Epidemiology and Public Health Team

Overview

Our research team is dedicated to advancing the field of epidemiology and public health, with a mission to improve health outcomes in Cyprus and contribute to global health. We focus on high-quality research to inform public health policies, improve clinical practice, and promote evidence-based medicine. We embrace the One Health approach, recognising the interconnectedness of human, animal, and environmental health through multidisciplinary research collaborations.

Our Objectives

  • Lead pioneering research addressing public health challenges.
  • Translate research findings into actionable insights for clinicians, policymakers, and the public.
  • Foster collaboration locally and internationally to impact global health.

Primary Research Areas

  • Epidemiology of Non-communicable Conditions
    • Focused on understanding the patterns, risk factors, and prognosis of non-communicable conditions such as cardiometabolic, respiratory, neurodegenerative, and neoplastic conditions, we aim to identify targeted strategies for prevention and management that can be implemented across healthcare systems, nationally, internationally, and worldwide.
  • Environmental and Occupational Health
    • Examining the impact of environmental exposures and occupational risks on population health, we aim to inform policies and preventive measures that promote safer living and working environments.
  • Infectious Diseases and Vaccination
    • With a focus on controlling and preventing infectious diseases through antimicrobial stewardship, vaccination, and public health interventions, our research supports efforts to mitigate antimicrobial resistance, respond to outbreaks, and improve global health security.
  • Clinical Prediction and Epidemiological Assessment Tools
    • Developing, validating, and evaluating clinical prediction and epidemiological assessment tools to enhance decision-making in healthcare and improve patient outcomes.
  • Evidence Synthesis
    • Conducting systematic reviews, meta-analyses, and other methods to synthesise evidence for guiding clinical and public health decision-making.

Coordinator

Members

Selected Publications

  1. Timing of Allergenic Food Introduction and Risk of Immunoglobulin E-Mediated Food Allergy: A Systematic Review and Meta-analysis. Scarpone R, Kimkool P, Ierodiakonou D, Leonardi-Bee J, Garcia-Larsen V, Perkin MR, Boyle RJ. JAMA Pediatr. 2023 May 1;177(5):489-497. doi: 10.1001/jamapediatrics.2023.0142. PMID: 36972063; PMCID: PMC10043805.
  2. Use of multiple epinephrine doses in anaphylaxis: A systematic review and meta-analysis. Patel N, Chong KW, Yip AYG, Ierodiakonou D, Bartra J, Boyle RJ, Turner PJ. J Allergy Clin Immunol. 2021 Nov;148(5):1307-1315. doi: 10.1016/j.jaci.2021.03.042. Epub 2021 Apr 20. PMID: 33862009; PMCID: PMC8588837.
  3. Doctors’ Perceptions, Attitudes and Practices towards the Management of Multidrug-Resistant Organism Infections after the Implementation of an Antimicrobial Stewardship Programme during the COVID-19 Pandemic. Spernovasilis N, Ierodiakonou D, Spanias C, Mathioudaki A, Ioannou P, Petrakis EC, Kofteridis DP. Trop Med Infect Dis. 2021 Feb 5;6(1):20. doi: 10.3390/tropicalmed6010020. PMID: 33562723; PMCID: PMC7930958.
  4. Chronic Obstructive Pulmonary Disease Self-Management Intervention for Improving Patient-Reported Outcomes in Primary Care in Greece. Tsaousi F, Bouloukaki I, Christodoulakis A, Ierodiakonou D, Tzanakis N, Tsiligianni I. A Medicina (Kaunas). 2024 Feb 23;60(3):377. doi: 10.3390/medicina60030377. PMID: 38541103; PMCID: PMC10972103.
  5. Magnitude and determinants of excess total, age-specific and sex-specific all-cause mortality in 24 countries worldwide during 2020 and 2021: results on the impact of the COVID-19 pandemic from the C-MOR project. Pallari CT, Achilleos S, Quattrocchi A, Gabel J, Critselis E, Athanasiadou M, Rahmanian Haghighi MR, Papatheodorou S, Liu T, Artemiou A, Rodriguez-Llanes JM, Bennett CM, Zimmermann C, Schernhammer E, Bustos Sierra N, Ekelson R, Lobato J, Macedo L, Mortensen LH, Critchley J, Goldsmith L, Denissov G, Le Meur N, Kandelaki L, Athanasakis K, Binyaminy B, Maor T, Stracci F, Ambrosio G, Davletov K, Glushkova N, Martial C, Chan Sun M, Hagen TP, Chong M, Barron M, Łyszczarz B, Erzen I, Arcos Gonzalez P, Burström B, Pidmurniak N, Verstiuk O, Huang Q, Polemitis A, Charalambous A, Demetriou CA. BMJ Glob Health. 2024 Apr 18;9(4):e013018. doi: 10.1136/bmjgh-2023-013018. PMID: 38637119; PMCID: PMC11029481.
  6. Barriers and facilitators for adopting healthy lifestyles in breast cancer survivors: a scoping review protocol. Shi A, Fong KHA, Rodomar C, Demetriou CA, Kolokotroni O, Philippou E, Salameh P, Mosquera MC, Papageorgiou E, Critselis E, Marcou Y, Constantinou C, Quattrocchi A. JBI Evid Synth. 2023 Nov 1;21(11):2218-2226. doi: 10.11124/JBIES-22-00395. PMID: 37395535.
  7. Weight Gain in Early Infancy Impacts Appetite Regulation in the First Year of Life. A Prospective Study of Infants Living in Cyprus. Hileti, D., Demetriou, C.A., Iasonides, M.C., Pipis, S., Mahmood, A., Lanigan, J., Singhal, A. Journal of Nutrition (2023), 153 (8), pp. 2531-2539. DOI: 10.1016/j.tjnut.2023.06.017
  8. Investigating the Dietary Intake Using the CyFFQ Semi-Quantitative Food Frequency Questionnaire in Cypriot Huntington’s Disease Patients. Christodoulou, C.C., Demetriou, C.A., Philippou, E., Papanicolaou, E.Z. Nutrients (2023), 15 (5), art. no. 1136. DOI: 10.3390/nu15051136
  9. Impact of the COVID-19 pandemic on total, sex-and age-specific all-cause mortality in 20 countries worldwide during 2020: Results from the C-MOR project. Demetriou, C.A., Achilleos, S., Quattrocchi, A., Gabel, J., Critselis, E., Constantinou, C., Nicolaou, N., Ambrosio, G., Bennett, C.M., Le Meur, N., Critchley, J.A., Mortensen, L.H., Rodriguez-Llanes, J.M., Chong, M., Denissov, G., Klepac, P., Goldsmith, L.P., Costa, A.J.L., Hagen, T.P., Chan Sun, M., Huang, Q., Pidmurniak, N., Zucker, I., Cuthbertson, J., Burström, B., Barron, M., Eraen, I., Stracci, F., Calmon, W., Martial, C., Verstiuk, O., Kaufman, Z., Tao, W., Kereselidze, M., Chikhladze, N., Polemitis, A., Charalambous, A. International Journal of Epidemiology (2023), 52 (3), pp. 664-676. DOI: 10.1093/ije/dyac170
  10. Relative validity and reproducibility of the CyFFQ semi-quantitative food frequency questionnaire for assessing dietary intake in Cypriot adults. Philippou, E., Demetriou, C.A., Loucaides, G., Solomonidou, N., Critselis, E., Polykarpou, M., Sioulis, S., Hadjisavvas, A., Kyriacou, K. Journal of Human Nutrition and Dietetics (2023), 36 (1), pp. 139-153. DOI: 10.1111/jhn.13032
  11. Temporal variations in the short-term effects of ambient air pollution on cardiovascular and respiratory mortality: a pooled analysis of 380 urban areas over a 22-year period. Schwarz M, Peters A, Stafoggia M, de ‘Donato F, Sera F, Bell L M, Guo Y, Honda Y, Huber V, Jaakkola JKJ, Urban A, Vicedo-Cabrera AM, Masselot P, Lavigne E, Achilleos S, Kysely J, Samoli E, Hashizume M, Ng CFS, da Silva SNP, Madureira J, Garland RM, Tobias A, Armstrong B, Schwartz J, Gasparrini A, Schneider A, Breitner S, on behalf of the MCC Collaborative Research Network. The Lancet Planetary Health, 2024, 8 (9), e657 – e665. DOI: 1016/S2542-5196(24)00168-2
  12. Airborne particle radioactivity during desert dust days in Cyprus. Achilleos S, Henderson C, Kouis P, Achilleos A, Argyrou A, Caballero A, Prokopiou E, Kokkinofta R, Savvides C, Vasiliadou E, Tzortzis M, Sisou A, Koutrakis P, Yiallouros PK, Quattrocchi A. Journal of Environmental Radioactivity, 2024, 278, 107467, ISSN 0265-931X, https://doi.org/10.1016/j.jenvrad.2024.107467.
  13. Temperature and hospital admissions in the Eastern Mediterranean: a case study in Cyprus. Wang Y, Achilleos S, Salameh P, Kouis P, Yiallouros PK, Critselis E, Nicolaides K, Tymvios F, Savvides C, Vasiliadou E, Papatheodorou SI, Koutrakis P, Alahmad B. Environ Res: Health, 2024, 2 025004, DOI 10.1088/2752-5309/ad2780.
  14. Achilleos S, Michanikou A, Kouis P, Papatheodorou SI, Panayiotou AG, Kinni P, Mihalopoulos N, Kalivitis N, Kouvarakis G, Galanakis E, Michailidi E, Tymvios F, Chrysanthou A, Neophytou M, Mouzourides P, Savvides C, Vasiliadou E, Papasavvas I, Christophides T, Nicolaou R, Avraamides P, Kang CM, Middleton N, Koutrakis P, Yiallouros PK. Improved indoor air quality during desert dust storms: The impact of the MEDEA exposure-reduction strategies. Sci Total Environ. 2023 Mar 10;863:160973. doi: 10.1016/j.scitotenv.2022.160973. Epub 2022 Dec 17. PMID: 36539092.
  15. Extensive Testing and Public Health Interventions for the Control of COVID-19 in the Republic of Cyprus between March and May 2020. Quattrocchi A, Mamais I, Tsioutis C, Christaki E, Constantinou C, Koliou M, Pana ZD, Silvestros V, Theophanous F, Haralambous C, Stylianou A, Sotiriou S, Athanasiadou M, Kyprianou T, Demetriou A, Demetriou CA, Kolokotroni O, Gregoriou I, Paphitou N, Panos G, Kostrikis L, Karayiannis P, Petrikkos G, Agathangelou P, Mixides G, Siakallis G, Hadjihannas L, Palazis L, Vavlitou A, Matsentidou-Timiliotou C, Koukios D, Adamidi T, Frangopoulos F, Constantinou E, Nikolopoulos G. J Clin Med. 2020 Nov 8;9(11):3598. doi: 10.3390/jcm9113598.
  16. Effect of vaccination on SARS-CoV-2 reinfection risk: a case-control study in the Republic of Cyprus. Quattrocchi A, Tsioutis C, Demetriou A, Kyprianou T, Athanasiadou M, Silvestros V, Mamais I, Demetriou CA, Theophanous F, Soteriou S, Gregoriadou C, Anastasiou E, Kolios P, Ηaralambous C, Gregoriou I, Kalakouta O, Nikolopoulos G. Public Health. 2022 Mar;204:84-86. doi: 10.1016/j.puhe.2022.01.008. Epub 2022 Jan 20. PMID: 35193032; PMCID: PMC8769923.
  17. Development and external validation of a risk prediction model for falls in patients with an indication for antihypertensive treatment: retrospective cohort study. Archer L, Koshiaris C, Lay-Flurrie S, Snell KIE, Riley RD, Stevens R, Banerjee A, Usher-Smith JA, Clegg A, Payne RA, Hobbs FDR, McManus RJ, Sheppard JP BMJ. 2022 Nov 8;379:e070918. doi: 10.1136/bmj-2022-070918. Erratum in: BMJ. 2023 Oct 24;383:p2267. doi: 10.1136/bmj.p2267. PMID: 36347531; PMCID: PMC9641577.
  18. Predicting the risk of acute kidney injury in primary care: derivation and validation of STRATIFY-AKI. Koshiaris C, Archer L, Lay-Flurrie S, Snell KI, Riley RD, Stevens R, Banerjee A, Usher-Smith JA, Clegg A, Payne RA, Ogden M, Hobbs FR, McManus RJ, Sheppard JP  Br J Gen Pract. 2023 Jul 27;73(733):e605-e614. doi: 10.3399/BJGP.2022.0389. PMID: 37130615; PMCID: PMC10170524.
  19. Early detection of multiple myeloma in primary care using blood tests: a case-control study in primary care. Koshiaris C, Van den Bruel A, Oke JL, Nicholson BD, Shephard E, Braddick M, Hamilton W. Br J Gen Pract. 2018 Sep;68(674):e586-e593. doi: 10.3399/bjgp18X698357. Epub 2018 Aug 13. PMID: 30104326; PMCID: PMC6104875.
  20. Clinical prediction tools to identify patients at highest risk of myeloma in primary care: a retrospective open cohort study. Koshiaris C, Van den Bruel A, Nicholson BD, Lay-Flurrie S, Hobbs FR, Oke JL. Br J Gen Pract. 2021 Apr 29;71(706):e347-e355. doi: 10.3399/BJGP.2020.0697. PMID: 33824161; PMCID: PMC8049204.
  21. Mandrik O, Tolma EL, Zielonke N, Meheus F, Ordóñez-Reyes C, Severens JL, Murillo R. Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening. J Med Screen. 2021 Jun;28(2):70-79. doi: 10.1177/0969141320930743. Epub 2020 Jun 9. PMID: 32517538; PMCID: PMC8167916.
  22. Tolma EL, Vesely SK, Boeckman L, Oman RF, Aspy CB. Youth Assets, Neighborhood Factors, Parental Income, and Tobacco Use: A Longitudinal Study of Health Disparities. Int J Environ Res Public Health. 2022 Sep 28;19(19):12330. doi: 10.3390/ijerph191912330. PMID: 36231631; PMCID: PMC9566558.
  23. Tolma EL, Stoner JA, Li J, Kim Y, Engelman KK. Predictors of regular mammography use among American Indian women in Oklahoma: a cross-sectional study. BMC Womens Health. 2014 Aug 28;14:101. doi: 10.1186/1472-6874-14-101. PMID: 25169207; PMCID: PMC4237829.
  24. Lehrnbecher T, Averbuch D, Castagnola E, Cesaro S, Ammann RA, Garcia-Vidal C, Kanerva J, Lanternier F, Mesini A, Mikulska M, Pana D, Ritz N, Slavin M, Styczynski J, Warris A, Groll AH; 8th European Conference on Infections in Leukaemia. 8th European Conference on Infections in Leukaemia: 2020 guidelines for the use of antibiotics in paediatric patients with cancer or post-haematopoietic cell transplantation. Lancet Oncol. 2021 Jun;22(6):e270-e280. doi: 10.1016/S1470-2045(20)30725-7. Epub 2021 Mar 31. PMID: 33811814.
  25. Groll AH, Pana D, Lanternier F, Mesini A, Ammann RA, Averbuch D, Castagnola E, Cesaro S, Engelhard D, Garcia-Vidal C, Kanerva J, Ritz N, Roilides E, Styczynski J, Warris A, Lehrnbecher T; 8th European Conference on Infections in Leukaemia. 8th European Conference on Infections in Leukaemia: 2020 guidelines for the diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or post-haematopoietic cell transplantation. Lancet Oncol. 2021 Jun;22(6):e254-e269. doi: 10.1016/S1470-2045(20)30723-3. Epub 2021 Mar 31. PMID: 33811813.
  26. Pana ZD, El-Shabrawi M, Sultan MA, Murray T, Alam A, Yewale V, Dharmapalan D, Klein JD, Haddad J, Thacker N, Pulungan AB, Hadjipanayis A. Fighting the hidden pandemic of antimicrobial resistance in paediatrics: recommendations from the International Pediatric Association. BMJ Paediatr Open. 2023 Jul;7(1):e002084. doi: 10.1136/bmjpo-2023-002084. PMID: 37500294; PMCID: PMC10387713.
  27. Bethe U, Pana ZD, Drosten C, Goossens H, König F, Marchant A, Molenberghs G, Posch M, Van Damme P, Cornely OA. Innovative approaches for vaccine trials as a key component of pandemic preparedness – a white paper. Infection. 2024 Jul 17. doi: 10.1007/s15010-024-02347-1. Epub ahead of print. PMID: 39017997.
  28. Rezae A, Fakak R, Alexander KG, Constantinou C. The Overlooked Association Between Nutrition and the Development of Acute Myeloid Leukaemia: A Scoping Review. Curr Nutr Rep. 2024 Jun;13(2):113-125. doi: 10.1007/s13668-024-00522-2. Epub 2024 Mar 2. PMID: 38430336; PMCID: PMC11133215.
  29. Bogdanova A, Andrawos C, Constantinou C. Cervical cancer, geographical inequalities, prevention and barriers in resource depleted countries. Oncol Lett. 2022 Apr;23(4):113. doi: 10.3892/ol.2022.13233. Epub 2022 Feb 9. PMID: 35251344; PMCID: PMC8850967.
  30. Nicolaides AN; Cardiovascular Disease Educational and Research Trust; European Society of Vascular Surgery; ,The International Angiology Scientific Activity Congress Organization; International Union of Angiology; Union Internationale de Phlebologie at the Abbaye des Vaux de Cernay. Investigation of chronic venous insufficiency: A consensus statement (France, March 5-9, 1997). Circulation. 2000 Nov 14;102(20):E126-63. doi: 10.1161/01.cir.102.20.e126. PMID: 11076834.
  31. Bergan JJ, Schmid-Schönbein GW, Smith PD, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. N Engl J Med. 2006 Aug 3;355(5):488-98. doi: 10.1056/NEJMra055289. PMID: 16885552.
  32. Nicolaides AN, Kakkos SK, Kyriacou E, Griffin M, Sabetai M, Thomas DJ, Tegos T, Geroulakos G, Labropoulos N, Doré CJ, Morris TP, Naylor R, Abbott AL; Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) Study Group. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification. J Vasc Surg. 2010 Dec;52(6):1486-1496.e1-5. doi: 10.1016/j.jvs.2010.07.021. PMID: 21146746.
  33. Nicolaides AN, Panayiotou AG, Griffin M, Tyllis T, Bond D, Georgiou N, Kyriacou E, Avraamides C, Martin RM. Arterial Ultrasound Testing to Predict Atherosclerotic Cardiovascular Events. J Am Coll Cardiol. 2022 May 24;79(20):1969-1982. doi: 10.1016/j.jacc.2022.03.352. PMID: 35589158.

Selected Research Projects

  • C-MOR: Research Consortium and Platform for Monitoring Overall and Cause-Specific Mortality Resulting from the COVID-19 Pandemic
  • CESA: The Cyprus Epidemiological Study on Atherosclerosis
  • Breath IN: Towards a Better and Sustainable Indoor Air Quality Environment
  • AIRCOMM: Relationship of Air Pollution with Cow’s Microbiome and Heavy Metals in Milk for Human Consumption — A Pilot Study of Dairy Farms in Cyprus
  • HEROES: Healthy Lifestyle Practices of Breast Cancer Survivors in Cyprus
  • CYGROW: The Cyprus Infant Growth Cohort Study
  • STADICAN-CY: Stage at Diagnosis and Cancer Survival in Cyprus — A Population-Based Study (2004-2017)
  • GUTBIOME: One Health Approach to Investigate the Role of the Gut Microbiome in Gastrointestinal Disease Transmission in Cyprus
  • Rural Medicine
  • Antimicrobial Resistance and Stewardship: A Bibliometric Analysis and Research Strategy Suggestions

Collaborations

Our research team engages in vital collaborations with numerous prestigious institutions and organisations both in Cyprus and internationally. These partnerships strengthen our research capacity, foster the exchange of knowledge, enhance the impact of our research findings, and influence public health policies and clinical practice.

Moreover, many of our team members maintain individual, longstanding collaborations with national public authorities (e.g., Ministry of Health, Ministry of Agriculture, Rural Development & Environment, Ministry of Labour & Social Insurance, Air Quality Section), universities, and research institutes in Cyprus (e.g., Cyprus University of Technology, University of Cyprus, The Cyprus Institute of Neurology and Genetics) and abroad (e.g., Imperial College London, Oxford University, University of Crete, Democritus University of Thrace, Harokopion University of Athens, Lebanese University, INSPECT-LB, Harvard T.H. Chan School of Public Health, Rutgers University, The Royal Melbourne Institute of Technology, University of Cologne, University of Antwerp, University of Paris). These collaborations aim to enrich our research in epidemiology and public health, particularly regarding chronic diseases and global health.

Additionally, our collaborations extend to the European Confederation of Medical Mycology (ECMM) and the global registry for fungal diseases, Fungiscope, where we participate in the development of global guidelines for Candida, Mucormycosis, and Aspergillosis. Our work includes partnerships with the Global Paediatric Network (PENTA) and the European Society of Paediatric Infectious Diseases (ESPID), as well as the International Paediatric Association (IPA), contributing to working groups on antimicrobial resistance (AMR) and HPV vaccination.

Cyprus Institute of Neurology and Genetics

Partnering with this leading institution facilitates research into neurological conditions of Cypriots and genetic epidemiology, contributing to advancements in personalised medicine.

biobank.cy Center of Excellence in Biobanking and Biomedical Research

Our partnership with this centre enhances research in biobanking, supporting large-scale population studies that inform genetic predispositions and health outcomes of the Cypriot population.

European Public Health Association(EUPHA)

EUPHA collaboration allows for the dissemination of research across Europe, promoting public health at an international level.

Cyprus Epidemiology & Public Health Association (CyEPHA)

Collaborating with CyEPHA supports local research initiatives, capacity building, and the promotion of evidence-based public health policies in Cyprus.

Cyprus Harvard Endowment Program for the Environment and Public Health

This collaboration supports research in environmental and public health, allowing for the development of impactful policies and preventive strategies. Participating students analyse datasets from Cyprus and other European countries, publishing results in leading international, peer-reviewed journals.

Environmental Health Research Centre

The Environmental Health (EH) Research Centre is guided by the underlying principles of One Health and recognizes the intrinsic and complex connection between the health of people, biodiversity and the environment. It relies on collaborative and transdisciplinary approaches at various levels (local, national and global), with a final goal to achieve optimal health outcomes, and taking into consideration the sphere where these three key partners interact.

Multi-Country Multi-City (MCC) Collaborative Research Network

This international collaboration of research teams works on programmes utilising large datasets and standardised methodologies to produce epidemiological evidence on associations between environmental stressors, climate, and health.

Mediterranean Lifestyle Medicine Institute

Faculty members of this institute collaborate with researchers and clinicians worldwide to advance the concept of the traditional Mediterranean Lifestyle (tMedLife) as a healthy paradigm for global lifestyle medicine interventions, developing and implementing educational programmes to study the effects on healthy ageing and promoting tMedLife principles.