BMJ public health最新文献

{"title":"Understanding influenza-like illness dynamics in Jiangsu, China: impacts of COVID-19 control measures and meteorological factors on the population health during 2018-2023.","authors":"Yi Yin, Xin Jiang, Shuhan Tang, Qigang Dai, Yuhang Ma, Jianli Hu, Changjun Bao, Yanping Zhang, Zhihang Peng","doi":"10.1136/bmjph-2024-001708","DOIUrl":"10.1136/bmjph-2024-001708","url":null,"abstract":"<p><strong>Background: </strong>Since the emergence of the COVID-19 pandemic, how meteorological factors and COVID-19 control measures in China impact the transmission dynamics of influenza-like illness (ILI) across age groups remains unclear.</p><p><strong>Objective: </strong>This study aims to explore the changes in the seasonal ILI epidemics and the effects of meteorological factors across age groups in Jiangsu, China, before the COVID-19 pandemic and after the relaxation of COVID-19 control measures.</p><p><strong>Methods: </strong>The time-varying reproduction number (<i>R</i> _t) and doubling time of ILI were deployed to describe the trend and iteration time of the ILI epidemic, and the effect of Chinese government response to COVID-19 on the ILI epidemic, respectively. Considering the stage factors, the role of various meteorological factors in the incidence rate of ILI across age groups from 2018 to 2023 was explored.</p><p><strong>Results: </strong>The <i>R</i> _t value decreased sharply at the beginning of the COVID-19 pandemic, but dramatically increased at the end of 2022 with the adjusted policy response to COVID-19 in China. The maximum doubling time in Stage II (COVID-19 pandemic period from 23 December 2019 to 26 December 2022) was 57.66 (95% CI: 55.16 to 60.39), while the shortest doubling time of 13.94 (95% CI: 12.91 to 15.13) was observed in Stage III (the period of implementing COVID-19 'opening up' policies from 26 December 2022 to 25 December 2023). By controlling the stage factors, temperature change contributed most to the incidence of ILI in the young group. The number of sunshine hours had a small impact on the incidence of ILI among all age groups.</p><p><strong>Conclusions: </strong>The relaxation of the COVID-19 prevention and control measures triggers increases in the population mobility, population contact rates and epidemic transmission. Meteorological factors pose various impacts on ILI dynamics. We recommended designing seasonal health interventions and vaccination plans against ILI based on meteorological changes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001708"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017019","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":"Breakthrough SARS-CoV-2 outcomes in immune-disordered people during the Omicron era: a prospective cohort study.","authors":"Mackenzie Zendt, Fausto Andres Bustos Carrillo, Viviane Callier, Maureen DeGrange, Anita Ginigeme, Lurline Wu, Bevin Manuelpillai, Ana Ortega-Villa, Emily E Ricotta","doi":"10.1136/bmjph-2024-002436","DOIUrl":"10.1136/bmjph-2024-002436","url":null,"abstract":"<p><strong>Introduction: </strong>Immune-deficient/disordered people (IDP) elicit a less robust immune response to COVID-19 vaccination than the general US population. Despite millions of IDP at presumed elevated risk, few population-level studies of IDP have been conducted in the Omicron era to evaluate breakthrough infection-related outcomes.</p><p><strong>Methods: </strong>We followed a prospective cohort of 219 IDP and 63 healthy volunteers (HV) in the USA from April 2021 (Alpha variant peak) to July 2023 (Omicron XBB variant peak). IDP had a primary or secondary immune disorder. All participants were≥3 years old and received COVID-19 vaccines external to this study. We quantified anti-spike IgG titre levels by ELISA, measured breakthroughs via participant reports and laboratory tests on saliva samples, compared breakthrough incidence among HV and IDP, assessed infection complications (persistent infections, reinfections and post-acute sequelae of COVID-19 (PASC)) and used surveys to capture COVID-19 symptoms and preventive attitudes/behaviours.</p><p><strong>Results: </strong>Among IDP, the incidence of initial breakthrough infection was 8.8 (95% CI 4.5 to 62.5) times higher during than before the Omicron era. There were 88 initial breakthrough infections among IDP (incidence rate 23.7/100 person-years) and 28 among HV (27.3/100) throughout the study period. While COVID-19 symptoms were generally mild, five participants, all IDP, were hospitalised. In traditional analyses and an emulated trial, the quantity of anti-spike IgG 1 month after participants' most recent pre-infection vaccination was not associated with breakthrough. HV and IDP frequently practiced infection-limiting behaviours, but IDP were more likely to continue such behaviours after vaccination. IDP experienced persistent infections, PASC and reinfections more commonly than HV.</p><p><strong>Conclusions: </strong>Breakthrough rates in IDP were largely equivalent to HV. However, IDP experienced a slightly higher frequency of symptoms, hospitalisations, infection persistence, PASC and reinfections than HV. Further study is needed to elucidate the immunological mechanisms that increase the risks of such complications in IDP.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002436"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017023","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":"Healthcare needs and treatment-seeking patterns of women living with obstetric fistula: a qualitative study in the Tamale Metropolis, Ghana.","authors":"Shaline Agamba, Abdul Razak Abubakari, Adadow Yidana, Vida Nyagre Yakong, Gifty Apiung Aninanya, Gilbert Abotisem Abiiro","doi":"10.1136/bmjph-2024-002184","DOIUrl":"10.1136/bmjph-2024-002184","url":null,"abstract":"<p><strong>Introduction: </strong>Obstetric fistula is a form of maternal morbidity that can lead to prolonged disability and poor quality of life. This study explored the healthcare needs and treatment-seeking patterns of women living with obstetric fistula in the Tamale Metropolis.</p><p><strong>Methods: </strong>A qualitative phenomenology design was used. The target respondents (women with obstetric fistula and their healthcare providers) were recruited using purposive sampling. 11 in-depth and three key-informant interviews were conducted with the women and healthcare providers, respectively, between January and March 2024. The data were audio-recorded, transcribed and manually analysed using thematic content analysis.</p><p><strong>Results: </strong>The results showed that improved access to quality antenatal care (ANC), skilled healthcare practitioners with expertise in fistula repair, appropriate health facilities and adequate fistula treatment services were the common healthcare needs of the respondents. When seeking treatment for obstetric fistula, the participants tried traditional methods such as spiritual therapies and herbs before finally reporting to the hospital. Extended family members and husbands were the major sources of support for women with obstetric fistula.</p><p><strong>Conclusion: </strong>It is critical to give obstetric fistula treatment a top priority and to allocate enough resources to enhance both the general well-being of women, and the quality and accessibility of fistula treatment. We, therefore, recommend effective education on fistula prevention and treatment during ANC, establishment of more fistula repair centres, increased training and deployment of specialists for fistula management at the regional and district levels, and a dedicated public funding source for obstetric fistula treatment.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002184"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017076","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":"Tobacco cessation interventions in high-income countries with Chinese, Vietnamese and Arab people who smoke: a scoping review of outcomes and cultural considerations.","authors":"Joshua Trigg, Alice McEntee, Victoria Kostadinov, Sonia Hines, A Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A Smith, Carlene Wilson, Lavender Otieno, Jacqueline Bowden","doi":"10.1136/bmjph-2025-002956","DOIUrl":"10.1136/bmjph-2025-002956","url":null,"abstract":"<p><strong>Objectives: </strong>There are large and growing communities of Chinese, Vietnamese and Arab populations within many high-income countries, including Australia. These populations experience disproportionately higher rates of tobacco smoking. Cessation strategies are required that acknowledge the cultural factors shaping smoking behaviours. This review aimed to synthesise the evidence for smoking cessation interventions among Chinese, Vietnamese and Arab people, including outcomes and cultural considerations.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Data sources: </strong>We searched five electronic databases for peer-reviewed literature (CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, PsycINFO, PubMed and Scopus). Relevant grey literature was sourced from research and health organisations, and community cultural organisations.</p><p><strong>Eligibility criteria: </strong>English-language studies of tobacco cessation interventions with Chinese-speaking, Vietnamese-speaking or Arabic-speaking participants conducted in Australia, the USA, Canada, the UK or New Zealand between 2013 and 2025.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently screened for eligible studies and, if included, assessed risk of bias using Joanna Briggs Institute critical appraisal tools.</p><p><strong>Results: </strong>We identified 23 studies describing 15 intervention types, with written resources most highly featured. Promising category evidence was found for nine intervention types with Chinese people (written information, education sessions, visual information, counselling, involving others, providing nicotine replacement therapy, intervention branded merchandise, mobile messaging and telephone follow-up), as well as counselling with Arab people, and telephone follow-up with Vietnamese people. A variety of cultural considerations were addressed in the interventions, most commonly language barriers as well as the use of co-design and community participation.</p><p><strong>Conclusions: </strong>Smoking cessation interventions with Chinese people were strongly supported, with less evidence for interventions with Vietnamese and Arabic people. Education-focused interventions were particularly effective, addressing low baseline knowledge underpinning smoking. Language barriers to smoking cessation were addressed through primary language supports. Further research is needed on effective smoking cessation intervention types with Arab and Vietnamese people.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002956"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017105","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":"Trends in the illicit tobacco market in New Zealand: a consumption gap analysis.","authors":"Pyi Pyi Phyo, Christopher Bullen","doi":"10.1136/bmjph-2025-002853","DOIUrl":"10.1136/bmjph-2025-002853","url":null,"abstract":"<p><strong>Introduction: </strong>Illicit tobacco poses a significant challenge to public health efforts. New Zealand (NZ) stands out for its stringent tobacco control policies, but there are concerns that the size of the illicit market could grow. Estimating the extent of the illicit tobacco trade in NZ remains challenging due to the diverse methodologies used by various stakeholders over different years.</p><p><strong>Methods: </strong>We did annual consumption gap analyses (CGA) from 2012 to 2023 by calculating the discrepancy between estimated cigarette smoking (factory-made cigarettes and roll-your-own cigarettes) and legal sales to examine trends in the illicit tobacco trade in NZ.</p><p><strong>Results: </strong>The proportion of illicit tobacco in the NZ market fluctuated between 2012 and 2023. The negative test statistic of Kendall's tau indicates a slightly downward trend, but the trend is weak and statistically insignificant. The negative percentage may reflect under-reporting or the absence of hidden populations' consumption estimates, or the overestimation of legal sales. Our analyses adjust for under-reporting of smoking by using an uplift factor of 1.23 and adopt a 'worst-case scenario' by using the upper limit of the 95% CI around the point estimate for the proportion of daily smokers.</p><p><strong>Conclusion: </strong>CGA is a useful tool for estimating the illicit tobacco trade, but it depends on accurate and valid estimates of consumption, under-reporting and reporting of legal tobacco supply. It is most useful to estimate the trend rather than the absolute amount of illicit tobacco. In NZ, the estimated proportion of illicit tobacco fluctuated between 2012 and 2023, supported by the statistically insignificant Mann-Kendall test. Reducing demand for smoking, alongside more vigorous border scrutiny and enforcement, is the most effective strategy for tackling the illicit trade. NZ's Smokefree aspirations to see prevalence drop to 5% or lower in the next few years may, therefore, significantly reduce the size of the illicit tobacco market.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002853"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017071","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 model for predicting hepatitis C seroconversion in methadone maintenance patients in China.","authors":"Xinyu Lu, Qing Yue, He Jing, Gangliang Zhong, Zhen Ning, Jiang Du, Min Zhao","doi":"10.1136/bmjph-2024-002290","DOIUrl":"10.1136/bmjph-2024-002290","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) infection is a substantial public health concern, particularly among individuals with opioid addiction. The methadone maintenance treatment (MMT) programmes serve as a harm reduction strategy to mitigate HIV disease spread, yet the risk of HCV infection remains high within these settings. Accurate risk prediction for HCV seroconversion is therefore crucial for improving patient outcomes.</p><p><strong>Methods: </strong>We collected data from 1547 individuals with opioid use disorder who entered the MMT programme from May 2005 to October 2023 in Shanghai, China, and 283 individuals from July 2006 to October 2023 in Mianyang, China, whose HCV infection status was monitored. Shanghai data were divided into training and validation sets in a 7:3 ratio, with 70% of the Shanghai samples used for model training and the remaining 30% reserved for internal validation. Additionally, the Mianyang dataset was employed as an independent external validation cohort to assess the model's generalisability. Four machine learning models were developed. We then validated the predictive performance of the model using C-index, receiver-operating characteristic curves, calibration plots and decision curve analysis.</p><p><strong>Results: </strong>13 predictive factors, including sex, age, ethnicity, education, occupation status, marriage status, living status, financial resource, drug use method in the past half year, injected drug last month, condom use, average methadone dosage and positive rate of drug urine tests, were all incorporated into the predictive model. The eXtreme Gradient Boosting (XGBoost) model exhibited superior performance in both discrimination and calibration compared with the other three models. Specifically, it achieved C-indices of 0.793 (95% CI: 0.771 to 0.813) in the training cohort, 0.744 (0.709 to 0.779) in the internal validation cohort and 0.756 (0.712 to 0.799) in the external validation cohort for predicting HCV seroconversion. A publicly accessible web tool was generated for the model.</p><p><strong>Conclusions: </strong>The developed XGBoost model has the potential to accurately predict individuals on MMT programmes at high risk of HCV seroconversion.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002290"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017095","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":"Long way to impact health: outputs and outcomes of a four-year multilevel participatory family health promotion programme in a low-income neighbourhood.","authors":"Gerda Wink, Gerdine Fransen, Koos van der Velden, Maria van den Muijsenbergh, Annemarie Wagemakers","doi":"10.1136/bmjph-2024-001979","DOIUrl":"10.1136/bmjph-2024-001979","url":null,"abstract":"<p><strong>Introduction: </strong>Improving health, in particular of people in a disadvantaged socioeconomic position (SEP), requires multilevel health promotion programmes with community engagement. However, the impacts of such complex and challenging programmes are not yet clear. This study aims to show the impact of a participatory multilevel family health promotion programme in a low-income neighbourhood at intrapersonal, interpersonal, organisational, community and policy level.</p><p><strong>Methods: </strong>A mixed-methods design was used to monitor and assess output and outcome realisation by parents and professionals from multiple sectors in a 4-year programme. Output realisation was monitored and reported half-yearly. Parents' knowledge, parent and child health (behaviours), social support and perceived neighbourhood child friendliness were measured through a cohort study in three successive years.</p><p><strong>Results: </strong>Changes found: Multiple activities were implemented, such as swimming lessons free of charge for children in low-income families. Parents' assessment of neighbourhood child friendliness increased significantly as well as their knowledge about financial, social and healthy diet support, particularly among parents (n=13) who had been actively engaged in the programme. Social support decreased significantly. Municipal policies addressed more of the needs of people in a disadvantaged SEP, such as low-cost sports possibilities.</p><p><strong>Conclusion: </strong>This study revealed multilevel impacts of the programme: health-enabling activities for low-income families were realised, used and sustained at the organisational and policy level, which focused on contributing to neighbourhood child friendliness (community level). The engaged stakeholders took steps on the long pathway towards improved parent and child health in a disadvantaged SEP (intrapersonal level). Constant stakeholder investment is needed at all levels in the community and at the national policy level.</p><p><strong>Trial registration number: </strong>Netherlands Trial Register (NL7738) Marissa Traets.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001979"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017107","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":"Measurement and interpretation of the Harare HIV combination prevention cascade in priority populations: a population survey of adolescent girls and young women and young men in Zimbabwe.","authors":"Louisa Moorhouse, Jeffrey W Imai-Eaton, Tawanda Dadirai, Rufurwokuda Maswera, Tafadzwa Museka, Phyllis Mandizvidza, Freedom Dzamatira, Blessing Tsenesa, Timothy B Hallett, Constance Nyamukapa, Simon Gregson","doi":"10.1136/bmjph-2025-002860","DOIUrl":"10.1136/bmjph-2025-002860","url":null,"abstract":"<p><strong>Introduction: </strong>HIV-negative adolescent girls and young women (AGYW), and men (ABYM), have disproportionately high HIV incidence in many African countries. We used a new HIV Prevention Cascade (HPC) approach to quantify levels of, and barriers to, prevention method use to guide interventions to increase effective uptake of primary HIV prevention.</p><p><strong>Methods: </strong>Data from the Manicaland HPC pilot study (2018-19; n=9803) in Zimbabwe were used to measure levels of sexual risk behaviour and construct HPCs for male condom, pre-exposure prophylaxis (females), voluntary medical male circumcision (males) and combination prevention use by HIV-negative sexually active AGYW (15-24 years) and male partners (15-29 years).</p><p><strong>Results: </strong>19% of AGYW (n=1140) and 37% of ABYM (n=955) who had started sex reported one or more HIV risk behaviour and met the definition of the priority populations for HIV prevention. Of these, 63% of AGYW and 87% of ABYM were motivated to use an HIV prevention method, 28% and 63% had access to a method and 16% and 53% used a method. Male condoms were the most commonly used prevention method, accounting for 97% of use in AGYW and 55% in ABYM. Barriers to motivation, access and capacity to use were reported for all priority populations and methods. Some barriers were common across HPCs (eg, lack of risk perception, social unacceptability and lack of acceptable provision); others were specific to particular prevention methods or priority populations (eg, lack of availability).</p><p><strong>Conclusion: </strong>HIV risk behaviours were commonly reported, but gaps in use of prevention methods exist among young people reporting these HIV risk behaviours in Manicaland. Population survey measurements of HPCs revealed large gaps in all steps in the cascade (lack of motivation, lack of access and lack of capacity to use prevention) and provided information on the reasons for these gaps that can aid in designing interventions that reduce new infections.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002860"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017109","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":"Correction: Spatial distribution of effective coverage of child immunisation in Ethiopia.","authors":"","doi":"10.1136/bmjph-2024-002255corr1","DOIUrl":"10.1136/bmjph-2024-002255corr1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1136/bmjph-2024-002255.].</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002255corr1"},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017080","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":"Attitude towards menstruation, prevalence of premenstrual syndrome and coping mechanisms among adolescent girls in Kerala, India: a cross-sectional study.","authors":"Ambily Vijayan Gopika, Sobha George, Brilly Michael Rose, Jeby Jose Olickal, Kavumpurathu Raman Thankappan","doi":"10.1136/bmjph-2024-002281","DOIUrl":"10.1136/bmjph-2024-002281","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive studies on attitudes towards menstruation and the prevalence of premenstrual syndrome (PMS) and its associated factors among adolescents are limited. Since both attitudes and responses towards PMS are shaped by psychosocial and cultural factors, this study was conducted to assess attitude towards menstruation, prevalence of PMS and coping mechanisms adopted to manage PMS among adolescent girls in Kerala, with a focus on psychosocial experiences rather than the biological aspects of PMS.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted among 1100 adolescent girls (aged 13-19 years), selected through multistage cluster sampling. Menstruation-related attitudes were measured using the Menstrual Attitude Questionnaire, which categorises attitudes as positive or negative, while PMS symptoms were assessed using the Premenstrual Symptoms Screening Tool. Multivariable analyses identified the factors associated with attitudes towards menstruation and severe PMS.</p><p><strong>Results: </strong>In our study, 51% reported a negative attitude towards menstruation (95% CI 47.8% to 53.8%). Severe PMS was reported by 36.8% (95% CI 33.9% to 39.7%). Severe PMS was significantly associated with negative menstrual attitudes (adjusted prevalence ratio (APR) 1.31, 95% CI 1.12 to 1.54)), nuclear family; defined as those living with only parents and siblings, (APR=1.25, 95% CI 1.04 to 1.51), Muslim religion (APR=1.58, 95% CI 1.03 to 2.42) and low maternal education (APR=1.28, 95% CI 1.03 to 1.59) compared with their counterparts. Adolescents who belonged to the Muslim religion (APR=1.20, 95% CI 1.05 to 1.37) and those from nuclear families (APR=1.21, 95% CI 1.05 to 1.39) were more likely to report negative attitudes towards menstruation compared with their counterparts.</p><p><strong>Conclusion: </strong>More than half of the adolescents reported a negative attitude towards menstruation, and a considerable proportion experienced severe PMS. Implementing targeted educational programmes for adolescents, particularly those from the Muslim religion, nuclear families and with less-educated mothers, may enhance menstrual awareness, promote healthier attitudes and support better coping mechanisms in managing PMS.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002281"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017054","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}