The concentration of potentially toxic elements (PTEs) in fruit juices: a global systematic review, meta-analysis and probabilistic health risk assessment

This study was conducted to estimate the containation of potentially toxic elements (PTEs) in fruit juice, e.g. apple, grape, mango, orange, peach, and pineapple. The related studies regarding the concentration of PTEs in fruit juice which have been published in recommended databases including PubMed, Embase, Web of Science and Scopus from 7 January 1969 to 20 February 2020 were analysed. Also, the health risk assessment for consumers due to PTEs ingestion via consuming various fruit juices was evaluated using target hazard quotient (THQ). Among 701 retrieved citations in the identification step, 44 articles were included in this conducted meta-analysis. In this context, the overall rank order of PTEs mean concentrations in the fruit juices were as follows: iron (Fe) >zinc (Zn)> copper (Cu)> lead (Pb) >nickel (Ni)> cadmium (Cd)> in apple and orange, Cu> Zn> Pb in grape, Fe> Zn>Cu>Ni>Cd>Pb in mango, Fe>Zn>Cu>Ni >Pb>Cd in peach and Cu>Zn>Cd>Ni>As in pineapple. Our results showed that the highest concentration of Pb and Cd were 0.075 and 0.204 mg/kg in orange and pineapple, respectively. The concentration of As in apple and orange juices was similar (0.003 mg/kg). Regarding Ni, Cu, Zn and Fe, the highest concentrations were 0.188, 0.508, 0.562 and 16.712 mg/kg in peach, mango and pineapple, respectively. The assessment of non-carcinogenic risk indicated that risk pattern was different in various countries. In addition, fruit juice consumers did not have a significant risk because of the ingestion of PTEs.</p

Additional file 3: of Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Standard questions to assess the quality of the monitoring system (PDF 139 kb

Additional file 2: of Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Accuracy ratio of pentvalent 3 and MMR1vaccines (PDF 9 kb

Additional file 1 of Developing and validation of COVID-19 media literacy scale among students during the COVID-19 pandemic

Supplementary Material

Additional file 4: of Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Standard questions to assess the quality of the monitoring system (PDF 200 kb

Additional file 1: of Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Accuracy ratio of pentvalent 3 & MMR1 register in the community (PDF 52 kb

Additional file 5: of Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

Timeliness and completeness of Pentavalent 3 and MMR1vaccines reporting (PDF 12 kb

Subnational mapping of HIV incidence and mortality among individuals aged 15-49 years in sub-Saharan Africa, 2000-18: a modelling study

Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676·5 (513·6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100 000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81·1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas. </p

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18: a modelling study

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18: a modelling stud

Mapping routine measles vaccination in low- and middle-income countries

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children