BMJ public health最新文献

{"title":"'Overhaul Medicare and perhaps train us better': a qualitative study of primary care general practitioners' perspectives on how to implement the low back pain clinical care standards.","authors":"Nathalia Costa, Chung-Wei Christine Lin, Fiona Blyth, Carmen Huckel-Schneider, Rachelle Buchbinder, Danijela Gnjidic, Aili Langford, Denise O'Connor, Carl Schneider, Simon French","doi":"10.1136/bmjph-2025-002564","DOIUrl":"10.1136/bmjph-2025-002564","url":null,"abstract":"<p><strong>Introduction: </strong>In September 2022, the Australian Commission on Safety and Quality in Healthcare released the Low Back Pain Clinical Care Standards ('Care Standard'). We aimed to explore general practitioners' (GPs') perspectives on how the Care Standard can be implemented, with a view to identifying what strategies could be used to do so.</p><p><strong>Methods: </strong>This qualitative study is underpinned by a critical realist philosophy. We interviewed 16 GPs across Australia with experience working with patients who present with low back pain (LBP). Interview questions were based on the Theoretical Domains Framework, and interview data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>We identified three themes: theme 1-'I have my own guidelines and ways of doing things'-guidelines and standards are not relevant for experienced GPs' captures the perceived unnecessariness of seeking advice from guidelines and standards for LBP; theme 2-I agree with the standards but the system, clinicians and patients hinder my ability to enact them-reports factors impacting the will and ability of clinicians to implement the standards in practice; theme 3-Change the system and train us better-discusses potential strategies to implement the Care Standard: changing funding and infrastructure (eg, improving GPs' reimbursement for time spent, investing in publicly funded allied health services); offering training and education (eg, continuing professional development courses, improving communication training in undergraduate courses), developing stakeholder relationships (eg, primary health networks, Health Pathways), supporting clinicians through interactive assistance (eg, reminders, embedding assessment tools in existing systems), engaging/educating patients and using evaluative strategies such as auditing.</p><p><strong>Conclusions: </strong>Our results suggest that the multidimensional nature of the challenges GPs face, and the strategies they suggest, calls for a multimodal and integrated approach to implementing the Care Standards, including system changes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002564"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042892","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":"Combination of housing type (detached houses vs flats) and tenure (owned vs rented) in relation to cardiovascular mortality: findings from a 6-year cohort study in Japan.","authors":"Wataru Umishio, Sakura Kiuchi, Toshiyuki Ojima, Masashige Saito, Masamichi Hanazato, Jun Aida","doi":"10.1136/bmjph-2025-003073","DOIUrl":"10.1136/bmjph-2025-003073","url":null,"abstract":"<p><strong>Introduction: </strong>The WHO Housing and Health Guidelines have highlighted the impact of housing quality on cardiovascular diseases (CVDs), including pathways such as cold-induced hypertension. Major factors influencing housing quality include architectural type (detached houses vs flats) and tenure (owned vs rented), but few studies have examined their effects on CVDs.</p><p><strong>Methods: </strong>46 850 occupants were included during the follow-up period from 1 January 2012 to 31 December 2017 in the Japan Gerontological Evaluation Study. By linking survey data with cause-of-death records, the Kaplan-Meier curves were constructed. Competing risk regression models were applied to calculate the subdistribution HRs (SHRs) for cardiovascular mortality risks across housing statuses, adjusted for demographics, socioeconomic factors and lifestyle behaviours. Sex-stratified analyses and Cox regression analyses were also conducted to calculate the HRs.</p><p><strong>Results: </strong>A total of 38 731 participants (46.6% men) were analysed, with a mean age of 73.6 years and a median follow-up period of 2091 days. The cardiovascular mortality rate was 3.97 per 1000 person-years, with 2.3% experiencing CVD-related deaths. The Kaplan-Meier curve indicated higher cardiovascular mortality for those living in rental flats and owned detached houses compared with those in owned flats. Competing risk regression models indicated a significantly higher risk of cardiovascular deaths among occupants living in rental flats compared with those in owned flats (SHR=1.78; 95% CI 1.05-3.02). For men, the risk was notably higher (SHR=2.32; 95% CI 1.13-4.75), though not statistically significant in women. Sensitivity analyses using Cox regression supported these findings, showing higher risk estimates for men (HR=2.36; 95% CI 1.16-4.82).</p><p><strong>Conclusions: </strong>Rental housing and detached houses are likely to have lower temperatures and greater temperature instabilities, raising blood pressure and increasing CVDs. Improving housing quality can contribute to cardiovascular health at the population level.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e003073"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042861","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":"Relations of problematic online dating app use with mental and sexual health: a cross-sectional study in Swiss university students.","authors":"Babette L Winter, Clarissa Janousch, Fabienne S V Wehrli, Jan S Fehr, Benjamin Hampel, Boris B Quednow","doi":"10.1136/bmjph-2025-002569","DOIUrl":"10.1136/bmjph-2025-002569","url":null,"abstract":"<p><strong>Background: </strong>The rise of online dating apps (ODAs) has raised concerns about potential mental and sexual health risks, particularly among emerging adults. However, limited research exists on how problematic ODA use and health outcomes are associated during this sensitive transition phase of early adulthood.</p><p><strong>Methods: </strong>Data were collected in an anonymous online survey from 923 Swiss university students (64% female) who had actively used ODA in the past 12 months. The Problematic Online Dating Apps Use Scale (PODAUS) and a variety of mental health, substance use and sexual health outcomes were assessed. Regression models were applied to examine associations between problematic ODA use and health outcomes. Measurement invariance (MI) of the PODAUS was tested across females and males. In a subsample (<i>N</i>=275), the PODAUS was retested at a 14-day follow-up.</p><p><strong>Results: </strong>Higher intensity of problematic ODA use was significantly associated with more symptoms of depression, impulsivity and a higher number of sexual partners. Furthermore, a higher PODAUS score was associated with higher lifetime and 12-month prevalence rates of sexually transmitted infections. PODAUS demonstrated good internal consistency (α=0.73) and acceptable retest reliability (r_s=0.54**), while MI was confirmed across genders.</p><p><strong>Conclusions: </strong>We identified significant associations between problematic ODA use and adverse health outcomes in a student population. Our findings highlight the necessity for targeted mental health interventions and sexual health education for university students, especially for those students exhibiting problematic ODA use patterns.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002569"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042967","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":"Retrospective population-based study of 132 000 Canadians on the relationship between community belonging and diabetes incidence.","authors":"Sarah M Mah, Mackenzie Hurst, Mindy Lu, Laura C Rosella","doi":"10.1136/bmjph-2024-001560","DOIUrl":"10.1136/bmjph-2024-001560","url":null,"abstract":"<p><strong>Introduction: </strong>Community belonging is a dimension of subjective well-being that is of growing public health interest for mitigating chronic disease. However, there is limited longitudinal evidence that such a relationship exists. We assessed the effect of community belonging on the subsequent 5-year risk of diabetes.</p><p><strong>Research design and methods: </strong>This population-based cohort study consisted of 132 295 Ontario respondents of the Canadian Community Health Survey (2000-2014) aged 30-75 years and diabetes-free. Individuals were linked to a validated diabetes registry and followed for 5 years or until 31 March 2020. Survey respondents rated their sense of belonging to community on a 4-point scale (very strong, somewhat strong, somewhat weak or very weak belonging). We estimated the effect of community belonging on 5-year diabetes incidence using Cox proportional hazards models. Inverse probability of treatment weighting (IPTW) was used to account for sociodemographic and behavioural confounders. Analyses were also stratified, weighted and modelled by key individual-level characteristics.</p><p><strong>Results: </strong>At survey response, 9.5% of the sample reported having very weak sense of belonging to their communities. By the end of study follow-up, 5.3% of the sample developed diabetes. IPT weighting achieved balance between community belonging groups across the sample and subgroups. Respondents with a very weak sense of belonging exhibited higher risk of diabetes (HR 1.26, 95% CI 1.09 to 1.46, compared with those with somewhat weak, somewhat strong and very strong sense of belonging), even after accounting for individual-level factors via IPTW (HR 1.16, 95% CI 1.01, 1.34). Those with very weak belonging exhibited elevated risk of diabetes across most subgroups, and this association remained conclusive after IPT weighting for Canadian-born and white participants.</p><p><strong>Conclusions: </strong>The association between weak sense of belonging to community and diabetes risk demonstrated by this study highlights the critical role that social connections play in chronic disease epidemiology. Our findings signal a need to include social and community factors in population health strategies for chronic disease prevention.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001560"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025116","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":"Vaping health perceptions and never vaping among Australian adolescents: a strength-based analysis of cross-sectional survey data.","authors":"Amelia Yazidjoglou, Christina Watts, Grace Joshy, Sam Egger, Emily Banks, Becky Freeman","doi":"10.1136/bmjph-2024-002414","DOIUrl":"10.1136/bmjph-2024-002414","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Introduction: </strong>Curbing adolescent vaping is a public health priority and little evidence exists examining protective factors. Using a strength-based approach, this study explored the relationship between adolescent vaping health perceptions and vaping use.</p><p><strong>Methods: </strong>Cross-sectional data from 9000 Australian adolescents aged 14-17 years recruited via multiple online panels as part of the Generation Vape Study were used. Logistic regression compared never vs ever vaping, and inversed multinomial logistic regression compared never vaping to four lifetime vaping categories (ranging from use on a few to >100 occasions) for eight health perceptions.</p><p><strong>Results: </strong>Overall, 66% (5948/9000) of participants reported never vaping. Within all vaping categories, most agreed that vapes are unsafe, can harm the lungs and brain and can cause addiction, and disagreed that nicotine is harmless. Compared with those who disagreed/strongly disagreed, the odds of never vs ever vaping were greater among those who agreed/strongly agreed that vapes are unsafe to use (adjusted OR=2.67; 95% CI 2.17 to 3.27), can harm the developing brain (2.61; 2.05 to 3.33), can damage the lungs (1.61; 1.23 to 2.10), can cause addiction (2.32; 1.79 to 3.00) and that they are unsafe to use around others (2.94; 2.48 to 3.49). Compared with those who agreed/strongly agreed that nicotine is harmless, there were greater odds of never use (vs ever use) among those who disagreed/strongly disagreed (1.75; 1.44 to 2.11). The protective relationship remained across different lifetime vaping categories. Neither agreeing nor disagreeing was not generally a factor protective against vaping.</p><p><strong>Conclusion: </strong>Perceptions of vape harms appear protective against experimental and regular vaping. Young people vape despite the majority of users being aware of harms, suggesting knowledge alone is an unlikely driver of behaviour. Comprehensive control efforts that embrace a suite of actions including education, policy, enforcement and monitoring activities are needed to best protect adolescent health.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002414"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025053","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":"Practical integrated healthcare prevention and management of children's health quality of respiratory functions: a systematic review.","authors":"Wen-Yi Liu, Tao-Hsin Tung, Leiyu Shi","doi":"10.1136/bmjph-2023-000477","DOIUrl":"10.1136/bmjph-2023-000477","url":null,"abstract":"<p><strong>Background: </strong>To synthesise recent empirical evidence for the prevention and management of respiratory function in children.</p><p><strong>Methods and findings: </strong>We searched the PubMed, Cochrane Library, Embase and Web of Science databases for studies published from inception to 16 September 2024. Two authors independently selected eligible studies, evaluated the quality of the included studies and assessed bias based on the Cochrane Collaboration tool for assessing the risk of bias. First, 968 studies that met the inclusion criteria were selected. We stratified all studies into three groups: asthma (n=50), pneumonia (n=4) and other respiratory diseases (n=15). We performed bias evaluations and summarised the paediatric respiratory function on a pathway based on probable aetiology. We determined that household and communal management schemes for different age groups were based on different types of diseases. We divided the children into the infant group (0-3 years old), preschool age (4-6 years old), school-going age (7-13 years old) and adolescents (14-18 years old) and summarised the appropriate management schemes according to the different characteristics of each group.</p><p><strong>Conclusion: </strong>Effective prevention and management strategies implemented at both the family and community levels can significantly enhance the quality of life for children with respiratory disorders. Our summary highlights the importance of these strategies throughout the preadult lifecycle. We emphasise the need for future research employing rigorous and advanced methodologies to explore and address prevention and management practices across varying severity levels of respiratory conditions.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e000477"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025099","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":"Treatment outcomes and associated factors of severe acute malnutrition among under-5 children in Jigjiga public hospitals, Somali region, Ethiopia: a retrospective cohort study.","authors":"Mustafe Mahamud Abdi, Iid Muktar Jama, Abdilahi Ibrahim Muse, Girma Tadesse Wedajo, Mohamed Omar Osman, Kalkidan Hassen Abate","doi":"10.1136/bmjph-2024-001737","DOIUrl":"10.1136/bmjph-2024-001737","url":null,"abstract":"<p><strong>Background: </strong>Severe acute malnutrition (SAM) affects about 20 million under-5 children and contributes to one million child deaths annually. Apart from the presence of clinical management protocols capable of reducing case fatality by 1%-5%, case fatality in hospitals in developing countries averages 20%-30% and has remained the same since the 1950s.</p><p><strong>Objective: </strong>This study aimed to assess treatment outcomes and associated factors of severe acute malnutrition among under-5-year-old children admitted to Jigjiga city public hospitals.</p><p><strong>Methods: </strong>A facility-based retrospective cohort study design was employed on patient records between 1 January 2020 and 31 December, 2021. A structured checklist was used for data extraction to collect data from patient record book. Cox proportional hazards model with a hazard ratio of 95% CI was used. The level of statistical significance was declared at a p<0.05.</p><p><strong>Results: </strong>Overall median length of stay, recovery, death, defaulted and non-responder rate were 7 days, 257 (70.2%), 32 (8.7%), 58 (15.8%) and 19 (5.2%), respectively. Managing facility, tuberculosis (TB), pneumonia and nasogastric (NG) tube insertion were found to be significantly associated with treatment outcomes at a p<0.05.Children who were managed at Jigjiga University Sheik Hassen Yabare Comprehensive Specialised Hospital were 57% less likely to recover from SAM than those managed at Karamardha General Hospital (adjusted hazard ratio (AHR)=0.437, 95% CI: 0.286 to 0.600). Children who did not have TB were almost three times more likely to recover than their counterparts (AHR=2.862, 95% CI: 1.604 to 5.107), and those without pneumonia were also 1.5 times more likely to recover than those with a diagnosis of pneumonia (AHR=1.509, 95% CI: 1.146 to 1.989). Furthermore, children without nasogastric tube insertion were about 1.5 times more likely to recover than their counterparts (AHR=1.472, 95% CI: 1.075 to 2.015).</p><p><strong>Conclusions: </strong>The recovery and defaulter rates fell outside the acceptable targets set by SPHERE standards; however, the death rate was acceptable. The significant predicting factors of treatment outcome were treating facility, TB, pneumonia and NG tube insertion.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001737"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025088","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":"Machine-learning-based model for analysing and accurately predicting factors related to burnout in healthcare workers.","authors":"Chao Liu, Yen-Ching Chuang, Lifen Qin, Lijie Ren, Ching-Wen Chien, Tao-Hsin Tung","doi":"10.1136/bmjph-2023-000777","DOIUrl":"10.1136/bmjph-2023-000777","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to analyse the factors affecting medical burnout in hospitals, identify the characteristics of staff experiencing high levels of burnout and devise a practical and sustainable prediction mechanism.</p><p><strong>Methods: </strong>A survey was conducted to access the current situation, followed by a regression analysis using data from the Maslach Burnout Inventory General Survey, demographic information related to healthcare personnel and employee job satisfaction metrics from the hospitals under study. Subsequently, four predictive models-logistic regression, K-nearest neighbour, decision tree and random forest (RF)-were employed to predict the degree of healthcare burnout.</p><p><strong>Results: </strong>The investigation revealed that 61.2% of the medical staff in the hospitals under study exhibited at least one symptom of burnout, with 9.8% experiencing high levels of burnout. Elevated rates of high burnout were observed in the 30-39 age group, among physicians and surgeons, and among those with 0-5 years of experience. In terms of predictive methods, the RF model demonstrated suitability for predicting burnout among medical staff, achieving a prediction accuracy of approximately 80%.</p><p><strong>Conclusions: </strong>A significant correlation was found between job satisfaction and burnout levels. Physicians and surgeons with less than a decade of professional experience are more prone to high levels of burnout. The RF model proved effective for predicting the burnout level among medical staff, consistently achieving an accuracy rate close to 80%. These findings can serve as valuable insights for hospital administrators in their effort to prevent and mitigate burnout among medical staff.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e000777"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025102","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":"Disruption and recovery in physical and mental health, body mass index and smoking during the COVID-19 pandemic: a trend analysis of US BRFSS data from 2016 to 2022.","authors":"Khushbu Balsara, Varun Kotharkar, Panagis Galiatsatos, Norma Kanarek","doi":"10.1136/bmjph-2025-002765","DOIUrl":"10.1136/bmjph-2025-002765","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic caused widespread disruptions to population health, affecting key risk factors such as physical and mental health, smoking status and body weight. While short-term impacts have been studied extensively, long-term trends and recovery patterns remain unclear.</p><p><strong>Methods: </strong>This study used data from the Behavioural Risk Factor Surveillance System covering 2016-2022. Weighted proportions for health outcomes were calculated, and trends were analysed using locally weighted scatterplot smoothing and Kendall's tau correlation. Bootstrapping was used to estimate CIs.</p><p><strong>Results: </strong>During the pandemic, individuals reporting 14+not good physical health days increased significantly (τ=0.7238, p<0.0001). Mental health also deteriorated, with 14+not good mental health days increasing (τ=0.7263, p<0.0001). Smoking prevalence declined (τ=-0.5536, p<0.0001) while those who 'never smoked' increased (τ=0.6024, p<0.0001). Obesity prevalence rose significantly postpandemic (τ=0.6632, p<0.0001).</p><p><strong>Conclusions: </strong>The findings highlight the pandemic's profound and differential impact on physical health and persistent worsening of not good mental health days and body mass index indicating obesity. The decline in smoking prevalence suggests a positive behavioural shift during the early years of the pandemic. Targeted public health interventions are needed to address these challenges and promote recovery.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002765"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215238","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":"Effects of mothers' water, sanitation and hygiene habits on diarrhoea and malnutrition among children under 5 years in Nepal.","authors":"Shalik Ram Dhital, Catherine Chojenta, Deborah Loxton","doi":"10.1136/bmjph-2024-001815","DOIUrl":"10.1136/bmjph-2024-001815","url":null,"abstract":"<p><strong>Introduction: </strong>Diarrhoea and malnutrition (stunting, wasting and underweight) are major public health problems in developing countries, including Nepal. Improved water, sanitation and hygiene (WASH) may reduce the global disease burden by as much as 10.0%. This paper aims to examine the effects of the WASH components on diarrhoea and malnutrition rates among children under 5 years in Nepal.</p><p><strong>Methods: </strong>The 2016 Nepal Demographic and Health Survey datasets were examined. The sample included children with outcome measures of diarrhoea (n=4846) and malnutrition (n=2363 for stunting, n=2360 for wasting and n=2370 for underweight). The study participants were mothers aged 15-49 with children under 5 years on the survey day. A multivariate logistic regression analysis was performed. The potential confounders were identified through Directed Acyclic Graphs software.</p><p><strong>Results: </strong>Among children under 5 years of age, 7.6% were suffering from diarrhoea, 35.6% from stunting, 9.8% from wasting and 27.1% from underweight. The absence of a fixed place for handwashing was associated with diarrhoea (adjusted OR (aOR)=1.63; 95%CI 1.20 to 2.22). Having no access to an improved toilet arrangement was associated with stunting and being underweight (aOR=1.78; 95%CI 1.25 to 2.55 and aOR=1.45; 95%CI 1.03 to 2.06, respectively). Having no fixed place for handwashing was associated with wasting (aOR=1.52; 95%CI 1.00 to 2.30).</p><p><strong>Conclusions: </strong>There is a significant relationship between diarrhoea and combined WASH facilities and mixed effects of an individual WASH components for malnutrition. A fixed place for handwashing can increase the rate of handwashing with soap practices. Importantly, combined WASH components can have positive effects on the control of diarrhoea but not necessarily on the prevention of malnutrition. Further, the results for individual WASH components in the prevention of malnutrition were also mixed. Therefore, further studies are needed to examine the association between combined WASH components and malnutrition.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001815"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025105","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}