Epidemiologia

Background/Objectives: Type 2 diabetes (T2DM) and hypothyroidism often coexist, worsening cardiometabolic risk. Oral semaglutide and levothyroxine each improve metabolic parameters, but the effect of combined therapy is understudied. This study aimed to evaluate whether oral semaglutide administered concomitant with levothyroxine provides additive benefits on lipid profile, glycemic control, and body weight in patients with both conditions. Methods: This prospective comparative observational study assessed a total of 210 patients who were enrolled (70 per group) with a 6-month follow-up. Group A (T2DM and hypothyroidism) received semaglutide and levothyroxine, group B (hypothyroidism only) received levothyroxine, and group C (T2DM only) received oral semaglutide. Lipid profile, glycemic profile (HbA1c), thyroid profile, and anthropometric parameters were comparable across groups at baseline and after 6 months. Results: Group A demonstrated significant improvements in lipid parameters: LDL-cholesterol decreased by 12.7%, HDL increased by 9.0%, and triglycerides decreased by 6.7% (all comparisons p < 0.001 unless otherwise specified). In contrast, group B experienced worsening lipid profiles (LDL increased by 11.0%, HDL decreased by 0.5%, and triglycerides increased by 9.1%), while group C showed modest changes (LDL increased by 4.5%). Glycemic control improved among diabetic patients, with HbA1c declining by 7.7% in group A and 12.6% in group C. Body mass index (BMI) decreased in groups A (4.9%) and C (6.0%). Conclusions: The concurrent administration of oral semaglutide and levothyroxine produces additive cardiometabolic advantages in individuals with T2DM and hypothyroidism. These findings suggest that combined treatment may optimize metabolic outcomes in this particularly high-risk population.

Background/Objectives: Vitamin D plays a role in cellular regulation and immune processes relevant to cervical carcinogenesis, yet data on vitamin D status and its determinants in high-burden settings such as South Africa remain scarce. This paper therefore describes the prevalence of vitamin D deficiency, insufficiency, and sufficiency, and explores associated factors among women with cervical lesions. Methods: A descriptive cross-sectional study was conducted among 103 women aged 18–81 years. Women were referred to Nelson Mandela Academic Hospital due to cervical cancer, high-grade squamous intraepithelial lesions (HSILs), or atypical squamous cells—cannot exclude HSIL, or low-grade squamous intraepithelial lesions, or atypical squamous cells of undetermined significance. The total serum 25(OH)D (D₂ + D₃) was quantified using the MAGLUMI 25-OH Vitamin D chemiluminescent immunoassay kit on the MAGLUMI X3 Fully Automatic Chemiluminescence Immunoassay Analyzer (Snibe Diagnostic, Shenzhen New Industries Biomedical Engineering Co., Ltd., Shenzhen, China). Serum vitamin D was categorized according to the Endocrine Society Task Force guidelines. Results: Vitamin D insufficiency was observed in 46.60% of participants and deficiency in 26.21% while only 27.18% had sufficient levels. Overall, vitamin D deficiency or insufficiency was more common than sufficiency (72.82%; 27.18%, p < 0.0001). Among HIV-positive women, 78.26% had vitamin D deficiency or insufficiency compared with 63.33% of HIV-negative women; however, this difference was not statistically significant. Vitamin D deficiency was most prevalent in women with healthy body mass index (BMI, 46.40%) values and decreased significantly with increasing BMI values (p = 0.008). Conclusions: Vitamin D deficiency and insufficiency were common among women with cervical lesions in this rural South African population. Associations with BMI suggest context-specific influences on vitamin D status. Owing to the study’s cross-sectional design and lack of normal cervical cytology participants, the findings are descriptive and exploratory, underscoring the need for longitudinal and comparative research to better define the role of vitamin D in cervical disease.

Background: Tuberculosis (TB) remains a major global public health challenge, with substantial variation across countries. South Africa has one of the highest TB incidence and mortality rates globally, while Bulgaria, a low-incidence country, faces a persistent TB burden among vulnerable populations. Objectives: To compare national trends in TB incidence and mortality in South Africa and Bulgaria from 2000 to 2023 and explore associations with selected socioeconomic indicators and health system coverage. Methods: An ecological, descriptive, analytical study used national-level data from the WHO, World Bank, and official statistics. TB trends were analyzed alongside income, poverty, unemployment, and Universal Health Coverage indicators. Time series measures and Pearson correlation were used descriptively to summarize co-variation over time. Results: Between 2000 and 2023, TB incidence declined by approximately 44% in the Republic of South Africa and 69% in Bulgaria. In both countries, TB incidence co-varied strongly with unemployment (RSA: r = 0.805; BG: r = 0.723). In Bulgaria, TB incidence was also strongly negatively associated with GDP per capita (r = −0.910), whereas no significant association with GDP was observed in South Africa. These findings indicate that TB trends co-varied more closely with labour market conditions in both contexts, while broader economic growth co-occurred with declining TB incidence only in Bulgaria. Conclusions: TB trends co-occurred with changes in socioeconomic conditions and health system coverage, with differing patterns across contexts. Findings highlight the relevance of equity-oriented, context-specific TB control strategies integrated with social and economic policies.