BMJ public health最新文献

{"title":"Building HIV/AIDS prevention communication strategies through community-informed formative research for a biobehavioural couple-based HIV prevention intervention for Latino men who have sex with men.","authors":"Greg Langan, Omar Martinez, Sarah B Bass, Omar Valentin, Max Supino, Kristine Kim, Juan Franco, Brian Mattera, Ashley French, Nelson Ortega, Ryan Tingler, Janel Leyden-Noels, Isa Fernandez, Mallory O Johnson","doi":"10.1136/bmjph-2024-001890","DOIUrl":"10.1136/bmjph-2024-001890","url":null,"abstract":"<p><strong>Purpose: </strong>Developing effective HIV/AIDS prevention communication strategies is critical to engaging diverse populations in HIV prevention efforts. While many programmes have demonstrated success, there remains a need for more tailored approaches for non-white and immigrant populations, who continue to face disproportionate burdens. Latino men who have sex with men (LMSM) are particularly impacted, underscoring the urgency of culturally responsive communication strategies. Guided by the social-ecological model and principles of community-based participatory research, we convened a Community Advisory Board (CAB) composed of community stakeholders and service providers to inform the adaptation of a biobehavioural, couple-based HIV prevention intervention for Latino men and their same-sex partners. Participants completed questionnaires and engaged in structured discussions to develop culturally and linguistically appropriate recruitment materials and refine intervention content.</p><p><strong>Methods: </strong>Qualitative data were collected through transcribed notes and questionnaire responses, then analysed using content analysis.</p><p><strong>Results: </strong>Four key themes emerged as essential to effective HIV prevention messaging: (1) inclusivity across race, gender and relationship types (including non-monogamous couples); (2) language and literacy considerations; (3) visual appeal and (4) responsiveness to broader social and contextual factors. CAB members recommended the use of simple, direct messages framed around positive outcomes (e.g., 'increasing safety' vs 'reducing HIV risk') and highlighted the need to address how hypersexualised portrayals of Latino men contribute to risk behaviours and negatively affect mental health.</p><p><strong>Conclusion: </strong>To enhance the relevance and impact of HIV prevention efforts for LMSM, communication strategies must address within-group diversity and the sociocultural context. CAB engagement is a critical foundation for designing scalable, community-informed interventions.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001890"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152698","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":"Antibiotic use in the commercial poultry sector of Uganda and its public health implications: a cross-sectional survey.","authors":"Israel Mugezi, Vivian Twemanye, Emmanuel Isingoma, Ceaser Adibaku Nyolimati, Jonathan Mayito, Richard Namwano Walwema, Francis Kakooza, Ross Fitzgerald, Anna Rose Okurut Ademun, Wilfred Opira, Adrian Muwonge","doi":"10.1136/bmjph-2024-002355","DOIUrl":"10.1136/bmjph-2024-002355","url":null,"abstract":"<p><strong>Introduction: </strong>Rising poultry demand is driving shifts towards intensive farming in the Global South, raising concerns about antibiotic use and food chain risks. This study examines the nature and extent of antibiotic use in Uganda's commercial poultry sector and quantifies antibiotic use at bird, farm and national levels. Further, the study estimates antibiotic residues in broiler, layer and duo-purpose poultry meat at slaughter to evaluate food chain risks.</p><p><strong>Methods: </strong>This cross-sectional survey used the World Organisation for Animal Health standards for monitoring quantities of antimicrobial agents used in food-producing animals, on 374 commercial poultry farms with 187 798 birds randomly selected from the Northern, West Nile, Eastern and Southwestern subregions of Uganda.</p><p><strong>Results: </strong>The overall antibiotic use was 82 kg per farm per cycle, with variability by poultry type, farm size and at regional level, that is, ~170 mg more were used in broiler than dual-purpose birds, ~220 mg more were used on broiler than layer farms, ~180 g more used in the Southwestern than the Eastern region. Smaller farms (≤200 birds) use 1050 mg more than larger farms (≥800 birds). Drug formulation (whether powdered or liquid) and access to veterinary extension services were associated with higher and lower antibiotic use, respectively. 24.7 tons (~63% of the poultry annual antibiotic imports) are used by the commercial sector. Tetracycline and colistin sulphate are the most used, and we estimated 14% and 54% of broiler farms with non-adherence to their withdrawal periods, respectively, exceeding maximum residue levels of 150 ng/kg and 200 ng/kg of meat.</p><p><strong>Conclusions: </strong>We estimate that the commercial poultry sector, that makes 30% of the national poultry population, uses 63% of imported antibiotics, with potential public health implications such as residues in the food chain. Interventions should be tailored to poultry production types hinged on robust veterinary extension services.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002355"},"PeriodicalIF":0.0,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152641","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":"Exploring the lived experiences of patients with type 2 diabetes mellitus-related complications in a healthcare setting in Singapore: a phenomenological study.","authors":"P V AshaRani, Kumarasan Roystonn, Madhumitha Ramu, Yeow Wee Brian Tan, Fiona Devi, Muhammad Iskandar Shah, Peizhi Wang, Sum Chee Fang, Subramaniam Tavintharan, Tan Hwee Huan, Lee Eng Sing, Chong Siow Ann, Mythily Subramaniam","doi":"10.1136/bmjph-2025-003183","DOIUrl":"10.1136/bmjph-2025-003183","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing prevalence of diabetes and its associated complications presents a significant public health challenge, particularly in ageing populations. This qualitative study conducted in a healthcare setting in Singapore explored the lived experiences of patients with type 2 diabetes mellitus (T2DM) progression and complications, aiming to uncover challenges and enablers of effective self-care and complication management, thereby informing patient-centred policy and healthcare improvements.</p><p><strong>Methods: </strong>A phenomenological approach was employed, involving one-to-one in-depth interviews with 13 participants with T2DM with complications. Participants were recruited through purposive sampling from the outpatient setting of a community-level diabetes care centre. Data were analysed through a reflexive thematic analysis.</p><p><strong>Results: </strong>Seven themes emerged from the analysis: (1) pathways to initial diagnosis of diabetes, (2) diagnosis of diabetes-related complications (with subthemes of diagnosis in emergency and non-emergency settings), (3) barriers to help-seeking for complications, (4) barriers to diabetes complications management, (5) enablers of complications management, (6) experience of living with diabetes complications and (7) suggestions and recommendations for better care. Subthemes for barriers and enablers encompassed personal, healthcare-related and social/community factors. Findings revealed significant gaps in symptom recognition, treatment adherence and glycaemic control among participants. Despite these challenges, participants demonstrated considerable resilience and adaptability.</p><p><strong>Conclusion: </strong>This study identified complex trajectories in T2DM progression, from the initial diagnosis to complication management, identifying key challenges and enablers. The findings highlighted the necessity for enhanced public education, tailored interventions and holistic care approaches. These insights have the potential to significantly improve the quality of life of individuals living with T2DM complications and alleviate the burden on healthcare systems, providing a foundation for future patient-centred diabetes management strategies.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e003183"},"PeriodicalIF":0.0,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152675","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":"You Need to Know: evaluation of a uterine cancer awareness campaign for Black and Asian ethnic minority women in North East London.","authors":"Anisha Chitrakar, Natalie Darko, Nessa Millet, Sherrice Weekes, Harjeet Dhanota, Alexandra Lawrence, Caroline Cook, Esther L Moss","doi":"10.1136/bmjph-2024-002475","DOIUrl":"10.1136/bmjph-2024-002475","url":null,"abstract":"<p><strong>Introduction: </strong>The 'You Need to Know' (YNTK) uterine cancer (UC) awareness campaign was designed and conducted in North East London (NEL) in response to high UC mortality rates reported among women from Black and Asian minority groups. YNTK aimed to raise awareness of red-flag symptoms, address misconceptions and encourage earlier presentation to healthcare services with a long-term aim of reducing the number of patients diagnosed with advanced stage UC. Information materials were designed in consultation with members of Black and Asian ethnic minority groups from NEL, and the YNTK campaign was delivered between January 2023 and April 2024, in collaboration with The Eve Appeal, a gynaecological cancer charity.</p><p><strong>Methods: </strong>A process evaluation was conducted using data collected through (1) A questionnaire of pre-campaign UC awareness in women from the target population, (2) Outreach talk attendance and feedback questionnaires and (3) Interviews with staff members who played a role in organising or delivering the outreach talks.</p><p><strong>Results: </strong>Application of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework enabled a comprehensive analysis of the impact of YNTK, and enabled the identification of areas for campaign refinement. In particular, enhancing language interpreter support and overcoming barriers to in-person events were highlighted. It was acknowledged that the campaign did require resources in the form of staff and venues, and maintenance could be supported through the use of multi-lingual information resources shared by community members.</p><p><strong>Conclusions: </strong>The YNTK campaign has provided valuable insights into maximising the effectiveness of a targeted cancer awareness intervention at the community level. Despite logistical challenges, YNTK appears to have been effective in achieving its primary objective of increasing UC awareness, as evidenced by the positive feedback from event attendees, although the clinical impact on UC diagnosis will need to be evaluated over the coming months and years.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002475"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152276","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":"Estimates of energy intake, requirements and imbalances based on anthropometric measurements at global, regional and national levels and for sociodemographic groups: a modelling study.","authors":"Marco Springmann","doi":"10.1136/bmjph-2024-002244","DOIUrl":"10.1136/bmjph-2024-002244","url":null,"abstract":"<p><strong>Introduction: </strong>An accurate understanding of total energy intake, energy requirements for healthy body weights and the resultant imbalance is important for many aspects of dietary analysis. Despite its importance, existing estimates are highly uncertain and not well aligned with trends in body weight and malnutrition, especially at regionally comparable and global levels. We estimated energy intake, energy requirements and energy imbalances at global, regional, national and sociodemographic levels based on anthropometric measures.</p><p><strong>Methods: </strong>We used predictive equations for estimating energy requirements derived from a comprehensive database of doubly labelled water studies, and paired them with global datasets on body weight, height and physical activity to estimate a new proxy of energy intake. We calculated energy requirements to attain healthy body weights by applying the predictive equations to a body mass index that minimises risks for weight-related diseases and is classified as normal. We calculated energy imbalances as the difference between the estimated intake and energy requirements to attain healthy body weights.</p><p><strong>Results: </strong>On average, 2160 kilocalories per person per day (kcal/day) were required in 2020 to sustain measured levels of body weight, height and physical activity (95% CI, 2100 to 2210 kcal/day), ranging from 1980 (95% CI, 1900 to 2060) kcal/day in low-income countries to 2360 (95% CI, 2310 to 2410) kcal/day in high-income countries. The estimated intake exceeded energy requirements to attain healthy body weights by 80 (95% CI, 70 to 100) kcal/day on average, with 192 countries (97%) having average intakes above recommendations, and 6 countries (3%) with intake below, and increasing to 14 (7%) when considering rural residences. Between 1990 and 2020, 50 countries (25%) changed from average intakes below recommendations to intakes above.</p><p><strong>Conclusions: </strong>Estimating total energy intake based on anthropometric measures captures the regional and temporal trends in body weight, height and physical activity. The estimates can be used as a complementary measure to existing proxies of energy intake. Among other things, they can inform misreporting of intake in dietary surveys, uncertainty in the amount of food wasted and the lack of data on at-home production in food availability statistics. Aligning existing measures of food intake with consistent estimates of overall energy intake could improve dietary analyses and policy planning.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002244"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152654","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":"Variant connective tissue as a risk factor for long COVID: a case-control study of data from a retrospective online survey of adults in the USA and UK.","authors":"Regina A Torok, Jeffrey Lubell, Rena M Rudy, Jessica Eccles, Lisa Quadt","doi":"10.1136/bmjph-2025-002949","DOIUrl":"10.1136/bmjph-2025-002949","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored the extent to which two measures of joint hypermobility, a marker of variant connective tissue, predict the development of long COVID after COVID-19 infection, and whether the severity of initial COVID-19 symptoms impacts this relationship.</p><p><strong>Methods: </strong>We recruited 1816 participants (352 (19.4%) reporting long COVIDLong COVID, 1464 (80,6%) not reporting long COVIDLong COVID) from the US and UK for a retrospective online survey. The primary outcome was self-reported long COVIDLong COVID, defined as experiencing symptoms related to a COVID-19 infection at least 3 months after infection. Secondary outcomes included severity of symptoms during each COVID-19 infection, generalised joint hypermobility (GJH), and the novel concept of 'extreme hypermobility'.</p><p><strong>Results: </strong>In separate binomial logistic regressions controlling for sex assigned at birth, age, number of infections and number of vaccine doses, both GJH (OR 1.29, 95% CI 1.00 to 1.65) and extreme hypermobility (OR 2.12, 95% CI 1.43 to 3.16) were found to be predictive of long COVIDLong COVID. This likely occurs through two pathways. First, both GJH and extreme hypermobility increase the risk that individuals with no or moderate initial symptoms from a COVID-19 infection experience long COVIDLong COVID. Second, both GJH and extreme hypermobility are significant predictors of developing severe initial symptoms from a COVID-19 infection, which is independently associated with increased long COVID risk. A mediation analysis confirmed that extreme hypermobility influences the odds of developing long COVID in part by increasing the likelihood that individuals experience severe initial symptoms from a COVID infection.</p><p><strong>Conclusions: </strong>Both GJH and extreme hypermobility are significant risk factors for long COVID. People with extreme hypermobility, as newly defined in this study, are at particularly high risk of developing long COVID after an initial COVID-19 infection. Further research is needed to replicate these findings with other datasets, clarify the pathophysiology that explains why people with hypermobility may be at greater risk of long COVID and assess the clinical significance of 'extreme hypermobility'.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002949"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152724","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":"Cross-sectional study of healthcare professionals' estimates of the health numeracy of inpatients and outpatients in a UK secondary care setting.","authors":"Calisha Allen, Chad Byworth, Rajashree Murki, Sarah Beale, Akifah Mojadady, Lubnaa Ghoora, Jameela Nagri, Chetan D Parmar","doi":"10.1136/bmjph-2025-002659","DOIUrl":"10.1136/bmjph-2025-002659","url":null,"abstract":"<p><strong>Introduction: </strong>A cross-sectional study to identify whether healthcare professionals (HCPs) can accurately estimate the health numeracy of patients.</p><p><strong>Methods: </strong>A convenient sample of inpatients and outpatients, in an urban UK general hospital, undertook a validated health numeracy assessment and associated demographics questionnaire. HCPs who had a care interaction with the patient were shown the health numeracy assessment, informed of the mean score and SD in the assessment's validation study, and were then asked to estimate their patient's score. Outcome measures were the proportion of underestimations, correct estimations and overestimations by HCPs and a comparison of HCP estimates to the patient's score on the assessment as assessed through the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Health numeracy assessments were completed by 142 patients with a mean score of 38.9% and an SD of 33.4%. There were 220 estimations of patients' health numeracy obtained from HCPs. All HCP groups overestimated patient health numeracy with overestimates accounting for 66.8% of all estimates. ICC was below 0.4 for all HCP groups (ICC 0.054; 95% CI -0.078 to 0.185) indicating poor agreement between the HCPs' estimations and the patient's health numeracy as measured by the health numeracy assessment. Senior doctors (consultants and registrars) were most likely to correctly estimate patient health numeracy (20.8% and 20.0% of estimates, respectively).</p><p><strong>Conclusions: </strong>Good health numeracy is vital to effective understanding of risk, shared decision-making and the consenting process. However, HCPs of varying professional backgrounds struggle to correctly estimate their patient's health numeracy and tend to overestimate it. Given that health numeracy is poor for a large proportion of patients, there is a risk that HCPs may fail to identify scenarios in which their patient's poor health numeracy could undermine shared decision-making and/or lead to poor outcomes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002659"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152693","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":"Generic competition and price developments in the USA, Germany and Switzerland (2007-2023): a longitudinal observational study.","authors":"Simon Hediger, Luca Locher, Kerstin Noëlle Vokinger","doi":"10.1136/bmjph-2024-002535","DOIUrl":"10.1136/bmjph-2024-002535","url":null,"abstract":"<p><strong>Introduction: </strong>Drug expenditure has increased over the past years in the USA and Europe, mainly driven by originator drugs. Generic drugs have a substantial cost-saving potential. We analysed the number of generic competitors entering the market over time, distribution of market share between originator drugs and their generic competitors and association between the number of generic competitors and price changes of originator and generic drugs in the USA, Germany and Switzerland.</p><p><strong>Methods: </strong>In this longitudinal observational study, we included all originator drugs and their corresponding generic competitors with market entry between 2007 and 2023 in the USA, Germany and Switzerland from the IQVIA database. We extracted quarterly price and sales volume data for the same study period from the IQVIA database. Descriptive statistics and regression analyses were conducted to answer the research questions.</p><p><strong>Results: </strong>530 active substances in the USA, 406 in Germany and 108 in Switzerland were included. 3 years after competition start, an average of four generic competitors entered the market in the USA, 7.6 in Germany and 3.3 in Switzerland. An increase in the number of generic competitors was associated with an increase in average generic market share. On average, the generic market share reached 90% after the entry of five generic drugs in the USA and nine in Germany, and was not reached in Switzerland. An association between the number of competitors and relative price decrease of generic drugs was observed in all three countries. This association was also observed for originator drugs in Switzerland and Germany, but not in the USA.</p><p><strong>Conclusions: </strong>The findings indicate that policies targeting market entry and prices of generic drugs would be helpful in all three countries. More research is needed to assess the impact of previous and future policies.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002535"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152729","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":"Snakebite incidence, knowledge and practices among rural subsistence farmers in Pwani Region, Tanzania: a cross-sectional study.","authors":"Abdallah Zacharia, Clemence Kinabo, Huda Omary, Ummul-Khair Mustafa, Yassin Athuman, Mary Joseph, Twilumba Makene, Anord Rwekaza Paschal, Salum S Ekenga, Monica Shabani, Billy Ngasala","doi":"10.1136/bmjph-2024-002407","DOIUrl":"10.1136/bmjph-2024-002407","url":null,"abstract":"<p><strong>Introduction: </strong>Snakebite is considered an occupational disease, primarily affecting farmers, pastoralists and other agricultural workers in poor rural communities. The WHO aims to reduce snakebite incidence by 50% by 2030. Given that snakebite is an ecological disease, understanding indigenous knowledge and practices is essential for effective intervention planning. This study aimed to determine the snakebite incidence rate, and the knowledge and practices related to snakebite among subsistence farmers in Pwani Region, Tanzania.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in two rural villages. Data were gathered using a pre-tested questionnaire and analysed using SPSS (Version 23.0). Snakebite incidence was calculated. Knowledge and practice scores were computed, categorised and analysed using Chi-squared or Fisher's exact tests, with significance set at 0.05.</p><p><strong>Results: </strong>Out of 766 subsistence farmers, 723 (94.4%, 95% CI: 92.6% to 96.1%) reported encountering snakes, and 104 (136 per 1000) reported having experienced snakebite in their lifetime. Snakebite incidence rate was significantly higher among participants aged 50 years and above (163 per 1000), widows or widowers (293 per 1000) and those residing in Miteza Village (167 per 1000) (p<0.05). Most incidences occurred during the dry season (67.7%, 95% CI: 58.2% to 75.8%), in the evening (30.8%, 95% CI: 22.4% to 40.0%) and on farms (39.4%, 95% CI: 28.8% to 49.4%). The lower limb was the most affected part of the body (87.5%, 95 CI: 78.6% to 93.8%). The knowledge of snakebite risks, signs and symptoms, first aid and prevention was significantly higher among participants who stayed at the villages for over 10 years (6.2%) and residents of Ngorongo Mashariki Village (7.3%) (p<0.05). Poor preventive practice was notably higher among females (53.7%), divorced individuals (65.3%), those with secondary education (67.7%) and residents of Ngorongo Mashariki (65.6%) (p<0.05).</p><p><strong>Conclusion: </strong>The findings indicate that snakebite is a common occupational hazard in the region, and the gaps in knowledge and preventive practices necessitate targeted intervention to improve snakebite management and prevention.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002407"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088698","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":"Acute cystitis and subsequent risk of urogenital cancer: a national cohort study from Sweden.","authors":"Filip Jansåker, Xinjun Li, Kristina Sundquist","doi":"10.1136/bmjph-2024-002495","DOIUrl":"10.1136/bmjph-2024-002495","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine the subsequent risks of urogenital cancers in men and women aged ≥50 years diagnosed with acute cystitis.</p><p><strong>Methods: </strong>A Swedish nationwide cohort study was conducted that included primary healthcare data. The total population consisted of 1 668 371 men and 1 889 211 women; of these, 177 736 men and 427 821 women were diagnosed with acute cystitis (first event) during 1997-2018 (91.3% in primary healthcare settings). The outcome was urogenital cancer in men and women with cystitis compared with the total population, measured as standardised incidence ratios (SIRs) and excess rates per 10 000 person-years.</p><p><strong>Results: </strong>A total of 199 144 men and 57 882 women were diagnosed with urogenital cancer (24 137 subsequently to cystitis). The most common cancers were prostate and bladder cancer. The urogenital cancer risks were elevated across all age groups of men and women with cystitis. The risks were highest within 3 months of follow-up but persisted over several years for most cancers. The risks within 3 months of follow-up were as follows: for bladder cancer, the SIR was 33.69 (95% CI 32.02 to 35.43) in men and 30.00 (28.02 to 32.09) in women, corresponding to 483.72 and 96.00 excess cancer rates per 10 000 person-years, respectively. For prostate cancer, the SIR was 7.05 (6.74 to 7.37) and the excess cancer rate was 550.88 per 10 000 person-years; between 3 and 12 months of follow-up, the excess rate was 104.89 per 10 000 person-years. For kidney cancer, the SIR was 11.28 for men and 7.72 for women. For gynaecological cancers, SIRs were between 4 and 8. Some interactions were observed between sex and cystitis in relation to urogenital cancer risks.</p><p><strong>Conclusion: </strong>Acute cystitis can precede urogenital cancers in men and women aged ≥50 years. The increased risks were particularly high within 3 months after the acute cystitis event and persisted for several years.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002495"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088692","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}