Search Results (60)

Maintaining proper hand hygiene is crucial in preventing the spread of infections and other communicable diseases. It is imperative to determine the factors that affect the likelihood of initiating and maintaining the recommended handwashing behavior, especially during a pandemic. This quantitative, secondary study employed a latent profile analysis (LPA) to identify the different attitudes toward behavior change based on the Multi-Theory Model (MTM) framework in the context of following the guidelines provided by the Centers for Disease Control and Prevention (CDC) during the COVID-19 pandemic. Data were collected from 602 college students at a large university in the southern region of the United States (U.S.) in 2020. Seven distinct profiles were identified, each reflecting unique attitudes toward following the recommended handwashing guidelines. Age (p < 0.01) and gender (p < 0.01) disparities were observed between profiles. This study is the first to apply LPA within the MTM framework and provides new insights for the development of targeted interventions based on the construct score profile. Full article

Mass gatherings are associated with the spread of communicable diseases. Some studies have suggested that acquisition of antimicrobial resistance (AMR) may be associated with attendance at specific mass gatherings. This systematic review aimed to synthesise evidence on the association between attendance at mass gatherings and antimicrobial resistance (AMR) and assess the prevalence of AMR at mass gatherings. A literature search of the Cochrane, Medline, Scopus, and Embase databases was performed. Studies were included if they reported original data, involved mass gatherings, and reported AMR results. Of 5559 titles screened, 44 studies met the inclusion criteria, most of which (n = 40) involved religious mass gatherings. The heterogeneity of the studies precluded a meta-analysis, hence a narrative synthesis by organism was conducted. A significant increase in antibiotic-resistant Escherichia coli and Klebsiella pneumoniae was reported following Hajj, as was a rise in gastrointestinal carriage of extended-spectrum β-lactamase (ESBL) or carbapenemase genes. Carriage of Streptococcus pneumoniae isolates non-susceptible to one or more antibiotics was also shown to increase from pre-Hajj to post-Hajj. There appears to be an association between attendance at mass gatherings and the acquisition of some AMR phenotypes and genotypes in some significant human pathogens, including E. coli and S. pneumoniae. Full article

In recent decades, the rapid spread of various communication media has led to changes in traditional eating habits. In the Mediterranean region, the classic (Mediterranean) dietary pattern has been lost as a result. This has led to a shift in eating habits towards unhealthy eating patterns, which in turn has resulted in an inadequate distribution of body composition. It is known that, among other things, the number of non-communicable diseases increases with the inadequate distribution of body composition. The aim of our study was to examine the level of adherence to the Mediterranean diet (MD) of older adults in the Mediterranean region in relation to specific body composition parameters. This study included 521 older adults with a mean age of 69.6 ± 6.3 years. Body composition was measured using the BIA 101 Anniversary device (Akern s.r.l., Florence, Italy) and adherence to the MD was assessed using the MEDLIFE index questionnaire. This study found significant differences in body composition between males and females. The mean adherence to the MD was 17.0 ± 3.3 points among the participants and there was higher adherence in females (p = 0.002, η_p² = 0.019). A multiple linear regression was performed to assess the relationship between the body composition parameters and MD. Multiple linear regression models were significant for reactance, fat mass (%), fat-free mass (%), skeletal muscle index, and total body water (%), with specific individual MEDLIFE items such as the consumption of processed meat, meat, white meat, fruit, vegetables, olive oil and limiting snacks between meals. Moreover, promising correlations were found between certain MD characteristics and BIA parameters, but the overall health effects of the MD remain unclear. Full article

Globally, SARS-CoV-2 has negatively impacted many lives and industries due to its rapid spread, severe outcomes, and the need for the implementation of lockdown strategies across the world. SARS-CoV-2 disease severity varies among different populations. Host genetics have been associated with various diseases, and their ability to alter disease susceptibility and severity. In addition, Human Leukocyte Antigen (HLA) expression levels and alleles vary significantly among ethnic groups, which might impact the host’s response to SARS-CoV-2. Our previous study highlighted that HLA-A might have an effect on COVID-19 disease severity across ethnicities. Therefore, in this study, we aim to examine the effect of HLA-B and C expression levels on COVID-19 disease severity. To achieve this, we used real-time PCR to measure the HLA mRNA expression levels of SARS-CoV-2-infected individuals from a South African cohort and compared them across ethnic groups, disease outcomes, gender, comorbidities, and age. Our results show (1) that the effect of HLA-B mRNA expression levels was associated with differences in disease severity when we compare symptomatic vs. asymptomatic (p < 0.0001). While HLA-C mRNA expression levels were not associated with COVID-19 disease severity. (2) In addition, we observed that HLA-B and HLA-C mRNA expression levels were significantly different between South African Black individuals and South African Indian individuals (p < 0.0001, p < 0.0001). HLA-B mRNA expression levels among symptomatic South African Black individuals were significantly higher than symptomatic South African Indian individuals (p < 0.0001). In addition, the HLA-B mRNA expression levels of symptomatic South African Black individuals were significantly higher than asymptomatic South African Black individuals (p > 0.0001). HLA-C mRNA expression levels among symptomatic South African Black individuals were significantly higher than among symptomatic South African Indian individuals (p = 0.0217). (3) HLA-C expression levels were significantly different between males and females (p = 0.0052). In addition, the HLA-C expression levels of asymptomatic males are higher than asymptomatic females (p = 0.0375). (4) HLA-B expression levels were significantly different between individuals with and without comorbidities (p = 0.0009). In addition, we observed a significant difference between individuals with no comorbidities and non-communicable diseases (p = 0.0034), in particular, hypertension (p = 0.0487). (5) HLA-B expression levels were significantly different between individuals between 26–35 and 56–65 years (p = 0.0380). Our work is expected to strengthen the understanding of the relationship between HLA and COVID-19 by providing insights into HLA-B and C expression levels across ethnic populations in South Africa among COVID-19-symptomatic and asymptomatic individuals. Our results highlight that HLA-B mRNA expression levels contribute to COVID-19 severity as well as variation in ethnicities associated with COVID-19. Further studies are needed to examine the effect of HLA expression levels across various ethnic groups with contributing factors. Full article

COVID-19 remains a communicable disease with the capacity to cause substantial damage to health and health systems. Enhanced health screening at points of entry (POEs) is a public health measure implemented to support early detection, prevention and response to communicable diseases, such as COVID-19. The purpose of this study was to review the available evidence on the effectiveness of POE health screening in the detection and containment of the COVID-19 pandemic. This study was registered under PROSPERO and followed PRISMA guidelines in which the literature between 2019 and 2022 was retrieved from Scopus, PubMed, Web of Science, Global Health, CINAHL, Embase, Google Scholar and international organizations. A total of 33,744 articles were screened for eligibility, from which 43 met the inclusion criteria. The modeling studies predicted POE screening able to detect COVID-19 in a range of 8.8% to 99.6%, while observational studies indicated a detection rate of 2% to 77.9%, including variants of concern depending on the screening method employed. The literature also indicated these measures can delay onset of the epidemic by 7 to 32 days. Based on our review findings, if POE screening measures are implemented in combination with other public health interventions such as rapid tests, they may help detect and reduce the spread of COVID-19. Full article

Background and Objectives: The epidemic of non-communicable diseases (NCDs) affects the lives of millions of people around the globe. It poses devastating health consequences for individuals, families and communities, threatening to overwhelm health systems. Non-communicable diseases, including heart disease, stroke, cancer, diabetes and chronic lung disease, are jointly responsible for around 75% of all deaths worldwide. The major NCD risk factors are modifiable behaviors such as tobacco use, unhealthy diet, physical inactivity and alcohol abuse. The European Commission has estimated that health promotion and disease prevention strategies can reduce the burden of NCDs by up to 70%. Taking this into consideration, the imperative approach to reducing the spread of NCDs is to control related risk factors. Methods: A literature review was performed by using major search engines such as Google Scholar, PubMed and ScienceDirect. The keywords used in the search were ‘nutrition’, ‘lifestyle interventions’, and ‘NCD’. The collected information was then critically assessed. Results and discussion: Lifestyle medicine (LM) is a branch of medicine focused on preventive healthcare and self-care dealing with the prevention, education, research and treatment of disorders caused by lifestyle factors. It aims to improve individuals’ health and quality of life through the six pillars of LM: nutrition, physical activity, sleep, stress management, avoidance of risky substances and positive social connection. Multiple studies have demonstrated that a lifestyle incorporating health-promoting practices profoundly impacts health and quality of life. The rising reputation of lifestyle medicine interventions can be attributed to their effectiveness in managing chronic conditions such as type 2 diabetes, metabolic syndrome, cardiovascular disease and obesity. Nutrition is one of the leading lifestyle modification factors with an impact on health status. An appropriate diet could reduce NCD risk and increase life expectancy due to different mechanisms, including effects on the immune system, gut microbiome modulation, anti-inflammatory properties, and others. Nutrition in particular plays a prominent role in LM interventions as it is essential to promoting health and preventing or even reversing disease. It is an integral part of LM interventions and is critical for the success of any LM program. Full article

Patients’ effective hand hygiene helps to reduce healthcare-associated infections and prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. Accordingly, this study aimed to describe effective hand hygiene decisions based on the Health Action Process Approach (HAPA) and whether this pattern is invariant for mental health. Data were collected cross-sectionally from patients who had previously been admitted to a hospital (N_{study 1} = 279; study 1) and longitudinally from psychosomatic rehabilitation patients (N_{study 1} = 1073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding compliance, social-cognitive variables of the HAPA, and mental health status were examined. The results revealed that the trimmed HAPA framework fitted the data well (χ² = 27.1, df = 12, p < 0.01, CMIN/df = 2.26, CFI = 0.97, RMSEA = 0.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior was found to be invariant regarding mental health. To conclude, the trimmed HAPA framework was revealed to be a generic framework for explaining social-cognitive processes relating to hand hygiene decisions. Therefore, helping individuals to perform hand hygiene recommendations requires intention formation and bridging the intention–behavior gap. This can be undertaken by promoting planning and self-efficacy. All processes appear generic to participants with and without mental health challenges. Full article

During the COVID-19 pandemic, extensive efforts focused on developing a better understanding of indirect transmission routes, environmental monitoring of fomites, and suitable surveillance strategies, providing new perspectives to also face other communicable diseases. Rapid methods for monitoring environmental contamination are strongly needed to support risk assessment, epidemiological surveillance and prevent infections from spreading. We optimized and automatized a protocol based on fomite detection by qPCR, using a microbial-signature approach based on marker genes belonging to the microbiota of droplets or different biological fluids. The procedure was implemented by exploiting the available tools developed for SARS-CoV-2 tracing, such as flocked swab sampling, real-time PCR equipment and automatic extraction of nucleic acids. This approach allowed scaling up, simplifying, and speeding up the extraction step of environmental swabs, processing at least 48 samples within 45 min vs. 90 min for about 24 samples by manual protocols. A comparison of microflora data by Next-Generation Sequencing (NGS) strongly supports the effectiveness of this semiautomated extraction procedure, providing good quality DNA with comparable representation of species as shown by biodiversity indexes. Today, equipment for qPCR is widely available and relatively inexpensive; therefore this approach may represent a promising tool for hospital hygiene in surveilling fomites associated with SARS-CoV-2 or other pathogen’s transmission. Full article

Food labels are low-cost, informational tools that can help curb the spread of diet-related non-communicable diseases. This study described consumers’ knowledge, attitudes, and practices related to food labels in Jordan and explored the relationship between knowledge and attitude with comprehensive use of food labels. A cross-sectional, online survey assessed Jordanian adult consumers’ ability to comprehend the nutritional contents of food labels (knowledge score), their attitudes towards food labels (attitude scale), and how frequently they used different parts of food labels (practice scale). Multivariate logistic regression models assessed predictors of comprehensive use of food labels. A total of 939 adults participated in the study. Total mean scores for the practice scale (14 questions), attitude scale (8 questions), and knowledge score (4 questions) were 49.50 (SD, 11.36; min, 5; max, 70), 29.70 (SD, 5.23; min, 5; max, 40), and 1.39 (SD, 1.33; min, 0; max, 4), respectively. Comprehensive users of food labels (26.4%) were more likely female, responsible for grocery shopping, and had higher mean knowledge and attitude scores. Jordanian consumers seem to have good practices and attitudes related to food label use but suboptimal knowledge regarding content. Future interventions should focus more on enhancing knowledge and awareness related to food labels. Full article

Identifying the relationship between human mobility, air pollution, and communicable disease poses a challenge for impact evaluation and public health planning. Specifically, Coronavirus disease 2019 (COVID-19) and air pollution from fine particulates (PM2.5), by which human mobility is mediated in a public health emergency. To describe the interplay between human mobility and PM2.5 during the spread of COVID-19, we proposed a nonlinear model of the time-dependent transmission rate as a function of these factors. A compartmental epidemic model, together with daily confirmed case data in Bangkok, Thailand during 2020–2021, was used to estimate the intrinsic parameters that can determine the impact on the transmission dynamic of the two earlier outbreaks. The results suggested a positive association between mobility and transmission, but this was strongly dependent on the context and the temporal characteristics of the data. For the ascending phase of an epidemic, the estimated coefficient of mobility variable in the second wave was greater than in the first wave, but the value of the mobility component in the transmission rate was smaller. Due to the influence of the baseline value and PM2.5, the estimated basic reproduction number of the second wave was higher than that of the first wave, even though mobility had a greater influence. For the descending phase, the value of the mobility component in the second wave was greater, due to the negative value of the estimated mobility coefficient. Despite this scaling effect, the results suggest a negative association between PM2.5 and the transmission rates. Although this conclusion agrees with some previous studies, the true effect of PM2.5 remains inconclusive and requires further investigation. Full article

Periodontitis has been linked to an increased risk of various chronic non-communicable diseases, including gastrointestinal cancers. Indeed, dysbiosis of the oral microbiome and immune-inflammatory pathways related to periodontitis may impact the pathophysiology of the gastrointestinal tract and its accessory organs through the so-called “gum–gut axis”. In addition to the hematogenous spread of periodontal pathogens and inflammatory cytokines, recent research suggests that oral pathobionts may translocate to the gastrointestinal tract through saliva, possibly impacting neoplastic processes in the gastrointestinal, liver, and pancreatic systems. The exact mechanisms by which oral pathogens contribute to the development of digestive tract cancers are not fully understood but may involve dysbiosis of the gut microbiome, chronic inflammation, and immune modulation/evasion, mainly through the interaction with T-helper and monocytic cells. Specifically, keystone periodontal pathogens, including Porphyromonas gingivalis and Fusobacterium nucleatum, are known to interact with the molecular hallmarks of gastrointestinal cancers, inducing genomic mutations, and promote a permissive immune microenvironment by impairing anti-tumor checkpoints. The evidence gathered here suggests a possible role of periodontitis and oral dysbiosis in the carcinogenesis of the enteral tract. The “gum–gut axis” may therefore represent a promising target for the development of strategies for the prevention and treatment of gastrointestinal cancers. Full article

This study analyzed the cattle trade network in Paraná, Brazil, for the years 2018 and 2019 to identify potential movement patterns that could contribute to the spread of brucellosis among farms. The brucellosis statuses of 1757 farms were incorporated into the analysis. Network parameters of farms with a known brucellosis infection status were statistically compared between infected and non-infected farms using traditional techniques and the quadratic assignment procedure. A multilinear regression model (MLR) was used to consider known risk factors for brucellosis infection in conjunction with the network parameters. The cattle trade network in Paraná during the study period comprised 115,296 farms linked by 608,807 cattle shipments. The movement pattern was marked by a high concentration of movements to and from a small percentage of farms. The existence of such highly connected farms could facilitate the transmission of communicable diseases via the cattle trade in Paraná. The trading communities in Paraná exhibited a spatial pattern, with proximate farms more likely to engage in trade. Brucellosis-infected farms traded more frequently than non-infected farms (odds ratio [OR] 3.61), supplied cattle to other farms more often than the regional average (OR 2.12), and received more cattle (OR 2.78). The in-degree and out-degree were associated with brucellosis infection on the farm. The mean shortest path between infected farms was significantly shorter than that between non-infected farms (4.14 versus 4.49, p = 0.004, OR 1.39). In the MLR, a higher out-degree was positively associated with infected farms after accounting for previously identified risk factors. This novel information offers insights into the factors driving the current endemic situation in the study area and can inform the development of targeted animal health policies. Full article

Previous research has highlighted the significant role social networks play in the spread of non-communicable chronic diseases. In our research, we seek to explore the impact of these networks in more detail and gain insight into the mechanisms that drive this. We use obesity as a case study. To achieve this, we develop a generalisable hybrid simulation and optimisation approach aimed at gaining qualitative and quantitative insights into the effect of social networks on the spread of obesity. Our simulation model has two components. Firstly, an agent-based component mimics the dynamic structure of the social network within which individuals are situated. Secondly, a system dynamics component replicates the relevant behaviours of those individuals. The parameters from the combined model are refined and optimised using longitudinal data from the United Kingdom. The simulation produces projections of Body Mass Index broken down by different age groups and gender over a 10-year period. These projections are used to explore a range of scenarios in a computational study designed to address our research aims. The study reveals that, for the youngest population sub-groups, the network acts to magnify the impact of external and social factors on changes in obesity, whereas, for older sub-groups, the network mitigates the impact of these factors. The magnitude of that impact is inversely correlated with age. Our approach can be used by public health decision makers as well as managers in adult weight management services to enhance initiatives and strategies intended to reduce obesity. Our approach is generalisable to understand the impact of social networks on similar non-communicable diseases. Full article

A wide spectrum of Gram-positive/Gram-negative bacteria has been found resistant to a wide spectrum of antibiotics in the United States of America during the past decade. Drug-resistant tuberculosis is not yet a major threat in North/South America, Europe, and the Middle East. However, the migration of populations in times of drought, famine, and hostilities may increase the global reach of this ancient pathogen. Given an increased spread from China and India to African countries, drug-resistant Mycobacterium tuberculosis has become an emerging topic of concern for Europe and North America. Due to the dangers associated with the spread of pathogens among different populations, the World Health Organization continues to expand healthcare advisories for therapeutic approaches for both stationary and migrating populations. As much of the literature focuses on endemic to pandemic viruses, we remain concerned that other treatable communicable diseases may be ignored. One such disease is multidrug-resistant tuberculosis. We focus on molecular mechanisms that this pathogen relies upon for the development of multidrug resistance via gene mutation and the evolutionary development of new enzyme and calcium channels. Full article

COVID-19-related knowledge and behaviors remain essential for controlling the spread of disease, especially among vulnerable patients with advanced, chronic diseases. We prospectively assessed changes over 11 months in COVID-19-related testing, knowledge, and behaviors among patients with non-communicable diseases in rural Malawi using four rounds of telephone interviews between November 2020 to October 2021. The most commonly reported COVID-19-related risks among patients included visiting health facilities (35–49%), attending mass gatherings (33–36%), and travelling outside the district (14–19%). Patients reporting having experienced COVID-like symptoms increased from 30% in December 2020 to 41% in October 2021. However, only 13% of patients had ever received a COVID-19 test by the end of the study period. Respondents answered 67–70% of the COVID-19 knowledge questions correctly, with no significant changes over time. Hand washing, wearing face masks and maintaining a safe distance were the most frequently reported strategies to prevent the spreading of COVID-19. Wearing face masks significantly improved over time (p < 0.001). Although the majority reported accurate knowledge about COVID-19 and enhanced adherence to infection prevention measures over time, patients commonly visited locations where they could be exposed to COVID-19. Government and other stakeholders should increase COVID-19 testing accessibility to primary and secondary facilities. Full article