BACKGROUND: Breast cancer is the most diagnosed cancer in the world, with a worse prognosis documented in low- and middle-income countries. Inequalities pertaining to breast cancer outcomes are observed at within-country level, with demographics and socioeconomic status as major drivers.
OBJECTIVE: This review aims to aggregate all available evidence from low- and middle-income countries on public health interventions that can be utilized to reduce breast cancer inequalities within the breast cancer continuum.
METHODS: The study was a systematic review and narrative synthesis of available literature, with the literature search conducted between September and October 2021. The search was re-run in September 2022 to update the review. PubMed, Scopus, Embase, African Index Medicus and LILACS were searched, based on predetermined criteria. Randomized controlled trials, cohort studies and quasi-experimental studies were included for review, while studies without an intervention and comparator group were excluded. The Joanna Briggs Institute family of checklists was used for quality assessment of the included studies. Data pertaining to study design, quality control and intervention effectiveness was extracted.
RESULTS: A total of 915 studies were identified for screening and 21 studies met the selection criteria. Only one study specifically evaluated the impact of an intervention on breast cancer inequalities. Diverse, multi-level interventions that can be utilized to address breast cancer inequalities through targeted application to disadvantaged subpopulations were identified. Educational interventions were found to be effective in improving screening rates, downstaging through early presentation as well as improving time to diagnosis. Interventions aimed at subsidizing or eliminating screening payments resulted in improved screening rates. Patient navigation was highlighted to be effective in improving outcomes throughout the breast cancer continuum.
CONCLUSIONS: Findings from the systematic review underline the importance of early detection in breast cancer management for low- and middle-income countries. This can be achieved through a variety of interventions, including population education, and addressing access barriers to public health services such as screening, particularly among under-served populations. This study provides a comprehensive database of public health interventions relevant to low- and middle-income countries that can be utilized for planning and decision-making purposes. Findings from the review highlight an important research gap in primary studies on interventions aimed at reducing breast cancer inequalities in low- and middle-income countries.
BACKGROUND: PROSPERO registration number: CRD42021289643.

BACKGROUND: Economic evaluations of public health interventions like sugar-sweetened beverage (SSB) taxes face difficulties similar to those previously identified in other public health areas. This stems from challenges in accurately attributing effects, capturing outcomes and costs beyond health, and integrating equity effects. This review examines how these challenges were addressed in economic evaluations of SSB taxes.
METHODS: A systematic review was conducted to identify economic evaluations of SSB taxes focused on addressing obesity in adults, published up to February 2021. The methodological challenges examined include measuring effects, valuing outcomes, assessing costs, and incorporating equity.
RESULTS: Fourteen economic evaluations of SSB taxes were identified. Across these evaluations, estimating SSB tax effects was uncertain due to a reliance on indirect evidence that was less robust than evidence from randomised controlled trials. Health outcomes, like quality-adjusted life years, along with a healthcare system perspective for costs, dominated the evaluations of SSB taxes, with a limited focus on broader non-health consequences. Equity analyses were common but employed significantly different approaches and exhibited varying degrees of quality.
CONCLUSIONS: Addressing the methodological challenges remains an issue for economic evaluations of public health interventions like SSB taxes, suggesting the need for increased attention on those issues in future studies. Dedicated methodological guidelines, in particular addressing the measurement of effect and incorporation of equity impacts, are warranted.

UNASSIGNED: The emergence of coronavirus disease 2019 (COVID-19) variants posed considerable threats to the global public health. We reviewed the epidemiology of variant cases and control measures implemented in Hong Kong.
UNASSIGNED: The epidemiological characteristics and the temporal trend of the COVID-19 variant cases and local clusters in Hong Kong, and the corresponding public health control measures were reviewed.
UNASSIGNED: Between December 2020 and June 2021, 393 variant cases were reported, including 153, 59 and 79 cases of Alpha, Beta and Delta variants with no Gamma variant. The vast majority (378, 96.2%) were imported cases. Since early June 2021, Delta variant had taken over Alpha as the dominant strain. Public health control measures, including risk-stratified quarantine and testing requirements for inbound travellers, banning of flights from extremely high-risk areas, enhanced contact tracing and quarantine, were implemented. Among the 3 clusters involving local transmissions, 2 were linked to imported cases while the source of the remaining one was unknown.
UNASSIGNED: Amid the global surges of COVID-19 variants, Hong Kong had continued to limit and prevent the occurrence of community-wide outbreak. Ongoing control strategies should be constantly reviewed and adjusted in response to the global and local COVID-19 situation.

BACKGROUND: Over the years there have been several interventions targeted at the public to increase their knowledge and awareness about Antimicrobial Resistance (AMR). In this work, we updated a previously published review by Price et al. (2018), on effectiveness of interventions to improve the public\'s antimicrobial resistance awareness and behaviours associated with prudent use of antimicrobials to identify which interventions work best in influencing public behaviour.
METHODS: Five databases-Medline (OVID), CINAHL (EBSCO), Embase, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL-OVID)-were searched for AMR interventions between 2017 and 2021 targeting the public. All studies which had a before and after assessment of the intervention were considered for inclusion.
RESULTS: In total, 17 studies were found to be eligible for inclusion in the review. Since there was a variety in the study interventions and in particular outcomes, a narrative synthesis approach was adopted for analysis. Whereas each study showed some impact on awareness and knowledge, none measured long-term impact on behaviours towards antibiotic use, awareness, or knowledge. Engagement was higher in interventions which included interactive elements such as games or videos. Social media was not used for recruitment of participants or as a mode of communication in any AMR interventions included in this review.

The coronavirus disease outbreak of 2019 (COVID-19) has been spreading rapidly to all corners of the word, in a very complex manner. A key research focus is in predicting the development trend of COVID-19 scientifically through mathematical modelling. We conducted a systematic review of epidemic prediction models of COVID-19 and the public health intervention strategies by searching the Web of Science database. 55 studies of the COVID-19 epidemic model were reviewed systematically. It was found that the COVID-19 epidemic models were different in the model type, acquisition method, hypothesis and distribution of key input parameters. Most studies used the gamma distribution to describe the key time period of COVID-19 infection, and some studies used the lognormal distribution, the Erlang distribution, and the Weibull distribution. The setting ranges of the incubation period, serial interval, infectious period and generation time were 4.9-7 days, 4.41-8.4 days, 2.3-10 days and 4.4-7.5 days, respectively, and more than half of the incubation periods were set to 5.1 or 5.2 days. Most models assumed that the latent period was consistent with the incubation period. Some models assumed that asymptomatic infections were infectious or pre-symptomatic transmission was possible, which overestimated the value of R0. For the prediction differences under different public health strategies, the most significant effect was in travel restrictions. There were different studies on the impact of contact tracking and social isolation, but it was considered that improving the quarantine rate and reporting rate, and the use of protective face mask were essential for epidemic prevention and control. The input epidemiological parameters of the prediction models had significant differences in the prediction of the severity of the epidemic spread. Therefore, prevention and control institutions should be cautious when formulating public health strategies by based on the prediction results of mathematical models.

Heatwaves form a serious public health threat, especially for vulnerable groups. Interventions such as active outreach programs, exposure reduction measures and monitoring and mapping of at-risk groups are increasingly implemented across the world but little is known about their effect.
To assess how vulnerable groups are identified and reached in heat health interventions, to understand the effectiveness and efficiency of those interventions, and to identify research gaps in existing literature.
We performed a literature search in relevant scientific literature databases and searched with a four element search model for articles published from 1995 onward. We extracted data on intervention measures, target group and evaluation of effectiveness and efficiency.
We identified 23 eligible studies. Patterns exist in type of interventions 1) to detect and 2) to influence extrinsic and intrinsic risk and protective factors. Results showed several intervention barriers related to the variety and intersection of these factors, as well as the self-perception of vulnerable groups, and misconceptions and unfavorable attitudes towards intervention benefits. While modest indications for the evidence on the effectiveness of interventions were found, efficiency remains unclear.
Interventions entailed logical combinations of measures, subsumed as packages. Evidence for effective and efficient intervention is limited by the difficulty to determine effects and because single measures are mutually dependent. Interventions prioritized promoting behavioral change and were based on behavioral assumptions that remain untested and mechanisms not worked out explicitly.
Multifaceted efforts are needed to tailor interventions, compiled in heat health warning systems and action plans for exposure reduction and protection of vulnerable populations, to fit the social, economic and geographical context. Besides adequately addressing relevant risk and protective factors, the challenge is to integrate perspectives of vulnerable groups. Future research should focus on intervention barriers and improving the methods of effectiveness and efficiency evaluation.