Preprint Feed – Epidemiology – The Science Collaborative

Biases in Attribution Methods for Norovirus and Rotavirus Diarrhea

by Chen, D., Shioda, K., Brouwer, A., Kraay, A., Handel, A., Lopman, B., McQuade, E. R., Nelson, K. on October 27, 2025 at 12:00 am

Background: The estimate of diarrhea burden attributed to a specific enteric pathogen, the population attributable fraction (PAF), depends on the specific calculation method. Two conventional methods are commonly used to estimate the PAF for enteric infections: the detection-as-etiology (DE) method, which defines the PAF as the pathogen prevalence in diarrheal cases; and the odds-ratio (OR) method, which expresses the PAF as a function of the OR between pathogen detection and diarrhea. A third, […]

Optimizing the timing of one or two doses of pneumococcal conjugate vaccines in older adults in the United States: a modeling study

by Thindwa, D., Wong, A., de Celles, M. D. on October 27, 2025 at 12:00 am

Background Older adults have a high burden of pneumococcal disease. Pneumococcal conjugate vaccines (PCVs) are effective in reducing disease risk. Recent changes to lower recommended age of pneumococcal vaccination among PCV-naive adults by the United States (US) Centers for Disease Control and Prevention (CDC) raises important questions on the optimal age of pneumococcal vaccination, as well as revaccination later in life when immunogenic responses to vaccination declines and disease activity […]

Viral genetic variability in wastewater predicts changes in community infection levels

by Hill, D. T., Schulman, R., Caldas, I. V., Dunham, C., Zhu, Y., Lamson, D. M., Rickerman, L., St. George, K., Ahmed-Braimah, Y., Green, H., Kmush, B., Middleton, F., Larsen, D. A. on October 27, 2025 at 12:00 am

Sequencing viruses found in community wastewater facilitates the study of diversity in circulating viruses at the population level. By analyzing 12,290 wastewater samples collected between January 2023 and April 2025 in New York State, USA from 196 sampling sites across all 57 counties, we assessed the diversity of the SARS-CoV-2 genome and how it changed over time compared to changes in COVID-19 infections and hospitalizations. We calculated three measures of SARS-CoV-2 genome diversity across […]

Pandemic-era sports league operations as a new paradigm for local epidemic resilience

by Tao, Y., Ogbunugafor, C. B., Bharti, N. on October 27, 2025 at 12:00 am

Strategic, coordinated, and rapid responses are essential when pathogens emerge, yet these responses are often mishandled during epidemics due to myriad factors, including entrenched socioeconomic and political constraints. Consequently, local communities are often left unprotected. Early in the 2020 COVID-19 pandemic, the National Basketball Association (NBA) implemented a variation of standard public health measures, popularly termed the "bubble", that kept the league […]

Prevalence and Severity of Anxiety, Depression, and Stress Among Optometry Students in Nigeria: A Cross-Sectional Study

by Kwarteng, A. M., Ogiemudia, O. M., Ekpenyong, B. N., Amaechi, O. U., Ogbonna, G., Daniel-Nwosu, E. I., Ike, O. O., Ezinne, N. E., Ogbuechi, K. C., Osuagwu, U. L. on October 26, 2025 at 12:00 am

Purpose: To assess the prevalence and severity of anxiety, depression, and stress among optometry students in Nigeria. Methods: A cross-sectional, online survey was administered among optometry students across Nigerian universities between 16 April and 18 November 2024. The mental health state was evaluated utilizing the Depression, Anxiety, and Stress Scale-21 (DASS-21). Data collected included demographic information such as age, gender, year of study, and DASS-21 scores. Descriptive […]

Cross-Country Differences in Self-Rated Health: Decomposing the Influence of Depressive Symptoms

by Wels, J., Maddock, J., Patalay, P. on October 25, 2025 at 12:00 am

Background: Despite extensive research on self-rated health (SRH), the extent to which mental health is a component part of SRH assessments and whether this relationship varies by country remains underexplored. This study quantifies the contribution of depressive symptoms to self-rated health and assesses cross-national variation in this association. Methods: Using general population data from older adults (age 55 years+) in 18 countries in the Survey of Health, Ageing and Retirement in Europe […]

Prevalence and Associated Factors of Female Genital Schistosomiasis in Nkhotakota District, Malawi.

by Kambalame, D. M., Thawani, A., Mtambo, J., Kamzati, M., Sambani, C., Mtoso, F., Mwale, T., Kafulafula, J., Manjawira, C., Luhanga, M., Lungu, S. A., Ngwira, S., Chimbatata, C., Ngwira, M. M., Mvula, B., Nyambalo, B., Phiri, B., Kayange, M., Kagoli, M., Mberu Kamau, E., Banda, E. C. on October 25, 2025 at 12:00 am

Background Female Genital Schistosomiasis (FGS) is an critical complication of schistosome infection, especially in schistosomiasis-endemic areas. It is a neglected disease and remains under-recognized in many areas. The prevalence of visual FGS in the endemic areas of Southern Malawi is 26.9%. This is higher in other African countries including Zambia and Tanzania and nosuch studies have been conducted in endemic areas in the Central Region of Malawi. The study aimed to determine the […]

The Role Of Drug Indication On Incidence Rate Heterogeneity: A Large-Scale, Systematic Evaluation Across An International Network Of Observational Databases

by Chen, H. Y., Knoll, C., Boventer, E., Pratt, N., Anand, T. V., Van Zandt, M., Morgan-Cooper, H., Ryan, P., Hripcsak, G. M. on October 24, 2025 at 12:00 am

Purpose: Incidence rate estimates are sensitive to a range of factors, including age, sex, and geographical setting (data source). The magnitude of the impact of drug indication on incidence rates remains underexplored. Methods: We conducted an observational cohort study using 13 healthcare databases to estimate the incidence rates of 73 health outcomes across 8 drug classes with multiple indications. We calculated incidence rates for each drug-outcome pair and performed random-effects […]

Cultural engagement is related to decelerated physiological but not subjective age: doubly-robust estimations in a national cohort study

by Fancourt, D., Finn, S., Mak, H. W., Steptoe, A., Bloomberg, M. on October 24, 2025 at 12:00 am

Cultural engagement (e.g. going to live music events, museums, galleries, theatre performances, and the cinema) is longitudinally associated in repeated epidemiological studies with age-related mental and physical health outcomes. However, it is unclear whether it also influences how fast older adults age psychologically and physically – so-called age acceleration. This study aimed to ascertain whether regular cultural engagement amongst older adults is related to slower physiological and […]

Antibiotic-resistance plasmid amplified among MRSA cases in an urban jail and its connected communities

by Thiede, S. N., Steinberg, H., Benedict, E., Sansom, S., Aroutcheva, A., Gontjes, K. J., Winner, K., Royzenblat, S., Pirani, A., Weinstein, R., Zawitz, C., Moore, N. M., Popovich, K. J., Snitkin, E. on October 24, 2025 at 12:00 am

Jails have been hypothesized to be hotspots for the spread of methicillin-resistant Staphylococcus aureus (MRSA). We integrate genomic and epidemiologic data to investigate USA300 MRSA transmission in an urban jail and its connected communities. A genome-wide association study of 308 jail isolates from 2015-2018 revealed a plasmid encoding the ermC clindamycin/erythromycin resistance gene was associated with a 6-fold increased odds of MRSA genetic linkages among detainees. Additionally, 52% of […]

Placental growth plays a key role in the link between maternal glucose levels in pregnancy and risk of preeclampsia

by Jaitner, A., Beaumont, R. N., Hughes, A. E., Tsaneva-Atanasova, K., Bowden, J., Freathy, R. M. on October 24, 2025 at 12:00 am

Preeclampsia is a serious condition affecting 2-4% of pregnancies globally. However, it is more common in pregnancies with diabetes (e.g. 10-20% in Type 1 diabetes) than in pregnancies without diabetes. In the general population, higher maternal fasting glucose levels are observationally associated with higher risk of preeclampsia, but whether the relationship is causal is unknown. Based on previous research, we hypothesise that higher fasting glucose increases placental weight, likely through […]

Capturing infant and child growth dynamics with P-splines mixed effects models

by Hernandez, M. A., Li, Z., Cole, T., Ong, Y. Y., Tilling, K., Elhakeem, A. on October 24, 2025 at 12:00 am

Investigating early life growth dynamics is crucial for a more comprehensive understanding of the developmental origins of obesity. Spline methods based on basis splines (B-splines) provide excellent flexibility for modelling complex nonlinear growth patterns, but they are prone to overfitting. To ensure good fit and avoid overfitting, B-splines can be extended by adding a penalty term to control their flexibility, resulting in what are commonly known as penalized B-splines (P-splines). Despite […]

Robust real-time estimation of pathogen transmission dynamics from wastewater

by Lison, A., McLeod, R., Huisman, J. S., Munday, J. D., Ort, C., Julian, T. R., Stadler, T. on October 24, 2025 at 12:00 am

Wastewater monitoring has proven effective for tracking SARS-CoV-2 transmission during the COVID-19 pandemic. However, estimating transmission parameters for other pathogens remains difficult due to lower concentrations in sewage, uncertain shedding kinetics, and limited clinical validation data. Here we present a Bayesian semi-mechanistic wastewater model, called EpiSewer, which jointly accounts for uncertainty in infection dynamics, pathogen shedding, and measurement noise, including outliers […]

Fragile X Syndrome in Brazil: Development and Validation of a Clinical Checklist for Population Screening

by Romero, L. M., Santos, G. C. C., Schubert, V., Scalabrin, E. E., Herai, R. H. on October 23, 2025 at 12:00 am

Fragile X Syndrome (FXS) is the most common inherited cause of intellectual disability and syndromic autism, but diagnosis remains challenging due to phenotypic variability and limited access to molecular testing in low- and middle-income countries. We conducted a cohort study of 419 individuals with molecularly confirmed full mutation or mosaicism (364 males, 55 females) from the Buko Kaesemodel Institute database to characterize clinical features and develop a screening tool for referral to […]

The road to interruption of transmission of Gambiense Human African trypanosomiasis in the Democratic Republic of the Congo, an analysis of 25 years of routine data

by Mwamba Miaka, E., Verschaeve, S., Lebuki, J., Shampa, T. M. P., Seghers, C.-A., Shih, P.-W., Inocencio da Luz, R., Nicco, E., Hasker, E. on October 23, 2025 at 12:00 am

IntroductionHuman African Trypanosomiasis (HAT) has caused hundreds of thousands of deaths in the Democratic Republic of the Congo (DRC) as recently as the 1990s. Since then annual incidence has reduced by 98% but the disease is known for its tendency of resurgence. We outlined areas at risk, HAT foci, and assessed trends in HAT infection within these foci. MethodsWe applied methodology developed by WHO to outline areas at risk by period and compared surface areas from 2000-2024. Combining […]

Ambient air pollution and the sex ratio at birth: a systematic review and narrative synthesis

by Gazeley, U., Eilerts-Spinelli, H., Abdel Ghany, J., Bonell, A., Wilde, J. on October 23, 2025 at 12:00 am

Ambient air pollution is associated with adverse pregnancy outcomes such as stillbirth, miscarriage, and preterm birth. However, its effects on the viability, implantation, and survival of conceptuses–largely unobserved before the clinical detection of pregnancy– remain poorly understood. Shifts in the sex ratio at birth (SRB) provide a sensitive, population-level indicator of sex-biased conception and pregnancy loss. This systematic review examined whether maternal exposure to ambient air […]

Association of air pollution with brain health: A cross-sectional analysis in adults living in Canada

by Azab, S. M., Anand, S. S., Doiron, D., Schulze, K., Brook, J. R., Brauer, M., Desai, D., Friedrich, M. G., Bangdiwala, S. I., Ho, V., Dummer, T. J. B., Poirier, P., Tardif, J.-C., Teo, K., Lear, S. A., Hystad, p., Yusuf, S., Smith, E. E., de Souza, R. J. on October 23, 2025 at 12:00 am

BackgroundAir pollution is a risk factor for dementia but its role in early cognitive dysfunction is not clear. We aimed to investigate the association of air pollution with cognitive function, and the role of cardiovascular risk factors and greenspace in this association. MethodsThe Canadian Alliance for Healthy Hearts and Minds Cohort Study (CAHHM) is a cohort of Canadian adults recruited between 2014-2018, for whom averages of exposures to nitrogen dioxide (NO2) and fine particulate matter […]

Associations between circulating metabolites and incidence of breast, prostate, lung and colorectal cancers in the HUNT Study and UK Biobank

by Denos, M., Sharma, A., Aasvold, B. O., Arham, A. G. A., Davey Smith, G., Loset, M., Brumpton, B. M., Debik, J., Giskeodegaard, G. F. on October 23, 2025 at 12:00 am

BackgroundBreast, prostate, lung and colorectal cancers are the most common cancers in both women and men globally. The role of circulating metabolites, including lipoprotein subfractions, in the development of these cancers remains unclear. ObjectiveThis prospective cohort study, including two large population-based cohorts, aimed to explore the associations between circulating metabolites and the incidence of breast, prostate, lung and colorectal cancers. MethodsFrom the Trondelag Health […]

Developing an online cannabis store paradigm for Cannabis Regulatory Science

by Borodovsky, J. T., Bairaboina, S., Struble, C. A., Preum, S. S., Sargent, J. D., Emond, J. A., Budney, A. J. on October 22, 2025 at 12:00 am

BackgroundThe legal cannabis industry is using online point-of-sale marketing, but few tools exist for evaluating how this marketing influences consumer behavior. To address this gap, we developed the Platform for Online Evaluation of Marijuana Marketing and Sales (POEMMS), a realistic, customizable online cannabis store. This study tested the feasibility, usability, and ecological validity of POEMMS. MethodsU.S. adults aged 18+ were recruited via social media advertisements. Participants […]

Trustworthiness and Transparency Features Were Less Frequent in Randomized Trials Presenting Large Effects in Abstracts

by Henssler, J., Reis-Pardal, J., Koppel, L., Ioannidis, J. on October 22, 2025 at 12:00 am

OBJECTIVESLarge effect sizes (ESs), especially when prominently presented in trial abstracts, draw large attention, but it is important to understand whether they are trustworthy. We aimed to assess indicators of transparency and trustworthiness in randomized controlled trials (RCTs) reporting some large ES in their abstract, in comparison with RCTs presenting only non-large ESs in their abstract. STUDY DESIGN AND SETTINGWe included RCTs indexed in MEDLINE between January 1, 2024 and March 18, […]

A prevalence study of Autism Spectrum Disorder in the Russian Federation

by Talantseva, O. I., Romanova, R. S., Kuznetsova, J. E., Manasevich, V. A., Lind, K. V., Parfenenko, M. A., Benoit, J., Grigorenko, E. on October 22, 2025 at 12:00 am

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by heterogeneity in presentation. In recent decades, ASD prevalence has risen globally, yet data from non-Western and middle-income countries, including Russia, remain scarce. Official statistics report a prevalence of 0.41 per 1000 (0.041%), far below global estimates of 32.2 per 1000 (3.2%), indicating underdiagnosis. This study provides the first population-based estimate of ASD prevalence among Russian elementary school […]

Infectious disease modeling for public health practice: projections, scenarios, and uncertainty in three phases of outbreak response

by Brouwer, A. F., Eisenberg, M. C., Dean, N. E., Hochheiser, H., Huang, P., Coyle, J. R., Rennert, L. on October 22, 2025 at 12:00 am

Public health departments need evidence-backed projections and scenarios to support decision making in infectious disease outbreaks. However, traditional infectious disease models are often not readily deployable or responsive to the urgent questions and priorities of public health departments or health systems. Moreover, uncertainty in model outputs is frequently misrepresented, undermining trust among public health practitioners and the public. To address these issues, we, the Insight Net […]

Proteomic signatures and machine learning based-prediction models for cardiovascular risk in survivors of myocardial infarction

by Xiang, S., Ye, Y., Cao, X., Zeng, H., Guan, Y., Zhu, S., Liu, X., Luo, D., Kong, Y., Shao, Z., Zhang, B., Hao, X. on October 22, 2025 at 12:00 am

BackgroundSurvivors of myocardial infarction (MI) are still at risk for adverse long-term outcomes such as all-cause mortality, heart failure (HF), and ischemic stroke (IS) after acute phase treatment. AimsThis study aimed to identify specific protein markers and construct risk prediction models for the main cardiovascular events in survivors of MI. MethodsA total of 30,135 survivors of MI were included in this study, all of whom had available follow-up data from the UK Biobank (UKB). […]

Probabilistic Forecasting of Monthly Dengue Cases Using Epidemiological and Climate Signals: A BiLSTM-Naive Bayes Model Versus Mechanistic and Count-Model Baselines.

by Sesay, M. M., Ngunyi, A., Imboga, H. on October 22, 2025 at 12:00 am

Reliable short-term forecasts can help urban health systems anticipate dengue surges and allocate resources. We assembled monthly dengue case counts for Freetown, Sierra Leone (2015-2025), and compared four probabilistic model families under a leakage-safe, rolling-origin protocol at 1-3-month horizons: a negative-binomial generalized linear model (NB-GLM), a negative-binomial INGARCH, a mechanistic renewal model with NB observations, and a Bidirectional LSTM with a negative-binomial output […]

Dual pandemic of firearm injury and COVID-19 in Central and Southeastern Ohio: An interrupted time series analysis

by Williams, H., Armstrong, M., Alexander, R., Groner, J., Lu, B., Kovach, S., Giambri, R., Xiang, H. on October 21, 2025 at 12:00 am

BACKGROUNDFirearm injuries increased as the United States faced the onset and first two years of the COVID-19 pandemic, a phenomenon some refer to as the "dual pandemic." Across the country, evidence suggests regional firearm injury rates and related mechanisms behind trends in firearm injury during this time differ, presumably according to local context. This study examines how one regional trauma system fared during the dual pandemic and explores potential explanatory mechanisms of […]

Regional variation in ADHD treatment and diagnosis in Denmark

by Sonne, H., Pottegard, A., Hansen, A. S. K., Bech, M., Kildegaard, H. on October 21, 2025 at 12:00 am

IntroductionAttention-deficit/hyperactivity disorder (ADHD) treatment and diagnoses show marked international and regional variation, not fully explained by underlying morbidity. In Denmark, earlier studies reported substantial regional differences, raising concerns about inequities in access to care. We examined nationwide patterns of ADHD medication use and diagnosis in 2024 and assessed system-level factors potentially contributing to geographic variation. MethodsWe conducted a […]

Combining polygenic risk scores to understand genetic liability to physical-mental health multimorbidity in UK BioBank

by Stow, D., Tsang, R. S. M., Katzourou, I. K., Underwood, J. F. G., The LIfespaN multimorbidity research Collaborative (LINC),, Holmans, P., Barroso, I., Martin, H. C., van den Bree, M. B. M., Finer, S., Timpson, N. J. on October 21, 2025 at 12:00 am

BackgroundInternalising and CardioMetabolic MultiMorbidity (ICM-MM) is a common form of mental-physical health multimorbidity, yet its genetic predisposition is largely unknown. We examined the polygenic nature of ICM-MM by assessing single trait-specific polygenic risk scores (PRSTRAIT) and whether combining them could increase the proportion of variance in liability to ICM-MM explained by genetic variation. MethodsWe developed PRSTRAIT using PRS-CS and summary statistics from the largest […]

Modelling Approaches for Predicting the Distribution of skin NTDs: A Systematic Review

by A.Bushara, M., Bushara, M. A., Hassan, R., Ahmed, R., Cano, J., Davey, G., Ganawa, E., Simpson, H. on October 21, 2025 at 12:00 am

BackgroundSkin neglected tropical diseases (NTDs) such as cutaneous leishmaniasis, lymphatic filariasis, mycetoma, and podoconiosis affect millions in endemic regions, but are under-recorded despite causing significant burdens. Predictive modelling has been used to estimate the distribution and prevalence of some of these diseases, and predictions may be useful for identifying at-risk populations and guiding interventions. This review synthesises the literature on modelling approaches to […]

by Badal, T., Baxter, W., Lloyd, L. K., Ruban, S., Nicholson, C., Strange, G., Rutherford, C., Celermajer, D. on October 20, 2025 at 12:00 am

BackgroundAs survival into adulthood improves for congenital heart disease (CHD) patients, the quality of survival is paramount. We assessed health-related quality of life (HRQL) in a large Australian adult CHD cohort and identified clinical, psychosocial and system-level predictors of better or worse HRQL. MethodsWe conducted a multicenter, registry-based cross-sectional study of a random stratified sample of adults from the Registry, assessing 868 participants who completed the PedsQL 4.0 […]

The impact of the number and the size of clusters on prediction performance of the stratified and the conditional shared gamma frailty Cox proportional hazards models

by Giardiello, D., Ratti, E., Austin, P. C. on October 19, 2025 at 12:00 am

Researchers in biomedical research often analyse data that are subject to clustering. Independence among observations are generally assumed to develop and validate risk prediction models. For survival outcomes, the Cox proportional hazards regression model is commonly used to estimate an individuals risk at fixed time horizons. The stratified Cox proportional hazards and the shared gamma frailty Cox proportional hazards regression models are two common approaches to account for the presence of […]

medrxiv Subject Collection: Epidemiology This feed contains articles for medRxiv Subject Collection "Epidemiology"