Trends In Prevalence Research Articles

Portrayal of gender roles in Emirati television dramas: a content analysis

This research investigates the portrayal of gender roles in Emirati television dramas and movies, contextualizing them within the evolving socio-cultural landscape of the United Arab Emirates (UAE). The study conducts a comprehensive analysis of Emirati dramas and movies, categorizing prevalent gender role trends and their alignment with Emirati culture. Through content analysis, the research identifies four primary patterns: the ratio of male to female characters, gender role diversity and plot-power, themes relating to culture and religion, and the intensity of gender role manifestation with external factors. Findings reveal a predominant focus on male characters in Emirati media, reflecting traditional values where men are depicted as providers and leaders, while women are often relegated to caretaking roles. Implications of the research highlight a gradual shift toward gender equality in the UAE, evidenced by the increasing participation of women in the workforce. However, entrenched cultural values continue to influence societal expectations, perpetuating certain gender stereotypes. The study underscores the importance of media literacy in fostering critical analysis and demands for more nuanced female representation in Emirati media. Recommendations are proposed for media producers and regulators, to collaborate in promoting gender-sensitive content and fostering social change. By embracing evolving gender dynamics while preserving cultural heritage, the UAE has the potential to emerge as a global exemplar of contemporary society, championing diversity and inclusivity on a regional and international scale.

Development of a Microsimulation Model to Project the Future Prevalence of Childhood Cancer in Ontario, Canada.

Estimates of the future prevalence of childhood cancer are informative for health system planning but are underutilized. We describe the development of a pediatric oncology microsimulation model for prevalence (POSIM-Prev) and illustrate its application to produce projections of incidence, survival, and limited-duration prevalence of childhood cancer in Ontario, Canada, until 2040. POSIM-Prev is a population-based, open-cohort, discrete-time microsimulation model. The model population was updated annually from 1970 to 2040 to account for births, deaths, net migration, and incident cases of childhood cancer. Prevalent individuals were followed until death, emigration, or the last year of simulation. Median population-based outcomes with 95% credible intervals (CrIs) were generated using Monte Carlo simulation. The methodology to derive model inputs included generalized additive modeling of cancer incidence, parametric survival modeling, and stochastic population forecasting. Individual-level data from provincial cancer registries for years 1970 to 2019 informed cancer-related model inputs and internal validation. The number of children (aged 0-14 y) diagnosed with cancer in Ontario is projected to rise from 414 (95% CrI: 353-486) in 2020 to 561 (95% CrI: 481-653) in 2039. The 5-y overall survival rate for 2030-2034 is estimated to reach 90% (95% CrI: 88%-92%). By 2040, 24,088 (95% CrI: 22,764-25,648) individuals with a history of childhood cancer (diagnosed in Ontario or elsewhere) are projected to reside in the province. The model accurately reproduced historical trends in incidence, survival, and prevalence when validated. The rising incidence and prevalence of childhood cancer will create increased demand for both acute cancer care and long-term follow-up services in Ontario. The POSIM-Prev model can be used to support long-range health system planning and future health technology assessments in jurisdictions that have access to similar model inputs. This article describes the development of a population-based, discrete-time microsimulation model that can simulate incident and prevalent cases of childhood cancer in Ontario, Canada, until 2040.Use of an open cohort framework allowed for estimation of the potential impact of net migration on childhood cancer prevalence.In addition to supporting long-term health system planning, this model can be used in future health technology assessments, by providing a demographic profile of incident and prevalent cases for model conceptualization and budget impact purposes.This modeling framework is adaptable to other jurisdictions and disease areas where individual-level data for incidence and survival are available.

Malaria prevalence and patients’ knowledge, attitude, and preventive practices toward the disease in the Jawi District, Awi Zone, Northwest Ethiopia

BackgroundMalaria is the most important parasitic illness causing morbidity and mortality with high prevalence in tropical regions.ObjectiveThis study was aimed at evaluating the 7-year malaria trend and community awareness at Jawi Health Center and primary Hospital in Northwest Ethiopia.MethodsA retrospective and cross-sectional or prospective design were used for the study. The data was analyzed using SPSS version 22 software. The findings were considered significant at P < 0.05.ResultsAmong 62,624 blood films between 2015 and 2021 at Jawi Health Center, 40.9% were positive. Plasmodium falciparum accounted for 85.8%. Women had more mixed infections (P. falciparum and P. vivax) (X2 = 8.9, df = 2, P = 0.011) than men. A greater proportion (20.6%) of malaria cases was observed within the under 5 years age group and the number of malaria cases was higher in September, October, and June. The overall prevalence of malaria was found to be 25.2% and June had the highest proportion (75.6%). In total, 335 (80.9%) respondents recognized mosquito bites as the cause and fever (50%) as a clinical symptom of malaria. More than half of the respondents (60.1%) never sleep under mosquito nets.ConclusionThus, these findings have substantial implications for the trend of malaria prevalence and patient awareness of the disease which support the existing malaria control efforts.

“Competitive” Food and Beverage Laws and Obesity Among Diverse Youth in California High Schools

To investigate associations between the California "competitive" food and beverage (CF&B) laws and overweight/obesity (OV/OB) among high school youth by gender, school-neighborhood income, and race/ethnicity, and to examine racial/ethnic OV/OB disparities before and after CF&B policies. Using an interrupted time series design paired with retrospective cross-sectional Fitnessgram data from 3,565,260 youth-level records on ninth-grade students in California public schools, we estimated gender, school-neighborhood income, and racial/ethnic OV/OB prevalence trends before (2002-2007) and after the CF&B policies were in effect (2008-2012). In the period before the CF&B policies, OV/OB prevalence increased annually among the majority of subgroups regardless of gender, school-neighborhood income and race/ethnicity. In the period after the policies took place, OV/OB increased at a slower rate, plateaued or declined. Changes in log odds of OV/OB trends ranged from-0.03 to-0.07. In the period before the CF&B policies, OV/OB disparities widened between African American and Latino versus White males within each school-neighborhood income tertile; afterwards, disparities ceased to increase or slightly narrowed. The California CF&B laws for high schools are associated with favorable trends in youth OV/OB. This is the first study to examine these associations among multiple socio-demographically diverse high school youth simultaneously considering gender, school-neighborhood income and race/ethnicity. The degree to which observed changes in OV/OB trends are attributable to CF&B policies is unclear. Nevertheless, the results suggest that strengthening CF&B policies may help further reduce OV/OB among youth of different genders and ethnicities in schools across neighborhoods of varying income levels.

Abstract TP309: Differences in ischemic stroke hospitalizations and risk factor prevalence by age, sex, and race/ethnicity: Findings from the Get With The Guidelines (GWTG)-Stroke Registry, 2010-2021

Introduction: A nation-wide stroke surveillance system is not available in the US, limiting analyses to identify subgroups at disproportionate risk for ischemic stroke (IS). These data are needed to help inform targeted interventions to improve primary stroke prevention in high-risk populations. We assessed trends in IS hospitalizations and risk factor prevalence by age, sex, and racial/ethnic subgroups using data from GWTG-Stroke. Methods: The sample included patients discharged from GWTG-Stroke participating hospitals in 2010-2021 with a final diagnosis of IS. We conducted a stratified analysis to determine the proportionate composition and temporal trends in IS hospitalizations by race/ethnicity (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic, or Other), sex (women, men), and age (18-44, 45-64, 65+ y). We then used logistic regression to calculate the unadjusted prevalence odds for 10 stroke risk factors for the different race/ethnic, sex, and age groups. Results: There were 4,229,981 IS hospitalizations (mean age 70.1±14.4 y, 49.8% women) from 2,771 hospitals. The Hispanic and Other groups comprised an increasingly greater proportion of total IS hospitalizations over the study period in both women and men and in all age groups (P for trend <0.001; Figure 1 ). Within each racial/ethnic group, hospitalizations for IS were particularly high for younger (i.e., age <65 y) NHB men (53% of hospitalizations), Hispanic men (47% of hospitalizations), and NHB women (43% of hospitalizations), as compared to NHW women and men (25% and 35% of hospitalizations, respectively; Figure 2 ). The prevalence odds of common stroke risk factors including hypertension, diabetes, and overweight/obesity were higher for NHB vs NHW subgroups (e.g., NHB women 18-44 y OR 2.71 [95% CI 2.63-2.79] for hypertension, 1.90 [1.83-1.96] for diabetes, 1.24 [1.20-1.28] for overweight/obesity; NHB men 18-44 y OR 2.33 [2.26-2.40] for hypertension, 1.71 [1.65-1.77] for diabetes, 1.09 [1.05-1.13] for obesity/overweight) and Hispanic vs NHW subgroups (e.g., Hispanic women 18-44 y OR 1.22 [1.17-1.28] for hypertension, 1.69 [1.61-1.77] for diabetes; Hispanic men 18-44 y OR 1.22 [1.18-1.27] for hypertension, 1.83 [1.75-1.92] for diabetes; Figure 3 ). Conclusions: Stroke prevention efforts particularly targeting hypertension, diabetes, and overweight/obesity in younger NHB and Hispanic women and men may provide an opportunity to address their disproportionately high hospitalizations for IS.

Trends in modifiable risk factors for dementia among midlife adults in the United States: The National Health and nutrition examination survey 1999-2018.

Dementia has a large public health burden, and modifiable risk factors, particularly in midlife, may provide an opportunity for early prevention. We aimed to examine trends in age-adjusted prevalence of modifiable risk factors for dementia and the number of modifiable risk factors among midlife adults from 1999 to 2018. A total of 14,851 participants aged 40 to 64years without a history of cardiovascular disease in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018 were included in the analysis. The age-adjusted prevalence of six modifiable risk factors consistently measured across all surveys, including hypertension, diabetes, hyperlipidemia, obesity, smoking, and heavy drinking, as well as the average number of these modifiable risk factors, were estimated and compared across survey periods. Subgroup analyses were conducted by sex, race/ethnicity, education, and family income. The age-adjusted prevalence of diabetes (p for linear trend <0.0001) and obesity (p for linear trend=0.0001) showed increasing trends from 1999 to 2018 among midlife adults in the U.S. and in virtually all subgroups, while smoking showed a decreasing trend (p for linear trend <0.0001). The average number of modifiable risk factors remained around two (p for linear trend=0.84). The prevalence of diabetes and obesity increased in this large, nationally representative U.S. study population, while the prevalence of smoking decreased. More effective public health interventions are needed to mitigate the impact of these risk factors and ultimately reduce the burden of dementia in aging populations.

Prevalence and Mortality Trends of Hypertension Subtypes Among US Adults: An Analysis of the National Health and Nutrition Examination Survey (NHANES).

Hypertension (HTN) has been demonstrated as one of the leading risk factors for development of cardiovascular disease (CVD) and CVD mortality. This study examines the prevalence and distribution of HTN subtypes (isolated diastolic hypertension [IDH], isolated systolic hypertension [ISH], and systolic-diastolic hypertension [SDH]) across age, sex, and race/ethnicity per the nationally representative National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020 based on the updated 2017 ACC/AHA HTN definition. We further examined for associations of each subtype with CVD and all-cause mortality using Cox regression analysis. Among US adults, the overall prevalence of HTN is 47.4%. Across increasing age, the prevalence of IDH decreased, ISH increased, and SDH increased and peaked in the 6th decade of life after which SDH prevalence decreased. By age 80, over 80% of persons with HTN demonstrated ISH. A sub-cohort from NHANES 1999-2008 with follow-up until 2018 showed that ISH and SDH were most strongly associated with increased risk for CVD (HR 1.18, 95% CI 1.01-1.38; HR 1.31, 95% CI 1.07-1.60, respectively) and all-cause mortality (HR 1.17, 95% CI 1.06-1.28; HR 1.21, 95% CI 1.08-1.37, respectively). Our data demonstrate the continuing importance of HTN subtype transitions across age and their differences in predicting future CVD and total mortality.

Age-Friendly Health Care: An Example of Providing Integrated Care for Older People (ICOPE) in Pingtung County, Taiwan

Population aging has become a prevalent societal trend in the 21st century, giving rise to intricate challenges for healthcare systems. Taiwan is expected to become a "super-aging society" in 2025. In 2020, the Health Promotion Administration, referencing World Health Organization (WHO) guidelines on integrated care for older people (ICOPE), began promoting person-centered functional assessments for older adults to prevent and delay disability, reduce reliance on formal healthcare, and promote healthy aging, aging in place, and active aging. Pingtung County faces a healthcare gap between urban and rural areas. To address this, the county's executive team integrated community and healthcare systems into a single Age-Friendly Health Network to help older adults self-detect intrinsic functional decline problems at an early stage and receive early treatment. The implementation of this network is being done in the following four phases: preparation, action, implementation and revision, and promotion. As of August 2024, ICOPE intake in the county reached 11,873, representing a coverage rate of 7.42%. In addition to inadequate training opportunities for community healthcare professionals, rural communities are currently confronted with a dearth of referral mechanisms for post-ICOPE screening aftercare services for anomalous cases, representing a significant challenge that demands collaboration between industry, government, academia, and research. In light of the expanding older adult population, community nursing can be a formidable undertaking, necessitating the provision of ongoing nursing professional training and psychosocial support.

Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050

Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050

Age trend in risks for the chronic diseases in miners and metallurgists of the Kola Arctic

Introduction. With the combined and complex action of harmful occupation factors, traditional methods fail to allow an objective assessing of age-related changes in health. The purpose of the work. To analyze and give a hygienic assessment of the age trend in prevalence in miners and metallurgists of the Kola Arctic. Materials and methods. There were examined three groups of workers of the Kola Arctic region including 1758 workers from the mining complex with harmful working conditions (degree of harm 3.1.–3.3); 2181 workers of the metallurgical enterprise (degree of harm 3.1.–3.3); 242 engineering and technical staff (hazard classes 2 and 3.1). There were investigated 12 classes of diseases, established according to the data of periodic medical examinations. The average values of morbidity indices and linear regression indice were calculated as “disease risk = annual gain in risk (AGR) · age + const”. The relative assessment of the AGR was carried out in relation to the actual value to the control, background value. Results. For each class of diseases in four age groups of employees (20–29; 30–39; 40–49; 50–59 years). These linear regressions were calculated. The obtained AGR values were compared with the control values and the values in the report. The obtained values ​​of the AGR were compared with the control values ​​and literature data. The highest AGR for diseases of the circulatory system, musculoskeletal system, and chronic diseases was found in workers in the mining complex. The highest annual increase in the risk of diseases of the respiratory, genitourinary and endocrine systems was observed in workers in metallurgical production. The annual rise in the risk of diseases of the organs of vision was the highest in the group of specialists. The differences in the prevalence in the examined groups of workers are due to the differences in the annual increases. Limitations. The limitation of the study may be the insufficient amount of data to calculate the AGR in women due to the legislative prohibition of the use of female labour in underground work and in some types of metallurgical industries. Conclusion. The workers at the mining complex have the highest annual gain in the risk for diseases of the circulatory system, musculoskeletal system, and in the number of chronic diseases. Metallurgical workers have the highest annual increase in the risk of diseases of the respiratory system, genitourinary, and endocrine systems. The annual increase in the risk of diseases of the visual organs is of the greatest importance in the group of specialists. The differences in the disease levels of the surveyed groups of workers are due to differences in their annual increases.

Global, regional, and national epidemiology of allergic diseases in children from 1990 to 2021: findings from the Global Burden of Disease Study 2021

BackgroundAsthma and atopic dermatitis (AD) represent significant global health challenges in children. This study aimed to investigate trends in incidence, prevalence, and disability-adjusted life years (DALYs) for childhood asthma and AD from 1990 to 2021.MethodsThe study utilized information from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study 2021. The sample size for this study consisted of children with asthma or AD between the ages of 0 and 14. From 1990–2021, we calculated asthma and AD’s age-standardized incidence, prevalence, and DALYs by area, age, sex, and socio-demographic index.ResultsIn 2021, global childhood asthma prevalence reached 95.7 million cases (age-standardized rate: 4,758 per 100,000), with the Low SDI region recording 25.4 million cases. For AD, global prevalence was 72.4 million cases (age-standardized rate: 3,600 per 100,000), predominantly in Middle SDI regions (19.7 million cases). Between 1990 and 2021, age-standardized incidence rates decreased for both conditions. Geographic variations were notable: High-income North America showed the highest asthma incidence, while Western Europe led in AD prevalence. The global burden of asthma-related DALYs declined from 6.9 million in 1990 to 4.6 million in 2021, with significant regional disparities.ConclusionsDespite decreasing age-standardized rates, childhood asthma and AD continue to pose substantial health burdens globally, with marked variations across regions and socioeconomic strata. These findings emphasize the need for targeted, region-specific interventions.

Twenty year trends in prevalence and incidence of diabetic retinal disease.

To determine how the rates of diabetic retinal disease (DRD) and its vision-threatening components (VTDR), diabetic macular edema (DME), and proliferative diabetic retinopathy (PDR) among patients with diabetes mellitus (DM) have changed over the past 20 years. Retrospective cohort study. All individuals in a US administrative medical claims database comprised of patients insured by commercial and Medicare Advantage insurance plans from 2000-2022 with DM and at least one full calendar year of data. Cohorts of patients with DM were created using ICD codes to determine the yearly prevalence and incidence of DRD, VTDR DME, and PDR. Logistic and Poisson regression models were used to create prevalence and incidence estimates, respectively. The main outcomes were the unadjusted prevalence and incidence of DRD, DME, and PDR. Among patients with DM, the prevalence of DRD initially decreased from 2001 (13.6%) to 2007 (10.9%) but then increased every year through 2021 (20.8%)(adjusted test for trend[aTT] p<0.001). DRD incidence varied considerably, ranging from 17.7 cases/1000 patient-years in 2013 to its highest of 32.2 in 2022 (aTT p<0.001). The prevalence of VTDR and DME trended similarly, with increases from 2007 (VTDR:5.2%; DME:3.2%) through 2016 (VTDR:7.5%; DME:5.4%) followed by decreases each year through 2021 (VTDR:6.9%; DME:4.9%)(aTT p<0.001). The VTDR and DME incidence rates also tracked similarly, with multi-year peaks in 2009 (VTDR:12.4; DME:8.6) and general decreases through 2022 (VTDR:6.1; DME:5.0)(aTT p<0.001 for both VTDR and DME). PDR prevalence varied between 3.2% and 4.0% throughout the 20-year observation, measuring 3.5% in 2021(aTT p<0.001). PDR incidence varied from 8.3 in 2002 to 7.0 in 2008, then decreased every year to 2.6 in 2022 (aTT p<0.001). DRD Prevalence (through 2007) and incidence (through 2014) initially decreased, but the rate of each has since doubled. Despite increases in DRD, incidence rates of VTDR, DME, and PDR have dramatically improved over the past 20 years.

P-456. Reduction in the incidence of chronic hepatitis C, liver cancer, and related healthcare burden following the introduction of interferon-free direct-acting antiviral therapy in Japan: a national claims database study

Abstract Background The World Health Organization aims to eliminate hepatitis C virus (HCV) infections by 2030. Interferon-free direct-acting antiviral (DAA) therapy, available in Japan since 2014, has demonstrated high hepatitis C cure rates and reduced hepatitis C-related hepatocellular carcinoma (HCC). However, DAA therapeutic efficacy on a national scale remains underexplored. In this study, we investigated national trends in HCV prevalence and complications, including liver cancer, during the era of interferon-free DAAs, with particular focus on the impact of coexisting human immunodeficiency virus (HIV) infection. Methods We used the National Database of Health Insurance Claims, covering &amp;gt;98% of the population in Japan, to extract claims data on patients with chronic hepatitis C between 2013 and 2022. We identified patients with chronic hepatitis C annually based on the presence of corresponding diagnostic codes and relevant tests (abdominal ultrasound or HCC tumor markers) within each fiscal year. Next, we analyzed the trends in the prevalence of chronic hepatitis C (stratified by HIV status), DAA therapy, HCC incidence and treatment, and healthcare costs. Results Between 2014 and 2022, 333,020 patients underwent interferon-free DAA therapy in Japan. The number of patients with chronic hepatitis C decreased from 690,336 in 2013 to 414,708 in 2022, representing a 40% prevalence reduction (95% confidence interval: 40%–40%). However, among people living with HIV (PLWH), we observed a 16% decline (10%–20%). Newly diagnosed HCC incidence among patients with chronic hepatitis C declined by 69% (68%–70%) over the 10 years. HCC treatment numbers also declined, with 50%, 80%, and 82% reductions in hepatectomies, radiofrequency ablation, and transarterial chemoembolization therapy, respectively. The total annual healthcare cost of HCV-infected individuals peaked in 2015 (1.1 trillion yen), coinciding with the widespread use of DAAs, and decreased to 65% of the 2013 expenses by 2022. Conclusion The introduction of DAAs significantly reduced the HCV infection-related healthcare burden in Japan. Extensive screening and treatment, particularly in PLWH, are crucial for successful HCV eradication. Disclosures All Authors: No reported disclosures

P-493. Decreasing Depressive Symptoms among Adults Living with HIV - United States Medical Monitoring Project (MMP), 2015-2022

Abstract Background People with HIV (PWH) have higher rates of depression than people without HIV. We assessed trends in prevalence of depression among PWH in the United States (U.S.). Methods We analyzed the weighted prevalence and estimated annual percentage change (EAPC), with associated 95% confidence intervals (CI), of DSM-IV criteria-defined major or other depression (depression) based on self-reported answers to Patient Health Questionnaire-8 questions from a nationally representative sample of U.S. adults with diagnosed HIV. Data were collected in 7 annual cycles (2015-2021) from June 01 of the indicated year to May 31 of the following year. Results From the 2015 through 2021 data collection cycles, prevalence of depression symptoms decreased an average of 8% annually (EAPC = -8.0%, CI -8.1%, -7.9%). Prevalence declined across most sociodemographic groups examined. Particularly large declines were seen among PWH self-identifying as heterosexual men (EAPC = -12.4%, CI -12.6%, -12.2%) or Black/African American persons (EAPC = -11.7%, CI -11.9%, -11.6%), particularly Black/African American cisgender women (EAPC = -13.8%, CI -14.0%, -13.6%; Fig 1a-1b). In contrast, prevalence of depression increased an average of 3% (EAPC = 3.0%, CI 2.2%, 3.8%) among transgender women (measured 2016-2021 due to small 2015 sample size) and changed minimally among people who injected drugs (PWID; EAPC = 0.4, 95% CI 0.1%, 0.8%; Fig 1a-1c). Further, in 2021 high prevalence of depression persisted among adult PWH who self-identified as transgender women (27.9%), PWID (39.5%) or aged 18-24 years (24.4%); experienced food insecurity (33.1%), homelessness (29.7%) or unemployment (22.8%); or self-reported disability (27.9%). Conclusion Overall, prevalence of depression among PWH declined an average of 8% per year during 2015-2022. However, this positive outcome was not observed among certain National HIV/AIDS Strategy priority groups; depression increased in transgender women and did not change among PWID. Understanding reasons for the decline could inform interventions to further reduce depression among PWH and address unique needs of transgender women and PWID who are most affected by persisting high levels of depression. Disclosures All Authors: No reported disclosures

Trends in incidence, prevalence, and mortality of non-communicable diseases in Iraq (2003–2021)

BackgroundNon-communicable diseases (NCDs) have become a major public health concern in Iraq, playing a significant role in the country’s morbidity and mortality rates. To offer a thorough overview of the patterns and the overall impact of NCDs on public health, this study aims to map the trends in the incidence, prevalence, and mortality rates of NCDs in Iraq between 2003 and 2021.MethodsData from the Global Burden of Disease (GBD) Study 2021 were utilized. The focus was on Iraq from 2003 to 2021, a period marked by significant social and political changes. Using the GBD results tool, age-standardized prevalence, incidence, and mortality rates (ASPR, ASIR, ASMR) for 12 major NCDs were extracted and expressed per 100,000 population. Descriptive statistics with 95% uncertainty intervals were calculated, and trends were analyzed.ResultsThe analysis revealed a nuanced trajectory of NCDs in Iraq between 2003 and 2021. The ASPR of all NCDs increased slightly (change %: 0.1, 95% UI: -2.2 to 2.4), with a notable decline in chronic respiratory diseases (change %: −14.4, 95% UI: (-30.9 to 6.1) and a significant rise in neoplasms (change %: 32.7, 95% UI: -5.9 to 81.3). The ASIR of diabetes and kidney diseases showed the largest increase (change %: 42.9, 95% UI: 28.4 to 59.3), while chronic respiratory diseases had the greatest decline (change %: −12.1, 95% UI: -36.8 to 22.5). Cardiovascular diseases remained the leading cause of mortality in both sexes, with ASMRs increasing slightly for males and decreasing for females over the period. Skin and subcutaneous diseases showed the highest increase in ASMR (change %: 48.2), while digestive diseases experienced the largest decline (change %: −21.4).ConclusionThe GBD 2021 study highlights progress in reducing NCD mortality in Iraq, especially among younger people. However, older males still face high death rates from cardiovascular diseases. Rising cases of cancer, diabetes, and kidney diseases signal the need for targeted interventions. Continued focus on risk factors and healthcare access is essential.

P-2103. Non-invasive Group A Streptococcus Infection in the United States, 2012 – 2023: a National Reference Laboratory Retrospective Study

Abstract Background Non-invasive Group A Streptococcus (GAS) infection prevalence is not actively monitored, however understanding seasonal patterns can help inform unexpected trends in invasive and non-invasive GAS prevalence. Methods De-identified results from 23,601,754 specimens for GAS detection from throat swabs performed at Labcorp sites from January 2012 – December 2023 were included in a retrospective, cross-sectional cohort study. 2,605,482 specimens with diagnostic tests to detect bacteria including GAS from blood culture positive bottles were included as a surrogate for invasive GAS infection (iGAS). Cross-correlation tests were used to compare the time series patterns for URT GAS and GAS bacteremia. Age-adjusted prevalence ratios comparing GAS prevalence in 2023 to 2017 were calculated using metabin function in the meta R package. Multivariable logistic regression models were used to test for association between patient sex, age, and geographic location and GAS infection. Results The highest URT GAS infection levels occurred between the 8th to 16th weeks of the year. Higher Risk of URT GAS infection was confirmed in patients 6 – 11 years of age and 15% increased risk was observed in males. Higher positivity of non-invasive Group A Streptococcus infection was consistently observed in East North Central, Middle Atlantic and Pacific divisions of the United States. A large decrease in non-invasive Group A Streptococcus infection due to the COVID-19 pandemic was followed by a significant resurgence in late 2022 and early 2023, with return to seasonal patterns in late 2023. Prevalence of URT GAS infections in March 2023 was 55% greater than the prevalence of URT GAS infections in March 2017 (age-adjusted PR: 1.55, 95% CI: 1.52 – 1.58). iGAS positivity rates generally corresponded to URT GAS positivity rates during the same time period, including during GAS resurgence in late 2022 and early 2023. Conclusion Data from national reference lab outpatient testing can provide potentially statistically significant infectious disease surveillance trends. Disclosures Min Kyung Lee, PhD, Labcorp: Salary Howard Engler, PhD, D(ABMM), Labcorp: Salary|Labcorp: Stocks/Bonds (Public Company) Rita Stainback, MS, MT (ASCP) SM, DLM, Labcorp: Salary David Alfego, PhD, Labcorp: Employee|Labcorp: Stocks/Bonds (Public Company) Samia Naccache, PhD, D(ABMM), Labcorp: Salary|Labcorp: Stocks/Bonds (Public Company)

P-1037. Prevalence and antifungal susceptibility of Candida species isolated from Korean infants and children with candidemia, 2011-2023

Abstract Background Candida is the most common cause of fungal infections, and candidemia is the most common form of invasive fungal infection. The widespread use of antifungal agents has led to a global increase in non-albicans Candida infections and antifungal resistance. This study aims to investigate the clinical characteristics, treatment outcomes, fungal species, and antifungal susceptibility results of candidemia cases in Korean children. Trend of annual candidemia prevalence and distribution of Candida species Methods This study retrospectively collected and analyzed clinical data from Korean children at two referring hospitals from 2011 to 2023. A case of candidemia was defined as a positive confirmation of any Candida species on at least one blood culture. Information on the Candida species and antifungal susceptibility was obtained from the results of the VITEK II automated equipment. The annual incidence of candidemia was adjusted to the combined number of hospitalized children in the two hospitals, and statistical analysis was performed on 30-day mortality as risk factors. Distribution of Candida species according to the age groups Results A total of 144 cases of candidemia were diagnosed in 139 children. The prevalence rate of candidemia per 1,000 actual hospitalized children was 0.6-2.4 (median 1.6). The age distribution showed 46.0% of individuals were younger than three months. All patients had an underlying medical condition, with prematurity (93.2%) most common in those under three months and hemato-oncology (HO) disease (44.0%) in those three months and older. In the younger age group, Candida glabrata was the most prevalent (31.8%), followed by Candida albicans (27.3%) and Candida parapsilosis (24.2%). In the older age group, C. albicans was the most prevalent (34.9%), followed by C. parapsilosis (26.5%). Non-susceptibility were 0.9% for amphotericin, 15.6% for fluconazole, 0% for voriconazole, 2.9% for caspofungin, and 7.7% for micafungin. The 30-day mortality rate for candidemia was 28%. The distribution of the Candida species was comparable between the mortality and survival groups. Age of 5-9 years and HO underlying disease were significantly associated with 30-day mortality. Antifungal non-susceptibility according to Candida species Conclusion The proportion of candidemia caused by non-albicans Candida species remained high in Korean children, requiring individualized strategies for initial treatment based on age group and underlying medical conditions. Risk factors for 30-mortality in Korean children with candidemia Disclosures All Authors: No reported disclosures

P-117. Wastewater-Based Surveillance (WBS) of Shiga Toxin-Producing Escherichia coli (STEC) in Alberta, Canada

Abstract Background Shigatoxin-producing E. coli (STEC) are responsible for significant human morbidity, with the potential to cause severe food-borne illness and outbreaks. STEC incidence varies between communities and peaks in summer months (PMID 31652648). Leveraging a SARS-CoV-2 WBS program, we sought to explore genomic targets for STEC WBS.Figure 1.Prevalence of STEC differs across Alberta’s municipal sewer sheds Methods Composite-24h wastewater (WW) was collected from geographically disparate, and socioeconomically diverse Alberta communities (n=5) at the level of municipal WW treatment plants. From 04/2022-03/2024, monthly WW underwent pelleting and DNA extraction by Qiagen DNeasy PowerSoil Pro kit. WW extracts were assessed for four potential genomic STEC targets: Shiga Toxin 1 (stx1), Shiga Toxin 2 (stx2), Intimin (eae) and LPS O antigen gene specific for O157 (rfbEO157), by multiplex PCR. Each target was normalized by 16S rRNA-for total bacterial burden. WW STEC targets were assessed for correlation using Spearman’s and compared between communities and seasonality (July-Sept vs Jan-Mar) by Mann-Whitney U-test.Figure 2.STEC WBS demonstrates seasonal prevalence trends Results Of 111 WW samples assessed, 108 (97%) were positive for all targets, and individual targets were identified in 110 (99%) stx1; 110 (99%;) stx2; 111 (100%) eae, and 110 (99%) rfbEO157. Gene abundance for each STEC target exhibited strong correlations across sites (stx1 vs stx2, r=0.802, p&amp;lt; 0.0001; stx2 vs rfbEO157, r=0.634, p&amp;lt; 0.0001; eae vs rfbEO157, r =0.551, p&amp;lt; 0.0001; stx2 vs. eae r=0.542, p&amp;lt; 0.0001). WW measured STEC gene targets exhibited significant differences between municipalities (Figure 1) with strong seasonal trends (Figure 2). Conclusion WBS for STEC yielded patterns consistent with established patterns of disease (PMID 31652648). All four STEC genomic targets demonstrated significant correlation across sewersheds. STEC WBS may represent a novel tool to understand and monitor population-level activity and prevent disease. Disclosures All Authors: No reported disclosures

Time trend analysis of osteoporosis prevalence among adults 50years of age and older in the USA, 2005-2018.

This is the first study to assess osteoporosis prevalence trends over time and the proportion of undiagnosed osteoporosis across gender, ethnicity/race, and age groups. Observational time trend analyses were conducted using the 2005-2006, 2007-2008, 2009-2010, 2013-2014, and 2017-2018 National Health and Nutrition Examination Survey (NHANES) datasets, along with a descriptive analysis using the 2017-2018 NHANES dataset to capture the proportion of undiagnosed osteoporosis. The findings showed a statistically significant increase in osteoporosis prevalence among women, non-Hispanic Whites, and all age groups (except for individuals 80years of age and older) during the study period. A subsequent analysis examining individuals by both gender and ethnicity/race demonstrated a statistically significant increase among Other Hispanic men and non-Hispanic White women. Additional descriptive analyses found that 69.12% of individuals with osteoporosis went undiagnosed. Specifically, 86.88% of men and 84.77% of individuals 50-59years of age with osteoporosis went undiagnosed, representing the two highest groups. The substantial and increasing prevalence among certain groups and sub-groups, along with the lack of diagnostic capture of osteoporosis, highlights existing gaps in public health efforts and care delivery infrastructure. This paper highlights high-risk groups and sub-groups that may benefit most from accelerated initiatives to reduce the burden of illness associated with osteoporosis.

Obesity Prevalence and Trend Among Mississippi High-School Students: Youth Risk Behavior Surveillance System (YRBSS) 2001–2021

Obesity has become the most consequential threat to the health of Mississippians, as it is known to be associated with major chronic diseases such as type II diabetes, heart disease, and strokes. Obesity prevalence among Mississippi adolescents has been among the highest in the nation. In this study, data from Mississippi Youth Risk Behavior Surveillance System (YRBSS) 2001–2021 were obtained from the Centers for Disease Control and Prevention (CDC). YRBSS is a survey using a self-administered questionnaire to track the risk behaviors of students in grades 9 to 12. The survey packages in R were utilized for summary statistics to account for the YRBSS complex sampling design that includes stratification, clustering, and unequal probabilities of selection. Logistic regression models and Joinpoint software 5.3.0 were used for trend analysis. Obesity prevalence in Mississippi high-school students demonstrated a significant increasing trend from 2001 to 2021, as a whole or stratified by gender or race. Furthermore, Mississippi obesity prevalence among high-school students has been increasing at a greater pace compared to that of the United States. The increasing trend in obesity prevalence among Mississippi high-school students warrants urgent attention at the government, community, school, family, and personal levels. Concerted efforts must be made to fight and eventually reverse this epidemic.