public health challenge

  • 文章类型: Journal Article
    丙型肝炎病毒(HCV)继续在伊朗构成重大的公共卫生挑战,反映了全世界的关注。这种情况要求采取协调一致的战略,以符合世界卫生组织(WHO)到2030年消除HCV的目标。这一战略的核心是针对高危人群,特别是注射毒品的人和囚犯,预防,筛查和治疗。在监狱和减少伤害设施中部署即时检测和治疗至关重要。采用具有成本效益的通用直接作用抗病毒药物是向前迈出的重要一步。此外,针对医疗保健提供者的创新教育举措和针对公众的宣传运动至关重要。此外,解决耻辱,确保治疗的可负担性,并坚持严格的监督和数据管理,加上正在进行的政策审查,是至关重要的组成部分。这种全面和综合的方法旨在推动伊朗消除HCV,并可以作为其他面临类似挑战的国家的蓝图。
    The hepatitis C virus (HCV) continues to pose a significant public health challenge in Iran, mirroring a worldwide concern. This situation calls for a cohesive strategy that aligns with the World Health Organization\'s (WHO) goals for HCV elimination by 2030. Central to this strategy is targeting high-risk groups, notably people who inject drugs and prisoners, with prevention, screening and treatment. The deployment of point-of-care testing and treatments in prisons and harm reduction facilities is vital. The adoption of cost-effective generic direct-acting antivirals represents a major step forward. Furthermore, innovative educational initiatives for healthcare providers and awareness campaigns for the public are critical. Additionally, tackling stigma, ensuring treatment affordability and upholding strict surveillance and data management, coupled with ongoing policy reviews, are vital components. This comprehensive and integrated approach is designed to drive Iran towards eliminating HCV and can serve as a blueprint for other countries with similar challenges.
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  • 文章类型: Journal Article
    背景:在尼日利亚,97%的人口面临感染疟疾的风险。它由携带疟原虫寄生虫的雌性按蚊传播,可能致命。据估计,每年有5500万种疾病和8万人死亡。五岁以下的儿童更容易感染疟疾。尼日利亚控制疟疾的努力包括室内残留喷洒,杀虫剂处理过的蚊帐,以及使用有效的抗疟药物快速检测和治疗确诊病例。这些尝试受到了有限的医疗保健服务的阻碍,融资不佳,和耐药寄生虫.因此,研究疟疾并发症与五岁以下儿童住房之间的关系至关重要。
    方法:人口与健康调查(DHS)疟疾指标调查(MIS)2021,这是发展中国家人口与健康的国家代表性数据集,用于这项研究。采用13,727的样品大小(n=13,727)。进行了Logistic回归分析,以测试居住地类型与疟疾并发症(结果)之间的关联。
    结果:总体而言,样本中有4.2%(n=570,体重HV005)的参与者报告了疟疾并发症。Logistic回归结果显示,居住在城市住区的儿童(aOR0.37,95%CI0.37-0.37,p值<0.001),来自最贫困家庭的儿童(aOR11.63,95%CI1.62-1.63,p值0.004),来自贫困家庭的儿童(aOR7.56,95%CI7.55-7.57,p值<0.001),来自中产阶级家庭的儿童(aOR4.05,95%CI4.03-9.06,p值<0.001),来自富裕阶层家庭的儿童(aOR1.22,95%CI2.21-2.23,p值<0.001),初等教育母亲的子女(aOR0.42,95%CI2.32-4.112,p值0.001),中等教育母亲的子女(aOR0.24,95%CI3.21-3.22,p值<0.001),受教育程度较高的母亲的子女(aOR0.08,95%CI0.72-0.80,p值<0.001),女性儿童(aOR0.65,95%CI0.65-0.66,p值<0.001)均与严重疟疾并发症相关。
    结论:结论:该研究调查了尼日利亚5岁以下儿童的疟疾并发症。研究结果表明,农村儿童比城市儿童更容易患严重的疟疾并发症。这强调了在医疗保健机会有限的农村地区进行有针对性的疟疾治疗的必要性。
    BACKGROUND: In Nigeria, 97% of the population is at risk of contracting malaria. It is transmitted by female Anopheles mosquitoes carrying the Plasmodium parasite and can be lethal. An estimated 55 million illnesses and 80,000 deaths per year result from it. Children under five are more likely to contract malaria. Efforts to control malaria in Nigeria include indoor residual spraying, insecticide-treated bed nets, and quick detection and treatment of confirmed cases with effective antimalarial medications. These attempts have been impeded by limited healthcare access, poor financing, and drug-resistant parasites. Thus, the study of the relationship between malaria complications and housing for children under five is essential.
    METHODS: The Demographic and Health Survey (DHS) Malaria Indicator Survey (MIS) 2021, a nationally representative data set from developing countries on population and health, was used for this study. A sample size of 13,727 was employed (n=13,727). Logistic regression analyses were conducted to test the association between the type of place of residence and malaria complications (outcome).
    RESULTS: Overall, 4.2% (n=570, weight HV005) of participants in the sample reported malaria complications. The results of the logistic regression revealed that children residing in urban settlements (aOR 0.37, 95% CI 0.37-0.37, p-value <0.001), children from the poorest class families (aOR 11.63, 95% CI 1.62-1.63, p-value 0.004), children from poorer class families (aOR 7.56, 95% CI 7.55-7.57, p-value <0.001), children from middle-class families (aOR 4.05, 95% CI 4.03-9.06, p-value <0.001), children from richer class families (aOR 1.22, 95% CI 2.21-2.23, p-value <0.001), children of mothers with primary education (aOR 0.42, 95% CI 2.32-4.112, p-value 0.001), children of mothers with secondary education (aOR 0.24, 95% CI 3.21-3.22, p-value <0.001), children of mothers with higher education (aOR 0.08, 95% CI 0.72-0.80, p-value <0.001), and children of the female gender (aOR 0.65, 95% CI 0.65-0.66, p-value <0.001) are all associated with severe malaria complications.
    CONCLUSIONS: In conclusion, the study examined malaria complications in Nigerian children under five by residency. The findings imply that rural children are more likely to have serious malaria complications than urban children. This emphasizes the necessity for targeted malaria therapies in rural areas with limited healthcare access.
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  • 文章类型: Journal Article
    在史坦顿岛上收集了三个亚洲长角蜱(Haemphysalislongicornis),里士满县,纽约,2014-2015年,作为纽约市卫生与精神卫生部和公共卫生防御中心-阿伯丁Tick-Borne疾病实验室进行的蜱传疾病监测计划的一部分。这些记录标志着纽约州检疫区外已知最早出现的长螺旋藻,比以前报告的检测早了几年。随后几年,在史坦顿岛遗址收集了大量的长蜱虫种群,证明小的侵扰有可能迅速扩散。长尾血丝是一种3宿主的ixodid蜱,原产于东亚,但现在在美国建立,以及大洋洲和几个太平洋岛屿。尽管长螺旋体在美国尚未与人类疾病传播有关,它作为潜在的载体值得关注,因为它被证明在其本地和引入的范围内具有医学和兽医学兴趣的各种病原体。
    Three Asian longhorned ticks (Haemaphysalis longicornis) were collected on Staten Island, Richmond County, New York, in 2014-2015 as part of a tick-borne disease surveillance program conducted by the New York City Department of Health and Mental Hygiene and the Defense Centers of Public Health - Aberdeen Tick-Borne Disease Laboratory. These records mark the earliest known occurrence of H. longicornis in New York State outside of quarantine areas, predating previously reported detections by several years. Robust populations of H. longicornis were collected in subsequent years at the Staten Island site where these few ticks were found, demonstrating that small infestations have the potential to proliferate quickly. Haemaphysalis longicornis is a 3-host ixodid tick native to eastern Asia but now established in the United States, as well as Australasia and several Pacific islands. Although H. longicornis has not yet been associated with human disease transmission in the United States, it warrants attention as a potential vector, as it is demonstrated to harbor various pathogens of medical and veterinary interest across its native and introduced range.
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  • 文章类型: Journal Article
    目的:卵巢癌(OC)是一种普遍存在的侵袭性恶性肿瘤,对公共卫生构成重大挑战。缺乏预防OC的策略会增加发病率,死亡率,和其他负面后果。通过风险预测筛查OC可以作为一种强大的预防策略,但并未受到太多关注。所以,本研究旨在利用机器学习方法作为预测辅助解决方案,筛选OC的高危人群并实现实际预防目的。
    方法:由于本研究是数据驱动和回顾性的,我们利用了2015年至2019年来自一个集中数据库的1516名可疑OC女性数据,该数据库属于萨里市6个临床环境.六种机器学习(ML)算法,包括XG-Boost,随机森林(RF),J-48,支持向量机(SVM),K最近邻(KNN),利用人工神经网络(ANN)构建OC预测模型。选择预测OC的最佳模型,我们比较了使用接受者特征算子曲线(AU-ROC)下面积建立的各种预测模型.
    结果:当前的实验结果表明,AU-ROC=0.93(0.95CI=[0.91-0.95])的XG-Boost被认为是预测OC的最佳性能模型。
    结论:ML方法具有显著的预测效率和互操作性,可以利用OC筛查高危人群来实现强大的预防策略。
    OBJECTIVE: Ovarian cancer (OC) is a prevalent and aggressive malignancy that poses a significant public health challenge. The lack of preventive strategies for OC increases morbidity, mortality, and other negative consequences. Screening OC through risk prediction could be leveraged as a powerful strategy for preventive purposes that have not received much attention. So, this study aimed to leverage machine learning approaches as predictive assistance solutions to screen high-risk groups of OC and achieve practical preventive purposes.
    METHODS: As this study is data-driven and retrospective in nature, we leveraged 1516 suspicious OC women data from one concentrated database belonging to six clinical settings in Sari City from 2015 to 2019. Six machine learning (ML) algorithms, including XG-Boost, Random Forest (RF), J-48, support vector machine (SVM), K-nearest neighbor (KNN), and artificial neural network (ANN) were leveraged to construct prediction models for OC. To choose the best model for predicting OC, we compared various prediction models built using the area under the receiver characteristic operator curve (AU-ROC).
    RESULTS: Current experimental results revealed that the XG-Boost with AU-ROC = 0.93 (0.95 CI = [0.91-0.95]) was recognized as the best-performing model for predicting OC.
    CONCLUSIONS: ML approaches possess significant predictive efficiency and interoperability to achieve powerful preventive strategies leveraging OC screening high-risk groups.
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