Epidemiologia

Objectives: The objectives are to evaluate the influence of different maternal characteristics on ultrasound image quality and operator satisfaction, and to assess, preliminarily, a rating scale to stratify the difficulty level of ultrasound examination in early gestation. Methods: A multicentric observational study of ultrasound scans was carried out on singleton pregnant women undergoing routine gestational ultrasound at 11–14 weeks and 19–21 weeks of gestation at two Prenatal Care Centers in the Apulia region (Southern Italy). Inclusion criteria included the presence of one or more limiting features, i.e., obesity, retroverted uterus, myomas, previous abdominal surgery, and limited echo-absorption. Each woman was given an overall pre-echographic limiting score from 0 to 9. The outcome measure was the operator’s satisfaction with the examination, scored on a Likert scale. Nested linear regression models (raw, semi- and fully adjusted) were built for each of the two trimesters on the pre-ecographic limiting score (0–9 points) as dependent variables, with the operator’s satisfaction as the regressor. Results: The whole sample included 445 pregnant women. The two-center samples did not show statistically different baseline features. The operator’s satisfaction with the sonographic examination was significantly (and inversely) related to the pre-echographic limiting score, regardless of the mother’s age, the operator performing the ultrasound, the Hospital Center where the ultrasound examination was performed, and the duration of the sonographic examination. Conclusions: A number of maternal conditions need to be monitored for good ultrasound performance; using a specific rating scale to stratify the level of difficulty of the ultrasound examination at early gestation could represent a potentially useful tool, although it requires further validation. Full article

Background/Objectives: The aim of this research is to study the prevalence of urinary incontinence (UI) and overactive bladder (OAB) among female university students in Kazakhstan and to analyze the risk factors associated with these conditions. Methods: A total of 574 female university students aged 18 to 40 years participated in this cross-sectional, questionnaire-based study. Self-completed questionnaires including the International Consultation on Urinary Incontinence Questionnaire Short Form (ICIQ-UI-SF), the V8 Overactive Bladder Questionnaire (OAB-V8), and data on demographic and general characteristics of the participants were collected. The frequency, type, and severity of UI, as well as factors associated with these conditions were analyzed. Results: The median age of the participants was 22.00 years (IQR 19.00–24.00). The prevalence of UI among female students was 27.5% (n = 158). The mean ICIQ-SF questionnaire score was 1.00 (IQR 1.00–2.00), while the OAB-V8 questionnaire score was 2.00 (IQR 0.00–4.00). In addition, 10.1% of the respondents reported having OAB. The analysis showed that factors such as childbirth and physical activity level were associated with the presence of UI. In addition, childbirth, the presence of chronic diseases, and physical activity level were associated with OAB. The probability of UI increased by 2.3 times for women who gave birth (OR 2.30, 95% CI 1.16–4.54). The likelihood of developing OAB rose by 3.3 times for women who gave birth (OR 3.36, 95% CI 1.76–6.42). The presence of chronic diseases was associated with a 2.7-fold increase in the probability of developing OAB (OR 2.74, 95% CI 1.51–4.96). Conclusions: This study found that UI and OAB are common problems among female university students in Kazakhstan. The risk factors identified as childbirth and physical activity level emphasize the need to raise awareness of these conditions and their impact on quality of life. The results of the study can serve as a basis for the development of targeted prevention programs and support strategies for young women. Full article

Background/Objectives: Congenital microcephaly is a clinical manifestation with a heterogeneous etiology, and its epidemiological surveillance relies on the systematic identification of cases and investigation of their underlying causes to inform preventive strategies and improve prognostic assessments. In Latin America, despite the existence of congenital anomaly reporting programs since 1967, the surveillance of microcephaly only gained substantial attention following the Zika virus (ZIKV) epidemic in 2015. Since then, efforts have predominantly concentrated on cases of infectious origin, often at the expense of recognizing endogenous etiologies, particularly those of genetic nature. This review aims to examine the role of genetic alterations in microcephaly pathogenesis and evaluates the limitations of current surveillance systems. Methods: A literature review centered on syndromic and non-syndromic genetic etiologies, alongside an analysis of Latin American surveillance frameworks (ECLAMC, RyVEMCE, ICBDSR, ReLAMC) was performed. Results: The findings reveal improved case detection and increased reported prevalence; however, the proportion of genetically attributed cases has remained stable. No systematic studies were found identifying the most common genetic causes; instead, genetic investigations were limited to isolated cases with a family history. Conclusions: While epidemiological surveillance systems in Latin America have advanced in the reporting of congenital microcephaly cases, substantial gaps remain in case ascertainment and etiological investigation, particularly concerning genetic contributions Full article

Background: he surge in the use of Pre-hospital Emergency Medical Systems (EMS) and Emergency Departments (ED) has become a pressing issue worldwide after the COVID-19 pandemic. To address this challenge, we developed an experimental and innovative care pathway supported by telemedicine. The aim of this study is to describe the activity of the Integrated Medical Center (CMI): a new telemedicine-based care model for patients referring to the Emergency Medical System. Methods: A prospective observational study was conducted from January 2022 to December 2022. The CMI was established to manage patients referring to the Emergency Medical System. Results: From January to December 2022, a total of 8680 calls were managed by CMI, with an average of 24 calls per day. 6243 patients (71.9%) were managed without ED access of whom 4884 patients (78.2%) were managed through telemedicine evaluation only, and 1359 (21.8%) with telemedicine evaluation and dispatch of the Home Rapid Response Team (HRRT). The population treated by the HRRT exhibited a higher age. The mean satisfaction score was 9.1/10. Conclusions: Telemedicine evaluation allowed for remote assessments, treatment prescriptions, and teleconsultation for HRRT and was associated with high patient satisfaction. This model could be useful in future pandemics for managing patients with non-urgent illnesses at home, preventing hospital admissions for potentially infectious patients, and thereby reducing in-hospital transmission. Full article

Background/Objectives: Although the Robin Hood Index (RHI) is increasingly used to quantify geographic health inequality and guide resource redistribution, empirical evidence on whether higher physician density reduces RHI-measured inequality remains limited. This study systematically reviews and meta-analyzes RHI-based research to assess the association between physician distribution and health inequalities. Methods: We conducted a systematic review and meta-analysis of studies using the RHI to evaluate health inequalities, without restrictions on country or publication date. Following PRISMA 2020 guidelines and registered in PROSPERO (CRD42024496486), we searched PubMed, Scopus, and OpenGrey literature, extracted data on physician density and RHI outcomes, and conducted a meta-analysis. Odds ratios (ORs), ln(OR), and 95% confidence intervals (CIs) were calculated, and risk of bias was assessed using the Robvis tool. Results: Seventeen studies covering 720 regions and 1.07 billion individuals were included. Three clusters emerged: physician redistribution (10 studies), poverty–mortality associations (six studies), and systematic reviews (one study). Physician redistribution was strongly associated with increased inequality and policy attention (r = 0.73; p = 0.0038). Meta-analysis of eight redistribution studies yielded a pooled OR of 1.24 (95% CI: 0.54–2.86), consistent in sensitivity analysis (OR = 1.26; 95% CI: 0.56–2.89). Poverty–mortality studies also showed a correlation with the number of variables considered (r = 0.59; p = 0.022). Conclusions: A greater physician supply is associated with increased health inequalities, with statistical support but limited certainty. Methodological heterogeneity in RHI-based studies constrains comparability. Standardized methodologies and broader analytic models are needed to inform research and guide health policy. Full article

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances. Full article

Background/Objectives: The COVID-19 pandemic highlighted the critical need for accurate predictive models to guide public health interventions and optimize healthcare resource allocation. This study evaluates how the complexity of compartmental infectious disease models influences their forecasting accuracy and utility for pandemic resource planning. Methods: We analyzed a range of compartmental models, including simple susceptible-infected-recovered (SIR) models and more complex frameworks incorporating asymptomatic carriers and deaths. These models were calibrated and tested using real-world COVID-19 data from the United States to assess their performance in predicting symptomatic and asymptomatic infection counts, peak infection timing, and resource demands. Both adaptive models (updating parameters with real-time data) and non-adaptive models were evaluated. Results: Numerical results show that while more complex models capture detailed disease dynamics, simpler models often yield better forecast accuracy, especially during early pandemic stages or when predicting peak infection periods. Adaptive models provided the most accurate short-term forecasts but required substantial computational resources, making them less practical for long-term planning. Non-adaptive models produced stable long-term forecasts useful for strategic resource allocation, such as hospital bed and ICU planning. Conclusions: Model selection should align with the pandemic stage and decision-making horizon. Simpler models are effective for rapid early-stage interventions, adaptive models excel in short-term operational forecasting, and non-adaptive models remain valuable for long-term resource planning. These findings can inform policymakers on selecting appropriate modeling approaches to improve pandemic response effectiveness. Full article

Background/Objectives: The Mediterranean diet (MD) is well-studied for its health-promoting effects, while the factors influencing adherence in children remain an important research focus. This study examines the sociodemographic, maternal, perinatal, and lifestyle determinants associated with MD adherence among children aged 6–9 years in an effort to identify key predictors and their impact on long-term nutritional habits. Methods: This study recruited 4851 children from diverse Greek rural and urban regions. The mothers of the enrolled children completed relevant questionnaires on their children’s sociodemographics, perinatal outcomes, anthropometric parameters, breastfeeding practices, and physical activity status. The enrolled children completed the Children’s Depression Inventory (CDI) and the State–Trait Anxiety Inventory for Children—State (STAIC-S) form to assess the presence of depression and anxiety symptoms, respectively. The KIDMED score was used to assess the MD compliance of the enrolled children. Results: The outcomes demonstrated that higher maternal education and family economic status gravitated toward increased MD adherence (p = 0.0071, p ˂ 0.0001), while exclusive breastfeeding (p ˂ 0.0001) and higher physical activity levels (p = 0.0101) were strong predictive factors for MD adherence, highlighting the role of early-life interventions in shaping dietary habits. In contrast, cesarean delivery (p = 0.0173) and higher birth weight (p ˂ 0.0001) were linked to lower MD adherence, indicating potential metabolic and behavioral predispositions. Notably, higher MD adherence correlated with lower prevalence of depressive and anxiety symptoms (p ˂ 0.0001, p = 0.0001), underscoring its potential protective role in mental health. Conclusions: Our findings highlight a complex interplay between early-life and dietary behaviors, while further longitudinal studies are needed to establish causality and optimize evidence-based nutritional strategies and education for childhood health and well-being. Full article

Background/Objectives: Inappropriate use of emergency department (ED) services is widely acknowledged to have a negative impact on health systems as a whole. A minor portion of Frequent User (FU) patients are often responsible for the disproportionate use of ED services. Methods: A retrospective population study was conducted on the attendances of pediatric EDs from 1 January 2022 to 31 December 2022 at the Roma 1 Local Health Authority in Rome, a territory served by more than 13 EDs. Nested logistic regression analysis was used to investigate patient characteristics in predicting inappropriate use of EDs. Results: In 2022, 35,691 pediatric ED attendances were recorded, with 24,824 patients distributed among 904 PCP/GPs in the six districts. A total of 71.8% of patients had only one attendance in 2022. A total of 3.5% of the patients were FUs, who were responsible for more than 10% of the attendances. However, most of the attendances were not appropriate. FUs, younger age (<2 yo), and more severe clinical presentations were more likely to be associated with appropriate ED attendance. PCPs/GPs and districts do not have a role in determining a higher number of ED attendances. The single patient’s characteristics have a greater influence on this phenomenon. Conclusions: Frequent use of the ED is not associated with inappropriate use among children, mainly due to the characteristics and needs of specific patients. However, parents’ education for a more rational use of health system resources and the provision of local solutions to children’s health needs may allow for a more appropriate use of health service resources. Full article

Background/Objectives: Mental health conditions represent a growing global health concern, disproportionately impacting populations in low- and middle-income countries like Pakistan. Limited epidemiological data, coupled with recent socioeconomic and environmental disruptions, has intensified the need for current insights into psychological burden and coping capacities in the Pakistani population. Methods: A descriptive, cross-sectional survey was conducted from January to May 2023 among 400 community-dwelling adults attending outpatient departments in Islamabad and Rawalpindi. A structured 75-item questionnaire incorporating validated tools (PHQ-9, GAD-7, WHO-5, CSES, and SRQ-20) was used to assess depression, anxiety, well-being, coping self-efficacy, and mental distress. Descriptive statistics, χ² and Fisher’s exact tests, and Spearman’s rank correlation (r_s) analyses were performed using IBM SPSS 22.0. Results: Most respondents were male (73.0%), aged 25–34 (60.0%), and urban-dwelling (80.0%). Clinically relevant depression and anxiety were observed in 57.0% and 19.5% of participants, respectively; 38.0% reported mental distress. Conversely, 76.5% demonstrated fair-to-good coping efficacy and 51.0% had high well-being scores. Younger age (≤34 years), higher income, urban residence, and male gender were associated with significantly better mental health outcomes. Strong positive correlation was found between PHQ-9 and GAD-7 scores (r_s = 0.672), and moderate negative correlations were found between GAD-7 and WHO-5 (r_s = −0.496), and PHQ-9 and WHO-5 (r_s = −0.310). Conclusions: Our findings highlight the significant psychological burden among urban Pakistani adults, alongside promising levels of resilience and coping self-efficacy. These results emphasize the urgent need for early, culturally adapted mental health screening and intervention programs in outpatient settings. Integrating such strategies into primary care, particularly for vulnerable subgroups like women, older adults, and those with lower income could facilitate timely diagnosis, improve outcomes, and reduce stigma surrounding mental health. Full article

Aim. This study aimed to assess the SARS-CoV-2 herd immunity in the Republic of Armenia (RA) by late 2022. Materials and Methods. A randomized study was conducted from 28 November to 2 December (2022) by the Saint Petersburg Pasteur Institute (Russia) in collaboration with the National Center for Disease Control and Prevention (Armenia). This study was approved by the ethics committees at both organizations. A volunteer cohort (N = 2974) was formed and grouped by participant age, region, or activity. Antibodies (Abs) to viral nucleocapsid antigen (Nc) and receptor-binding domain (RBD) in plasma were determined by ELISA. The statistical significance of differences was calculated using a p < 0.05 threshold, unless noted. Results. At the end of 2022, estimated SARS-CoV-2 seroprevalence (Nc and/or RBD Abs) among the Armenian population was 99% (95%CI: 98.5–99.3). It was evenly distributed throughout the cohort without any significant differences by age, region, or activity. Volunteers with low (32–124 BAU/mL) or medium (125–332 BAU/mL) anti-Nc Ab levels prevailed: 32.4% (95%CI: 30.7–34.1) and 25.5% (95% CI: 24.0–27.1), respectively. Regarding anti-RBD Abs, maximum levels (>450 BAU/mL) were detected in 40% of children. The share of individuals with high anti-RBD Abs levels increased with age, reaching 65% among those aged 70⁺ years. The important contribution to the formation of herd immunity to coronavirus infection was made by vaccination in the preceding period (1 April 2021 to 1 May 2022). The contribution from individuals with post-vaccination immunity was estimated to be above 80%. Hybrid immunity, formed after vaccination of those who had earlier experienced COVID-19, was characterized by greater effectiveness than post-vaccination immunity alone. Conclusions. Within the context of mass prophylactic vaccination, effective herd immunity to SARS-CoV-2 was formed, which helped to stop epidemic spread in the Republic. Full article

Introduction: Stroke is one of the leading causes of death and disability worldwide. In Brazil, it remains the primary cause of mortality among adults. Although overall stroke mortality rates have declined, the absolute number of stroke incidents, deaths, and years of life loss continues to rise, particularly in developing and underdeveloped countries. Objective: The aim of this study was to analyze trends in stroke mortality across different age groups and both sexes in Espírito Santo, Brazil, from 2000 to 2021. Methods: This ecological time series study utilized secondary data from Espírito Santo, Brazil, from 2000 to 2021. Mortality data, categorized by sex and age group, were obtained from the Department of Informatics of the Unified Health System (DATASUS) database. Stroke-related mortality included deaths recorded under the International Classification of Diseases, 10th Revision (ICD-10) codes for subarachnoid hemorrhage (I60), intracerebral hemorrhage (I61), cerebral infarction (I63), and stroke not specified as hemorrhagic or ischemic (I64). Temporal trends in stroke mortality were assessed using joinpoint regression analysis. Results: From 2000 to 2021, there was a significant reduction in proportional mortality from stroke, with an overall decrease of −3.7% (p < 0.001). When analyzed by sex, the decline was −3.0% (p < 0.001) for males and −3.9% (p < 0.001) for females. The most significant decrease in proportional mortality was observed in the 50 to 59 age group, with an average annual percentage change of −4.9% (p < 0.001). The 30 to 39 age group exhibited the smallest decline, with an average annual percentage change of −2.4% (p < 0.001). No significant segments were observed in the 40 to 49, 60 to 69, and 70 to 79 age groups during the study period. Conclusions: This study identified a notable decline in stroke-related proportional mortality in the adult population of Espírito Santo between 2000 and 2021. While males had a higher absolute number of deaths, females exhibited a higher proportional mortality rate, underscoring the need for targeted preventive measures and effective acute stroke treatment, particularly among men. Full article

Background: Newly licensed physicians play a significant role in healthcare systems. However, they often lack knowledge about vaccine practices. This study aims to evaluate their ability to distinguish between fake news and the actual side effects of vaccines. Methods: We distributed a questionnaire to assess newly licensed physicians’ knowledge of side effects of vaccines and widespread fake news about them. We enrolled 317 newly licensed Italian physicians. Results: The average questionnaire score was 6.21/10 (SD = ±1.25). Work experience and age did not correlate with scores. Conclusions: Many participants were not able to distinguish between fake news and real vaccines’ side effects (e.g., the possible association between varicella vaccine and seizures). Furthermore, many physicians have been shown to believe in fake news. This lack of knowledge could lead to the inability to scientifically respond to anti-vaccinationists, thus increasing mistrust in medical counseling. Addressing knowledge gaps among recently licensed physicians is crucial to improving proper counseling and increasing public adherence to vaccination campaigns. Full article

Background: Frequency indicators are used by epidemiologists to facilitate public health professionals in estimating the impact of diseases. As of April 2022, Romania had reported 2.8 million confirmed COVID-19 cases to the World Health Organization, equating to a prevalence rate of 13.94%. A more accurate method for assessing the cumulative number of cases is the use of seroprevalence studies. This study retrospectively evaluates infection trends in Romania to enhance understanding of the virus’s spread and may support future comparative analyses of public health responses and community-level immunity. Methods: We analyzed 51,533 qualitative test results for high-affinity IgG antibodies targeting the SARS-CoV-2 nucleocapsid protein. Results: The largest proportion of tested individuals (59.4%) was aged 18–49 years. Among all serological tests, 18,980 were positive, corresponding to an adjusted seroprevalence rate of 40%. Conclusions: During the second year of the pandemic, seropositivity rates were highest among young adults, particularly in the western regions, and lowest among children and adolescents. These findings point out variations in exposure across age groups and geographic areas. Full article

Background/Objectives: Epidemics have historically shaped societies, influencing demographic structures, social organization, and economic stability. The 1742–1743 epidemic had a profound impact on populations along the Royal Road (Camino Real), the main colonial corridor between Buenos Aires and Lima. However, its specific demographic and socio-economic effects remain underexplored. This study aims to examine these impacts of the 1742–1743 epidemic through a comparative analysis of urban centers and Indigenous communities. Methods: A historical–comparative approach was employed, analyzing secondary sources including parish records and colonial administrative documents. This study assessed excess mortality and socio-economic consequences across different population groups and settlement types. Results: Mortality rates increased dramatically—up to twelve times the pre-epidemic average in Cordova (Córdoba) and by 45% in Santa Fe—disproportionately affecting Indigenous and enslaved populations. Urban centers experienced severe economic disruption and slow recovery, whereas Indigenous communities and Jesuit missions demonstrated greater resilience. Their communal strategies and early isolation measures contributed to a faster demographic stabilization. Additionally, the epidemic weakened colonial governance in some areas, altering local power structures. Conclusions: The epidemic of 1742–1743 revealed divergent patterns of vulnerability and resilience. Comparative analysis underscores recurring themes in the epidemic response and recovery, drawing relevant parallels with contemporary crises such as COVID-19. Recognizing these historical patterns of adaptation can inform present and future public health strategies. The terminology “plague” is used based on contemporary sources and not confirmed clinically. Full article

Population ageing is driving a growing demand for orthopedic surgical procedures. The rise in chronic conditions such as osteoarthritis significantly contributes to disability among older adults, particularly women, and primarily affects the hip and knee joints, thereby increasing the need for arthroplasties. Objective: To determine the future demand for lower limb arthroplasty procedures among individuals aged 60 and over in Colombia up to 2050, using official public health records and national demographic projections. Methods: This study used an observational longitudinal retrospective design, using a Poisson regression model with official records from the Integrated Social Protection Information System—which consolidates procedures reported by both public and private healthcare service providers—to identify lower limb arthroplasties performed between 2015 and 2023. Population projections from the National Department of Statistics were incorporated to model future demand, accounting for demographic ageing and mortality trends. An additional analysis was conducted by sex and the most prevalent types of arthroplasties. Results: A total of 62,728 procedures took place from 2015 to 2023, with women undergoing approximately twice as many as men. The highest intervention rates occurred in the 65–69 and ≥80 age groups. By 2050, projections indicate the number of procedures will reach 39,270, with 52.7% projected among women. Conclusions: This study reports demographic trends in arthroplasties between 2015 and 2023 and offers insights into the anticipated future burden of lower limb arthroplasties among Colombia’s older population. Full article

Vegetarianism, as a dietary pattern, is characterized by animal product avoidance and increased consumption of fruits, vegetables, whole grains, and legumes. It has been associated with health benefits, both physical and psychological, and has raised interest as a potential strategy for cancer prevention and treatment, which remains one of the leading causes of morbidity and mortality worldwide, demanding continual exploration of novel approaches. Background/Objectives: This study aims to describe trends in scientific publications about the relationship between vegetarianism and cancer and to highlight research gaps using bibliometric analysis. Methods: The methodology includes comprehensive research of three literature databases. After combining and cleaning these data, a final sample of 3427 studies was obtained that was analyzed using the Bibliometrix-R package. Results: The results indicate a continuously growing production of scientific publications. The most impactful sources, authors and their collaborations were identified. Author keywords, their co-occurrence network, and thematic trends were studied. Conclusions: Through synthesizing and critically evaluating insights from the scientific literature, we aim to contribute to the understanding of the potential benefits of vegetarianism in cancer prevention and management. However, due to the complexity of the topic, the results are often contradictory and could be used as a starting point for further research. Full article

Congenital syphilis (CS) is an important infectious cause of miscarriage, stillbirth, and neonatal morbidity and mortality. Despite the advances in diagnosis and treatment, CS continues to challenge health systems with increasing incidence and mortality rates in recent years worldwide. Given this, the present study aims to comparatively analyze the temporal trends in CS incidence and mortality in Brazil’s Southeast Region from 2008 to 2022. This is an ecological time-series study using secondary data on congenital syphilis from the states of Espírito Santo, Minas Gerais, Rio de Janeiro, and São Paulo. The data was extracted from the Brazilian Health System Informatics Department. Incidence and mortality rates were calculated per 100,000 live births. Joinpoint regression models were employed to identify trends in annual percentage change and average annual percentage change with 95% confidence intervals. The temporal trend of CS incidence in Brazil’s Southeast Region increased 12.8% between 2008 and 2022. Minas Gerais, São Paulo, Espírito Santo, and Rio de Janeiro showed increasing temporal trends of 21.4%, 14.1%, 14.0%, and 10.9%, respectively. The temporal trend of CS mortality in Brazil’s Southeast Region rose 11.9% between 2008 and 2022. Minas Gerais, São Paulo, and Rio de Janeiro exhibited increasing mortality temporal trends of 21.9%, 20.8%, and 10.1%, respectively. In contrast, Espírito Santo showed reduced mortality, with no deaths in 2021 and 2022. The temporal trend of CS incidence increased in all states of Brazil’s Southeast Region between 2008 and 2022, highlighting the need to reassess control measures. The temporal trend of CS mortality also increased during the same period, except in Espírito Santo. Considering that CS is preventable with adequate prenatal care and low-cost measures, these findings can serve as instruments to support strengthening public health policies. Full article

Background/Objectives: This narrative review provided a broad synthesis of recent epidemiological trends, priority resistance mechanisms, and public health implications of multidrug-resistant (MDR) bacteria. We focused on the most clinically significant MDR pathogens, regional differences in resistance, and the effectiveness of containment strategies. Our goal was to synthesize current knowledge and propose research directions. Methods: Through comprehensive analysis of epidemiological studies, surveillance reports, clinical trials, and meta-analyses, we present a detailed assessment of the evolving landscape of antimicrobial resistance across both developed and developing nations. The review encompasses data from 187 countries, analyzing over 2500 published studies and reports from major health organizations. Results: Our findings reveal a concerning 43% increase in multidrug-resistant infections globally, with particularly sharp rises in healthcare-associated infections (67% increase) and community-acquired infections (38% increase) in regions with high antibiotic misuse. The analysis specifically focuses on critical pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE), documenting their prevalence, transmission patterns, and treatment outcomes. Economic impact assessments indicate annual global healthcare costs exceeding USD 100 billion due to resistant infections. The review identifies significant gaps in current surveillance systems, particularly in low- and middle-income countries, and proposes standardized approaches for monitoring and containment strategies. We evaluate the effectiveness of various antimicrobial stewardship programs, documenting success rates and implementation challenges across different healthcare settings. Conclusions: The analysis concludes with evidence-based recommendations for policy reforms, research priorities, and international collaboration frameworks necessary to address this growing global health crisis. Our findings highlighted the importance of strengthening stewardship efforts, proposing novel diagnostics and therapeutic interventions, and addressing inequities in access to care and data across different countries. Full article