Abstract Background Hemorrhagic fever with renal syndrome (HFRS) is a climate-sensitive zoonotic disease that poses a significant public health burden worldwide. While previous studies have established associations between meteorological factors and HFRS incidence, there remains a critical knowledge gap regarding the heterogeneity of these effects across diverse epidemic regions. Addressing this gap is essential for developing region-specific prevention and control strategies. This study conducted a national investigation to examine the associations between meteorological factors and HFRS in three distinct epidemic regions. Methods We collected daily meteorological data (temperature and relative humidity) and HFRS incidence cases of 285 cities in China from the Resource and Environment Science and Data Center and the Chinese National Notifiable Infectious Disease Reporting Information System from 2005–2022. Study locations were stratified into three distinct epidemic categories (Rattus-dominant, Apodemus-dominant, and mixed) based on the seasonality of peak incidence. The associations between meteorological variables and HFRS incidence were investigated using a time-stratified case-crossover design combined with distributed lag nonlinear modeling for each epidemic category. Results The exposure-response relationships between meteorological factors and HFRS incidence revealed significant heterogeneity across epidemic regions, as evidenced by Cochran’s Q test for temperature (Q = 324.40, P < 0.01) and relative humidity (Q = 30.57, P < 0.01). The optimal daily average temperature for HFRS transmission in Rattus-dominant epidemic regions (− 6.6 °C), characterized by spring epidemics, was lower than that observed in Apodemus-dominant epidemic regions (13.7 °C), where primary cases occurred during autumn and winter months. Furthermore, the association between relative humidity and HFRS incidence exhibited as a monotonic negative correlation in Rattus-dominant regions, while Apodemus-dominant regions showed a nonlinear, inverted U-shaped association. Conclusions This study highlights the heterogeneous effects of meteorological factors on HFRS incidence across different epidemic regions. Targeted preventive measures should be taken during cold and dry spring days in Rattus-dominant regions, and during warm and moderately humid winter days in Apodemus-dominant regions. In mixed epidemic regions, both scenarios require attention. These findings provide novel scientific evidence for the formulation and implementation of region-specific HFRS prevention policies. Graphical Abstract
Introducción: El desgaste proteico-energético es común en el paciente renal, ocasiona deterioro en la calidad de vida y, disminuye la supervivencia a corto plazo. Una dieta inadecuada desencadena complicaciones en el tratamiento de la enfermedad renal crónica y mala calidad de vida en pacientes en hemodiálisis. Objetivo: Evaluar la prevalencia del desgaste proteico-energético y calidad de la dieta de pacientes en hemodiálisis de la Unidad de Hemodiálisis del Hospital General Renacimiento de Acapulco, Guerrero. Material y Método: Estudio observacional transversal con enfoque cuantitativo, se evaluó el desgaste proteico-energético con los criterios de la Sociedad Internacional de Nutrición Renal y Metabolismo Mineral y se determinó la calidad de la dieta con el cuestionario Short Diet Quality Screener. Resultados: Se incluyeron 79 pacientes con edad promedio de 54.9 ± 1.5 años. 36.7% de la población presentó desgaste proteico-energético y 62.07% de los pacientes con desgaste proteico-energético presentó calidad de la dieta inadecuada. Los pacientes con desgate proteico-energético presentaron peso seco promedio de 54.4 ± 1.64 kg, esto es 8.9 kg menos que aquellos que no tienen desgaste proteico-energético (p<0.05). Conclusión: Se encontró prevalencia elevada de desgaste proteico-energético, así como alta frecuencia de calidad de la dieta inadecuada.
Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures. Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed. A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide “J”-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0–11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95
The main cause of anemia in the preschool population is dietary iron deficiency; however, there are other conditions that can lead to anemia such as diseases that produce chronic inflammation and obesity. The objective was to evaluate the prevalence of anemia and iron deficiency in children aged 6 to 59 months and the association with inflammation, global overweight and maternal educational level. A national sample of cross-sectional study design was carried out. Hemoglobin, ferritin, soluble transferrin receptors, leukocytes, C-reactive protein, and alpha-1 acid glycoprotein were assessed. Nutritional status was evaluated and level of mother education was collected by survey. A total of 1417 children were studied. Anemia prevalence was 22.5% and constitutes a moderate public health problem. Iron deficiency prevalence was 35.6% and erythropoietic dysfunction 13.3%; with elevated inflammation indicators 37.6% and leukocytosis 36.1%. Malnutrition occurred in 1.0% of the children, with a prevalence of overweight in 4.7% and obesity in 2.8%. Anemia was associated with iron storage deficiency OR=2.07 (1.45-2.97) and inflammation OR=2.01 (1.45-2.78). No associations were found between anemia OR=0.68 (95% CI= 0.35-1.32) and iron deficiency OR=0.96 (95% CI= 0.68-1.35) with global overweight. Global overweight does not explain the inflammation found OR=1.13 (95% CI= 0.54-2.37), neither by CRP OR=0.57 (0.24-1.37) or AGP OR=1.14 (0.54-2.42). Low education level of the mother was associated with anemia in the children (χ2 trend= 4.327 p=0.037), but not with iron deficiency (χ2 trend= 0.212 p=0.646). Anemia and iron deficiency in Cuban preschool children was a moderate public health problem associated with inflammation.
Objetivo Indagar los modos en que las familias y referentes sociales adoptaron diferentes políticas para enfrentar la inseguridad alimentaria de infancias vulnerables de la provincia argentina de Mendoza durante el aislamiento por COVID-19. Método Estudio exploratorio y cualitativo. La muestra intencional incluyó a adultos responsables de la alimentación de niños y adolescentes que residen en hogares que registraban inseguridad alimentaria antes de la pandemia. Se realizaron entrevistas semiestructuradas (abril a junio 2021) a madres y/o abuelas (n:27) y a referentes sociales (n:15). El análisis de la información se orientó por el método de comparación constante de Glaser y Strauss. Resultados Los adultos participantes de la investigación trabajan en la economía informal. Ante la crisis económica que desencadenó el aislamiento dispuesto por el Gobierno para prevenir el COVID-19, activaron redes de ayuda entre vecinos y organizaciones comunitarias en todos los espacios sociales estudiados. Comedores y merenderos barriales mantuvieron e incrementaron sus actividades en pandemia. Engeneral, la alimentación entregada por el estado provincial y nacional fue poco variada y se focalizó en alimentos no perecederos. Las transferencias monetarias ampliaron las opciones de acceso a la alimentación de los niños. Conclusiones Las políticas públicas implementadas para enfrentar la inseguridad alimentaria de las infancias en pandemia fueron significativas para las familias y referentes sociales entrevistadas. Sin embargo, manifiestan reparos que deberían contemplarse, de modo tal que el diseño de futuras políticas tenga en cuenta la subjetividad de sus destinatarios y fortalezca iniciativas y esfuerzos de las organizaciones barriales.
