Jul 2026· Frontiers in Public Health· Vol 14· 0 citations· 38 references
Medicine
TL;DR
Strengthening surveillance capacity, improving mushroom species identification, and implementing region-specific health education and risk communication strategies may help reduce the burden of mushroom poisoning.
Abstract
Mushroom poisoning is a significant foodborne disease in China, with southwestern regions being high-risk areas. These incidents place ongoing pressure on primary healthcare facilities and the public health surveillance system. This study aimed to examine area-level factors associated with reported mushroom poisoning case incidence using aggregated prefecture-level data in Sichuan Province. This ecological panel study used surveillance data from the National Foodborne Disease Outbreak Surveillance System in Sichuan Province from 2019 to 2024. The unit of analysis was prefecture-level cities, and all variables were aggregated at the regional level. Potential determinants were selected based on the Social Determinants of Health framework. Panel regression models were used to estimate associations between area-level variables and reported mushroom poisoning case incidence. From 2019 to 2024, Sichuan Province reported 1,029 mushroom poisoning incidents involving 3,551 cases. The average annual reported incidence rate was 7.07 per million people, showing a fluctuating upward trend over the study period. In the multivariable analysis, per capita GDP (β = 0.109, 95% CI: 0.016 to 0.202) was positively associated with the reported mushroom poisoning case incidence, while the climate index (β = −0.072, 95% CI: −0.118 to −0.026) and urbanization rate (β = −0.140, 95% CI: −0.224 to −0.056) were negatively associated with incidence. The medical staff allocation index (β = 0.069, 95% CI: 0.010 to 0.129) and education level index (β = 0.064, 95% CI: 0.010 to 0.119) were positively associated with the reported incidence rate. Between 2019 and 2024, the reported mushroom poisoning case incidence in Sichuan Province exhibited an increasing trend with substantial regional variation. Regional differences in reported incidence may be associated with a combination of socioeconomic conditions, environmental context, and healthcare system characteristics. Strengthening surveillance capacity, improving mushroom species identification, and implementing region-specific health education and risk communication strategies may help reduce the burden of mushroom poisoning.
To understand the epidemiological characteristics and patterns of mushroom poisoning in Zhejiang Province from 2012 to 2023, and to overcome the limitations of previous descriptive studies in precise early warning and spatial identification, this study explored the feasibility of identifying spatial distribution characteristics and high-risk spatiotemporal clusters. First, descriptive epidemiological analysis was conducted on 2276 cases from the Foodborne Disease Case Surveillance System and 408 outbreaks from the Foodborne Disease Outbreak Surveillance System reported over the 12-year period to clarify the basic characteristics and trends of poisoning. Subsequently, spatial autocorrelation analysis (Moran’s I) was employed to reveal spatial dependence and clustering patterns. Finally, spatiotemporal scan statistics (SatScan) were used to precisely identify high-risk spatiotemporal clusters, systematically analyzing the spatiotemporal distribution and clustering patterns of mushroom poisoning cases. The results showed a distinct summer–autumn seasonal peak (June–October), attributed to the subtropical monsoon climate with high temperatures and abundant rainfall, which is conducive to mushroom growth. Farmers were the most affected population (47.93%), and homes were the primary poisoning locations (71.7%), reflecting widespread foraging habits and insufficient risk awareness in rural areas. Chlorophyllum molybdites (36.27%) and Russula japonica (10.05%) were the dominant poisoning mushroom species, with gastrointestinal symptoms being the predominant clinical manifestation (84.07%). Spatial analysis revealed significant spatiotemporal clustering of mushroom poisoning in Zhejiang Province. The global Moran’s I index showed significant positive autocorrelation in some years (p < 0.05), with local hotspots mainly distributed in western Zhejiang counties. This pattern is driven by a dual model of environmental suitability and behavioral risk, resulting from the high forest coverage and humid climate of the western Zhejiang mountainous areas providing suitable habitats, combined with long-standing foraging habits among local residents. Retrospective spatiotemporal scanning identified high-risk clusters for each year from 2018 to 2023, with the Lishui area in 2023 being the most significant cluster (Relative Risk (RR) = 15.44, Log-Likelihood Ratio (LLR) = 114.49). The results confirm that mushroom poisoning in Zhejiang Province exhibits a stable and identifiable spatiotemporal clustering pattern, providing a quantitative basis for precise health education and targeted prevention and control in high-risk counties of western Zhejiang during June–October, thereby shifting the approach from passive reporting to targeted intervention.
BACKGROUND
Pesticides are extensively employed across agricultural, public health, and industrial sectors, yielding significant benefits in crop protection and food security. However, their overuse and misuse have escalated pesticide poisoning into a pressing global public health issue-particularly in developing countries such as China. As the world's largest pesticide consumer, China continues to experience a disproportionately high burden of pesticide-related morbidity and mortality, even following the nationwide phase-out of highly hazardous compounds. Alarmingly, intentional ingestion of pesticides remains the most common method of suicide in the country. Shandong Province-the leading agricultural producer in China-offers a strategically relevant setting for epidemiological investigation. Within it, Zibo City stands out as a representative case: it integrates both traditional and modern farming systems and operates a well-established, comprehensive surveillance system for pesticide poisoning, thereby providing robust empirical grounding for analyzing the distribution, determinants, and trends of pesticide poisoning.
METHODS
A retrospective epidemiological study was conducted on pesticide poisoning cases reported in Zibo City between 2014 and 2023. Case data were extracted from the Occupational Disease and Health Hazard Factors Monitoring Information System-a nationally standardized subsystem of China's Integrated Disease Prevention and Control Information System-while population denominators were obtained from the official Zibo Statistical Yearbooks (2014-2023 editions). A structured case database was developed in Microsoft Excel, and all statistical analyses were performed using R 4.5.2 Categorical variables were compared using chi-square tests (or Fisher's exact test where expected cell counts were < 5), and binary logistic regression was employed to identify independent predictors of in-hospital mortality; results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI), with statistical significance set at P < 0.05. Case definitions encompassed demographic characteristics, exposure circumstances, pesticide classification (e.g., organophosphates, carbamates), clinical severity, treatment outcomes, and occupational attribution-specifically distinguishing between occupational and non-occupational poisoning.
RESULTS
A total of 762 pesticide poisoning cases were identified between 2014 and 2023 in Zibo City, including 400 males (52.5%) and 133 fatalities, yielding an overall case fatality rate (CFR) of 17.6%. The mean age of cases was 55.10 ± 20.04 years, with an average annual incidence of 1.63 per 100,000 population. The 65-75-year age group accounted for the largest proportion of cases (20.5%), and CFR increased monotonically with advancing age. Females exhibited a significantly higher CFR (18.8%) than males (16.5%). Non-occupational intentional ingestion-predominantly self-poisoning-constituted the leading exposure mechanism (68.9% of all cases) and carried the highest CFR (23.6%), whereas no fatalities were observed among occupationally exposed individuals (CFR = 0%). Among pesticide classes, herbicides demonstrated the highest CFR (48.3%), followed by insecticides (14.6%); organophosphorus compounds represented 84.3% of all insecticide-related poisonings, with dichlorvos being the most frequently implicated active ingredient. Temporally, the annual incidence of pesticide poisoning rose steadily over the study decade, peaking in 2023 (n = 147) and reaching its nadir in 2015 (n = 30), while the CFR declined progressively. Seasonally, cases were concentrated between March and October: occupational and intentional poisonings peaked during June-August, whereas accidental poisonings clustered in April-September. Geographically, Linzi, Zichuan, and Gaoqing Districts reported the highest case counts; conversely, Huantai, Yiyuan, and Boshan Districts recorded elevated CFRs. Multivariable binary logistic regression identified four independent predictors of in-hospital mortality: age ≥ 45 years (with CFR risk increasing incrementally with age), female sex (aOR = 1.69, 95% CI: 1.08-2.72), herbicide exposure (aOR = 1.79, 95% CI: 1.16-2.80), and non-occupational intentional ingestion (aOR = 2.71, 95% CI: 1.31-6.37). Comparative analysis with the preceding 2006-2013 period revealed a declining trend in the proportion of organophosphorus pesticide poisonings and a concurrent rise in herbicide-related incidents.
CONCLUSIONS
Zibo's pesticide poisoning features a notably higher CFR than other Chinese regions, with rising incidence yet falling CFR reflecting partial treatment success and unoptimized prevention, and non-occupational intentional ingestion stands as the core issue for local control. Age, gender, pesticide type and poisoning cause are key mortality factors, and the poisoning presents distinct demographic and geographical distribution characteristics driven by rural aging, social pressure and regional medical-economic gaps, for which targeted prevention and control strategies are proposed accordingly. This study has certain limitations in data sources and research scope, so future research needs to improve data collection and expand research coverage to offer more scientific support for relevant policies.
TRIAL REGISTRATION
Clinical trial number: Not applicable. This is a retrospective observational epidemiological study without any health-related interventions assigned to participants, which does not meet the WHO/ICMJE definition of a clinical trial, so trial registration is not required.
Ning Li, Guangyong Liu, Huali Duan et al.· BMC Public Health· 0 citations
Dengue fever has emerged as a major public health concern in Pakistan, particularly in Balochistan, where climatic variability and limited surveillance infrastructure have contributed to increasing disease burden. This study aimed to investigate the relationship between climatic factors and dengue transmission across multiple districts of Balochistan using a retrospective district-level epidemiological approach. Dengue surveillance data were collected from Public Health Laboratories, District Health Offices (DHOs), dengue surveillance units, and People’s Primary Healthcare Initiative (PPHI) centers, while climatic variables including temperature, rainfall, and humidity were obtained from national and global meteorological sources. The integrated datasets were analyzed using RStudio to assess seasonal trends, spatial distribution, and climate–dengue associations through descriptive statistics, correlation analysis, and negative binomial regression modeling. A total of 26,482 confirmed dengue cases were identified from 125,780 diagnostic tests conducted during 2024. The highest disease burden was observed in Turbat, Panjgur, Jhal Magsi, and Khuzdar districts. Dengue incidence showed a strong seasonal pattern, with cases increasing sharply during the summer and post-monsoon months and peaking in September. Regression analysis demonstrated that increasing temperature was significantly associated with higher dengue incidence, while rainfall exhibited delayed effects through enhanced vector breeding conditions. The combined influence of high temperature and high rainfall produced the greatest transmission intensity. The findings indicate that dengue transmission in Balochistan is highly climate-sensitive and increasingly shifting toward an endemic transmission pattern. Strengthening climate-informed surveillance systems, improving early warning mechanisms, enhancing vector control strategies, and promoting community awareness are essential for reducing the growing dengue burden in the region.
Iqra batool, Abdul Rehman, Ali Nawaz et al.· International Journal of Agr...· 0 citations
Climate change has intensified public health challenges in coastal Bangladesh, particularly increasing the prevalence of diarrheal diseases. This study assesses the vulnerability to diarrheal diseases in four coastal districts-Satkhira, Jhalakathi, Barguna, and Gopalganj-by examining the relationship between climate variability and disease occurrences. A mixed-methods approach was used, integrating hospital admission records (n = 46,741 diarrheal cases identified from 361,265 patients) from five government health facilities between January 2017 and December 2022 with meteorological data from the Bangladesh Meteorological Department. Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs) were conducted in all four districts. A total of 28 KIIs and 9 FGDs were conducted across the selected upazilas to collect field-level information. Findings indicate a significant positive correlation between maximum temperature and diarrheal incidence (r = 0.228, p = 0.0012). Diarrhea cases were more prevalent at maximum temperatures of 30-35 °C. In contrast, rainfall showed no statistically significant association with diarrheal trends (r = 0.094, p = 0.235), although descriptively fewer cases were observed at rainfall levels above 60 mm. Seasonal analysis revealed peak diarrheal cases between March and May, coinciding with the hottest months of the year. Age-specific analysis showed that children aged 0-3 years accounted for 37.6% of total cases, and females represented 52.7% of reported cases (χ2 test, p < 0.001). Qualitative findings from KIIs and FGDs highlighted salinity intrusion, flooding, waterlogging, inadequate sanitation, and limited healthcare resources as key drivers of vulnerability in the study districts. Vulnerable groups, including children under five and women, are disproportionately affected due to exposure to contaminated water and healthcare access constraints. To mitigate climate-induced diarrheal diseases, the study recommends improvements in water and sanitation infrastructure, enhanced healthcare services, and community-based awareness programs. Integrating climate resilience into public health policies is essential to reducing disease vulnerability in coastal regions.Findings indicate a significant positive correlation between maximum temperature and diarrheal incidence (r = 0.228, p = 0.0012). Diarrhea cases were more prevalent at maximum temperatures of 30-35 °C. In contrast, rainfall showed no statistically significant association with diarrheal trends (r = 0.094, p = 0.235), although descriptively fewer cases were observed at rainfall levels above 60 mm. Seasonal analysis revealed peak diarrheal cases between March and May, coinciding with the hottest months of the year. Age-specific analysis showed that children aged 0-3 years accounted for 37.6% of total cases, and females represented 52.7% of reported cases (χ2 test, p < 0.001). Qualitative findings from KIIs and FGDs highlighted salinity intrusion, flooding, waterlogging, inadequate sanitation, and limited healthcare resources as key drivers of vulnerability in the study districts. Vulnerable groups, including children under five and women, are disproportionately affected due to exposure to contaminated water and healthcare access constraints. To mitigate climate-induced diarrheal diseases, the study recommends improvements in water and sanitation infrastructure, enhanced healthcare services, and community-based awareness programs. Integrating climate resilience into public health policies is essential to reducing disease vulnerability in coastal regions.
Golam Kibria, Md Raisul Islam, Hashinur Rahman Pavel et al.· BMC Public Health· 0 citations
Background: Malaria remains a global public health concern. In Jayapura City, Hebeybhulu Yoka Public Health Center ranked second highest in malaria cases in 2024, with 2,797 cases recorded. This study aimed to analyze behavioral risk factors associated with malaria incidence in the working area of Hebeybhulu Yoka Public Health Center, Jayapura City. Methods: This analytic survey used a case-control design conducted from 10–30 September 2025. A total of 92 respondents (46 cases and 46 controls; ratio 1:1) were selected using simple random sampling with age matching between groups. Data were collected through structured interviews using a questionnaire and analyzed using univariate, bivariate (chi-square, odds ratio), and multivariate (backward LR logistic regression) tests. Results: Bivariate analysis showed that hanging clothes indoors (p=0.005; OR=3.927; 95% CI=1.583–9.743) and going outdoors at night (p=0.027; OR=3.024; 95% CI=1.218–7.510) were significant risk factors for malaria incidence, while bed net use (p=0.021; OR=0.341; 95% CI=0.145–0.798) and mosquito repellent use (p=0.027; OR=0.331; 95% CI=0.133–0.821) were significant protective factors. Multivariate analysis identified hanging clothes indoors as the most dominant behavioral factor associated with malaria incidence (p=0.015; Exp(B)=3.213; 95% CI=1.254–8.235). Conclusion: Hanging clothes indoors and nighttime outdoor activity increase the risk of malaria, while bed net and mosquito repellent use are protective. Hanging clothes indoors is the dominant behavioral risk factor in this population. Community-based interventions targeting these specific behaviors are recommended to reduce malaria transmission in the study area.
D. Bouway, Elsa Destalya Pasanda, K. Pariaribo· Open Access Health Scientifi...· 0 citations
INTRODUCTION
Hantavirus cardiopulmonary syndrome (HCPS) is a severe zoonotic disease caused by Orthohantavirus andesense (Andes virus, ANDV), with significant public health burden in Chile. Despite decades of surveillance, knowledge gaps remain regarding the ecological drivers of notification burden and the individual-level determinants of in-hospital mortality among hospitalized patients. This study aimed to address both dimensions simultaneously, providing a multilevel characterization of HCPS epidemiology in Chile from 2005 to 2022.
METHODS
Two complementary analyses were conducted. First, an ecological study examined district-level HCPS notifications (2005-2022) using a negative binomial mixed-effects model, with predictors including male population rate, urbanization proportion, population density, season and burned area due to forest fires during the most recent summer season. Second, an individual-level analysis of hospitalized HCPS patients (2010-2020) used a logistic mixed-effects model to identify correlates of in-hospital mortality among hospitalized patients, including age, sex, indigenous group affiliation, hospitalization duration and number of surgical interventions.
RESULTS
A total of 886 HCPS cases were notified across 187 districts, averaging 49.2 cases per year. Notifications were positively associated with higher male population rates and greater burned area due to forest fires, and negatively associated with urbanization and population density. Among 462 hospitalized patients, the in-hospital case-fatality ratio was 19.7%. Older age, female sex and indigenous group affiliation were significantly associated with higher in-hospital mortality risk among hospitalized patients. Shorter hospitalization duration and greater number of surgical interventions, as correlates of clinical severity and complexity, were also associated with in-hospital mortality among hospitalized patients.
CONCLUSIONS
HCPS notification burden in Chile is shaped by environmental and demographic factors, with forest fire activity representing a novel and actionable ecological risk indicator. In-hospital mortality among hospitalized patients is disproportionately concentrated in older, female, and indigenous populations, highlighting the need for targeted surveillance, equitable healthcare access and integrated One Health strategies to reduce the burden of HCPS in Chile.
Benjamín Diethelm-Varela, Nicolhole Atero, Fernanda Sánchez-Rodríguez et al.· Zoonoses and Public Health· 0 citations
