Background: Climate change is recognised as having a ‘multiplier effect’ on food insecurity and adverse health experiences of communities in the Pacific region. Islands are especially at risk due to their limited land availability, population pressures and, in the case of atolls, their low-lying topography making them vulnerable to sea level rise. Aim: This review examines the literature describing the relationship between climate change, food security and health in Kiribati. Method: A narrative review was conducted, looking at both peer-reviewed and non-peer-reviewed literature available online from 1 January 2008 to 14 August 2018, the search date. Sources from three databases of peer-reviewed literature, Google and additional sources from reference lists were included in the review. Results: Thirty-seven items were included in this review. These show climate change is having a noticeable impact on food security and health in Kiribati. Four themes were identified from the literature that provide different perspectives to the problem outlined. Conclusion: Climate change is a pressing concern for the government of Kiribati and communities alike, and yet the problem is worsening, not improving. Further research is required to look at effective policies and cultural perspectives to address this problem.

Environmental exposures are known to play a role in the development of cancer, including breast cancer. There are known associations of breast cancer with

We conducted a multicentre hospital‐based test‐negative case–control study to measure vaccine effectiveness (VE) against PCR‐confirmed influenza in adult patients with severe acute respiratory infection (SARI) during the 2022/2023 influenza season in Europe. Among 5547 SARI patients ≥18 years, 2963 (53%) were vaccinated against influenza. Overall VE against influenza A(H1N1)pdm09 was 11% (95% CI: −23–36); 20% (95% CI: −4–39) against A(H3N2) and 56% (95% CI: 22–75) against B. During the 2022/2023 season, while VE against hospitalisation with influenza B was >55%, it was ≤20% for influenza A subtypes. While influenza vaccination should be a priority for future seasons, improved vaccines against influenza are needed.

Introduction: The I-MOVE-COVID-19 and VEBIS hospital networks have been measuring COVID-19 vaccine effectiveness (VE) in participating European countries since early 2021. Aim: We aimed to measure VE against PCR-confirmed SARS-CoV-2 in patients ≥ 20 years hospitalised with severe acute respiratory infection (SARI) from December 2021 to July 2022 (Omicron-dominant period). Methods: In both networks, 46 hospitals (13 countries) follow a similar test-negative case–control protocol. We defined complete primary series vaccination (PSV) and first booster dose vaccination as last dose of either vaccine received ≥ 14 days before symptom onset (stratifying first booster into received < 150 and ≥ 150 days after last PSV dose). We measured VE overall, by vaccine category/product, age group and time since first mRNA booster dose, adjusting by site as a fixed effect, and by swab date, age, sex, and presence/absence of at least one commonly collected chronic condition. Results: We included 2,779 cases and 2,362 controls. The VE of all vaccine products combined against hospitalisation for laboratory-confirmed SARS-CoV-2 was 43% (95% CI: 29–54) for complete PSV (with last dose received ≥ 150 days before onset), while it was 59% (95% CI: 51–66) after addition of one booster dose. The VE was 85% (95% CI: 78–89), 70% (95% CI: 61–77) and 36% (95% CI: 17–51) for those with onset 14–59 days, 60–119 days and 120–179 days after booster vaccination, respectively. Conclusions: Our results suggest that, during the Omicron period, observed VE against SARI hospitalisation improved with first mRNA booster dose, particularly for those having symptom onset < 120 days after first booster dose.

BACKGROUND: Surveillance of severe acute respiratory infections (SARI) using ICD-10 codes from electronic health records (EHR) lacks consensus on optimal case-defining codes. AIM: We determined codes that maximise sensitivity (Se) and positive predictive value (PPV) for SARI associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus and respiratory syncytial virus (RSV) in Denmark, Iceland, Malta, Norway and Spain. METHODS: We included hospitalisations from week 21/2021 to 39/2023, with ICD-10 diagnostic codes for respiratory disease (three-character codes J00–J99) or COVID-19 (U07.1, U07.2, country-specific codes for Denmark). We assessed Se and PPV of individual codes against laboratory results. Based on Se and PPV rank-sum, we selected the top 10 codes and combined them into 10 sets per pathogen. We identified sets that maximised the clinical utility index (CUI = Se × PPV), categorised as excellent (≥ 0.81), good (0.64–0.80), satisfactory (0.49–0.63) and poor (< 0.49). RESULTS: We assessed 395,163 hospitalisations for SARI-SARS-CoV-2, 313,418 for SARI-influenza and 192,936 for SARI-RSV, all tested. For SARI-SARS-CoV-2, code U07.1 (B34.2A, B97.2A for Denmark) had excellent utility in Denmark, Malta, Norway, Spain (≥ 0.82), and good utility in Iceland (0.79). For SARI-influenza, J09, J10 and J11 performed excellently in Denmark, Norway, Spain (≥ 0.83), satisfactorily in Malta (0.52), and poorly in Iceland (0.43). For SARI-RSV, J12, J20 and J21 achieved highest CUI but had poor utility (0.17–0.34). CONCLUSIONS: COVID-19- and influenza-specific three-character ICD-10 codes accurately identified SARI associated with SARS-CoV-2 and influenza virus. For SARI-RSV, four-character codes should be explored. We recommend context-specific assessments in countries adopting EHR-based surveillance.