BMJ public health最新文献

{"title":"Health professional and facility engagement in antimicrobial resistance prevention and containment strategic initiatives at public hospitals in Southern Ethiopia: facility-based cross-sectional study.","authors":"Mende Mensa Sorato","doi":"10.1136/bmjph-2024-002314","DOIUrl":"https://doi.org/10.1136/bmjph-2024-002314","url":null,"abstract":"<p><strong>Objective: </strong>Antimicrobial resistance (AMR) threatens millions of lives and poses significant health, economic and development challenges. Policies implemented to prevent and contain AMR should address it through a One Health Approach. This study assessed health professional and facility engagement in Southern Ethiopia's AMR prevention and containment strategic initiatives and associated factors.</p><p><strong>Design: </strong>A hospital-based cross-sectional study was conducted among 634 health professionals.</p><p><strong>Settings: </strong>Five randomly selected public hospitals from three (Gofa, Gamo and South Omo) zones.</p><p><strong>Participants: </strong>Health professionals working in the outpatient department in the randomly selected hospitals.</p><p><strong>Outcome measure: </strong>Health professional and facility engagement in AMR prevention and containment strategies. A binary logistic regression model was used to evaluate the association between the explanatory variables (socio-demographic characteristics, institutional and professional factors) and dependent variables (professional engagement in AMR PCSIs). To avoid many variables and unstable estimates and control possible confounders in the subsequent model, only variables that reached a p value less than 0.25 at binary analysis were used in the multivariate logistic regression analysis to identify factors independently associated with health professional and facility engagement level in AMR prevention and containment strategies.</p><p><strong>Result: </strong>This study included 634 participants (56.5% males). Among these professionals, the vast majority (n=444, 70.0%) were aware of the One Health perspective on AMR. Concerning health facility engagement in AMR PCSIs, about one-third (n=203; 32.0%) of professionals reported full engagement in the facilities. Nearly one-fourth of professionals (n=169; 26.7%) reported including AMR prevention and containment procedures in their facility's annual plan. The overall health professional and facility engagement in AMR PCSIs was 412 (65.0%). Having a history of sharp injury (adjusted odds ratio (AOR)=1.88 (1.19, 2.97; p=0.007)), working in a general hospital (AOR=3.746 (2.657, 5.282; p=0.000)), having good knowledge on healthcare waste management (AOR=1.99 (1.225, 3.258; p=0.006)) and being from a facility that included AMR prevention and containment in the annual plan (AOR=3.796 (2.01, 7.180; p=0.000)) were positively and independently associated with the dependent variable (professional engagement in AMR PCSIs). However, a working experience of 6-10 years (AOR=0.6 (0.32, 0.96, p<0.05)), receiving infection prevention control training (AOR=1.47 (1.02, 2.13, p=0.041)) and lack of adequate knowledge on One Health approach (AOR=0.50 (0.32, 0.79; p=0.003)) were negatively associated with professional and facility engagement in AMR PCSIs.</p><p><strong>Conclusion: </strong>In the study area, professional and facility enga","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002314"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061444","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":"Are food taxes for healthy eating acceptable? A survey of public attitudes in the UK.","authors":"Mario Martínez-Jiménez, Hannah Brinsden, Franco Sassi","doi":"10.1136/bmjph-2024-001731","DOIUrl":"https://doi.org/10.1136/bmjph-2024-001731","url":null,"abstract":"<p><strong>Introduction: </strong>Appropriately designed food taxes can improve diet quality and health. Fiscal levers are used in several countries to combat the rise in obesity and diet-related diseases. This study aims to investigate public attitudes, knowledge and policy preferences regarding food taxes for promoting healthy eating in the UK.</p><p><strong>Methods: </strong>A survey was administered through YouGov Plc to a nationally representative sample of 2125 adults, gathering information on: acceptability and support for different types of food taxes, awareness and knowledge of existing taxes and preferences for the characteristics of possible new taxes.</p><p><strong>Results: </strong>Overall, 48% of respondents support higher taxes on unhealthy foods, rising to 72% if taxes made healthy foods more affordable. Respondents with high socioeconomic status and those living in London showed the highest support. Respondents had limited awareness of existing food and beverage taxes and prioritised discretionary items such as cakes and crisps for possible increased taxation.</p><p><strong>Conclusions: </strong>The survey shows a high level of support for taxing unhealthy foods, as well as concern for the affordability of healthy foods. A carefully designed holistic approach to food taxation can be part of a wider public health strategy and can be favourably met by the general population in the UK.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001731"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061167","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 prevalence of long COVID and its most common symptoms among healthcare workers: a systematic review and meta-analysis.","authors":"Amani Al-Oraibi, Katherine Woolf, Jatin Naidu, Laura B Nellums, Daniel Pan, Shirley Sze, Carolyn Tarrant, Christopher A Martin, Mayuri Gogoi, Joshua Nazareth, Pip Divall, Brendan Dempsey, Danielle Lamb, Manish Pareek","doi":"10.1136/bmjph-2023-000269","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000269","url":null,"abstract":"<p><strong>Objectives: </strong>Long COVID, a condition where symptoms persist after the acute phase of COVID-19, is a significant concern for healthcare workers (HCWs) due to their higher risk of infection. However, there is limited knowledge regarding the prevalence, symptoms and clustering of long COVID in HCWs. We aimed to estimate the pooled prevalence and identify the most common symptoms of long COVID among HCWs who were infected with SARS-CoV-2 virus globally, and investigate any differences by geographical region and other factors.</p><p><strong>Design: </strong>Systematic review and meta-analysis (PROSPERO CRD42022312781).</p><p><strong>Data sources: </strong>We searched MEDLINE, CINAHL, EMBASE, PsycINFO and the grey literature from 31 December 2019 until 18 February 2022.</p><p><strong>Eligibility criteria: </strong>We included studies reporting primary data on long COVID prevalence and symptoms in adult HCWs who had SARS-CoV-2 infection.</p><p><strong>Data extraction and synthesis: </strong>Methodological quality was assessed using the Joanna Briggs Institute checklist. Meta-analysis was performed for prevalence data of long COVID following SARS-CoV-2 infection.</p><p><strong>Results: </strong>Out of 5737 articles, 28 met the inclusion criteria, with a combined sample size of 6 481 HCWs. 15 articles scored equal to or above the median score for methodological quality. The pooled prevalence of long COVID among HCWs who had SARS-CoV-2 infection was 40% (95% CI: 29% to 51%, I²: 97.2%; 12 studies), with a mean follow-up period of 22 weeks. The most prevalent symptoms reported were fatigue (35%), neurologic symptoms (25%), loss/decrease of smell and/or taste (25%), myalgia (22%) and shortness of breath (19%).</p><p><strong>Conclusion: </strong>This review highlights the substantial burden of long COVID among HCWs worldwide. However, limitations in data quality and inconsistent definitions of long COVID impact the generalisability of these findings. To improve future interventions, we recommend enhanced cohort study designs for better characterisation of long COVID prevalence and symptoms in HCWs.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e000269"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063925","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":"Mixed-method longitudinal investigation of sexual and gender-based violence following COVID-19 in South Africa.","authors":"Miriam Hartmann, Marie C D Stoner, Simone Storey, Danielle Giovenco, Yanga Zembe Zondi, Nontembeko Qwabe, Anna Mia Ekström, Audrey E Pettifor, Linda Gail Bekker, Anna Kågesten","doi":"10.1136/bmjph-2024-001697","DOIUrl":"10.1136/bmjph-2024-001697","url":null,"abstract":"<p><strong>Background: </strong>Throughout the COVID-19 pandemic, concerns were raised about unintended effects of measures taken to prevent its spread, on sexual and gender-based violence (SGBV). The United Nations called for understanding how national lockdowns put young people at risk of SGBV. This research is particularly needed in contexts such as South Africa, where pre-existing levels of SGBV are high and limited data has been released.</p><p><strong>Methods: </strong>This mixed-method longitudinal study characterised trajectories of household-level and partner-level SGBV exposure over 6 months, approximately 1 year after the initial COVID-19 lockdown. Utilising group-based trajectory modelling, survey data from 535 male and female participants, ages 13-24 and qualitative insights from 20 in-depth interviews were analysed.</p><p><strong>Results: </strong>Two trajectory groups emerged for both household-level and partner-level SGBV: (1) groups of participants with consistently low SGBV levels (household: 77.5%; partner: 89.4%) and (2) groups with high baseline levels of SGBV, followed by decreases to moderate levels (household: 22.5%; partner: 10.8%). Characteristics significantly associated with the latter groups included being female, not employed or in school, food insecurity and symptoms of probable common mental disorders. Qualitative data supported these findings and revealed the mitigating role of positive household communication skills, along with potentially unmeasured levels of technology-facilitated partner violence, occurring over phones and social media during lockdown.</p><p><strong>Conclusions: </strong>Findings should inform the targeting of financial, food and mental health support to those at higher risk of ongoing violence during future times of crises. Further research on technology-facilitated violence should be conducted to better understand its prevalence.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001697"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047805","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":"Special care baby unit neonatal disease outcomes in a tertiary hospital in Nigeria: 2-year retrospective cross-sectional analysis.","authors":"Udochukwu Godswill Anosike, Ugochukwu Godson Amalahu, Chijioke Amara Ezenyeaku, Chika Florence Ubajaka, Ifeanyi Osmond Anokwulu, Chiamaka Sandra Nsude, Joseph Moses Adenyi, Chinemerem Okonkwo, Uzoma Love Nwajinka, Malachy Echezona DivineFavour, Chukwuemelie Darlington Okeke, Chidozie Valentine Akwiwu-Uzoma","doi":"10.1136/bmjph-2024-002141","DOIUrl":"10.1136/bmjph-2024-002141","url":null,"abstract":"<p><strong>Background: </strong>Neonatal diseases contribute significantly to global under-five mortality. The highest neonatal mortality rate in sub-Saharan Africa can be traced to Nigeria. This study aims to evaluate the outcomes of neonatal admissions in a select tertiary hospital in Nigeria.</p><p><strong>Methods: </strong>A retrospective analysis of data collected on 656 neonates admitted in the special care baby unit of Nnamdi Azikiwe University Teaching Hospital, Nigeria over a period of 2 years (January 2021 and December 2022). Descriptive analysis and inferential statistics were done at p<0.05 using SPSS V.25.</p><p><strong>Results: </strong>Median age at presentation was 4 hours (IQR 0.5, 24) hours. The median duration of hospital stay was 6 days (IQR 3, 11). The most common morbidities were perinatal asphyxia (n=295/656; 45.0%) and preterm (n=175/656; 26.7%); while congenital anomalies (n=22/47; 46.8%), perinatal asphyxia (n=73/295; 24.7%) and preterm (n=37/175; 21.1%) had the highest case fatality rates. Gestational age at birth, duration of hospital stay, place of delivery and mode of delivery were the variables determined to be statistically associated with the outcome of care.</p><p><strong>Conclusion: </strong>This study showed a mortality of 22.9% (n=150/656) in our study area with perinatal asphyxia (48.7%; n=73/150), preterm (24.7%; n=37/150), congenital anomalies (11.3%; n=22/150) and neonatal sepsis (6.7%; n=10/150) as the primary causes. This work highlights the need for emergency care of critically ill newborns through financing the transition from special care baby unit to neonatal intensive care unit across tertiary institutions in Nigeria.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002141"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164556","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 district implementation of national guidelines and maintenance of essential health services during the COVID-19 pandemic in Uganda.","authors":"Dorit Talia Stein, Adrian Ssessanga, Charles Olaro, Jesca Nsungwa Sabiiti, Betty Kyaddondo, Catherine Mbabazi, Freddie Ssengooba, Fredrick E Makumbi","doi":"10.1136/bmjph-2024-001813","DOIUrl":"10.1136/bmjph-2024-001813","url":null,"abstract":"<p><strong>Introduction: </strong>The effectiveness of national policies in decentralised health systems depends on local-level implementation. This study examines whether variation in implementation of national guidelines across districts and health system functions explains differences in local health system performance in maintaining continuity of essential maternal health, family planning and child vaccination services during the COVID-19 pandemic in Uganda.</p><p><strong>Methods: </strong>We used routine health data and an interrupted time-series analysis to estimate district-specific relative declines in service outputs during COVID-19 compared with expected volumes if prepandemic trends continued for maternal health, family planning and child vaccination services. We randomly selected 57 districts across 15 regions and measured the implementation of national guidelines for maintaining essential health services through a web-based survey of district health teams. We generated 'implementation summary scores' by health system function and service category, representing the proportion of guidelines reported implemented by districts. We tested associations between implementation scores and performance.</p><p><strong>Results: </strong>On average, districts (n=42; 74% response rate) reported implementing 58% (95% CI 54-62) of guidelines across health system functions, ranging from 33% (24-41) for 'financing' and 43% (36-49) for 'service delivery' to 93% (89-96) for 'coordination and communication' and 88% (81-94) for 'monitoring'. Districts reported implementing 60% (53-68) of guidelines requiring national government action. District performance in maintaining child vaccination services was positively associated with vaccine-specific 'financing' and 'national government' implementation summary scores after controlling for geography and district characteristics.</p><p><strong>Conclusion: </strong>Variation in implementing national-level policy across districts indicates inefficiencies or inequities across geographies in Uganda in terms of ability and capacity to respond to emergencies. Local guideline implementation also varied across health system functions, with financing and service delivery-related guidelines having the lowest implementation scores. Future emergency responses should consider how to balance local adaptations with central support by identifying which health system functions districts can more easily manage and adjust independently.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001813"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164439","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":"Key service delivery processes, challenges and barriers to healthcare access for managing diabetes outside target HbA1c levels in primary care settings in Qatar: a qualitative inquiry of healthcare professionals' and service users' perspectives.","authors":"Muslim Abbas Syed, Abduljaleel Abdullatif Zainel, Ahmed Sameer Alnuaimi, Shajitha Thekke Veettil, Mohamed Ahmed Syed","doi":"10.1136/bmjph-2024-001969","DOIUrl":"10.1136/bmjph-2024-001969","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Globally, diabetes constitutes a major proportion of non-communicable diseases. Qatar has one of the highest prevalences of diabetes worldwide and a high proportion of people visiting non-communicable disease clinics in primary care settings have diabetes. A significant percentage of people with diabetes in Qatar have glycosylated haemoglobin (HbA1c) levels outside the target range. The aim of this study is to explore the perspectives of people with diabetes, whose HbA1c is above target range, and healthcare providers (HCPs) who are directly involved in the management of care of their disease condition within primary care settings. The key objectives of the study include highlighting the key components of service delivery mechanisms and expectations of both service care providers and people living with diabetes to identify the existing gaps and generate recommendations for improving the quality of services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study design was qualitative research. A focus group discussion was conducted among HCPs (n=23) mainly comprising family medicine physicians, ophthalmologists, dieticians, nurses, health educators and pharmacists who are directly involved in supporting (caring for) people with diabetes to manage their condition and currently working in primary health centres in the state of Qatar. People with diabetes and an HbA1c greater than 7% over the previous 6 months were recruited to participate in telephone interviews by non-probability convenience sampling. The results of the study are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The main themes that emerged from the interviews with people with diabetes included (1) desirable attributes of physician, (2) medication, (3) privacy and confidentiality, (4) exclusive services and (5) recommendations to improve the services. Among the key recommendations to improve the existing services, the HCPs emphasised the need to introduce an integrated model of care composed of a multidisciplinary team of HCPs mainly prioritising and targeting high-risk patients. The integration of medical and social models of care as well as innovative interventions such as introducing social support groups, peer support, strengthening health literacy channels, artificial intelligence-powered applications and life coaches to support people with diabetes and elevated HbA1c to improve self-management were also suggested by HCPs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Strengthening health literacy and communication channels, implementing an integrated model of care, and testing innovative interventions (such as social support groups, artificial intelligence-powered applications and life coaches) by conducting high-quality research can improve the existing healthcare services for management of diabetes. These proposed strategies can ","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001969"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164471","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":"Barriers and facilitators to exercise participation in women with polycystic ovary syndrome: a qualitative study.","authors":"Manjushree Umamaheswar, Shweta S Bhatbolan","doi":"10.1136/bmjph-2023-000707","DOIUrl":"10.1136/bmjph-2023-000707","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is an endocrine disorder known to affect women's participation in different aspects of life. The aetiology of PCOS is not well understood, although exercise and a 5% reduction in body weight and waist to hip ratio are said to improve its symptoms. Thus, exercise participation is seen as the first line of treatment in women with PCOS. Although there are proven benefits to exercise participation, women with PCOS are known to rarely actively participate in exercise behaviour; thus, understanding the barriers and facilitators to participation is important to this population.</p><p><strong>Aim: </strong>To identify the barriers and facilitators to exercise participation in women with PCOS.</p><p><strong>Design: </strong>Qualitative study.</p><p><strong>Subjects and methods: </strong>16 participants with PCOS were recruited. A qualitative indepth interview method was adopted to identify the barriers and facilitators to exercise participation in women with PCOS.</p><p><strong>Results: </strong>Most participants mentioned that no information on PCOS and no advice on physical activity were given to them on diagnosis of the condition. Thus, this lack of education on the role of physiotherapy or exercise in PCOS prevented them from participating in exercise for a substantial amount of time. Other identified barriers included lack of time, laziness, work pressure, climate changes and tiredness. Social support and health concerns were identified as facilitators to participating in exercise.</p><p><strong>Conclusion: </strong>We identified that the main barrier to exercise participation in women with PCOS was lack of education, awareness and knowledge about the condition and the role of physiotherapy in PCOS. Meanwhile, social support and information or knowledge about exercises were identified as the biggest facilitators to exercise participation.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e000707"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164410","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":"Health status of adults exposed to severe acute malnutrition during childhood in the Eastern Democratic Republic of the Congo: the Lwiro cohort study.","authors":"Christian Chiribagula, Ghislain Bisimwa, Michel P Hermans, Michele Dramaix, Samuel Makali, Gaylord Ngaboyeka, Christine Chimanuka, Corneille Lembebu, Rosine Bigirinama, Jonathan C Wells, Pacifique Mwene-Batu","doi":"10.1136/bmjph-2024-001510","DOIUrl":"10.1136/bmjph-2024-001510","url":null,"abstract":"<p><strong>Background: </strong>While most studies of adults with a history of severe acute malnutrition (SAM) focused on survival and long-term non-communicable diseases, few studies have examined community health. The aim of this study was to compare the overall health status and its predictors between adults with a history of SAM and healthy controls in the context of Eastern Democratic Republic of the Congo using the WHO Disability Assessment Schedule (WHODAS).</p><p><strong>Methods: </strong>We evaluated 257 adults in Eastern Democratic Republic of the Congo who were treated for SAM during childhood between 1988 and 2007. They were compared with 187 age-matched and sex-matched control adults living in the same community who had not been exposed to malnutrition as a child. The main outcome was the WHODAS summary score, measuring an individual's health status in six domains of disability (household daily tasks, cognitive, mobility, self-care, social networks and social participation). A multivariable logistic regression model was used to identify the predictors of health status.</p><p><strong>Results: </strong>The median age of the participants in both groups was 20 years. The median (P25-P75) WHODAS score in SAM+ participants was 25.0 (14.6-33.3), whereas it was 8.3 (4.2-14.6) in SAM- participants (p<0.001). In five of the six disability domains (except individual self-care), SAM+ participants had significantly higher scores (poorer health) than SAM- participants. Consequently, 63% of SAM+ participants had a higher level of dependency compared with 16.6% of SAM- participants. Finally, being SAM+ was predictive of a higher WHODAS score (OR 8.6, 95% CI 5.4 to 13.6, p=0.002). In the multivariable logistic regression model, occupation, socioeconomic status and use of social networks, introduced separately in addition to SAM, remained significant but had no confounding effect on the association between SAM and WHODAS score.</p><p><strong>Conclusion: </strong>SAM during childhood has deleterious consequences on the state of health during adulthood. It is imperative to implement interventions to prevent and treat SAM during childhood to maximise adult population health.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e001510"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164467","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":"The issue with incidence: a scoping review of reported medication-related osteonecrosis of the jaws (MRONJ) incidence around the globe.","authors":"Ailish Suzanne Emuss Clark, Anne-Marie Glenny","doi":"10.1136/bmjph-2024-002009","DOIUrl":"10.1136/bmjph-2024-002009","url":null,"abstract":"<p><strong>Background: </strong>Medication-related osteonecrosis of the jaws (MRONJ) can be a debilitating condition which is challenging to manage. While vast literature exists surrounding MRONJ, many studies have small participant numbers and are heterogeneous in design, leaving unanswered questions and making evidence-based practice challenging.</p><p><strong>Objective: </strong>Provide an overview of recent MRONJ incidence data, over a 5-year period, identify potential issues in reporting MRONJ cases and propose changes for future reporting.</p><p><strong>Eligibility criteria: </strong>Studies with original data regarding MRONJ incidence published from 2015 to 2020.</p><p><strong>Sources of evidence: </strong>A search was conducted on MEDLINE Ovid, the National Library of Medicine's bibliographic database, using a combination of medical subject headings (MeSH) and free text terms and run on 29 April 2021.</p><p><strong>Charting method: </strong>Each title was hand-screened, and the abstract/article in full was reviewed to establish suitability for inclusion by two authors. Data extraction by two reviewers included author, year of publication, study design, population-cancer/osteoporosis/both/other, description of population, sampling method, exclusion criteria, single centre Y/N, reported rate of MRONJ cases/number of participants, details of diagnosis and diagnostic criteria, duration of follow-up and location of study.</p><p><strong>Results: </strong>The initial search returned 1186 titles, detailed screening and inclusion of additions resulted in 92 articles for data extraction. Mean incidence of MRONJ across all studies was 4.34% (median 2.42%, range 0% to 31.80%). The mean incidence based on patient group was oncology 6.22% (32 954 participants), osteoporosis 0.58% (498 443 participants), oncology and osteoporosis 7.21% (54 7651 participants) and other, including autoimmune, inflammatory and other bone conditions, 2.55% (4487 participants). Further analysis showed incidence influenced by study size (>500 participants), diagnostic criteria used, location of study and other factors.</p><p><strong>Conclusion: </strong>Heterogeneity in studies reporting MRONJ incidence impacts results and conclusions. Standardised, contemporaneous reporting of MRONJ cases would eliminate this variation and provide valuable insight into the epidemiology, natural history and outcomes of these patients, supporting evidence-based management and service provision of patients affected.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 1","pages":"e002009"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805260","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}