BMJ public health最新文献

{"title":"Global trends in inappropriate use of antibiotics, 2000-2021: scoping review and prevalence estimates.","authors":"Ranya Mulchandani, Katie Tiseo, Arindam Nandi, Eili Klein, Sumanth Gandra, Ramanan Laxminarayan, Thomas Van Boeckel","doi":"10.1136/bmjph-2024-002411","DOIUrl":"10.1136/bmjph-2024-002411","url":null,"abstract":"<p><strong>Introduction: </strong>Inappropriate antibiotic use is a major driver of antimicrobial resistance. However, the scope of literature and its prevalence across world regions remain largely unknown, as do the most common indicators and study designs used. In this study, we summarised the current literature on inappropriate use of antibiotics by world regions. We also provided the first global estimates of the overall amount of antibiotics that are potentially used inappropriately each year.</p><p><strong>Methods: </strong>We considered both patient and provider-mediated inappropriate antibiotic use. We reviewed 412 studies published between 2000 and 2021 and used beta regression and marginal contrasts to compare prevalence of inappropriate use by study design, indicator, world region, and national income level. Country-level sales of antibiotics from 2022 were combined with inappropriate antibiotic use estimates derived from two study designs (clinical audits and patient interviews) and one indicator (lack of indication) to estimate the amount of antibiotics inappropriately used globally.</p><p><strong>Results: </strong>Clinical audits (50.1%, 208/412) and 'non-prescription' use (37.1%, 153/412) were the most common study design and indicator, respectively, used to estimate inappropriate antibiotic use. Inappropriate antibiotic use prevalence was ~6% higher in low-income and middle-income than in high-income countries. However, this difference disappeared after accounting for a proxy of access to care: physicians per capita. Globally, based on clinical audits, patient interviews and lack of indication, the estimated proportion of inappropriate antibiotic use was 29.5%, 36.5% and 30.8%, respectively, with an average of ~30% (~13 000 000 kg) the equivalent of the annual antibiotic consumption in China.</p><p><strong>Conclusions: </strong>Inappropriate antibiotic use is highly prevalent across all countries regardless of national income level, with a third of global antibiotic consumption potentially due to unnecessary prescription ('lack of indication'). Antibiotic stewardship efforts and defining internationally standardised indicators are needed to track progress in reducing the occurrence of inappropriate antibiotic use where necessary, as well as identifying gaps in access to care.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002411"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case-crossover assessment of the modifying effects of home medication use on acute kidney-related morbidity due to elevated ambient heat exposure in Atlanta, GA, from 2013 to 2019.","authors":"Zachary McCann, Haisu Zhang, Kenneth Mueller, Yaoyao Qian, Morgan Lane, Rohan Dsouza, E Jennifer Weil, Stefanie Ebelt, Noah Scovronick, Howard H Chang","doi":"10.1136/bmjph-2024-001703","DOIUrl":"10.1136/bmjph-2024-001703","url":null,"abstract":"<p><strong>Background: </strong>Elevated ambient temperatures increase the risk for acute kidney-related morbidity, and medication use may increase vulnerability to heat exposure. This study examines whether medication use, and combination medication use (ie, polypharmacy), modifies the risk for temperature-related volume depletion (VD) and acute kidney injury (AKI).</p><p><strong>Methods: </strong>This study uses patient-level emergency department (ED) visit data from four Atlanta-area hospitals during the warm season from 2013 to 2019. ED patient-visits who reported a medication were matched with up to five ED patient-visits without the medication. Medications included angiotensin converting enzymes and angiotensin receptor blockers (ACE/ARBs), anti-depressants, anti-convulsants, β-blockers, diuretics, non-steroidal anti-inflammatory drugs and statins. A case-crossover framework is used to estimate associations between daily maximum temperature, medication use and VD/AKI ED visits.</p><p><strong>Results: </strong>There were 14 635 VD and 18 716 AKI ED visits in this study. For a change in ambient temperature (lags 0-2) from the 50^th to 95^th percentiles, patients using antidepressants had a higher risk for AKI (OR 1.28, 95% CI 1.08 to 1.52) compared with antidepressant nonusers (1.03, 95% CI 0.95 to 1.12). Polypharmacy analysis indicated that patients taking statins with ACE/ARBs were at an elevated risk for AKI (OR 1.38, 95% CI 1.02 to 1.86) relative to all other groups. This includes patients taking only an ACE/ARB (OR 1.00, 95% CI 0.82 to 1.21), only a statin (OR 1.10, 95% CI 0.90 to 1.33) or neither medication (OR 1.07, 95% CI 0.93 to 1.23).</p><p><strong>Conclusion: </strong>Results show that both single and combined medication use are associated with elevated risk for VD and AKI during periods of elevated ambient temperature.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001703"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and regional burden of congenital birth defects, 1990-2021: persistent healthcare disparities and emerging challenges from non-fatal health burden.","authors":"Junchao Duan, Ruiyang Ding, Yongbo Yu, Menglong Li, Yanping Ruan, Yifei Hu, Yihua He, Zhiwei Sun","doi":"10.1136/bmjph-2024-001608","DOIUrl":"10.1136/bmjph-2024-001608","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 3%-6% of infants were born with congenital birth defects worldwide every year, which ranked as the third leading cause of deaths among the population under 20 years of age in 2021.</p><p><strong>Methods: </strong>By adopting the methodology from Global Burden of Disease Study 2021, we systematically analysed the burden and temporal trend of congenital birth defects at the global and regional levels. Correlations between these metrics and Healthcare Access and Quality (HAQ) Index were investigated by the Spearman correlation analyses.</p><p><strong>Results: </strong>In 2021, there were 7.2 million cases of congenital birth defects and 0.53 million associated deaths. The highest incidence rates were observed in Central Asia, Central Sub-Saharan Africa and Western Sub-Saharan Africa, while the highest mortality rates were reported in Oceania, Western Sub-Saharan Africa and the Caribbean. Congenital heart anomalies remained the leading cause of deaths and disability-adjusted life years (DALYs). The proportion of years lived with disability (YLD) in total DALY increased significantly from 1990 to 2021, indicating a shift from fatal to non-fatal burden. The global age-standardised mortality rate markedly declined from 1990 to 2021, while the YLD rate remained relatively stable. Negative correlations were observed between the incidence, mortality, years of life lost (YLL) and DALY rates of congenital birth defects and HAQ Index of 204 countries and territories, whereas positive correlations were found for prevalence and YLD.</p><p><strong>Conclusions: </strong>Although remarkable progress has been made in reducing the global burden of congenital birth defects, it remains a major health issue in low sociodemographic index regions lacking equitable access to healthcare facilities. The shift from fatal to non-fatal burden underscores specific medical conditions for the increasing number of adult patients with congenital birth defects to promote postoperative rehabilitation and prevent complications.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001608"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of colorectal cancer screening under different scenarios of colonoscopy adherence: a microsimulation study.","authors":"Weimiao Wu, Juan Yang, Yuting Tan, Kai Gu, Qiuming Shen, Chen Yang, Min Hu, Yongbing Xiang, Wanghong Xu","doi":"10.1136/bmjph-2024-001344","DOIUrl":"10.1136/bmjph-2024-001344","url":null,"abstract":"<p><strong>Introduction: </strong>Low adherence to colonoscopy has greatly reduced the efficiency and cost-effectiveness of colorectal cancer (CRC) screening in China. This study aims to examine the cost-effectiveness of five initial tests followed by several scenarios of colonoscopy adherence.</p><p><strong>Methods: </strong>A microsimulation model was constructed to compare the parallel use of risk assessment and two-specimen faecal immunochemical test (FIT) (currently used method in Shanghai) and several assumed initial tests (one-specimen FIT, two-specimen FIT, and risk scoring systems (RSS) incorporating one-specimen or two-specimen FIT) under adherence of observed levels, 50%, 60%, 70%, 80% or 90% among 100 000 individuals aged 50-74 years. Incremental cost-effectiveness ratios (ICERs) were computed using the currently used or the next most effective method as the reference. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the findings.</p><p><strong>Results: </strong>The RSS incorporating two-specimen FIT was more effective in reducing CRC incidence and mortality at colonoscopy adherence levels below 80%, whereas the currently used method performed better at higher adherence levels. The currently used method was effective and cost-effective for CRC screening, with an ICER relative to the next most effective method ranging from 153.000 to 29 165.120 CNY per quality-adjusted life-year. Enhancing adherence to colonoscopy increased the detection of early-stage CRC and improved the cost-effectiveness ratio and ICER of the current method. The current method had a probability of 35.5%, 34.5%, 35.5%, 40.0%, 32.0% and 38.0% for being the optimal strategy at observed level, 50%, 60%, 70%, 80% and 90% adherence, respectively, all within a willingness-to-pay threshold of 1 to 3 times the gross domestic product per capita.</p><p><strong>Conclusions: </strong>The parallel use of risk assessment and two-specimen FIT is a cost-effective method for CRC screening in Chinese populations. Enhancing colonoscopy adherence may further improve the effectiveness and cost-effectiveness of the screening programme.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001344"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles of dentistry in identifying and supporting individuals who have experienced gender-based violence: a scoping review.","authors":"Danielle Toccalino, Cyndirela Chadambuka, Isabel Arruda-Caycho, Navya Arora, Margaret Powell, Carlos Quiñonez, Beverley M Essue","doi":"10.1136/bmjph-2024-001770","DOIUrl":"10.1136/bmjph-2024-001770","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>Gender-based violence (GBV) is a significant public health concern affecting one in three women globally. GBV is deeply rooted in gender inequality and societal constructs of gender roles, which significantly contribute to its prevalence and impact on women. Injury to the head, face, and neck, including broken teeth and jaws, is common in GBV, as is dental neglect, indicating a role for dental care. However, the impact of maxillofacial injuries or poor oral health and the role dental professionals may play in supporting individuals experiencing GBV are often overlooked. This review aimed to explore the research question: What is known in the literature about the roles of dentistry in identifying and supporting individuals who have experienced GBV?</p><p><strong>Approach: </strong>A search strategy including dental care and GBV-related text words and subject headings was developed and run across seven databases. Searches were not limited by date, location, or language. Articles were eligible for inclusion if they (1) described or evaluated provision of, need for, or outcomes of dental care; AND (2) focused on individuals who had experienced GBV aged 18+. Data were extracted from articles meeting inclusion criteria and narrative synthesis used to describe and synthesise findings.</p><p><strong>Results: </strong>84 articles met inclusion criteria, predominantly published in the United States and focused on dental care providers' knowledge, perceptions, and actions related to GBV. Only four identified articles looked at dental care interventions tailored to GBV. Individuals who experienced GBV were found to experience high rates of maxillofacial injury because of the violence. They also reported more oral health issues, negative perceptions of their teeth, and irregular dental visits than individuals who have not experienced GBV. Dental professionals were generally underprepared to support individuals experiencing GBV, but training interventions proved effective in increasing knowledge and competency. Overall, the literature supported a need for dental care in GBV and a tailored approach to supporting individuals who have experienced GBV.</p><p><strong>Conclusion: </strong>GBV can have profound impacts on oral health. There is a lack of knowledge about GBV in dental settings and the need to include GBV in dental curricula and further training is often overlooked. Policies and mandatory guidelines are necessary to ensure that GBV education and training are integrated into dental care settings. Trauma-informed dental care, integration of dental care into GBV support settings, and broader awareness of GBV among dental care providers are also needed.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001770"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial distribution of effective coverage of child immunisation in Ethiopia.","authors":"Samrawit Birhanu Alemu, Daniel Gashaneh Belay, Aynalem Belay, Melaku Birhanu Alemu","doi":"10.1136/bmjph-2024-002255","DOIUrl":"10.1136/bmjph-2024-002255","url":null,"abstract":"<p><strong>Introduction: </strong>Child immunisation is a cost-effective strategy to reduce vaccine-preventable diseases. While effective coverage is key to ensuring quality immunisation, little is known about its geographical distribution in Ethiopia. This study aims to assess the spatial distribution of effective coverage of child immunisation and identify areas with low coverage to inform targeted interventions.</p><p><strong>Methods: </strong>We used the 2019 Ethiopia Mini Demographic and Health Survey and Ethiopia Service Provision Assessment datasets. After calculating the effective coverage of immunisation, Bayesian model-based geostatistics were employed to assess the spatial distribution of effective immunisation coverage in Ethiopia, using relevant covariates to estimate coverage rates across regions.</p><p><strong>Results: </strong>The national effective coverage of immunisation was 34% (95% CI: 31.9% to 36.5%), with significant regional variation. Addis Ababa, western Benishangul-Gumuz, Dire Dawa city administrative, the northern part of South West Ethiopia and the northwest part of Amhara had hotspots for high level of effective coverage of child immunisation. On the other hand, central Amhara, northern Gambela, central Oromia, Sidama, northern Southern Nations, Nationalities and Peoples regions (SNNPR) and Somali had low effective coverage of child immunisation. Travel time to the nearest city (-0.292: 95% CI:-0.533 to -0.052) was found to be negative predictor of spatial distribution.</p><p><strong>Conclusion: </strong>There were significant geographical variations in the effective coverage of immunisation services in Ethiopia. Travel time to nearest city was a significant predictor of spatial distribution. Policymakers are advised to prioritise underserved areas and improve spatial predictors to have a safe, effective and life-saving vaccination program in Ethiopia.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002255"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Did trade unions protect employees' mental health during the COVID-19 pandemic? A mixed effects model using UK data from Understanding Society.","authors":"Theocharis Kromydas, Evangelia Demou, Alastair H Leyland, Srinivasa Vittal Katikireddi, Jacques Wels","doi":"10.1136/bmjph-2024-001756","DOIUrl":"10.1136/bmjph-2024-001756","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have addressed the relationship between trade unions and workers' mental health during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We analysed panel data from Understanding Society collected before and during the COVID-19 pandemic (49 915 observations; 5988 respondents) to assess the relationship between union presence within the workplace and union membership and a binary measure of common mental disorders (CMD), the 12-Item General Health Questionnaire (>4, probable psychological distress). A mixed-effect log-linear model assessed effect heterogeneity across time and industries, with average marginal effects (AME) indicating effect differences between groups.</p><p><strong>Results: </strong>Of our sample, 49.1% worked in a unionised workplace, with 53.8% of them being union members. Approximately 25% of the entire workforce was trade union members. Psychological distress prevalence was higher during the pandemic (25.4%) compared with prepandemic (18.4%). Union presence ((AME_pre-pandemic: 1.0, 95% CI-0.66 to 2.70) (AME_-pandemic: -0.2, 95% CI-1.91 to 1.58)) and union membership ((AME_pre-pandemic: 1.6, 95% CI -0.69 to 3.93) (AME_pandemic: -0.1, 95% CI -2.29 to 2.00)) were both associated with modest protection against CMD risk. Although, industry heterogeneity exists.</p><p><strong>Conclusions: </strong>Trade union presence may have a protective effect on workers' mental health in periods of crisis, such as during a pandemic. Within unionised workplaces, trade union membership further mitigated the negative effects of the pandemic on mental health. Collective negotiation may be protective in periods of uncertainty, benefiting all workers.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001756"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing of a multi-theory model (MTM) to determine factors associated with the initiation and maintenance of adequate sleep behaviour among students from a Southeastern US medical school.","authors":"Amanda H Wilkerson, Manoj Sharma, Krishen Dennis Samuel, Anjali Chandra, Vipina B Nair, Syed Siraj A Quadri, Joshua Mann, Vinayak K Nahar, Robert Davis","doi":"10.1136/bmjph-2024-001244","DOIUrl":"10.1136/bmjph-2024-001244","url":null,"abstract":"<p><strong>Background: </strong>The quality of one's sleep directly affects both physical and cognitive performance as well as overall physiologic health. Sleep deprivation occurs when a person does not get enough sleep. According to recent estimates, one in five Americans does not get enough sleep. Anybody who lacks sleep might suffer negative impacts, but those who work in high-stress, high-risk jobs that need greater concentration and focus are most affected. One group that fits that criteria is medical students. The purpose of this study was to evaluate how well the multi-theory model (MTM) can explain both initiation and maintenance of healthy sleep behaviour in medical college students.</p><p><strong>Methods: </strong>A convenience sample of medical students from a medical college in the Southeastern USA was recruited for participation in this cross-sectional study. An online survey was used to gather self-reported sociodemographic information as well as variables based on MTM.</p><p><strong>Results: </strong>Of the 327 participants, 54.3% were women and 76.7% were White. Over one-third (35.6%) of the medical students reported inadequate sleep. Regression models were created to explain the initiation and sustenance of adequate sleep behaviour among individuals not currently engaging in adequate sleep behaviour. For initiation, participatory dialogue and behavioural confidence were statistically significant and explained 44.4% of the variance in the initiation of adequate sleep behaviour change among medical students. For sustenance, the MTM constructs emotional transformation, practice for change, and changes in the social environment were statistically significant and explained 38.6% of the variance in the continuation of adequate sleep behaviour change.</p><p><strong>Conclusions: </strong>The MTM shows promise as a sound theoretical framework to inform the development of intervention programmes focused on behavioural modification to improve sleep quality among medical students.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001244"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of syphilis and associated factors among pregnant women who attended antenatal care follow-up at public hospitals in Bahir Dar city, north-west Ethiopia: a cross-sectional study.","authors":"Bantayehu Nega Arega, Wassihun Ayeligne Wassie, Lakachew Asrade Feleke, Adela Menberu Alemu","doi":"10.1136/bmjph-2024-002017","DOIUrl":"10.1136/bmjph-2024-002017","url":null,"abstract":"<p><strong>Background: </strong>Syphilis, caused by <i>Treponema pallidum</i>, remains a significant global public health concern, especially among pregnant women due to its severe impact on maternal and fetal health. Although the burden of syphilis and its risk factors has been extensively studied worldwide, data specific to Bahir Dar, particularly within the context of three public hospitals, remain limited. This is further compounded by the inconsistent implementation of existing prevention and treatment policies. Untreated syphilis can lead to adverse pregnancy outcomes, including spontaneous abortion, stillbirth, early neonatal death and congenital syphilis. This study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending antenatal care (ANC) at three public hospitals in Bahir Dar, North-West Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 551 pregnant women attending ANC at Tibebe Ghion Specialized Hospital, Felege Hiwot Comprehensive Specialized Hospital and Addis Alem Hospital from January to April 2023 Gregorian Calender (G.C). Participants were selected using systematic random sampling, and data were collected through structured interviews using a pretested questionnaire. Data were processed using EpiData V.3.1 and analysed with SPSS V.25, employing bivariate and multivariable logistic regression to identify significant factors.</p><p><strong>Results: </strong>The seroprevalence of syphilis was 2.4% (95% CI: 1.3-3.8), with a higher prevalence among urban residents (3.6%) compared with rural residents (1%). Significant associations were found between syphilis prevalence and a history of stillbirth (adjusted OR (AOR)=7.28; 95% CI: 1.05-24.87) and a history of active or previous sexually transmitted infections (AOR=5.3; 95% CI: 1.23-22.52).</p><p><strong>Conclusion: </strong>The study's seroprevalence aligns with previous findings, emphasising the need for routine syphilis screening and treatment in ANC services. Special attention should be given to women with a history of stillbirth, other adverse pregnancy outcomes or sexually transmitted infections. Enhanced counselling on syphilis screening and treatment is essential to reduce the burden of syphilis and improve maternal and fetal health outcomes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002017"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitude and determinants of post-abortion contraceptive use among women of reproductive age seeking care in healthcare facilities in Ile-Ife, Nigeria: a cross-sectional study.","authors":"Olabisi Muslimat Odekunle, Uchechi Grace Okonta","doi":"10.1136/bmjph-2024-001124","DOIUrl":"10.1136/bmjph-2024-001124","url":null,"abstract":"<p><strong>Background: </strong>Post-abortion contraception is the commencement of the chosen contraception method immediately after or within 48 hours of an abortion episode. It is a key strategy for the reduction of unintended pregnancies and repeated abortion.</p><p><strong>Objective: </strong>The study aimed to assess the knowledge and attitude towards post-abortion contraception and examine the determinants of post-abortion contraceptive use among women of reproductive age seeking care in healthcare facilities in Ile-Ife.</p><p><strong>Design: </strong>The study was a facility-based descriptive cross-sectional survey which employed a quantitative method.</p><p><strong>Method: </strong>The study was conducted among women of reproductive age who have had abortion and are seeking care in the family planning units of healthcare facilities in Ile- Ife. 285 respondents were recruited for the study using a two-stage sampling technique. A pre-tested interviewer-administered structured questionnaire was used for data collection. Data was analysed using IBM Statistical Product for Service Solutions (SPSS) version 23. Three levels of analyses were carried out-univariate, bivariate and multivariate-to determine the frequencies of variables and summary statistics, the association between awareness and knowledge of post-abortion contraception, attitude as well as post-abortion contraceptive use and to identify factors influencing post-abortion contraception use. The level of significance was determined at a p value of less than 0.05.</p><p><strong>Results: </strong>53% had adequate knowledge of post-abortion contraception. 22% of the women had used or accepted the use of post-abortion contraceptives. The factors influencing post-abortion contraception use were educational status, socio-economic status, number of pregnancies and number of living children. The study concluded that post-abortion contraception use was low among women of reproductive age seeking abortion services.</p><p><strong>Conclusion: </strong>The study concluded that post-abortion contraceptive use was low among women of reproductive age seeking abortion services. There is a need for increased knowledge of the importance of post-abortion contraception through community awareness and mass media. Further research on follow-up discontinuation rates of post-abortion contraception use should be investigated.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001124"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}