CURRENT ISSUE

ABSTRACT: Coronary artery disease remains a major cause of death and disability worldwide. Chronic Coronary disease one of its most common clinical forms, reflects the combined effects of age, obesity, hypertension, diabetes, and other chronic conditions. This study analyzed national administrative data from Kazakhstan between 2014 and 2021 to explore trends in Chronic Coronary disease incidence, comorbidities, and mortality among patients coded under ICD-10 codes I20–I20.9 within the Unified National Electronic Healthcare System (UNEHS). A total of 624,852 patients with Chronic Coronary disease were identified through the national electronic health system. Demographic, clinical, and outcome indicators were examined to assess trends and disparities across sex, ethnicity, and place of residence. During the study period, the recorded incidence of Chronic Coronary disease decreased from 584 to 211 cases per 100,000 population, whereas the mortality rate rose from 19 to 100 per 100,000. The 2014 incidence figure should be interpreted with caution as it likely reflects a prevalent pool effect at the inception of systematic UNEHS data capture. Mortality was highest among men, older adults, ethnic Russians, and rural residents. Patients undergoing coronary artery bypass grafting showed better survival than those treated with percutaneous coronary intervention, though this comparison should be interpreted cautiously given potential confounding by indication. Hypertension, diabetes, and multiple comorbidities substantially increased the risk of death and adverse cardiovascular events. These results underline widening health inequalities and the urgent need for improved prevention, equitable access to care, and integrated management of chronic cardiovascular disease in Kazakhstan.

ABSTRACT: Background: Obesity is increasingly understood as a health outcome shaped by social conditions, yet evidence on socioeconomic inequalities in obesity in South Korea remains mixed, particularly with regard to lifestyle behaviours and sex differences.
Methods: This study uses pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2022–2024 (N=11,714 adults aged 19–64 years). Obesity was defined as body mass index ≥25 kg/m². Socioeconomic status (SES) was assessed using education, income, occupation, and a composite SES index. Lifestyle factors, including physical activity, smoking, alcohol consumption, sleep duration, and working hours, were included in sequential regression models to assess whether associations between socioeconomic status and obesity were attenuated after adjustment for these factors. Survey-weighted logistic regression models were estimated, with additional analyses stratified by sex.
Results: Lower socioeconomic status was associated with a higher likelihood of obesity, although the strength and pattern of this relationship differed between men and women. Among women, clear inverse gradients were observed across education, income, and the composite SES index. Among men, associations were weaker and less consistent. Adjustment for lifestyle factors attenuated several socioeconomic associations with obesity, although socioeconomic differences remained evident, particularly among women. The composite SES index showed more consistent associations than individual socioeconomic indicators.
Conclusion: Socioeconomic inequalities in obesity persist in South Korea and differ substantially by sex. Associations between socioeconomic status and obesity were attenuated after adjustment for lifestyle factors, although socioeconomic differences remained evident after adjustment. These findings highlight the importance of considering both behavioural and broader structural factors when addressing obesity inequalities.

ABSTRACT: Background: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease characterized by intense pruritus, xerosis, recurrent eczematous lesions, and impaired quality of life. Although AD is common in North Africa, data on its associated comorbidities in Algerian children remain scarce.
Objective: To characterize the clinical profile and associated comorbidities of pediatric atopic dermatitis in an Algerian cohort and to review current therapeutic advances.
Methods: We conducted a retrospective cross-sectional study including 53 children diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria at the Pediatric Dermatology Unit of the University Hospital of Oran, Algeria, between January 2025 and January 2026. Demographic characteristics, clinical manifestations, allergic comorbidities, family history, and quality of life assessed using the Children's Dermatology Life Quality Index (CDLQI) were analyzed.
Results: Atopic dermatitis represented 4.42% of all dermatology consultations during the study period. The mean age was 6.7 years, with a female predominance. Familial atopy was the most frequent comorbidity (90.6%), followed by familial asthma (49.1%) and familial eczema (43.4%). Among personal allergic comorbidities, asthma affected 26.4%, allergic rhinitis 24.5%, and allergic conjunctivitis 11.3% of patients. Personal atopy was significantly associated with asthma (OR = 7.9, 95% CI: 2.46–25.46), food allergy (OR = 6.2, 95% CI: 2.30–17.10), allergic conjunctivitis (OR = 4.1, 95% CI: 1.50–11.29), and allergic rhinitis (OR = 3.5, 95% CI: 1.38–9.22). Quality of life was markedly affected, with sleep disturbances reported in 92.5% of patients, stress and anxiety in 50.9%, reduced daily activities in 34.0%, and school absenteeism in 32.1%.
Conclusion: Pediatric atopic dermatitis in this Algerian cohort was characterized by a high burden of allergic comorbidities, a strong familial atopic background, and a substantial impact on quality of life. Early recognition of associated conditions and timely multidisciplinary management are essential to improve patient outcomes and may help reduce progression along the atopic march.

ABSTRACT: Effective vaccine communication has become a defining challenge of global health emergency preparedness, as scientific advances in vaccine development have not been accompanied by comparable gains in public trust. Experiences from recent outbreaks, particularly Ebola, COVID-19, and mpox, demonstrate that vaccine availability alone is insufficient to achieve high vaccine uptake when communication is inconsistent, misinformation proliferates, and public confidence in health institutions is weakened. This narrative review critically synthesizes current evidence to examine the determinants of public trust, evaluate the strengths and limitations of existing vaccine communication strategies, and identify priorities for future research and policy. The review highlights five interconnected determinants of effective vaccine communication: institutional transparency, evidence-based messaging, trusted community partnerships, digital information monitoring, and continuous communication adaptation. It further identifies persistent challenges, including reactive communication approaches, political polarization, inequitable access to trustworthy information, and the growing influence of artificial intelligence-driven misinformation. Current evidence is also limited by the predominance of cross-sectional studies, underrepresentation of low- and middle-income countries, and insufficient evaluation of long-term trust-building interventions. To address these challenges, we propose the Adaptive Vaccine Trust Communication (AVTC) Framework, which conceptualizes vaccine communication as a continuous adaptive process rather than a one-way transfer of information. By integrating institutional transparency, evidence-based messaging, trusted community partnerships, digital information monitoring, and continuous feedback, the framework provides a practical roadmap for strengthening public trust, improving vaccine confidence, and enhancing preparedness for future global health emergencies.

ABSTRACT: Introduction: Workplace stress among healthcare workers is a major occupational and public-health concern, yet post-pandemic evidence from Nigerian tertiary hospitals remains limited. This study assessed perceived stress, psychological distress and workplace stressors among healthcare workers in Abuja, Nigeria.
Methods: A cross-sectional descriptive study was conducted among 340 clinical healthcare workers in two public tertiary hospitals. Perceived stress, psychological distress and workplace stressors were measured using validated and structured questionnaires. Data were analysed using descriptive statistics, Spearman correlation and the Kruskal-Wallis test.
Results: Respondents were predominantly male (57.1%) and nurses/midwives formed the largest cadre (28.2%). The mean perceived-stress score was 25.5 ± 2.88; 36.2% reported high perceived stress and 63.8% reported moderate stress. Probable psychological distress was uncommon (6.8%; mean score 18.0 ± 3.1). Lack of essential equipment or supplies was the most frequently reported stressor (82.1% sometimes/often/always; mean 1.66 ± 0.9). Perceived stress was not significantly correlated with psychological distress (Spearman correlation coefficient = -0.031, p = 0.565). Only fear of litigation was significantly associated with higher perceived stress (Spearman correlation coefficient = 0.285, p = 0.01).
Conclusion: Healthcare workers reported elevated perceived stress, with organisational and resource-related conditions frequently reported. Probable psychological distress was uncommon and was not correlated with perceived stress. Interventions should target equipment and staffing shortages, medico-legal support and staff-wellbeing systems.

ABSTRACT: Background: Sickle cell disease (SCD) and malaria remain major health challenges in sub-Saharan Africa. CRISPR-Cas9 has enabled advances in SCD gene therapy and malaria-related experimental research, but these applications represent distinct biological and translational pathways. This systematic review evaluated CRISPR-Cas9 applications in SCD and malaria research while distinguishing clinical therapeutic evidence from experimental malaria-related findings.
Methods: A systematic review was conducted following PRISMA 2020 and Joanna Briggs Institute guidance. PubMed, ScienceDirect and Google Scholar were searched on 12 August 2026. Studies investigating CRISPR-Cas9 applications related to SCD or malaria, including HBBcorrection, fetal haemoglobin induction, host-cell modification, parasite genome editing and mosquito-vector modification, were included. Data were synthesised narratively due to substantial heterogeneity among study designs and outcomes.
Results: Thirteen studies were included, comprising six SCD-related and seven malaria-related studies. SCD studies demonstrated progression from experimental genome correction and haemoglobin regulation strategies to clinical application of CRISPR-edited autologous haematopoietic stem and progenitor cells. Malaria-related studies primarily investigated parasite functional genomics, erythrocyte invasion mechanisms and mosquito genetic modification. No included study evaluated a single CRISPR-Cas9 intervention that simultaneously treated SCD and enhanced malaria resistance.
Conclusion: CRISPR-Cas9 represents an advancing therapeutic platform for selected SCD applications and an important experimental tool in malaria research. Current evidence supports separate translational pathways, with clinical progress established in SCD and malaria applications remaining predominantly preclinical.