Journal of Health, Population, and Nutrition最新文献

{"title":"Ensuring equitable emergency, critical and operative care.","authors":"Tim Baker, Carl Otto Schell, Pauline Convocar, Fitsum Kifle, Niranjan Kissoon, Nobhojit Roy, Karima Khalid","doi":"10.1186/s41043-026-01472-x","DOIUrl":"https://doi.org/10.1186/s41043-026-01472-x","url":null,"abstract":"<p><p>Conditions requiring emergency, critical and operative (ECO) care account for a substantial proportion of preventable mortality and disability worldwide, yet ECO systems remain fragmented and underdeveloped in many settings. Recent global policy advances, including the adoption of the World Health Organization (WHO) Global Strategy and Action Plan for Integrated ECO Care by the World Health Assembly, provide an important opportunity to strengthen these systems. However, implementation must prioritise equity. ECO care spans a wide spectrum of complexity and cost, from basic triage, oxygen therapy and essential operations to advanced intensive care and specialised surgery. Given finite resources, health systems should first ensure universal access to foundational ECO care: early recognition of illness, basic airway and oxygen support, essential medications, monitoring, infection prevention, and timely referral. Approaches such as Essential Emergency and Critical Care (EECC) offer a feasible, highly cost-effective minimum standard of care, and prioritising such foundational ECO care is both an ethical imperative and the most effective pathway to achieving equitable population-level health gains.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories and associated factors of life-space in older patients following percutaneous coronary intervention: a mixed-methods study.","authors":"Yanyan Zhang, Bei Yang, Yin Wang, Kangyao Cheng","doi":"10.1186/s41043-026-01447-y","DOIUrl":"10.1186/s41043-026-01447-y","url":null,"abstract":"<p><strong>Background: </strong>Older patients following percutaneous coronary intervention (PCI) face long-term health risks such as in-stent restenosis. Life-space serves as a valuable clinical indicator for assessing and predicting the overall health of patients. Monitoring changes in life-space can facilitate early detection of health status changes. This study aimed to identify the trajectories and associated factors of life-space among older patients following PCI, thereby prompting timely intervention and improving cardiac rehabilitation outcomes.</p><p><strong>Methods: </strong>A total of 236 patients were enrolled. During hospitalization, patients' general information was assessed. At 1, 3, and 6 months after discharge, the patients' life-space was assessed firstly, followed by semi-structured interviews with voluntary participants via outpatient or telephone. Purposive sampling selected 10 patients from the low-to-medium trajectory groups for qualitative analysis based on information sufficiency. Latent class growth model was used to analyze life-space trajectories, and multinomial logistic regression analysis was conducted to examine their associated factors. Conventional content analysis method was used to provide additional possible factors hindering patients from achieving high-level life-space trajectory.</p><p><strong>Results: </strong>The life-space of older patients following PCI showed an upward trend within 6 months of discharge, with an initial rapid increase followed by a slower progression. Three trajectory subgroups of life-space were identified: low-level persistently restricted group (18.14%), medium-level gradually improving group (47.55%), and high-level unrestricted group (34.31%). Factors associated with trajectory membership included times of PCI, single stent implantation, outings due to family affairs, exercise endurance, depression, and self-efficacy. Additionally, qualitative analysis revealed 4 categories of factors associated with achieving a high-level life-space: physical symptom fluctuation factors, psychosocial adaptation factors, information-cognitive coordination factors, and external environmental interaction factors.</p><p><strong>Conclusion: </strong>There were three distinct heterogeneous trajectories, including one with persistently restricted life-space. Factors associated with life-space trajectories include physiological, psychosocial, disease cognition, and environmental factors. Targeted interventions such as symptom management, psychological counseling, health education, and supportive external environment may promote life-space expansion.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's where I buy lunch or anything that I want to buy\": a participatory photo elicitation study on adolescents' experience of food choice and environment in Kisumu, Kenya.","authors":"Elisa Gobbo, Alice Achieng Ojwang, Kristi Sidney Annerstedt, Joseph Ochieng Amoke, Loyce Joyce Anyango, Sibylle Herzig van Wees, Donvan Nunda, Edward Ouko, Esther Oruko, Helle Mølsted Alvesson","doi":"10.1186/s41043-026-01421-8","DOIUrl":"10.1186/s41043-026-01421-8","url":null,"abstract":"<p><strong>Background: </strong>In Kenya, adolescents face a rapidly changing nutritional landscape, a growing triple burden of nutrition, and a rising risk of non-communicable diseases. Behaviors that begin in adolescence can influence lifelong dietary patterns and future disease risk. Yet, there is limited understanding of contextually grounded, adolescent-centered experiences of their food environments and food choice in the African Region. This study aims to address this gap by exploring how young adolescents attending school in an informal settlement in Kisumu, Kenya, experience and visualize their local food environment.</p><p><strong>Methods: </strong>This is a qualitative participatory study using the visual methods of photo elicitation and social foodscape mapping. Participants took photos of their food environment and then participated in group-based discussions and mapping with researchers. The participants were recruited using convenience sampling from grade 7 until information power was reached. Eighteen adolescents participated (9 females, 9 males, ages 12-13 years). Nine have access to a phone at home. 157 unique images and 17 map drawings were created. Data were analyzed using Drew & Guillemin's three-stage methodology and an abductive reflexive thematic analysis to interpret both images and narratives.</p><p><strong>Results: </strong>The analysis generated three main themes: (1) food choices are shaped by convenience and familiarity, yet the adolescents express an interest in items beyond the familiar, (2) adolescents mostly receive food from adults but are beginning to make some independent choices, and (3) adolescents value the social dimensions of food, yet they navigate different forms of belonging across family and peer contexts. Overall, adult routines and provisions remain central, but adolescents value moments of autonomy and express curiosity for more processed and peer-valued foods.</p><p><strong>Conclusions: </strong>These young adolescents in Kisumu are navigating an early transition point shaped by financial constraints, physical accessibility, and adult-led routines. However, they also express pride in independent choice and interest in greater influence. This signals they are developing volitional autonomy within their social and environmental constraints. These findings position early adolescence as a critical window for intervention to enhance adolescents' capacity to negotiate healthy food choices and influence lifelong dietary patterns.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Note: Evaluating the impact of school-based influenza vaccination programme on absenteeism and outbreaks at schools in Hong Kong: a retrospective cohort study protocol.","authors":"Chuhan Miao, Qingyang Lu, Yuqian Wu, Jianxun He","doi":"10.1186/s41043-026-01435-2","DOIUrl":"https://doi.org/10.1186/s41043-026-01435-2","url":null,"abstract":"","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between hearing and vision impairment and type 2 diabetes among middle-aged and older chinese adults: a nationwide longitudinal cohort study.","authors":"Naixue Wang, Tiantian Wang, Xiaojuan Mao, Li Huang, Huajian Chen","doi":"10.1186/s41043-026-01423-6","DOIUrl":"10.1186/s41043-026-01423-6","url":null,"abstract":"<p><strong>Background: </strong>Sensory impairments, including visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI), are more common in middle-aged and older adults and are associated with poor health outcomes. However, the effect of VI, HI, and DSI on the risk of developing type 2 diabetes (T2D) is unclear.</p><p><strong>Methods: </strong>This study was based on the China Health and Retirement Longitudinal Study (CHARLS), which included a nationally representative sample of 13,484 middle-aged and older participants. HI and VI statuses were collected through self-reported questions. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to analyze the associations of VI, HI, and DSI with the risk of T2D.</p><p><strong>Results: </strong>During the 7-year follow-up period, 1267 participants developed new-onset T2D. Compared with normal hearing participants, individuals with HI had a higher risk of developing T2D (HR 1.19 [95% CI, 1.06-1.34]). Individuals with VI also had a higher risk of developing T2D than individuals with normal vision (HR 1.28 [95% CI, 1.11-1.49]). Individuals with DSI had a 42% increased risk of developing T2D compared with participants without sensory impairment (HR 1.42 [95% CI, 1.18-1.69]).</p><p><strong>Conclusions: </strong>The results of this study suggest that HI and VI have a combined effect on the incidence of T2D. Early identification of vision and hearing impairment may help identify individuals at higher risk of T2D and inform risk stratification and targeted prevention efforts. Individuals with DSI or more severe sensory impairment may warrant priority in diabetes risk assessment and closer monitoring.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical significance of the modified Naples prognostic score for prostate cancer: a population-based study.","authors":"Hong Zeng, Fan Yang, Qian Wang, Tianyi Zhang, Junhao Chen, Shijie Jin, Tianrui Feng, Zhen Liang, Yuliang Chen, Zhiwei Xie, Chenhui Tang, Zhien Zhou, Yi Zhou, Weigang Yan","doi":"10.1186/s41043-026-01402-x","DOIUrl":"https://doi.org/10.1186/s41043-026-01402-x","url":null,"abstract":"<p><strong>Purpose: </strong>The Naples Prognostic Score (NPS) is a widely recognized scoring system used to assess inflammation and nutrition status, yet its role in prostate cancer (PCa) remains unclear. This study aims to investigate the association between the modified NPS (MNPS) and PCa prevalence and mortality outcomes among participants with self-reported PCa.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey 1999-2018 were collected. The NPS was calculated using MaxStat analysis, while M1NPS and M2NPS were constructed with X-Tile analysis. Weighted logistic regression was used to estimate the odds ratio (OR) for PCa prevalence. Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazard ratios (HR) were employed to analyze the mortality risk.</p><p><strong>Results: </strong>Among 22,027 individuals, 717 had PCa. After considering the interactions among different factors and adjusting for confounding variables, the prevalence of PCa was notably higher in participants with the highest MNPS groups (group 3) compared with those with the lowest groups (group 1) (OR (95% CI) = 2.96 (1.57-5.57) for M1NPS; 15.50 (1.78-134.71) for M2NPS). With a median follow-up of 9.92 years, 326 (45.47%) of all-cause deaths occurred among participants with self-reported PCa. Significant differences in all-cause mortality were observed between the MNPS groups (log-rank P < 0.001 for M1NPS and M2NPS). Compared to participants with self-reported PCa in group 1, the adjusted HRs for all-cause mortality in group 3 were 1.12 (95% CI: 0.49-2.57) for M1NPS and 2.02 (95% CI: 1.19-3.44) for M2NPS. Furthermore, a significant association was found between M2NPS and cardiovascular mortality (HR (95% CI) = 4.77 (1.95-11.65).</p><p><strong>Conclusion: </strong>The modified and optimized NPS, which integrates inflammation and nutritional status, is associated with PCa prevalence and with all-cause and cardiovascular mortality among individuals with self-reported PCa.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Violations of the breast milk substitutes act-2013 and its rules - 2017 in Bangladesh.","authors":"S K Roy, Khurshid Jahan, Saria Tasnim, Soofia Khatoon, Nurul Alam, Tofail Md Alamgir Azad, Shahidul Islam, Khadijatul Cubra","doi":"10.1186/s41043-026-01382-y","DOIUrl":"10.1186/s41043-026-01382-y","url":null,"abstract":"<p><strong>Background: </strong>Inadequate breastfeeding practices increase the risk of mortality and morbidity among infants and young children. Recent global estimates suggest that inadequate breastfeeding is responsible for approximately 16% of child deaths worldwide each year, highlighting the ongoing need to strengthen support systems to improve infant and young child feeding practice in Bangladesh, 55% of infants under six months of age are exclusively breastfed. To improve breastfeeding rates and reduce infant mortality, the Government of Bangladesh enacted the Breast-milk Substitute (BMS) Act, 2013, and its Rules in 2017 to regulate the marketing of breast-milk substitutes.</p><p><strong>Objectives: </strong>The study aimed to assess violations of the BMS Act, 2013, and Rules, 2017, focusing on the types, actors, and settings of such violations, while also raising awareness of the Act among key stakeholders and the public.</p><p><strong>Method: </strong>We carried out a cross-sectional survey among 818 retail outlets and pharmacies; 969 baby-friendly hospitals; 969 doctors, nurses, and other health professionals; and 315 mothers with children aged 0-24 months across eight divisions of Bangladesh from August 2016 to December 2019. Data were collected through structured interviews, direct observations, and document reviews using a modified International Baby Food Action Network-International Code Documentation Centre (IBFAN-ICDC) protocol and the BFHI Hospital External Assessment Tool.</p><p><strong>Results: </strong>All retail outlets surveyed (n = 818) sold unregistered BMS products, and all displayed promotional materials. These retail outlets also sold BMS products labeled with health and nutrition claims. In hospitals, 25.5% of doctors (n = 247) and 21.3% of nurses and other health professionals (n = 206) promoted BMS without medical indication. Additionally, 32.0% of health facilities (n = 300) reported providing financial incentives to health professionals to participate in events sponsored by BMS manufacturers. Furthermore, BMS manufacturers violated the BMS Act, 2013 by establishing breastfeeding corners in 164 hospitals (17.5%).</p><p><strong>Conclusion: </strong>This study identified extensive violations of the BMS Act 2013 and its Rules 2017 in Bangladesh, revealing unethical promotion and distribution of BMS. Health professionals in BFHI-trained hospitals played a significant role in these breaches, contributing to the erosion of breastfeeding practices. Urgent monitoring and enforcement are needed to protect infant health and uphold national regulations.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity in health insurance coverage among women with children under two years of age in Laos: a cross-sectional study of sociodemographic disparities and implications for universal health coverage.","authors":"Elizabeth Bunde, Kola A Oyediran, Bouangern Xayalath, Jessica Posner, Nicole Davis, Souksakhone Inthavong, Banthida Komphasouk","doi":"10.1186/s41043-026-01393-9","DOIUrl":"10.1186/s41043-026-01393-9","url":null,"abstract":"<p><strong>Background: </strong>Achieving universal health coverage (UHC) in Laos requires a financing system that supports equitable access to essential services, especially for underserved groups. The National Health Insurance (NHI) scheme, integrating prior social and community-based programs, provides coverage for essential services and reduces out-of-pocket costs. Understanding socioeconomic factors shaping enrollment is critical to avoid policies that unintentionally reinforce inequities.</p><p><strong>Methods: </strong>We conducted a secondary analysis of cross-sectional survey data from 2,138 women with children aged 0-23 months across five Laos provinces. Multivariable logistic regression models estimated associations between sociodemographic factors and health insurance coverage, including an interaction term to examine provincial variations in the effect of education.</p><p><strong>Results: </strong>One-third of women had health insurance. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) were estimated using multivariable logistic regression. Coverage was higher among older women, those with secondary education or above (aOR = 2.00, 95% CI: 1.57-2.54), employed women (aOR = 1.71, 95% CI: 1.30-2.24), women exposed to health messages (aOR = 2.03, 95% CI: 1.62-2.54), and those from wealthier households (highest vs. lowest quintile: aOR = 1.91, 95% CI: 1.23-2.91). Rural residence (aOR = 0.65, 95% CI: 0.48-0.87) and larger households (7-8 members: aOR = 0.68, 95% CI: 0.37-0.91) were associated with lower coverage. Provincial variation in maternal education showed Savannakhet and Oudomxay had relatively high coverage even among less educated women, whereas Phongsaly, Salavan, and Sekong displayed marked socioeconomic disparities.</p><p><strong>Conclusions: </strong>Health insurance enrollment is driven by a multidimensional set of factors, including education, household wealth, and geographic location. While provincial disparities and education are critical determinants, they interact with broader socioeconomic constraints. Achieving UHC coverage requires holistic interventions that not only target specific disadvantaged regions but also address the underlying social and financial barriers impeding access for vulnerable women.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is carbohydrate, protein, fat, and energy intake adequate among lactating women in Northwest Ethiopia?","authors":"Mahider Awoke Belay, Hanna Demelash Desyiblew, Samuel Dagne, Tadele Derbew Kassie, Mekuanent Asmare Yizengaw, Yonatan Menber","doi":"10.1186/s41043-026-01391-x","DOIUrl":"10.1186/s41043-026-01391-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maternal nutrition is an important factor in the health of lactating women and their children. Due to increased energy and nutrient needs during lactation, women in middle- and low-income nations are more nutritionally vulnerable than other women of reproductive age. Inadequate energy and macronutrient intake can also contribute to stunting, muscle wasting, edema, loss of bone density, anemia, and increased susceptibility to infections and nutritional deficiencies in women and babies. Some previous studies reported only the descriptive results of energy and macronutrient intake. But the current study assessed both the prevalence and associated factors. Therefore, this study aimed to assess energy and macronutrient intake inadequacy and its associated factors among lactating women in Bahir Dar City, Northwest Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A study was conducted in Bahir Dar city from February 27 to March 21, 2021. A systematic random sampling technique was used to select 318 respondents. Data were collected by interviewer-administered, semi-structured questionnaires after the pilot survey had been completed. A single 24-hour multi-step dietary recall was used to collect the respondent's dietary data. Data entry and analysis were performed using EpiData version 3.1 and SPSS version 24, respectively. Energy and macronutrient intake values were calculated from the ESHA Food Processor and the Ethiopian and World Food Composition Tables. The macronutrient intake was evaluated by the Acceptable Macronutrient Distribution Range (AMDR). Bivariable and multivariable binary logistic regression were used to declare the significant variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prevalence of energy, carbohydrate, protein, and fat intake inadequacy among respondents was 52%, 66.2%, 17%, and 90.4%, respectively. The percentage of energy derived from carbohydrates, protein, and fat was 74%, 16%, and 10%, respectively. The median energy intake was 2416.8 kcal. Approximately 55%, 84%, and 90% of the respondents had carbohydrate, protein, and fat intakes above, within, and below the acceptable macronutrient distribution range, respectively. Not receiving nutrition education (AOR = 1.32, 95% CI (1.01, 2.83)) and being categorized as medium wealth (AOR = 2.04, 95% CI (1.03, 6.03)) were significantly associated with inadequate energy intake. Having a primary educational level (AOR = 2.56, 95% CI (1.07, 7.17)) and a secondary school educational level (AOR = 0.47, 95% CI (0.24, 0.93)) were associated with inadequacies in carbohydrate intake. Being a merchant (AOR = 2.01, 95% CI (1.12, 6.52)), daily laborer (AOR = 9.28, 95% CI (1.61, 43.65)), or private employee (AOR = 2.12, 95% CI (1.11, 8.07)) was associated with protein intake inadequacy. Due to the low prevalence outcome (&lt; 10% adequacy) of fat intake, regression was not performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion and recommendation: &lt;/strong&gt;More than half of lactating women's ener","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"45 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of digestive congenital anomalies in the Middle East and North Africa region between 1990 and 2021.","authors":"Fatemeh Akhlaghi, Azin Kadkhodamanesh, Faegheh Bahri, Reyhane Khajezade, Arya Adinepour, Mahsa Iranmanesh, Mohammad Amin Khajuei Gharaei, Zahra Sarkoohi, Mohammad-Mahdi Bastan, Hossein Pourghadamyari, Hamid Sharifi, Omid Eslami, Seyed Aria Nejadghaderi","doi":"10.1186/s41043-026-01398-4","DOIUrl":"10.1186/s41043-026-01398-4","url":null,"abstract":"<p><strong>Background: </strong>Digestive congenital anomalies (DCAs), the fourth leading cause of death and disability among all congenital birth defects, have a substantial impact on both the duration and quality of life. This study aimed to present the burden and socioeconomic associates of DCAs in the Middle East and North Africa (MENA) region from 1990 to 2021.</p><p><strong>Methods: </strong>DCAs were defined based on the International Classification of Diseases codes (ICD-9: 750-751.9, 756.6-756.79; ICD-10: Q38-Q45.8, Q79.0-Q79.59). Mortality was estimated using the Cause of Death Ensemble Model, and DisMod-MR 2.1 was employed to model cause-specific mortality and excess mortality. Metrics were presented as crude counts and age-standardized rates per 100,000, with 95% uncertainty intervals. The association between socio-demographic index (SDI) and DCAs burden was examined using smoothing spline models.</p><p><strong>Results: </strong>In 2021, the age-standardized incidence rate of DCAs in the MENA region was 7.17 (5.64, 9.15), while the age-standardized point prevalence was 50.57 (40.88, 59.51) per 100,000 individuals. MENA had a DALY rate of 67.85 (47.56, 88.75) and a death rate of 0.74 (0.50, 0.97). From 1990 to 2021, there were significant reductions in the age-standardized rates of incidence (-25.99% [-33.70, -17.06]), prevalence (-10.55% [-18.88, -2.04]), DALY (-62.35% [-78.36, -10.86]), and death (-62.97% [-78.95, -10.76]) associated with DCAs in MENA. In 2021, Afghanistan had the greatest age-standardized DALY rate, while Qatar had the lowest. Males generally had a greater burden of DCAs. A negative association was identified between age-standardized DALY rates and the SDI for DCAs in the MENA.</p><p><strong>Conclusions: </strong>From 1990 to 2021, we observed a significant decrease in the burden of DCAs in MENA, although the trends vary across countries. These findings offer crucial insights for developing effective prevention and management strategies for these anomalies.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}