BMJ public health最新文献

{"title":"Assessing heat stress, ambulatory hypertension and thermal symptoms in fish smokers along coastal areas in Ghana: a cross-sectional study.","authors":"Edward Wilson Ansah, Emmanuel Ankomah-Appiah, Thomas Hormenu","doi":"10.1136/bmjph-2024-001378","DOIUrl":"10.1136/bmjph-2024-001378","url":null,"abstract":"<p><strong>Background: </strong>Many workplace illnesses are increasing exponentially because of the rapid change in climate and associated workplace heat exposure that lead to heat stress and ambulatory hypertension among workers. Fish smoking is a common livelihood among people residing along the coastal areas in developing countries who work outdoors and in extreme heat.</p><p><strong>Objective: </strong>The objective of this study is to assess the prevalence of heat stress and ambulatory hypertension among fish smokers in coastal areas of Ghana and to identify work-related factors that influence these conditions.</p><p><strong>Methods: </strong>This exploratory cross-sectional survey sampled 2018 fish smokers from various communities along the coastal areas of Ghana. Using a convenient sampling method to select the workers, data were collected with a questionnaire, collecting anthropometric information like weight, height and physiological parameters, including blood pressure, heart rate and body temperature using sphygmomanometer and thermometer. Also, the Wet Bulb Globe Temperature index was used to measure heat stress exposure among the workers. The data were analysed using descriptive statistics, Kruskal-Wallis H test, in SPSS V.25.0.</p><p><strong>Results: </strong>The study found that 87.6% of fish smokers in coastal Ghana reported high levels of heat stress, and 59.0% recorded ambulatory hypertension. Workers on the afternoon shift showed higher levels of heat stress compared with those on morning and evening shifts. The number of workdays per week was also linked to severe ambulatory hypertension. The analysis confirmed significant differences in heat stress across shifts (χ²=103.51, p<0.001, η²p=0.165) and in ambulatory blood pressure among workers based on workdays (χ²=96.04, p<0.001, η²p=0.352), showing moderate-to-large effects.</p><p><strong>Conclusions: </strong>The study emphasises the importance of creating safe and healthy work environments that protect fish smokers from health hazards associated with heat exposure. There is the need for fish smokers to adopt less heat emission ovens for fish smoking and regularly cool their bodies during the afternoon shift as they pay attention to rehydration.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001378"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824441","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":"Determinants of influenza vaccination uptake among older adults in Catalonia using a longitudinal population study: the role of public health campaigns.","authors":"Toni Mora, Montserrat Martinez-Marcos, Carmen Cabezas","doi":"10.1136/bmjph-2025-002698","DOIUrl":"10.1136/bmjph-2025-002698","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines the impact of influenza vaccination campaigns on the probability of immunisation among older adults in Catalonia, Spain.</p><p><strong>Methods: </strong>A population-based cohort study was conducted using the Catalan administrative and health dataset. Longitudinal data on healthcare resource use for individuals born before 1965 in Catalonia were used to compute descriptive statistics and concentration measures. A Regression Discontinuity Design (RDD) was performed to calculate the jump in the probability of becoming vaccinated. The database covers administrative data from primary care, hospitalisations and emergency care in the national health system from January 2014 to October 2021.</p><p><strong>Results: </strong>Significant differences were found across age groups, gender, drug copayment levels and nationality, and these differences were corroborated through concentration measures conditioned on health status. The RDD indicates a 4.78% increase in the probability of vaccination at the age at which vaccines were offered (60 years old), with the main differences observed among individuals from lower-income levels, specific health regions and nationalities. Age, a diagnosis of influenza in the previous vaccination campaign, and particular comorbidities were factors positively associated with a higher likelihood of vaccination.</p><p><strong>Conclusions: </strong>Understanding the interplay of factors is crucial to addressing disparities and ensuring preventive measures reach vulnerable groups. Our findings have direct implications for influenza vaccination coverage among older adults, providing policymakers with valuable insights for enhancing outcomes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002698"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824501","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":"Association between infant mortality and community social vulnerability in the USA: a cross-sectional study.","authors":"Catherine G Coughlin, Gabrielle D'Ambrosi, Michael C Monuteaux, Katherine Economy, Rebekah Mannix, Lois Lee","doi":"10.1136/bmjph-2025-002835","DOIUrl":"10.1136/bmjph-2025-002835","url":null,"abstract":"<p><strong>Introduction: </strong>Infant mortality rates in the USA demonstrate significant disparities among marginalised racial and ethnic groups. The Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) represents a novel metric to identify patients with increased social vulnerability who may be at risk for worse health outcomes. The objective of this study was to examine the association between county-level SVI and infant mortality rates.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study using the 2018 National Center for Health Statistics Restricted Vitals Statistics birth cohort linked files. We used multivariable negative binomial regression with the county-level count of infant mortality as the dependent variable and SVI as the independent variable and adjusted for maternal factors (proportion of women in each county with each of the following characteristics: aged <19 years, unmarried, inadequate prenatal care, maternal smoking during pregnancy and ≥2 maternal risk factors).</p><p><strong>Results: </strong>There were 3 791 712 infants in the study. Increased social vulnerability, measured by higher county-level SVI score, was associated with increasing infant mortality; quintile 2: adjusted incidence rate ratio (aIRR) 1.07 (95% CI 1.01 to 1.13); quintile 3: 1.11 (1.02 to 1.20); quintile 4: 1.14 (1.03 to 1.28); quintile 5: 1.21 (1.05 to 1.40). Being unmarried (aIRR 1.09 (1.01 to 1.13)), smoking (aIRR 1.05 (1.01 to 1.10)) and having inadequate prenatal care (aIRR 1.09 (1.01 to 1.16)) were also associated with increased infant mortality.</p><p><strong>Conclusions: </strong>County-level infant mortality was associated with increasing levels of social vulnerability in a stepwise fashion.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002835"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824442","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":"Development of a new indicator of surgical burden using person-time-adjusted surgical volume: a cross-sectional regional analysis in Japan.","authors":"Shima Asano, Susumu Kunisawa, Yuichi Imanaka","doi":"10.1136/bmjph-2025-002720","DOIUrl":"10.1136/bmjph-2025-002720","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical volume is widely used as an indicator to assess surgical burden in many areas; however, it has a risk of neglecting the differences of individual operations. Moreover, the characteristics of operations differ between rural and urban areas. Fewer but more varied operations are performed in rural settings than in urban settings. A new indicator, the person-time-adjusted surgical volume, was developed by integrating surgical volume, operative time and the surgeon's workforce in each operation. This innovative measure expands the use of surgical volume in healthcare strategies, providing a promising tool for evaluating the surgical workforce on a timely basis.</p><p><strong>Methods: </strong>The new indicator of surgical volume, person-time-adjusted surgical volume, was developed using weighted standard operative time and the standard number of surgeons. All statistical data were derived from three published sources. Rural and local city area data were grouped together as regional areas, on the prefectural basis (n=47) and compared with the data from the urban areas of the secondary medical area (n=48) in Japan. The surgical volume of gastrointestinal surgeries and surgeon density in each area was collected and analysed. All analyses used the person-time-adjusted surgical volume per surgeon to account for differences between medical areas.</p><p><strong>Results: </strong>A negative association was found between the person-time-adjusted surgical volume and surgeon density. Regional areas had more person-time-adjusted surgical volume per surgeon than urban areas. A decrease in surgeon density resulted in an increased rate of person-time adjusted surgical volume in regional areas, which was a 10-fold increase in person-time-adjusted surgical volume per surgeon with decreasing surgeon density in regional areas. This suggests that surgeons in rural and local areas have a higher risk of overworking or burnout than those in urban areas.</p><p><strong>Conclusion: </strong>The person-time-adjusted surgical volume is useful for evaluating surgical burden and visualising the gap in underprivileged areas.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002720"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824503","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 there inequalities in the attendance at and effectiveness of behavioural weight management interventions for adults in the UK? An individual participant data meta-analysis.","authors":"Jack M Birch, Julia Mueller, Sarah Damery, Stephen J Sharp, Rebecca A Jones, Michael P Kelly, Annie S Anderson, Nerys Astbury, Paul Aveyard, Rebecca J Beeken, Angela Craigie, Colin Greaves, Susan Jebb, Alex McConnachie, Kiran Nanchahal, Beth Stuart, Martin White, Simon J Griffin, Amy L Ahern","doi":"10.1136/bmjph-2024-001382","DOIUrl":"10.1136/bmjph-2024-001382","url":null,"abstract":"<p><strong>Objectives: </strong>Interventions for obesity that require individual behaviour change, such as behavioural weight management interventions, may contribute to health inequalities. We explored if there was evidence of inequalities in the attendance at and effectiveness of behavioural weight management interventions in adults.</p><p><strong>Design: </strong>Two-stage individual participant data meta-analysis.</p><p><strong>Data sources: </strong>Eligible studies were extracted from a previous systematic review and an updated search was completed on PubMed.</p><p><strong>Eligibility criteria: </strong>UK-based randomised controlled trials of behavioural weight management interventions suitable for use in primary care, published until 31 December 2021.</p><p><strong>Data extraction and synthesis: </strong>Multivariable regression analyses were conducted with weight at 12-month follow-up as the primary outcome and included an interaction between inequality characteristic and trial arm (control or intervention). Each model was adjusted for baseline weight, age and gender. Estimated interactions were combined across trials using a random-effects meta-analysis. Intervention attendance was defined as number of in-person sessions attended. Risk of bias was assessed using Cochrane's RoB 2 tool.</p><p><strong>Results: </strong>Data from 13/16 eligible weight loss trials were analysed (complete case data n=5531 participants). The effect of the intervention on weight at 12 months was greater in male participants (-2.58 kg (95% CI -3.52 to 1.64)) than female participants (-1.71 kg (95% CI -2.79 to -0.63); p value for interaction=0.02, tau²=0) and greater for participants of white ethnicity (-2.74 kg (95% CI -4.30 to -1.19)), than those from an ethnic minority background (0.03 kg (95% CI -1.29 to 1.35); p interaction=0.04, tau²=0). Age, education, occupation, place of residence and household income did not significantly moderate effectiveness. We did not find evidence of inequalities in intervention attendance by ethnicity, occupation, gender/sex, area-level socioeconomic deprivation or age.</p><p><strong>Conclusions: </strong>Behavioural weight management interventions had smaller effects in people from ethnic minority backgrounds and larger effects in men. There was no evidence of other differences in intervention effectiveness or adherence. This is the first synthesis study to access individual participant data and quantitatively assess inequalities in these interventions. Future research should further explore reasons for differences in outcomes and consider how to prevent behavioural weight management interventions from potentially exacerbating health inequalities.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001382"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824474","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":"Impact of tobacco control policies on socioeconomic inequalities in smoking prevalence and quit ratios: an ecological study in the European Union (2009-2020).","authors":"Ariadna Feliu, Esteve Fernandez, Irene Tamí-Maury, Cristina Martinez","doi":"10.1136/bmjph-2024-002418","DOIUrl":"10.1136/bmjph-2024-002418","url":null,"abstract":"<p><strong>Background: </strong>Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.</p><p><strong>Methods: </strong>Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple linear regression models.</p><p><strong>Findings: </strong>In the EU27, high inequalities exist among different income groups. High-income residents had lower smoking prevalence (19 vs 40%) and higher quit ratios (55 vs 32%) compared with the low-income group. Positive changes in smoking indicators from 2009 to 2020 were stronger in the high-income group. There was a stronger negative correlation between TCS scores and smoking prevalence in high-income groups (r_sp=-0.615, p<0.01; r_sp=-0.498; p=0.01) and between its relative changes but only in the high-income group (r_sp=-0.478; p=0.01). A positive correlation was observed between TCS scores and quit ratios (r_sp=0.580, r_sp=0.548, both p<0.01) in high- and moderate-income populations.</p><p><strong>Conclusions: </strong>Declines in smoking prevalence and increases in quit ratios were considerably lower in moderate- and low-income groups. Tailoring tobacco control policies to address financial, social and structural barriers, such as ensuring free access to cessation services, implementing targeted outreach programmes, adopting culturally and linguistically appropriate interventions, among others, is essential for making these measures more equitable, which is key for the EU27 to achieve its tobacco-free goal by 2040.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002418"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824506","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":"Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022.","authors":"Bidhya Shrestha, Yogendra B Gurung, Tara Lal Shrestha, Kamala Lamichhane, Rita Karki, Sharadha Hamal","doi":"10.1136/bmjph-2025-002576","DOIUrl":"10.1136/bmjph-2025-002576","url":null,"abstract":"<p><strong>Objectives: </strong>To assess how education and the use of family planning methods intersect to influence women's empowerment among currently married women of reproductive age in Nepal.</p><p><strong>Design setting and participants: </strong>The study analysed a combined weighted sample of 21 023 currently married women in the age group (15-49 years) using data sets of two cross-sectional Nepal Demographic and Health Survey (NDHS). A weighted analysis of the samples was carried out, accounting for the complex survey design. In NDHS 2016, the sample size was 9,868, and in NDHS 2022, it was 11, 155. Thirteen indicators that have been used in previous studies were employed to measure women's empowerment. To examine the relationship between education, family planning use and women's empowerment, a multivariate binary logistic regression analysis was conducted, taking into account cluster and survey weights.</p><p><strong>Outcome measures: </strong>Women's empowerment is the primary outcome measure, which was assessed using a composite index of 13 indicators based on previous studies. The indicators encompassed sexual and reproductive autonomy, participation in household decision-making, control over financial decisions and attitudes towards wife-beating.</p><p><strong>Results: </strong>The results indicate that women with higher education and those who use family planning methods are significantly more empowered, with adjusted ORs of 3.764 (95% CI 2.894 to 4.895) in 2016 and 4.541 (95% CI 2.914 to 7.079) in 2022 compared with women without education and family planning use. This consistent pattern across both surveys highlights a significant association between education, family planning use and women's empowerment.</p><p><strong>Conclusion: </strong>The study suggests the importance of advocating for education and family planning use as interlinked pathways to empower women. To fulfil Sustainable Development Goal 5-achieving gender equality and empowering all women and girls-government must ensure intersectional strategies that remove barriers to education and reproductive autonomy.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002576"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional analysis of cannabis use at work in the USA: differences by occupational risk level and state-level cannabis laws.","authors":"Ava Kucera, David Hammond","doi":"10.1136/bmjph-2024-001589","DOIUrl":"10.1136/bmjph-2024-001589","url":null,"abstract":"<p><strong>Objective: </strong>To examine the prevalence of workplace cannabis use, including by state-level cannabis laws, occupational risk and medical cannabis use.</p><p><strong>Methods: </strong>Data are cross-sectional from wave 6 (2023) of the International Cannabis Policy Study (ICPS) and include 26 458 respondents aged 16-65 years from the USA. Separate regression models were run analysing workplace cannabis use across: (1) state-level cannabis laws and occupational risk, (2) reasons for cannabis use and (3) medical cannabis authorisation. All models were adjusted for sociodemographic characteristics.</p><p><strong>Results: </strong>Overall, 7.4% of workers and 21.5% of past 12-month cannabis consumers reported using cannabis at or within 2 hours of starting work in the last 30 days. Workplace cannabis consumption was highest among workers in states with 'recreational' cannabis laws (8.5%) compared with states with medical (6.3%; adjusted OR (AOR)=1.45, p=0.006) or illegal laws (6.2%; AOR=1.06, p=0.005). Workers in high-risk jobs were more likely to use cannabis at work (11.4%) than those in lower risk jobs (5.8%; AOR=1.58, p<0.001). Workplace cannabis use was also greater among cannabis consumers who use cannabis for medical versus recreational (29.4% vs 15.6%; AOR=2.35, p<0.001) or mixed reasons (24.2%; AOR=1.78, p=0.007); the same was true for consumers who reported having medical cannabis authorisation (39.0%) versus those without authorisation (17.4%; AOR=2.66, p<0.001).</p><p><strong>Conclusions: </strong>Reported cannabis use at work was most prevalent in states with recreational legalisation, particularly among individuals with medical cannabis authorisation and those who work higher risk jobs. Longitudinal research should examine the individual and occupational-level factors associated with workplace cannabis use.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001589"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791242","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":"Development and evaluation of a quasi-experimental sexual and reproductive health literacy (SRHL) programme for marriage immigrants in South Korea: focus on Vietnamese women.","authors":"Heeran Chun, Young Sook Lee, Hyeran Yoon","doi":"10.1136/bmjph-2024-002473","DOIUrl":"10.1136/bmjph-2024-002473","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual and reproductive health (SRH) literacy is a key determinant of health outcomes for women. In South Korea, Vietnamese marriage migrant women face substantial linguistic and cultural barriers to accessing SRH services. This study aimed to develop and evaluate a culturally tailored SRH literacy programme to enhance SRH knowledge and empowerment among Vietnamese marriage migrant women.</p><p><strong>Methods: </strong>A quasi-experimental study using a non-equivalent control group with a pre-post test design was conducted. 64 Vietnamese marriage migrant women aged 20-39 were recruited from Multicultural Family Support Centers in C city, South Korea. The intervention group (n=32) attended four weekly 100 min face-to-face educational sessions using bilingual materials, while the control group (n=32) received no intervention. Outcomes included subjective SRH literacy (SRHL-K), self-efficacy and objective SRH knowledge, measured via online surveys. Statistical analyses included Mann-Whitney U tests and generalized estimating equations.</p><p><strong>Results: </strong>The intervention group showed a significant post-intervention increase in SRHL-K scores, particularly in the 'information and knowledge' and 'empowerment and relationship' domains, compared with the control group. However, no significant changes were observed in the 'prevention and treatment' domain. The intervention group also demonstrated a significant improvement in SRH knowledge. In contrast, changes in SRH self-efficacy were not significant, potentially due to the limited scope of the self-efficacy tool.</p><p><strong>Conclusion: </strong>The findings suggest that a culturally and linguistically tailored SRH literacy programme can improve SRH knowledge and empowerment among Vietnamese marriage migrant women. Future interventions should explore strategies to strengthen SRH behaviours and self-efficacy in this population.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002473"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824502","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":"Epidemiological and clinical profile of hepatitis B infection in ART-naïve people living with HIV in Maputo, Mozambique: a cross-sectional study.","authors":"Lucia Mabalane Chambal, Charlotta Nilsson, Elias Manjate, Corssino Tchavana, Orvalho Augusto, Vanda Dos Muchangos, Júlia Muando, Esperanca Sevene","doi":"10.1136/bmjph-2024-001563","DOIUrl":"10.1136/bmjph-2024-001563","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, more than 254 million people are living with hepatitis B virus (HBV), and 7.4% of the people living with HIV (PLHIV) are coinfected with HBV. More than 70% of them reside in Africa. We aimed to describe the characteristics of newly diagnosed antiretroviral treatment (ART)-naïve HIV/HBV co-infected and HIV monoinfected patients.</p><p><strong>Methods: </strong>This cross-sectional study included newly HIV-diagnosed ART-naïve patients recruited at Mavalane Health Centre located in a periurban area of Maputo City. Between May 2021 and November 2022, all patients over 18 years old were enrolled and screened for hepatitis B surface antigen (HBsAg). Data on socio-demographic and clinical characteristics, haematology, liver and kidney function tests, CD4+T cell counts, serological markers of hepatitis B (IgM Core hepatitis B antibody, hepatitis B e antigen, and hepatitis B e antibody), HIV and HBV viral loads were assessed using standard procedures.</p><p><strong>Results: </strong>A total of 1106 participants were included. The age of the participants ranged from 18 years to 71 years with a median of 34.0 (IQR: 28.0-42.0) years, 513 (46.4%) were men and HBsAg was reactive in 81 participants, yielding a co-infection rate of 7.3%. Being male (OR, 1.72; 95% CI, 1.06 to 2.83) or a sex worker (OR, 3.69; 95% CI, 1.10 to 10.58) was associated with the co-infection. The median Aspartate Aminotransferase-Platelet Ratio Index (APRI) of the HIV/HBV co-infected was 0.5 (IQR 0.3-1.1), with 40/81 (49.4%) presenting with an APRI>0.5. Overall, 67/81 (80.2%) of the co-infected people were HBeAg-negative. The median APRI was 0.5 (IQR, 0.3-1.1) for the HBeAg-negative and 0.7 (IQR 0.3-1.4) for the HBeAg-positive subjects. The median HBV-DNA was 258.0 IU (IQR, 10.0-4974.5) for the HBeAg-negative and 746 287.0 IU (IQR 2720.0-49 899 213.0) for the HBeAg-positive subjects. Two (3.0%) HBeAg-negative and one (7.1%) HBeAg-positive subjects presented with hepatocellular carcinoma.</p><p><strong>Conclusion: </strong>These data confirm the high prevalence of HIV/HBV co-infection in Mozambique and bring new data related to HBeAg status, reinforcing the need to test all PLHIV for HBV and to integrate the management and monitoring of hepatitis B and liver disease-specific tests in public ART programmes to predict and reduce the occurrence of HBV complications and mortality.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001563"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791243","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}