Rapid changes in urbanization in India have paralleled increased prevalence in noncommunicable diseases (NCDs), including type 2 diabetes (T2D), hypertension (HTN), and obesity. To examine sex-specific temporal trends in the prevalence of T2D, HTN, general obesity (GO), and abdominal obesity (AO) among urban populations in India since 2000, a systematic review and meta-analysis was conducted in accordance with a registered Prospective Register of Systematic Reviews protocol (CRD42024548962). PubMed, Global Health (via EBSCOhost), Embase, Scopus, and Web of Science were searched for studies from 2000-2025 (initial search: October 12, 2024; update: July 4, 2025). Eligible studies were cross-sectional and reported the prevalence of T2D or HTN or obesity in urban Indian populations. Screening, data extraction, and risk-of-bias assessment using the Hoy tool were performed independently by 2 reviewers, with a third resolving conflicts. Pooled prevalence was estimated via random-effects meta-analysis in R (version 4.5.3), with forest and funnel plots generated using ggplot2. Out of 3143 records screened, 57 studies were included. The pooled prevalence demonstrated upward trajectory. T2D rose from 13% in 2000-2005 to 21% in 2021-2025, and HTN from 29% to 31%. For obesity, GO increased from 24% in 2000-2005 to 36% in 2016-2020, while AO rose from 47% to 72% over the same period. Sex-stratified analyses showed greater increases among males for T2D and HTN, whereas AO increased more among females. These findings underscore increasing T2D, HTN, and obesity in urban India, highlighting the need for strengthened primary care and supportive environmental and policy measures address the urban NCD burden.
High-density lipoprotein nHDL) is a highly heterogeneous lipoprotein with multiple physiological functions. However, observational studies present conflicting evidence regarding its association with various diseases. This study systematically summarizes evidence from Mendelian randomization (MR) studies to investigate the causal relationships between HDL-related biomarkers and a wide spectrum of disease outcomes. We systematically searched multiple databases up to November 2024. The causal relationship between HDL and 158 diseases was studied. Findings reveal that the role of HDL is highly disease-specific. Genetically predicted higher HDL levels are protective against the majority of circulatory and digestive system diseases. Conversely, they are associated with an increased risk of certain conditions, including breast cancer, intracerebral hemorrhage, and age-related macular degeneration. MR analyses revealed inconsistent and sometimes conflicting findings for several disease outcomes, notably including Alzheimer's disease. This review underscores the context-dependent nature of HDL's effects, which may be driven by factors like HDL particle heterogeneity and functional transformation into a pro-inflammatory state. Future research should move beyond concentration-based metrics to focus on HDL functionality and precise subtyping to fully understand its role in disease etiology.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne viral disease with a high fatality rate among older adults. It is posing a growing public health threat across Asia, with increasing potential for geographic spread beyond the region. Control efforts remain largely confined to individual-level tick-bite prevention, reflecting persistent gaps in understanding the ecological mechanisms that sustain SFTS transmission, particularly how environmental factors shape transmission dynamics across vectors, animal reservoirs, and human populations. We systematically reviewed 2910 studies to synthesize evidence on associations between environmental factors and SFTS occurrences across populations. Temperature, humidity, precipitation, elevation, and land cover are consistently linked to human SFTS occurrence through nonlinear, often reverse-U-shaped, relationships, underscoring the need for analytical frameworks capable of capturing the inherently nonlinear nature of environmental influences. However, we identified no quantitative assessments of how environmental factors shape SFTS occurrence in vectors or animal reservoirs, nor any stage-specific assessment of how these factors act across the transmission cycle, leaving multifaceted environmental effects acting across the tick-animal-human interface collapsed into oversimplified estimates based solely on human cases. To address these critical gaps, research must prioritize stage-specific elucidation of environmental drivers across the SFTS transmission cycle through mechanistic modeling approaches integrated with transboundary surveillance under a One Health framework. As climate and land-use changes continue to reshape vector habitats and expand regions at risk, such efforts will be essential for enhancing ecological understanding and guiding One Health-grounded surveillance and control strategies that can mitigate the growing transboundary burden of SFTS.
Gastrointestinal (GI) diseases represent a significant global health burden, and emerging evidence suggests air pollution may be a risk factor. We reviewed relevant literature and performed a meta-analysis. We searched original studies investigated the associations between long- and short-term exposure to particulate matter (diameter ≤ 2.5 µm [PM2.5], ≤ 10 µm [PM10]) and gaseous pollutants (nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone [O3]) and GI diseases. DerSimonian and Laird random-effects meta-analyses were conducted when at least 2 studies were available for a given pollutant (per 10 μg m-3 increment) and a specific GI disease. A total of 70 studies were included. Long-term exposure to PM2.5 was significantly associated with increased mortality rate from all GI cancers (OR = 1.128; 95% CI, 1.019-1.248), with the strongest association observed for colorectal cancer (OR = 1.214; 95% CI, 1.061-1.389). For non-cancer GI diseases, long-term exposure to PM2.5 was significantly associated with increased risks of duodenal ulcer (OR = 1.073; 95% CI, 1.057-1.089) and irritable bowel syndrome (OR = 1.353; 95% CI, 1.222-1.497); PM10 was also linked to the latter (OR = 1.108; 95% CI, 1.012-1.213). Short-term exposure, particularly to PM2.5, PM10, and O3, was significantly associated with appendicitis hospitalization (OR = 1.003 [95% CI, 1.001-1.004]; OR = 1.017 [95% CI, 1.015-1.019]; and OR = 1.001 [95% CI, 1.000-1.003], respectively). PM2.5 was also associated with peptic ulcer bleeding (OR = 1.006; 95% CI, 1.001-1.011). Long- and short-term exposures to air pollution, especially PM2.5, are associated with increased risks of GI diseases.
Digital solutions are essential for eliminating tuberculosis as a public health problem. They can be applied across all stages of patient care, health surveillance, program management, workforce development, and community engagement. In this study, we aimed to identify and map digital solutions for tuberculosis developed and/or validated within the context of primary health care. We retrieved studies from Medline, Scopus, Embase, Web of Science, and Google Scholar that focused on digital solutions for tuberculosis, targeting managers, health professionals, or patients. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines to review, synthesize, and report the findings of articles that met our inclusion criteria. Of 3133 identified publications, 96 were included after full-text screening. Most solutions focused on treatment monitoring and adherence (n = 46 studies). There was particular emphasis on electronic directly observed therapy, smart pillboxes, and mobile applications. Artificial intelligence-based solutions also emerged that were applied to diagnosis, prediction of treatment nonadherence, and prognosis. The findings show that digital solutions have evolved from simple tools to advanced artificial intelligence models. We conclude that the systematic incorporation of these technologies into national protocols is crucial to accelerate progress toward the targets established by the End TB Strategy.
People with disability experience health inequities and mostly live in low- and middle-income countries (LMICs), because that is where most of the world's population resides. Despite this, existing evidence on health equity for people with disability mostly comes from high-income settings. Monitoring and evaluation of health equity are crucial for countries to address and track progress toward goals, such as the highest attainable standard of health for people with disability. This scoping review summarizes the available literature on approaches and indicators used in LMICs to evaluate health-related outcomes between people with and without disability. Peer-reviewed articles were included that were published between 2008 and 2024 that compared health-related outcomes between these 2 populations. We identified 59 eligible studies from a broad range of LMICs. Disability indicators varied, with most studies using 1 of multiple Washington Group question sets to enable disaggregation of data by disability status. Survey data were the type most frequently used; only 2 studies used administrative data. A wide range of health-related outcomes were explored; themes of maternal and child health and HIV-related outcomes emerged as key areas of focus. Disparities were consistently found, with almost all included studies reporting poorer outcomes for people with compared with people without disability. There was a noticeable lack of action taken to improve future policy or monitoring and evaluation or to enact real and meaningful change in health equity for people with disability.
Persistent inequities in the social determinants of health contribute to poor health outcomes among people with disability. People with disability are more likely to live in unaffordable housing, which is associated with increased risk of chronic conditions and poor mental health. However, there is limited research on how housing affordability affects health in this priority population. We undertook a scoping review to evaluate existing evidence on the health impacts of living in unaffordable housing for people with disability. Peer-reviewed literature published in English between 2004 and 2024 was considered. The MEDLINE, SocIndex, and Web of Science databases were searched to identify studies examining possible links between housing affordability and any health outcome in a population of people with disability. Two independent reviewers performed study screening and data extraction. Of the 1386 studies identified initially, 3 met the eligibility criteria. The included studies focused on individuals with acquired, psychiatric, or military-related disability. Each study provided evidence suggesting unaffordable housing negatively affected mental health in people with disability. Substantial methodological and conceptual heterogeneity limited direct comparison or synthesis. This review highlights a critical knowledge gap in the relationship between housing affordability and health for people with disability, limiting the development of evidence-informed policy and intervention. People with disability have a fundamental right to access affordable, appropriate housing, as well as the right to the highest attainable standard of health. High-quality, targeted research using consistent definitions of disability and housing affordability, as well as validated health outcome measures, is needed to inform future policy.
HPV-induced oropharyngeal cancer (HPV-OPC), caused by persistent infection with high-risk subtypes such as HPV16 and HPV18, poses a significant global health challenge. Epidemiological research on HPV-OPC focuses on prevention, detection, distribution, and disease incidence, revealing an increasing OPC burden related to HPV exposure. The objective of this study was to identify research hotspots and trends in HPV-OPC epidemiology, highlighting the role of epidemiology in guiding prevention and control strategies. A bibliometric analysis of 960 articles (published between 1987 and 2025) from the Web of Science Core Collection, SCOPUS, and PubMed Central was performed, using Python to assess collaborations across countries, institutions, and individuals, as well as literature citation, research timelines, and clustering. Results show a substantial increase in publications, especially from 2013 to 2025, with researchers in United States and China as leading contributors and identifies several prolific authors. Research has primarily focused on HPV vaccination, screening, attributable fraction, and incidence prediction, though challenges such as data quality, vaccination efficacy, limited resource, and modeling limitations also are foci. Future directions include improving data reliability, promoting early and direct vaccination, strengthening international funding, and integrating multiple models. This bibliometric study provides valuable insights into research hotspots and future directions in HPV-OPC, offering researchers and clinicians an overview of current situations and future developments in HPV-OPC epidemiology, potentially improving HPV vaccination and screening strategies and promoting preventive and diagnostic approaches to reduce OPC incidence.
Loneliness and social isolation are emerging public health concerns among young adults, yet the role of community and societal factors remains poorly understood. Existing research has predominantly focused on individual or interpersonal determinants. This systematic review synthesized observational evidence on community- and societal-level factors associated with loneliness and social isolation among young adults aged 18-30 years. Five databases were searched for observational studies examining place-based community or societal exposures and loneliness or social isolation outcomes. Thirteen eligible studies were identified, and a structured narrative synthesis was undertaken. The exposure variables explored were diverse. Neighborhood characteristics (including trust, safety, and atmosphere), community participation, cultural and societal norms, and structural conditions demonstrated consistent associations with loneliness. Greater neighborhood cohesion, safety, and belonging were protective, whereas neighborhood disorder, minority status, perceived discrimination, and individualistic cultural orientations were associated with greater loneliness. Evidence for social isolation was sparse and methodologically heterogeneous, though area-level disadvantage and remoteness showed emerging relevance. Most studies had a cross-sectional design, and the ways loneliness and social isolation were measured across studies were heterogenous. Community and societal determinants meaningfully shape young adults' experiences of loneliness, but evidence for social isolation remains limited. Findings highlight the need for longitudinal research, improved consistency in the use of measurement tools, and further examination of moderators between individual factors and community influences, which will all contribute to the development of multilevel public health strategies addressing structural and neighborhood conditions.
Hepatitis E virus (HEV) infection can progress to chronic hepatitis in immunosuppressed individuals. The seroprevalence of hepatitis E among people living with HIV remains controversial. In this systematic review and meta-analysis, the pooled global seroprevalence of hepatitis E among people living with HIV is estimated. This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and was registered in PROSPERO. Searches were conducted in the PubMed, Embase, and Web of Science databases. The seroprevalence of hepatitis E (anti-HEV IgG) among people living with HIV was estimated by meta-analysis using the random-effects model. Subgroup meta-analyses were performed for each continent. A total of 88 studies from 5 continents were included; most were conducted in European countries (48.9%). The pooled seroprevalence of HEV infection was 16.0% (95% CI, 13.0-18.0; I2 = 97.7%). Subgroup analyses revealed seroprevalence rates of 12.0% in Europe, 24.0% in Asia, 19.0% in Africa, and 11.0% in the Americas, and a notably high prevalence was observed in low-income countries (37.0%). Sensitivity analyses restricted to studies with sample sizes of more than 200 participants and risk of bias score ≥ 7 indicated seroprevalence estimates of 18.0% and 15.0%, respectively. In conclusion, this meta-analysis demonstrates a pooled global seroprevalence of HEV infection of 16.0% among people living with HIV, ranging from 11.0% to 24.0% across the continents.
Chronic pain is the leading cause of disability worldwide and chronic neuropathic pain (NP) disproportionately affects individuals with unmet health care needs, especially those facing health inequities. This scoping review addresses 3 research questions: (1) What are the characteristics and outcomes of cognitive behavioral therapy (CBT), mindfulness, and meditation-based intervention studies designed to manage NP? (2) Do these intervention studies include participants from populations experiencing health inequities? (3) Are the interventions customized to meet the needs of people experiencing health inequities? Ten databases were searched for studies focused on the search terms "cognitive behavioral therapy," "CBT," "mindfulness meditation," "and neuropathic pain." In total, 1732 abstracts were screened and a total of 24 articles from 22 original studies were included. The primary characteristics of the studies showed that 99% of participants had NP attributable to diabetes, cancer, or spinal cord injury. Outcomes were consistent with previous reviews, demonstrating promise for CBT, mindfulness, and meditation-based therapies in relieving NP. However, demographics were poorly reported, and there was little diversity among participants. Individuals from groups experiencing health inequities were largely unrepresented. Although 55% of studies tailored intervention materials and provided content to support long-term practice, few included long-term follow-up to evaluate sustained impact. In general, research on this topic has fallen short in including and addressing the needs of people experiencing health inequities. Future research should prioritize broader participant inclusion criteria, involve individuals with lived experience in intervention design and delivery, and conduct long-term follow-up to enhance the accessibility, relevance, and sustainability of NP interventions.
High-density lipoprotein (HDL) is a highly heterogeneous lipoprotein with multiple physiological functions. However, observational studies present conflicting evidence regarding its association with various diseases. This review systematically summarizes evidence from Mendelian randomization (MR) studies to investigate the causal relationships between HDL-related biomarkers and a wide spectrum of disease outcomes. We systematically searched multiple databases up to November 2024. The causal relationship between HDL and 158 diseases was studied. Findings reveal that the role of HDL is highly disease-specific. Genetically predicted higher HDL levels are protective against most circulatory and digestive system diseases. Conversely, however, they are associated with an increased risk of certain conditions, including breast cancer, intracerebral hemorrhage, and age-related macular degeneration. The MR analyses revealed inconsistent and sometimes conflicting findings for several disease outcomes, notably Alzheimer's disease. This review underscores the context-dependent nature of HDL's effects, which may be driven by factors like HDL particle heterogeneity and functional transformation into a pro-inflammatory state. Future research should move beyond concentration-based metrics to focus on HDL functionality and precise subtyping to fully understand its role in disease etiology.
Administrative data, including electronic health record (EHR) and claims data, are increasingly used to generate real-world evidence for epidemiologic research. Unlike clinical trials, which assess baseline conditions at the initial visit, observational studies using these data must define an appropriate look-back period to identify baseline characteristics. However, to our knowledge, no established guidelines exist on the optimal length of look-back periods by clinical outcome. We conducted a scoping review, with a lens on methodological studies, to assess the frequency and variability of look-back periods used in epidemiologic studies. We searched PubMed for studies that used look-back periods using EHRs, claims data, or international registries. Our search yielded 262 studies spanning a broad range of clinical outcomes. Look-back periods varied substantially, ranging from 12 hours to 39 years, depending on the clinical outcome. The most common clinical areas included pharmacology, cardiovascular disease, cancer, and health care utilization. Our review underscores the need for tailored look-back periods based on the clinical context; we suggest a one-size-fits-all approach may be inadequate. Research should focus on the impact of look-back periods on less-studied outcomes. This review provides a resource for researchers to make informed decisions on the appropriate look-back periods in epidemiologic studies using administrative data.
Hysterectomy is the most frequently performed nonobstetric surgery in women. Women with disabilities face barriers to reproductive health care, and little is known about their hysterectomy risk. The objective of this systematic review was to compare hysterectomy risk among women with and without disabilities. We searched the MEDLINE, Embase, PsycInfo, and CINAHL Plus databases from inception to May 2024 using validated search strategies. We included peer-reviewed observational studies that compared hysterectomy in women with physical, sensory, cognitive, and intellectual or developmental disabilities with those without disabilities. Study characteristics and data were extracted using a standardized form; the Newcastle-Ottawa Scale (NOS) was used for quality assessment. Study findings were summarized narratively following Synthesis Without Meta-analysis guidelines. The search yielded 3686 unique records, of which 5 met our criteria. These included 1 retrospective cohort and 4 cross-sectional studies, which were conducted in the United States (n = 3), Canada (n = 1), and South Korea (n = 1), and ranged in size from 881 to 42 842 participants. Evidence from 4 studies indicated hysterectomy frequency was higher among women with disabilities (range: 6.1% to 22.8%) compared with those without disabilities (range: 2.2% to 18.6%). Three studies suggested the disparity in hysterectomy was greatest among premenopausal women. Quality assessment scores on the NOS ranged from 0 to 8 (median, 3), with limitations mostly related to measurement of the exposure and outcome. The limited research on this topic points to the need for more studies on hysterectomy among women with disabilities, given historical reproductive injustices faced by this population.
The large number of people infected by SARS-CoV-2 necessitates estimation of the future health care burdens. We updated a systematic review examining associations between SARS-CoV-2 infection and incidence of new diagnoses and exacerbations of chronic conditions. Updated searches were run September 4, 2024, in the MEDLINE and Embase databases for observational studies with a control group, adjustment by sex and comorbid conditions, and reporting age-stratified data for 1 or more chronic condition category (n = 12) or condition type (n = 46) of interest. Two human reviewers screened 50% of titles and abstracts, then DistillerAI acted as second reviewer. Two human reviewers assessed full texts of relevant studies for eligibility based on a priori criteria. One reviewer extracted data and assessed risk of bias using the JBI cohort studies checklist; a second reviewer verified results data and risk-of-bias assessments. Pooled hazard ratios (HRs) were estimated with inverse-variance weighting. Using the Grading of Recommendations, Assessment, Development, and Evaluation approach, 2 reviewers assessed certainty in conclusions of little to no association (ie, HR = 0.75-1.25), small to moderate association (ie, HR = 0.51-0.74 or 1.26-1.99), or large association (ie, HR ≤ 0.50 or ≥ 2.00). We identified 46 new studies and brought forward 23 studies from the original review. After SARS-CoV-2 infection, there is probably increased risk of new diagnoses for several chronic conditions, especially in adults. Most findings are based on data from earlier pandemic periods; their relevance to contemporary populations is uncertain due to differences in vaccination rates and circulating variants of concern. PROSPERO registration identifier CRD42024585278.
Dietary fiber plays a key role in preventing chronic diseases, but sex disparities in its health effects remain unclear. This meta-analysis examined the associations between fiber intake and chronic disease risk in men and women; cohort studies reported on in published articles found in the PubMed, Web of Science, and Embase databases were reviewed up to July 2025. Among 2 408 576 participants (n = 1 035 449 men and 1 392 820 women) from 20 studies, higher fiber intake was linked to reduced chronic disease risk in both sexes, with a pooled hazard ratio (HR) of 0.80 (95% CI, 0.75-0.84) for men and 0.83 (95% CI, 0.76-0.91) for women. Notably, fiber significantly lowered cancer risk only in men (HR = 0.81; 95% CI, 0.75-0.87). Grains and vegetable fiber reduced chronic disease risk in men (HR = 0.90 and 0.86, respectively), whereas no specific fiber source had significant benefits for women. In conclusion, although dietary fiber significantly reduced the risk of chronic diseases for both sexes, the threshold for observing beneficial effects is lower in men compared with women, in whom its impact may be more susceptible to confounding factors. More research is needed to clarify sex-specific dietary recommendations for chronic disease prevention.
Bloodstream infection (BSI) can be a serious complication among injured patients. Understanding the burden of injury-related BSI is important for early detection and implementing appropriate treatments to improve patient outcomes. Incidence rates and risk factors are important measures that help provide insights into the burden of injury-related BSIs and early diagnosis of patients. In this review, the aim was to comprehensively summarize incidence rates and risk factors for injury-related BSIs from scientific literature. Four electronic databases (PubMed, CINAHL [via EBSCOhost], Embase, and Web of Science) were searched. There were no limitations on the language. Studies reporting the incidence rates or risk factors associated with incidence or adverse outcomes from injury-related BSIs were included. Database searches returned 9830 articles, of which 48 were included. Incidence rates of injury-related BSIs ranged from 0.71 to 27.4 episodes per 1000 patient-days. A total of 237 potential factors associated with the development and/or outcomes of injury-related BSIs were identified and classified into 8 broad categories: demographics, prognostic scores, burn extent, clinical and patient health factors, biomarkers, resource utilization and treatments, pathogens and injuries, and mechanisms. Older age, male sex, higher injury severity score, longer length of stay, greater total body surface burn area, and inhalation injuries were the most frequently reported risk factors. This review identified a large variation in reported incidence rates but no population-based studies. Many factors have been associated with injury-related BSIs; however, the direction of association and effect sizes vary across the studies, which can be attributed to the differences in study design.
COVID-19 has transitioned from a pandemic to an endemic state, but the emergence of novel variants continues to pose significant public health challenges. In this study, the application of spatial and spatiotemporal machine learning (ML) models in understanding the dynamics of COVID-19 was systematically reviewed, as were contextual local-level comprehensive socio-environmental drivers. A systematic search was conducted across the Scopus, Web of Science, PubMed, Emcare (via Ovid), and the World Health Organization COVID-19 databases, and gray literature, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction was conducted according to the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist, and study quality was assessed using a validated scoring system. A total of 42 studies met the inclusion criteria. The review Findings indicate that global-scale spatial and spatiotemporal ML models dominate the field. Long-standing standalone factors in the demographic, environmental, and socioeconomic domains are frequently used as local-level drivers. However, the integration of composite indicators, aggregating multiple standalone factors into a single score, is notably lacking. Such composite indicators have the potential to reduce model complexity, improve interpretability, and enhance performance by capturing multidimensional aspects of vulnerability or risk in a more simplified form. This review highlights critical gaps in the current use of spatial and spatiotemporal ML models to understand the spatial epidemiology of COVID-19. Addressing these gaps could significantly enhance the understanding of COVID-19 dynamics and inform the development of effective public health strategies to mitigate future threats.
This systematic review was conducted to identify effect modification and interaction factors that moderate the association between socioeconomic status (SES) and smoking behavior among adolescents. We searched the PubMed, Embase, PsycINFO, and Web of Science databases using keywords including "adolescents," "smoking," "inequality," "effect modification," and "interaction." Peer-reviewed articles published in English or French between January 1, 2011, and December 31, 2021, were included, as were relevant studies identified from reference lists. Of 3485 articles, 23 met the eligibility criteria. All reported quantitative observational study designs to identify factors that modify the SES-smoking behavior association. Two independent reviewers extracted data from each article, using a standardized form. Reporting quality was assessed using the Strengthening the Reporting of Observational Articles in Epidemiology guidelines. Of 23 studies, 13 reported statistically significant moderation associations. The most frequently studied moderators were race/ethnicity (n = 5; significant in 4) and sex (n = 5; no significant associations). Contextual factors, including school-level SES (n = 2; significant in 1), neighborhood SES (n = 2; significant in both), and peer influence (n = 2; significant in both), were also examined. Time trends (n = 2), country-level factors (n = 2), and social capital (n = 1) were significant moderators in the few studies that investigated them. Methodologically, adherence to best practices was limited. This review highlights the need for use of a wider range of SES measures, exploration of understudied potential moderators, and consistent adherence to standardized methodologies to better inform public health interventions addressing adolescent smoking inequalities.
The Gulf Cooperation Council (GCC) countries face a substantial impact from the increasing prevalence of diabetes mellitus, which experts identify as a major public health challenge in the region. Despite the escalating burden of diabetes mellitus and its related complications, including diabetic foot disease (DFD), there are noteworthy knowledge gaps concerning the prevalence and trends of DFD in the GCC countries. Furthermore, there is insufficient understanding of the management of DFD within health care settings in this region. The objective of this scoping review is to comprehensively assess the extent and nature of DFD management across different health care settings in GCC countries. The study will use the population, concept, and context framework: the population of interest is individuals with DFD, the concept is the management or treatment of DFD or its complications, and the context includes the GCC countries. The review will include published articles and unpublished quantitative and qualitative research papers, from 1981 onward, aligning with the establishment of the first multidisciplinary team diabetic foot clinic at King's College Hospital, London. The scoping review will follow guidelines from Joanna Briggs Institute (JBI) and be reported following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews Checklist. A comprehensive search will be conducted, across various databases including CINAHL, MEDLINE (Ovid), Embase, Scopus, Cochrane CENTRAL, PsycINFO, Global Health, and the Arabic database Al Manhal, and gray literature sources. Studies in Arabic and English language will be included. A data extraction tool will be used to extract the data and will enable a chronological narrative synthesis of results.
