Jul 2026· Frontiers in Public Health· Vol 14· 0 citations· 23 references
Medicine
TL;DR
Human brucellosis in Hulunbuir showed persistent seasonality and marked county-level heterogeneity and formal population-adjusted interpretation was strongest for 2016–2024, while 2025 results should be read as provisional reported-case evidence.
Abstract
Background Human brucellosis remains an important zoonotic public health problem in northern China, especially in pastoral and agro-pastoral areas. County-level evidence is needed to distinguish large absolute service burden from high population-adjusted risk and to support seasonal preparedness. Methods We conducted a retrospective surveillance-based county-level analysis integrating descriptive epidemiology, population-adjusted spatial analysis, Bayesian smoothing, short-term forecasting, and approximate non-fatal burden estimation. County-level population denominators were available for 2016–2024. Because 2025 records had a high deletion rate and lacked reliable county-level denominator linkage, analyses involving 2025 were treated as provisional reported-case analyses. Results After excluding 2,615 deleted records, 12,220 reported cases were included; the denominator-linked 2016–2024 panel contained 10,824 cases and 21,892,827 person-years. Annual crude incidence peaked in 2021 at 68.96 per 100,000 population. The largest absolute burdens occurred in Zhalantun City, Arun Banner, and Morin Dawa Daur Autonomous Banner, whereas the highest population-adjusted incidence rates were observed in New Barag Right Banner, New Barag Left Banner, and Chen Barag Banner. Monte Carlo scan-statistic testing supported the leading population-adjusted excess windows in Arun Banner in 2019, Zhalantun City in 2021, and New Barag Right Banner in 2022 (all Monte Carlo p < 0.001). BYM smoothing produced consistent high-relative-risk areas, and posterior medians, credible intervals, and exceedance probabilities are reported in the Supplementary materials. In rolling-origin validation, SARIMA achieved the lowest average monthly MAE and MAPE; LightGBM produced a marginally lower mean annual total error across all four folds, but this advantage was not retained after excluding the provisional 2025 fold. Forecasting was interpreted as short-term preparedness support, not as evidence of a single superior model. Approximate non-fatal burden estimates varied across disability-weight and duration assumptions; the upper-bound proxy scenario produced approximately 1,530 DALYs for 2016–2025 and approximately 1,350 DALYs when provisional 2025 records were excluded. Conclusion Human brucellosis in Hulunbuir showed persistent seasonality and marked county-level heterogeneity. Formal population-adjusted interpretation was strongest for 2016–2024, while 2025 results should be read as provisional reported-case evidence.
Background Dengue has shifted from Dhaka‐centric to nationwide in Bangladesh. Aim To quantify spatiotemporal patterns and identify high‐risk clusters across all 64 districts from 2021 to 2025, and, extending previous reports with data from 2025, this study aims to observe an ongoing shift in per‐capita risk hotspots. Methods Retrospective ecological study of the Directorate General of Health Services (DGHS) aggregate yearly data on suspected and laboratory‐confirmed dengue admissions (n = 637,626 cases). Incidence per 100,000 population was calculated using 2022 census projections with 1.12% annual growth. Global (Moran’s I) and local (Getis‐Ord Gi∗) spatial autocorrelation and prospective space–time scan statistics (SaTScan) were applied. Results National incidence: 76.4/100,000/year. 2025 rate‐adjusted Moran’s I = 0.328 (p = 0.001). Raw‐case hotspots: Greater Dhaka; population‐adjusted hotspots: Jhalokathi, Barguna (coastal). High‐rate space–time cluster (2024–2025): Dhaka, Manikganj (RR = 3.13, p = 0.001). Dhaka O/E = 4.31 (RR = 6.38). Two low‐rate clusters (north, southeast). Conclusion Urban hyperendemicity, characterized by a high case volume, coupled with the emerging coastal per‐capita risk, necessitates tailored interventions. Intensive vector control is essential in Dhaka, while early‐warning surveillance should be implemented in coastal districts.
P. Hasan, Tazdin Delwar Khan, M. Islam et al.· Journal of Tropical Medicine· 0 citations
BACKGROUND
Multidrug-resistant Tuberculosis (MDR-TB) remains a major public health threat in China, Geographic heterogeneity and poorly understood epidemiological trends limit precision control and resource optimization.
METHODS
This study systematically assessed the disease burden of MDR-TB in China and its provinces from 1990 to 2023, using data from the Global Burden of Disease Study (GBD) 2023 database. The analysis includes age-standardized rates (ASR) and absolute case numbers for incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lost (YLL), and years lived with disability (YLD). The data spans 31 provinces, autonomous regions, municipalities, and the Special Administrative Regions of Hong Kong and Macao. The Joinpoint regression model was used to analyze trends in disease burden from 1990 to 2023 and calculate the average annual percentage change (AAPC) and annual percentage change (APC). In addition, a Bayesian age-period-cohort (BAPC) model was employed to project the disease burden trends from 2024 to 2050.
RESULTS
In 2023, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of MDR-TB in China were 1.630 per 100,000 population [95% uncertainty interval (UI): 0.196, 4.967] and 2.740 per 100,000 population (95% UI: 0.340, 8.794), respectively. From 1990 to 2023, ASIR declined significantly [AAPC = -2.859%, 95% confidence interval(CI): -3.487, -2.231], whereas ASPR increased significantly (AAPC = 7.800%, 95% CI: 7.022, 8.578); however, recent trends suggested stabilization, with ASIR plateauing from 2016 to 2023 (AAPC=-0.270%, 95%UI: -1.275, 0.746) and ASPR showing no significant change from 2017 to 2023 (APC = 0.503%, 95% CI: -1.635, 2.687). In 2023, age-standardized mortality rate (ASMR), age-standardized Disability-adjusted life years rate (ASDR), age-standardized Years of Life Lost rate(ASYLLR), and age-standardized Years Lived with Disability rate (ASYLDR) were 0.098 per 100,000 population (95% UI: 0.011, 0.354. AAPC = -6.714%, 95% CI: -7.265, -6.164), 3.718 per 100,000 population (95% UI: 0.466, 13.091. AAPC = -6.633%, 95% CI: -7.130, -6.135), 2.837 per 100,000 population (95% UI: 0.331, 10.333. AAPC = -6.633%, 95% CI: -7.130, -6.135), and 0.881 per 100,000 population (95% UI: 0.118, 2.943. AAPC = -1.614%, 95% CI: -2.366, -0.862), respectively, with significant long-term declines. Xinjiang had the highest ASIR(8.212 per 100,000 population, 95%UI: 1.008, 24.719) and ASPR (12.695 per 100,000 population, 95%UI: 1.513, 39.693). ASIR (AAPC=0.160%, 95% CI: 0.137, 0.183) and ASPR (AAPC=0.086%, 95% CI: 0.073, 0.098) are forecasted to rise from 2024 to 2050.
CONCLUSION
Persistent MDR-TB challenges in China, including rising prevalence and spatial heterogeneity, demand a sustainable model combining policy, AI diagnostics, and community engagement.
Shunxiang Zhang, Jinlei Qi, Jinxin Zheng et al.· Journal of Infection· 0 citations
Brucellosis is a neglected zoonosis with a considerable disease burden in livestock‐dependent areas. Khuzestan Province, southwestern Iran, exhibits diverse ecological and agricultural landscapes that may drive heterogeneous transmission. Knowledge of recent epidemiological trends is important for targeted control. We aimed to characterize the temporal and demographic patterns of human brucellosis in Khuzestan from 2017 to 2024, with emphasis on changes observed after 2021. We analyzed aggregated surveillance data for all laboratory‐confirmed human brucellosis cases reported in Khuzestan Province between 2017 and 2024. Crude annual incidence rates were calculated using population denominators linearly interpolated from the 2017 census and the 2023 official estimate. Log‐linear trend regression, performed using Joinpoint software, estimated the annual percentage changes (APCs) in incidence case counts. Poisson′s regression with population offset quantified period relative risks (RRs) comparing 2022–2024 with 2017–2021. Chi‐square tests assessed temporal shifts in distributions across age groups (15 categories), sex, residence (rural/urban/nomadic), and four geographical zones (Northern Highlands, Central Plains, Southern Coastal and Marshland, and Western Borderlands). A total of 3923 cases were reported. Crude incidence remained stable at 7.9–8.1 per 100,000 during 2017–2019, declined to 6.3–7.0 in 2020–2021, and then increased sharply to 12.3–14.7 in 2022–2024 (APC = +10.7%; 95% CI: 2.2–19.9; p = 0.019). Incidence during 2022–2024 was 1.66 times higher than during 2017–2021 (95% CI: 1.52–1.81; p < 0.001). The largest relative increases in reported case counts were in adults aged ≥ 70 years (APC = +21.1%; 95% CI: 11.1–32.2) and in adults aged 65–69 years (+20.0%, 9.9–31.1), whereas children aged 0–4 years showed no significant change. The male‐to‐female ratio shifted from 0.88 in 2017 to 1.22 in 2024 (p = 0.032), driven by a significant rise in male cases (APC = +11.5%, p = 0.011) against a nonsignificant female increase. Rural cases increased significantly (APC = +11.2%, p = 0.009), accounting for 47%–61% of annual cases. The Northern Highlands zone bore 62.7% of total cases (APC = +11.6%, p = 0.003); the Southern Coastal zone exhibited the steepest relative increase (APC = +15.8%, p = 0.020). Although statistically significant, changes in composition over time were small in magnitude (Cramér′s V = 0.06 − 0.12). Human brucellosis in Khuzestan Province has resurged dramatically since 2021, with a 66% increase in period risk. The epidemiological profile shifted to older adults, males, and people living in rural areas, with marked geographical heterogeneity. The results emphasize the need for targeted vaccination of livestock in high‐burden areas (Northern Highlands and Southern Coastal), enhanced surveillance in older age groups, and increased One Health approaches to reverse this trend.
Mehran Varnasseri Ghandeali, Amirmansoor Varnasseri Ghandali, H. Amiri et al.· International Journal of Mic...· 0 citations
Purpose: This study aimed to analyze the spatio-temporal patterns of dengue virus infection via kernel density estimation to assess the relative risk distribution and identify transmission hotspots in the Bobonaro municipality.
Methods: A retrospective analysis was conducted on confirmed dengue cases (n=311) reported from seven community health centers and one referral hospital in Bobonaro from January 2022 to December 2024. Kernel density estimation with optimal bandwidth selection was employed to map the relative risk distributions and identify spatial clusters. Demographic patterns across age categories were analyzed using negative binomial regression with a quadratic age-rank term, and sex distribution was analyzed using an exact two-proportion binomial test.
Results: Annual dengue cases increased by 41.48% over the study period, with significant seasonal patterns observed during the dry and rainy seasons. Case counts increased from the infancy category toward a peak in the youth category (5–14 years, 158 cases, 50.8% of all cases) before declining in older age groups, a pattern confirmed by negative binomial regression with a quadratic age-rank term (incidence rate ratio [IRR] 8.45, 95% CI 2.70–25.37, p<0.001 for the linear term and 0.74, 95% CI 0.65–0.85, p<0.001 for the quadratic term). Females accounted for a slightly higher proportion of cases (51.8%, n=161) than males (48.2%, n=150), a difference that was not statistically significant (p= 0.571). Spatial analysis revealed persistent hotspots in southeastern Bobonaro, with new clusters emerging in the northern regions by 2023 and transmission typically contained within an 80 m radius.
Conclusion: This study identified clear demographic vulnerabilities and dynamic spatial patterns of dengue transmission in Bobonaro, demonstrating the utility of GIS-based spatial analysis for strengthening surveillance and guiding targeted vector control in resource-constrained settings.
Zito Viegas da Cruz, I. Made, D. Adnyana· Berita Kedokteran Masyarakat· 0 citations
Typhoid fever remains a vaccine-preventable cause of childhood and adolescent morbidity in settings with limited water, sanitation, diagnostic capacity, and treatment capacity. We used Global Burden of Disease Study 2021 estimates to assess typhoid fever burden among individuals aged 0-19 years in 204 countries and territories from 1990 to 2021, with projections to 2045. We analyzed prevalence, incidence, deaths, and disability-adjusted life-years (DALYs); estimated average annual percentage changes using joinpoint regression; decomposed changes into epidemiological and demographic components; assessed Sociodemographic Index (SDI)-related inequality using the Slope Index of Inequality and Concentration Index; benchmarked countries against SDI-adjusted incidence frontiers; and projected future burden using Bayesian age-period-cohort models. Globally, the age-standardized incidence rate declined from 653.07 per 100,000 population in 1990 to 194.81 in 2021, while incident cases decreased from 14.76 million to 4.98 million. Deaths declined from 152,567 to 69,364, and DALYs from 12.93 million to 5.86 million. Despite these reductions, the burden remained concentrated in South Asia, sub-Saharan Africa, Oceania, and low- and low-middle-SDI settings. In 2021, South Asia accounted for 3.37 million incident cases, 44,095 deaths, and 3.74 million DALYs. Decomposition showed that declining age-specific rates drove global reductions, whereas population growth partly offset gains in lower-DI settings. Negative inequality indices indicated persistent concentration of burden among lower-SDI countries. Frontier analysis identified large excess-incidence gaps in South Asia, Oceania, Southeast Asia, and parts of sub-Saharan Africa. Projections suggested continued global reductions under historical-trend assumptions but persistent concentration in South Asia and widening uncertainty. Integrated typhoid conjugate vaccine scale-up, water and sanitation investment, diagnostic strengthening, and antimicrobial-resistance surveillance remain priorities for equitable typhoid control.
Kui Wang, Shanshan Zhang· Foodborne pathogens and dise...· 0 citations
ABSTRACT Background Crimean–Congo hemorrhagic fever (CCHF) remains a significant zoonotic and public health threat in endemic regions, including Iraq, which has experienced repeated outbreaks over the past decade. Recent surveillance data suggest evolving transmission dynamics influenced by climatic variability, ecological conditions, and the intensity of public health interventions. Objective This study aimed to describe the epidemiological trends of laboratory‐confirmed CCHF cases in Iraq from 2023 to 2025, characterize the distribution of cases across time and provinces, and assess the potential influence of seasonal factors and combined risk communication and community engagement (RCCE) interventions. Methods A descriptive ecological study was conducted using aggregated laboratory‐confirmed Crimean–Congo hemorrhagic fever (CCHF) surveillance data collected by the Iraqi Ministry of Health and supplemented with reports from the World Health Organization (WHO) and collaborating public health partners. Temporal and geographic distributions of confirmed cases reported during 2023–2025 were summarized descriptively. Public health response activities, including risk communication and community engagement (RCCE), vector control, laboratory strengthening, and clinical preparedness, were reviewed to provide epidemiological context. No analytical methods were performed to evaluate intervention effectiveness or infer causal relationships. Results Although Iraq remains endemic for CCHF, a marked reduction in confirmed cases was observed in 2024 and 2025 compared with 2023. The decline was particularly evident during early transmission periods and coincided with delayed seasonal onset, increased rainfall, and the early implementation of coordinated multisectoral prevention campaigns initiated in 2024/2025. Enhanced collaboration between human and veterinary health sectors, expanded laboratory diagnostic capacity, and intensified public awareness campaigns were temporally associated with this reduction. Conclusion The observed decline in CCHF burden during 2024/2025 compared with 2023 coincided with intensified multisectoral interventions, particularly strengthened RCCE activities. These findings underscore the critical role of early, coordinated, and climate‐sensitive public health responses, as well as sustained RCCE strategies, in mitigating CCHF transmission in the absence of a licensed human vaccine. Continued cross‐sectoral collaboration among human, animal, and environmental health systems is essential to prevent future outbreaks in Iraq.
Sirwan Sleman, Zaniar A Abass, Masood B Ameen et al.· Health Science Reports· 0 citations