. ROC curve analysis of these variables showed that CA5, CA6, CA9, dyslipidemia had significant diagnostic value for the occurrence of CKD. The accuracy of diagnosis was CA5 (57.0%), CA6 (58.3%), CA9 (59.4%), and dyslipidemia (59.8%). This study, through longitudinal investigation, has identified potential links between ACEs and disease-related factors with CKD. These findings can still provide assistance to clinicians and public health administrators, helping them understand the association between ACEs and CKD, and offering theoretical support for their clinical decision-making or development of public health policies.

Global prevalence of stillbirth among fetuses from twin pregnancies: a systematic review and meta-analysis.

Evidence shows that twin pregnancy is associated with increased adverse outcomes, including stillbirth. The present study aimed to investigate the global prevalence of stillbirth among fetuses resulting from twin pregnancies through a systematic review and meta-analysis. To identify relevant studies, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched databases including PubMed, Web of Science, Google Scholar, Scopus, Embase, and Science Direct using keywords such as "stillbirth," "twin pregnancy," "fetus," and "prevalence" without applying any time constraints to the search. The quality of the articles was evaluated using the STROBE checklist. To ensure the reliability of our findings, we employed a random-effects model for analysis, and the heterogeneity of the studies was assessed using the I2 index. Data analysis was conducted using Version 2 of Comprehensive Meta-Analysis software. In a review of 10 studies with a sample size of 627,797 people, our meta-analysis revealed a global prevalence of stillbirth among fetuses resulting from twin pregnancies, reported to be 1.4% (95% CI 0.9-2.1). Our study also showed that with increasing sample size and years of study, the global prevalence of stillbirth among fetuses resulting from twin pregnancies decreased (p < 0.05). The highest prevalence of stillbirth, 3.5 (95% CI 2.2-5.4), was reported in the monochorionic type. The occurrence of stillbirth in twin pregnancies is a significant health concern for countries worldwide. Identifying its prevalence and contributing factors can aid health planning and policy development.

Cultural practices, oral health service utilisation and oral health policy and guidelines development in Africa: insights from the yorùbá ethnic group.

Cultural beliefs and practices influence oral health behaviors in Africa, where traditions around health are deeply woven into daily life and community values. From the symbolism embedded in African art, belief in efficacy of herbs and natural elements, to the communal customs around oral hygiene, culture serves as a lens through which health beliefs and practices related to oral health are cultivated, understood and acted upon. This manuscript discusses rituals and embodied culture practices surrounding oral health among yorùbá, and links this discussion to the implications for oral health policies and interventions in Africa. Yorùbá is a prominent ethnic group in West Africa with oral traditional practices which reflect the community's emphasis on natural remedies, often reducing reliance on professional dental care. Through an analysis of oral health "rituals" embedded in yorùbá songs, proverbs, and Ifá divination poetry, this manuscript argues that cultural expressions reinforce the importance of oral health as a manifestation of spiritual balance and personal oral hygiene. Despite this cultural reverence, the manuscript finds that dental service utilization remains low among the yorùbá, with spiritual and traditional interpretations of oral health concerns often delaying professional intervention. It further suggests that integrating culturally resonant strategies into oral health policies could bridge gaps in service uptake. By analyzing these dynamics, the study offers a culturally informed perspective on oral health research and proposes policy frameworks that integrate indigenous and modern health approaches.

Global, regional, and national burden of chronic kidney disease and its underlying etiologies from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundWe aimed to investigate global, regional, and national burden of chronic kidney disease (CKD) and its underlying etiologies from 1990 to 2021.MethodsWe summarized the results of the Global Burden of Disease (GBD) 2021 to derive the disease burden of CKD by considering four distinct types of epidemiological data, namely incidence, prevalence, mortality, and disability-adjusted life years (DALYs). The Joinpoint regression analysis, which is skilled in calculating annual percentage change (APC) and average annual percentage change (AAPC), was used to estimate global trends for CKD from 1990 to 2021.ResultsThe age-standardized mortality rate (ASMR) and age-standardized DALYs rate of CKD were more prominent in regions with Low and Low-middle socio-demographic index (SDI) quintiles. From 1990 to 2021, the countries with the largest increases in ASMR were Ukraine. Globally, the most common cause of death for CKD was type 2 diabetes mellitus (T2DM), while the most common cause of prevalence, incidence, and DALYs was the other and unspecified causes. The main causes of death and DALYs from CKD varied in different parts of the world. The disease burden of CKD increased with age. In most age groups, the global prevalence and incidence of CKD were higher in females than males. At all ages, the global mortality rate and DALYs rate of CKD were higher in males compared to females. Joint point regression analysis found that from 1990 to 2021 the global age-standardized prevalence rate (ASPR) revealed a downward trend, while age-standardized incidence rate (ASIR), ASMR, and age-standardized DALYs rate showed an upward trend, with the most notable increase in ASMR during the 1997–2000 period and in age-standardized DALYs rate during the 1996–2003 period.ConclusionsThe study unveiled the uneven global distribution of the burden of CKD and its attributable causes. From 1990 to 2021, an increase in the burden of incidence, mortality, and DALYs due to CKD was observed. Population growth and aging will contribute to a further increase in the burden of CKD. Healthcare providers should develop health policies, and optimize the allocation of medical resources, based on age, sex, region, and disease type.

Implementation and first report of the Brazilian Kidney Biopsy Registry.

Kidney biopsy registries are valuable tools for guiding clinical practice and developing health policies. In 2021, the Brazilian Society of Nephrology (SBN) created the Brazilian Kidney Biopsy Registry (BKBR). This is the first BKBR report, presenting patient data from 2021. BKBR is a web-based platform hosted on the BSN website, which contains patient demographics, clinical data, frequency, and distribution of histologic diagnosis of Brazilian adult native kidney biopsies. Of the 1012 cases registered in 2021, 954 cases were evaluated after excluding pediatric and kidney transplant cases. Twenty-one centers enrolled patients, with representation from all Brazilian regions. There was a slight predominance of females (52.6%), a mean age of 44.7 ± 16 years, and 13.6% of patients were >65 years old. The main indication for kidney biopsy was renal dysfunction (56%) and nephrotic syndrome (41.4%), respectively. At the time of the biopsy, 47.9% of the patients were hypertensive and 15.2% were diabetic. Although 66.2% of patients had eGFR ≤60ml/min/1.73m2 upon biopsy, the majority (60.2%) had mild interstitial fibrosis and tubular atrophy. The most frequent diagnosis in the BKBR was glomerular disease (74.8%). Lupus nephritis was the most frequent diagnosis of glomerular disease (22.6%), followed by IgA nephropathy (13%) and focal segmental glomerulosclerosis (12.2%). This is the first report of a Nationwide registry of kidney biopsies in Brazil. This data provides pivotal information about the kidney disease profile in this country with continental dimensions.

Patterns and Trends of Respiratory Diseases in Indonesian Hajj Pilgrims in Mecca: 2024 Descriptive Study

Background and Objective: Respiratory diseases are a major health problem for Indonesian Hajj pilgrims in Mecca, triggered by extreme environmental factors such as high temperatures (39-43°C), crowding, and air pollution. Changes in physical activity and dust exposure also play a role, especially in the elderly and those with comorbidities. Data from the Ministry of Health shows that &gt;50% of Hajj pilgrims experience respiratory problems, with pneumonia, bronchitis, and asthma as common diagnoses, particularly after the peak of the Hajj pilgrimage. This study aims to analyze the patterns and trends of respiratory diseases among Indonesian Hajj pilgrims in Mecca in 2024. Methods: This descriptive-analytic study uses secondary data from the registration of regular Hajj pilgrims at the KKHI Mecca in 2024 (1445 H). The total sample consists of 1962 Hajj pilgrims. Data were analyzed quantitatively using descriptive. Results: The majority of Hajj pilgrims seeking treatment were male (55.4%) and aged &gt;61 years (65.3%). Pneumonia was the most common respiratory disease (62%), followed by COPD (11.8%), asthma (4.3%), and ARI (8.1%). Risk factors included old age, extreme weather changes, physical fatigue, and air pollution. The majority of cases were treated on an outpatient basis at the KKHI Mecca (61.1%). Conclusion: Pneumonia is a major health problem among Indonesian Hajj pilgrims in Mecca. Old age is an important risk factor. Comprehensive prevention and treatment efforts are needed, including health education, awareness of medical personnel, and further research. This study provides valuable information for the development of more effective Hajj health policies.