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This analysis estimates the tax incidence for leased cropland and pastureland in Oklahoma. Periodic adjustments to agricultural land taxes may lead to an incidence, a share of the property tax burden, passed on to renters as higher rental rates. This pass-through can discourage rental activity, limit renters’ access to land, and jeopardize broader agricultural development goals. There was a statistically significant increase in the incidence for cropland and pastureland renters. The combined pastureland and cropland incidence over the study period was $7.83 million, representing 22% of the total current agricultural use value assessment for the same period.
Epidemiological evidence on the incidence and remission of anxiety and depressive disorders is limited. We estimated age- and sex-specific incidence and remission rates of moderate-to-severe anxiety and depressive symptoms using the illness-death model.
Methods
The German National Cohort (NAKO) is a cohort of over 200,000 participants aged 19–74 at baseline. Prevalence of probable cases, estimated with the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire data 2014–2019 across five regions, was related to general mortality rates and disorder-specific mortality rate ratios in the illness-death model. The partial derivative of prevalence was modeled as a function of incidence and remission, with parameters estimated via least-squares optimization through 2,000 bootstrap resamples.
Results
The highest incidence rates (per 1,000 person-years) occurred at ages 19–21 for anxiety symptoms: 4.07 (95% CI: 0.00–7.57) in women and 2.55 (0.00–4.94) in men; and at ages 28–34 for depressive symptoms: 4.41 (0.00–9.81) in women and 3.30 (0.00–7.34) in men, all in Hamburg. Remission rates (per 100 person-years) were highest at older ages. For anxiety symptoms, rates peaked at 71.8 years in women (4.10 [0.00–11.94]) and 64.2 years in men (3.00 [0.00–9.23]) in Freiburg. For depressive symptoms, the highest observed was at 74.0 years, both among women (6.61 [0.00–15.50] in Münster) and men (3.58 [0.00–11.51] in Berlin).
Conclusions
Incidence and remission rates of anxiety and depressive symptoms can be estimated from prevalence and mortality data, revealing regional, sex-, and age-related variation. Validation with longitudinal data is warranted.
Because of advances in technology and the provision of critical care, an increasing number of patients are surviving critical illness; this growing population of survivors of critical illness is characterized by heightened vulnerability to a host of adverse health outcomes and by the development of multidimensional impairments that significantly impact their quality of life and societal participation. Post-intensive care syndrome (PICS) is defined as new or worsening impairments in physical, cognitive, or mental health status arising after a critical illness and persisting beyond acute care hospitalization. PICS-Family describes the psychological and social impairments that family members, loved ones, and caregivers can develop as a consequence of their loved one’s critical illness. Survivors of critical illness are a heterogeneous patient population, and considerable variation exists with respect to the breadth, depth, duration, and mutability of their symptoms and impairments. This chapter explores the clinical manifestations of PICS, its incidence and prevalence, the co-occurrence of impairments in multiple domains, duration and severity of impairments, risk factors for its development, prediction tools, prevention strategies, screening and diagnosis, and treatment options. Additional topics include the biophysical model of disability, functional trajectories following critical illness, and the lack of communication about post-ICU problems.
This study focuses on the national and subnational estimation of prevalence, incidence, disability-adjusted life years (DALYs) related to self-harm and suicide mortality in Iran. These indicators of disease burden were analyzed over the period from 1990 to 2021, with stratifications based on sex, age and geographic location. Additionally, the percentage change observed between 1990 and 2021 was documented. The age-standardized prevalence rate (per 100,000) of self-harm decreased from 173.92 (95% UI: 146.13–208.75) in 1990 to 131.2 (95% UI: 110.55–156.67) in 2021, reflecting a percentage change of −0.25% over the period. In terms of self-harm prevalence in 2021, males had a higher rate (137.62 per 100,000) compared to females (124.82 per 100,000). The findings of the current study revealed that, despite significant challenges such as demographic shifts, economic instability and the impacts of war, the trends in self-harm incidents and suicide mortality rates in Iran have generally been on the decline. Additionally, it was observed that suicide-related deaths were more prevalent among males when compared to females. However, when examining self-harm behaviors over previous decades, these acts appeared to be more frequent among females.
Community-acquired pneumonia (CAP) remains an important public-health problem, and the COVID-19 pandemic and non-pharmaceutical interventions (NPIs) may have altered its burden. This study aimed to provide updated CAP burden among adults in Shanghai from 2016–2023.We analysed 61,230 participants aged 20–74 years from the Shanghai Suburban Adult Cohort and Biobank. CAP episodes were ascertained via ICD codes and clinical diagnoses. We calculated incidence rates before, during, and after NPIs, conducted subgroup analyses by age, sex, comorbidity and lifestyle. We used Poisson regression to compare stages, and Cox models to identify risk factors. The Overall CAP incidence was 42.1 per 1,000 person–years (95% CI 41.3–42.8). Incidence declined during NPIs (24.2/1,000 py) and rose after NPIs (95.9/1,000 py). The inpatient-to-outpatient ratio increased to 10.1% during NPIs and fell to 5.7% post–NPI. Among those without underlying conditions, rates were 40.1, 20.1 and 73.6/1,000 py before, during and after NPIs. Incidence was higher in participants ≥60 years and in those with multiple comorbidities, especially respiratory diseases. CAP burden temporarily fell during NPIs but resurged post–NPI, notably among high–risk groups. These findings highlight the need for targeted preventive strategies and continued CAP surveillance in the post-pandemic era.
The effect of the Japanese diet on cancer incidence remains unclear. The purpose of this study was to examine the association between the Japanese diet and the risk of all-cause and site-specific cancer. We analysed 14-year follow-up data from the Osaki Cohort study of 25 570 Japanese men and women aged 40–79 years. The Japanese diet was evaluated using a thirty-nine-item FFQ at baseline. Based on a previous study, we used eight food items to calculate the Japanese Diet Index score: rice, miso soup, seaweed, pickles, green and yellow vegetables, seafood, green tea and beef and pork. The participants were divided into quartiles based on their Japanese Diet Index scores. The Cox proportional hazards model was used to estimate the hazard ratios and 95 % CI of cancer incidence. During the mean 10·4 years of follow-up, we identified 3161 incident cases of all-cause cancer. Multivariable analysis showed that the Japanese Diet Index score was not associated with cancer incidence. In comparison with Q1 (the lowest), the multivariable hazard ratios and 95 % CI were 1·01 (0·92, 1·12) for Q2, 0·94 (0·85, 1·04) for Q3 and 1·06 (0·95, 1·18) for Q4 (the highest). Furthermore, separate analyses of nine common cancer sites demonstrated no association with the Japanese Diet Index score. The results were consistent even after a sensitivity analysis using multiple imputation. This prospective study showed that the Japanese diet was not associated with cancer incidence. The results suggest that the Japanese diet could contribute to a person’s overall health and well-being without increasing cancer risk.
The COVID-19 pandemic significantly impacted Saskatchewan, resulting in high per capita case counts and COVID-19-related deaths. While vaccination mandates have been a key strategy to control the pandemic, their impact in Saskatchewan remains poorly documented. This study assessed the effect of COVID-19 vaccine mandates on the incidence of COVID-19 cases and deaths in Saskatchewan during the first year following vaccine rollout.
Methods
A single-group interrupted time series analysis with multiple intervention points was conducted using aggregated daily COVID-19 incidence and mortality rates as outcome variables. The models accounted for confounding effects of daily total vaccine doses administered and public health countermeasures, including the stringency index and economic support index, from April 1, 2020 to January 20, 2022. Average daily COVID-19 incidence and mortality rates were estimated for the pre-vaccine rollout period (April 1 to December 14, 2020), and the post-rollout period (December 15, 2020 to January 20, 2022). In addition, nine supplementary initiatives were introduced during the implementation phase. All estimated effects reflected cumulative changes in trend relative to the pre-vaccination period.
Results
Cumulatively, COVID-19 incidence increased faster than the pre-vaccination trend, likely driven by successive variant surges from wild-type to Omicron, while COVID-19–related deaths remained stable across the same period. The implementation of vaccine rollout, prioritization of vaccines for high-risk populations, and proof-of-vaccination policy were effective in reducing daily COVID-19 incidence and deaths in Saskatchewan. Economic support and an increased number of daily vaccine doses administered were also associated with an improved provincial COVID-19 response. Conversely, surges in COVID-19 incidence and deaths occurred following the introduction of the centralized virtual booking system and booster doses. These surges may reflect accessibility challenges, increased testing, emergence of immune-escape variants, relaxation of public health measures before achieving herd immunity, and waning immunity over time.
Conclusions
Economic support, policy measures, and vaccination efforts played important roles in managing public health crises, hence the need for an integrated approach to managing public health crises. However, temporary surges following certain interventions underscore the need for accessible, adaptable strategies that account for variant emergence, immunity waning and public adherence.
This study aimed to evaluate the epidemiological characteristics, incidence trends and survival outcomes of nasopharyngeal carcinoma from 2000 to 2021.
Methods
A retrospective analysis of 10,419 NPC cases from the SEER database (2000–2021) was conducted. Incidence rates were calculated per 100,000 population. Joinpoint regression assessed trends, and Kaplan–Meier and Cox regression evaluated survival.
Results
Most patients were male (68.9 per cent) and White individuals (51.2 per cent), with 49.5 per cent presenting at a regional stage. Males were more likely to present with distant disease than females (72.2 per cent vs. 27.8 per cent; p < 0.001). Nasopharyngeal carcinoma incidence was higher in males (0.8/100,000) and Asian populations (1.87/100,000). Overall incidence declined (average annual per cent change: –0.8 per cent; p = 0.002). Median survival was 79 months, longer in females (90) and Asian populations (118). Distant disease predicted higher mortality (hazard ratio 1.71; p < 0.001). Nasopharyngeal carcinoma was the leading cause of death (43.6 per cent).
Conclusion
Males and Asian populations had higher nasopharyngeal carcinoma incidence. Female sex and Asian race predicted better survival, while distant-stage disease increased mortality.
Kawasaki disease is a systemic vasculitis that primarily affects young children and represents a major cause of acquired heart disease in children in developed countries. The incidence of Kawasaki disease exhibits significant global variation, and the worldwide burden remains limited.
Methods:
A systematic review was conducted to investigate the global incidence of Kawasaki disease in children under 5 years of age. A comprehensive literature search was performed in PubMed, Embase, and KoreaMed up to July 15, 2024. Studies reporting population-level Kawasaki disease incidence were included. Data extraction and quality assessment were performed independently by two reviewers.
Results:
The search yielded 3,197 articles, of which 105 met the inclusion criteria. These studies examined Kawasaki disease incidence in children under 5 years of age across 34 countries, with the majority focusing on the Western Pacific Region and the Region of the Americas. The results demonstrated a wide range of Kawasaki disease incidence globally, with significant geographic variations. The highest incidence rates were observed in Japan, Korea, and Taiwan, with a trend of gradual increase over time.
Conclusions:
This study represents the most comprehensive review of global Kawasaki disease incidence to date. The substantial variation in incidence underscores the need to understand the factors influencing regional differences.
When students are asked about the difficulties they experience in their epidemiology classes, one of the biggest barriers they report is the language their teachers use to describe the concepts being explained (note, it is the language rather than the concepts themselves). And here’s the thing: it is epidemiologists who are largely to blame, not the teachers! Being a relatively young discipline, it is not unusual to come across different words being used to describe the same concept, or the same word being used to describe different concepts – sometimes fundamentally different. Confusing, right?
Clostridiodes difficile’s epidemiology has evolved over the past decades, being recognized as an important cause of disease in the community setting. Even so, there has been heterogeneity in the reports of CA-CDI. Therefore, the aim of this study was to assess the epidemiologic profile of CA-CDI.
This systematic review and meta-analysis were conducted according to PRISMA checklist and Cochrane guidelines (CRD42023451134). Literature search was performed by an experienced librarian from inception to April 2023, searching in databases like MEDLINE, Scopus, Web of Science, EMBASE, CCRCC, CDSR, and ClinicalTrials. Observational studies that reported prevalence, incidence of CA-CDI, or indicators to calculate them were included. Pool analysis was performed using a binomial-normal model via the generalized linear mixed model. Subgroup analysis and publication bias were also explored. A total of 49 articles were included, obtaining a prevalence of 5% (95% CI 3–8) and an incidence of 7.53 patients (95% CI 4.45–12.74) per 100,000 person-years.
In conclusion, this meta-analysis underscores that among the included studies, the prevalence of CA-CDI stands at 5%, with an incidence rate of 7.3 cases per 100,000 person-years. Noteworthy risk factors identified include prior antibiotic exposure and age.
Extraintestinal pathogenic Escherichia coli (ExPEC) causes invasive E. coli disease (IED), including bacteraemia and (uro)sepsis, resulting in a high disease burden, especially among older adults. This study describes the epidemiology of IED in England (2013–2017) by combining laboratory surveillance and clinical data. A total of 191 612 IED cases were identified. IED incidence increased annually by 4.4–8.2% across all ages and 2.8–7.6% among adults ≥60 years of age. When laboratory-confirmed urosepsis cases without a positive blood culture were included, IED incidence in 2017 reached 149.4/100 000 person-years among all adults and 368.4/100 000 person-years among adults ≥60 years of age. Laboratory-confirmed IED cases were identified through E. coli-positive blood samples (55.3%), other sterile site samples (26.3%), and urine samples (16.6%), with similar proportions observed among adults ≥60 years of age. IED-associated case fatality rates ranged between 11.8–13.2% among all adults and 13.1–14.7% among adults ≥60 years of age. This study reflects the findings of other published studies and demonstrates IED constitutes a major and growing global health concern disproportionately affecting the older adult population. The high case fatality rates observed despite available antibiotic treatments emphasize the growing urgency for effective intervention strategies. The burden of urosepsis due to E. coli is likely underestimated and requires additional investigation.
The goal of public health is to improve the overall health of a population by reducing the burden of disease and premature death. In order to monitor our progress towards eliminating existing problems and to identify the emergence of new problems, we need to be able to quantify the levels of ill health or disease in a population. Researchers and policy makers use many different measures to describe the health of populations. In this chapter we introduce more of the most commonly used measures so that you can use and interpret them correctly. We first discuss the three fundamental measures that underlie both the attack rate and most of the other health statistics that you will come across in health-related reports, the incidence rate, incidence proportion (also called risk or cumulative incidence) and prevalence, and then look at how they are calculated and used in practice. We finish by considering other, more elaborate measures that attempt to get closer to describing the overall health of a population. As you will see, this is not always as straightforward as it might seem.
Communities living in African animal trypanosomiasis (AAT) endemic areas of Zambia use several control strategies to protect their livestock from the devastating effects of trypanosomiasis. Several studies have reported the effectiveness of trypanosomiasis control strategies based on retrospective data. In this study, we assessed incidence rates of AAT in cattle (n = 227) using a prospective cohort study comprising 4 treatment groups, i.e., Diminazene aceturate, Isometamidium chloride, Cyfluthrin pour-on and Cypermethrin treated targets. The study was conducted in Mambwe district in Eastern Zambia between February 2019 and March 2020. The endemic prevalence of AAT for each group was determined using ITS-PCR prior to application of treatments. High endemic trypanosome pre-treatment rates were found in all Groups (Diminazene aceturate (61%), Isometamidium chloride (48%), Cyfluthrin pour-on (87%) and Cypermethrin targets (72%)). The overall apparent prevalence for the Mambwe district was 67% (152/227) and true prevalence at 95%CI was 63–71%. Once treatments were implemented, 12 monthly follow-ups were conducted. The average monthly incidence rates without standardization recorded: Diminazene aceturate (67%) Isometamidium chloride (35%), Cyfluthrin pour-on (55%) and Cypermethrin targets (61%). Incidence rates were standardized considering the endemic level of disease for each Group and the average standardized monthly incidence rate in the Diminazene aceturate Group was 7%; the Isometamidium chloride Group −13%; the Cyfluthrin Group −26%; and the Cypermethrin target Group, −17%. All Groups showed a decrease in incidence of AAT over the period of the study with the Cyfluthrin group showing to be the most effective in reducing AAT incidence in cattle.
Although there is now substantial evidence on the acute impacts of the COVID-19 pandemic on anxiety disorders, the long-term population impact of the pandemic remains largely unexplored.
Aims
To quantify a possible longitudinal population-level impact of the pandemic by projecting the prevalence of anxiety disorders through 2030 among men and women aged up to 95 years in Germany under scenarios with varying impacts of the pandemic on the incidence of anxiety disorders.
Method
We used a three-state illness–death model and data from the Global Burden of Disease Study to model historical trends of the prevalence and incidence of anxiety disorders. The German population projections determined the initial values for projections. The COVID-19 incidence rate data informed an additional incidence model, which was parameterised with a wash-in period, delay, wash-out period, incidence increase level and decay constant.
Results
When no additional increase in the incidence during the pandemic waves during 2020–2022 was assumed, it was estimated that 3.86 million women (9.96%) and 2.13 million men (5.40%) would have anxiety disorders in 2030. When increases in incidence following pandemic waves were assumed, the most extreme scenario projected 5.67 million (14.02%) women and 3.30 million (8.14%) men with the mental disorder in 2030.
Conclusions
Any increased incidence during the pandemic resulted in elevated prevalence over the projection period. Projection of anxiety disorder prevalence based on the illness–death model enables simulations with varying assumptions and provides insight for public health planning. These findings should be refined as trend data accumulate and become available.
The epidemiological and burden characteristics of nutritional deficiencies (ND) have been evolving, and it is crucial to identify geographical disparities and emerging trends. This study aimed to analyse the global, regional and national trends in the burden of ND over the past 30 years. Data were obtained from the Global Burden of Disease (GBD) 2019 database for the period 1990–2019. The study examined the incidence rates and disability-adjusted life years (DALY) of ND at various levels. Globally, the incidence rate of ND decreased from 2226·2 per 100 000 in 2019 to 2096·3 per 100 000 in the same year, indicating a decline of 5·8 %. The average annual percentage change (AAPC) was −0·21 (–0·31, −0·11). Similarly, DALY, prevalence and mortality rates of ND exhibited significant declines (AAPC = −3·21 (–3·45, −2·96), AAPC = −0·53 (–0·55, −0·51) and AAPC = −4·97 (–5·75, −4·19), respectively). The incidence rate of ND varied based on age group, sex, cause and geographical area. Moreover, a negative association was observed between incidence and the sociodemographic index. At the regional level, the South Asia and sub-Saharan Africa regions had the highest incidence rates of ND. In conclusion, the global incidence rate of ND showed a mixed pattern, while the DALY rate consistently declined. Additionally, prevalence and mortality rates of ND decreased between 1990 and 2019.
Migration is a well-established risk factor for psychotic disorders, and migrant language has been proposed as a novel factor that may improve our understanding of this relationship. Our objective was to explore the association between indicators of linguistic distance and the risk of psychotic disorders among first-generation migrant groups.
Methods
Using linked health administrative data, we constructed a retrospective cohort of first-generation migrants to Ontario over a 20-year period (1992–2011). Linguistic distance of the first language was categorized using several approaches, including language family classifications, estimated acquisition time, syntax-based distance scores, and lexical-based distance scores. Incident cases of non-affective psychotic disorder were identified over a 5- to 25-year period. We used Poisson regression to estimate incidence rate ratios (IRR) for each language variable, after adjustment for knowledge of English at arrival and other factors.
Results
Our cohort included 1 863 803 first-generation migrants. Migrants whose first language was in a different language family than English had higher rates of psychotic disorders (IRR = 1.08, 95% CI 1.01–1.16), relative to those whose first language was English. Similarly, migrants in the highest quintile of linguistic distance based on lexical similarity had an elevated risk of psychotic disorder (IRR = 1.15, 95% CI 1.06–1.24). Adjustment for knowledge of English at arrival had minimal effect on observed estimates.
Conclusion
We found some evidence that linguistic factors that impair comprehension may play a role in the excess risk of psychosis among migrant groups; however, the magnitude of effect is small and unlikely to fully explain the elevated rates of psychotic disorder across migrant groups.
Brucellosis, a global zoonosis, is endemic in Israel. We used a national database of culture-confirmed cases (2004–2022) to analyse the trends of brucellosis. Of 2,489 unique cases, 99.8% were bacteraemic, 64% involved males, and the mean age was 30.5 years. Brucella melitensis was the dominant species (99.6%). Most cases occurred among the Arab sector (84.9%) followed by the Jewish (8.5%) and Druze (5.5%) sectors. The average annual incidence rates overall and for the Arab, Druze, and Jewish sectors were 1.6/100,000, 6.6/100,000, 5.5/100,000, and 0.18/100,000, respectively. The annual incidence rates among the Arab (incidence rate ratio (IRR) = 36.4) and the Druze (IRR = 29.6) sectors were significantly higher than among the Jewish sector (p < 0.001). The highest incidence rates among the Arab sector occurred in the South District, peaking at 41.0/100,000 in 2012. The frequencies of B. melitensis isolated biotypes (biotype 1 – 69.1%, biotype 2 – 26.0%, and biotype 3 – 4.3%) differed from most Middle Eastern and European countries. A significant switch between the dominant biotypes was noted in the second half of the study period. Efforts for control and prevention should be sustained and guided by a One Health approach mindful of the differential trends and changing epidemiology.
Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People’s Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.