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Background: Malaria contributes substantially to the persistent burden of child deaths in sub-Saharan Africa. Accurate and comprehensive malaria mortality data are crucial to monitor the progress in reducing malaria incidence and mortality. Verbal Autopsy (VA) ascertains the cause of death despite its limitations leading to misclassification errors. Minimally Invasive Tissue Sampling (MITS) is being conducted in some settings as an alternative to Complete Diagnostic Autopsy (CDA). The present study examines the validity of malaria-related deaths comparing VA diagnoses with those obtained through MITS and/or CDA. Methods: A comprehensive literature search for original studies in English language using Ovid MEDLINE, Ovid Embase, CINAHL via EBSCO, Scopus, The Cochrane Library via Wiley, Google Scholar and searching the MITS Surveillance Alliance papers was carried out. The reference period was January 1, 1990–March 31, 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. Results: Among 71 articles identified in the databases, 21 matched the eligibility criteria. Qualitative syntheses showed that malaria Cause Specific Mortality Fractions (CSMFs) across various studies ranged from 2 to 31%. Plasmodium falciparum was mostly responsible for these deaths and the most common complications were anaemia and cerebral malaria. The sensitivity and specificity of the VA validation studies ranged from 18.4% to 33% and from 86.6% to 97%, respectively, and there was a high level of misclassification for both InSilico and Expert Algorithm VA for malaria compared to MITS. The overall concordance rates between MITS and CDA diagnoses ranged from 68 to 90%, with the highest concordance seen in deaths due to infectious diseases and malignant tumours. Clinical data increased diagnostic coincidence between MITS blind to clinical data and the gold standard CDA by 11%. Conclusions: The comprehensive review finds that MITS demonstrated better accuracy compared to VA in diagnosing malaria-attributed deaths, particularly in hospital settings. The high specificity of malaria in VA diagnosis suggests population-based estimates of the proportion of deaths due to malaria are broadly plausible. [ABSTRACT FROM AUTHOR]

Traffic-calming measures (TCMs) are physical modifications of the road network aimed at making the roads safer. Although researchers have reported reductions in numbers of road crashes and injuries tied to the presence of TCMs, such studies have been criticized for their pre-/post- designs. In this study, we aimed to complement our knowledge of TCMs' effectiveness by assessing their impact using a longitudinal design. The implementation of 8 TCMs, including curb extensions and speed humps, was evaluated at the intersection and census tract levels in Montreal, Quebec, Canada, from 2012 to 2019. The primary outcome was fatal or serious collisions among all road users. Inference was performed using a Bayesian implementation of conditional Poisson regression in which random effects were used to account for the spatiotemporal variation in collisions. TCMs were generally implemented on local roads, although most collisions occurred on arterial roads. Overall, there was weak evidence that TCMs were associated with study outcomes. However, subgroup analyses of intersections on local roads suggested a reduction in collision rates due to TCMs (median incidence rate ratio, 0.31; 95% credible interval: 0.12, 0.86). To improve road safety, effective counterparts of TCMs on arterial roads must be identified and implemented. [ABSTRACT FROM AUTHOR]

Using data from the 2003 Ontario Student Drug Use Survey (Centre for Addiction and Mental Health, Toronto), the relationships between bullying and smoking in adolescents were examined. A representative sample of 3314 grade 7-12 students was included in the analysis. Models were adjusted for confounders identified in the current literature. Multinomial logistic regression showed that current smokers were more likely to be bullies than nonsmokers (relative risk ratio = 2.3, p less than 0.001); being a current smoker was not associated with being a victim or a bully/victim (one who is both a bully and a victim). Moreover, gender was found to modify the effect of smoking on bullying status. Female smokers were more likely to be bullies and bully/victims than nonsmokers while there were no statistically significant differences for males. The associations between bullying status and smoking are consistent with those found in a multinational World Health Organization survey of adolescent health. Findings of the study suggested that girls were at much higher risk for involvement in bullying if they smoked, although girls were less frequently involved in bullying.

OBJECTIVES: To describe the prevalence of drug use in males in a provincial detention centre during the year before incarceration and to examine the association between socio-demographic and behavioural factors and drug use. METHODS: In 2009, 500 adult males completed a survey after admission to a provincial detention centre in Ontario. Past- year prevalence rates were calculated for the use of opioids, cocaine, crack and methamphetamine, and by route of administration. Bivariate logistic regression was used to examine associations between drug use and socio-demographic and behavioural factors. RESULTS: More than 56% of participants reported use of opioids, cocaine, crack or methamphetamine in the previous year. Risk factors for blood-borne and sexually transmitted infections were commonly reported for the previous year: 12.2% had injected drugs, 78.0% had had unprotected sex, and 48.0% had had more than one sexual partner. In unadjusted analyses, participants who were older than 24 years were more likely to have used any drugs and to have injected drugs in the previous year. CONCLUSIONS: This study provides the first Canadian data in the past decade on drug use by recently incarcerated adults. We found that drug use and behaviours that increase the risk of transmission of sexually transmitted and blood-borne infections remain very common in this population. Incarceration provides an opportunity to provide services and links to programs for people who use drugs, which could decrease drug-related harms to individuals and society. KEY WORDS: Prisons; drug use disorders; substance use disorders; street drugs OBJECTIFS : Decrire la prevalence de la consommation de drogue dans la population carcerale masculine d'un centre de detention provincial durant l'annee precedant l'incarceration et examiner l'association entre les facteurs sociodemographiques et comportementaux et la consommation de drogue. METHODE : En 2009, 500 hommes adultes ont rempli un questionnaire apres leur arrivee dans un centre de detention provincial en Ontario. Les taux de prevalence de l'annee anterieure ont ete calcules pour la consommation d'opioides, de cocaine, de crack et de methamphetamine, et selon la voie d'administration de ces drogues. Une regression logistique bivariee a servi a examiner les liens entre la consommation de drogue et les facteurs sociodemographiques et comportementaux. RESULTATS : Plus de 56 % des participants ont declare avoir consomme des opioides, de la cocaine, du crack ou de la methamphetamine au cours de l'annee anterieure. Des facteurs de risque d'infections transmissibles sexuellement et par le sang ont souvent ete declares pour l'annee anterieure : 12,2 % s'etaient injecte de la drogue, 78 % avaient eu des rapports sexuels non proteges, et 48 % avaient eu plus d'une ou d'un partenaire sexuel. Selon nos analyses non ajustees, les participants de plus de 24 ans etaient plus susceptibles d'avoir consomme l'une de ces drogues et de s'etre injecte de la drogue au cours de l'annee anterieure. CONCLUSIONS : Cette etude presente les premieres donnees canadiennes de la derniere decennie sur la consommation de drogue chez des adultes recemment incarceres. Nous constatons que la consommation de drogue et les comportements qui augmentent le risque de transmission des infections transmissibles sexuellement et par le sang sont encore tres courants dans cette population. L'incarceration presente la possibilite d'offrir des services aux personnes qui consomment de la drogue et de les aiguiller vers des programmes, ce qui pourrait reduire les mefaits lies a la drogue au niveau individuel et societal. MOTS CLES : prison; troubles dus a la consommation de drogue; troubles lies a une substance; drogues de rue, International data reveal high rates of illicit drug use, misuse and dependence in incarcerated populations, and also of adverse sequelae of drug use such as blood-borne infections and death from [...]