Abstract Background Self-swab enhanced surveillance of respiratory pathogens is an emerging public health tool that could expand the reach of existing surveillance, providing real-time monitoring of circulating pathogens in the community. Methods We conducted a literature search using terms covering self-swabbing, respiratory infection, and surveillance. For inclusion, publications had to describe a study on the use of serial unsupervised self-swabbing for the purpose of tracking the frequency of respiratory infections in the general population. Results We found 42 publications originating from 27 unique studies on self-swab enhanced surveillance for respiratory infection. Twenty-six studies (96%) were conducted in a high-income setting. Eleven studies (41%) included children under the age of 12 years. Most studies involved a central laboratory conducting polymerase chain reaction testing on returned self-swabs which permitted testing for a wide range of pathogens. Among studies reporting the number of invitees, <20% of invited individuals typically agreed to join. In studies requiring regular symptom reporting, adherence was commonly >75%. Adherence rates for self-swab return were more variable (between 42-96%). Eight studies (30%) explored rapid antigen testing which appears to reduce the time taken between symptom onset and test result notification but limits the number of pathogens that can be evaluated compared with polymerase chain reaction testing. Based on our findings we present a list of suggestions to guide future implementation and investigation. Conclusions Further work is needed to characterise self-swab enhanced surveillance approaches that optimise community participation and protocol adherence, generate as close to real-time data as possible, and minimise costs.
Abstract With the aim to identify risk factors associated with bloodstream infections (BSI) caused by carbapenem-resistant Enterobacterales (CRE) in patients with hematological malignancies (HM), a systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251176369). MEDLINE, PubMed, and Embase were searched for studies published up to 31 October 2025. Observational studies evaluating risk factors for laboratory-confirmed CRE BSI in adult or paediatric patients with HMs were included. Adjusted and unadjusted effect estimates were analysed separately. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models based on heterogeneity. Six studies were included. In meta-analyses based on adjusted estimates, prior exposure to carbapenems (OR 8.01, 95% CI 2.98–21.54), cephalosporins (OR 4.11, 95% CI 1.53–11.05) and fluoroquinolones (OR 3.94, 95% CI 1.83–8.44) resulted to be associated with CRE BSI. Meta-analyses of crude data showed additional associations with CRE colonization, previous infections, newly diagnosed disease or first relapse, chronic liver disease, diabetes mellitus, and prior exposure to multiple antibiotic classes. Prior exposure to carbapenems, cephalosporins, and fluoroquinolones was consistently associated with CRE BSI in adjusted analyses. However, the small number of included studies and the wide confidence intervals limit the precision and generalizability of these estimates. Previous antibiotic exposure should therefore be considered as part of an integrated risk assessment together with colonization status, previous microbiological findings, clinical severity, and local epidemiology, rather than as a stand-alone criterion for empirical therapy.
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.
