Tropical Medicine and Health最新文献

{"title":"Clinical characteristics and outcomes of paediatric acute lymphoblastic leukaemia in a tertiary hospital in Tanzania: a single-centre observational study.","authors":"Koki Shimizu, Koga Luhulla, Magreth Msoffe, Chambega Chambega, Salama Mahawi, Primus Ewald, Godlove Sandi, Irene Msirikale, Ruchius Philbert, Regina Kabona, Lulu Chirande, Nana Jacqueline Nakiddu, Patricia Scanlan, Chris Smith, Yasushi Miyazaki, Camille Maringe, Bernard Rachet, Hadija Mwamtemi","doi":"10.1186/s41182-025-00760-2","DOIUrl":"10.1186/s41182-025-00760-2","url":null,"abstract":"<p><strong>Background: </strong>A wide inequality exists between high- and low-income countries in the outcome of paediatric acute lymphoblastic leukaemia (ALL). At a tertiary-level hospital in Tanzania, multidimensional approaches have been taken to improve cancer care for children. This study aimed to update the outcomes of paediatric ALL at Muhimbili National Hospital (MNH), Tanzania from 2016 to 2020.</p><p><strong>Methods: </strong>We performed a retrospective chart review of children who were treated with modified UKALL2003 protocol at MNH from January 1, 2016 to December 31, 2020. We used the Cox proportional hazards model to estimate the effect of each prognostic factor on event-free survival (EFS).</p><p><strong>Results: </strong>We identified 202 patients who had confirmatory diagnoses of ALL and initiated treatment at MNH. Fifty-two patients (26%, 52/202) died (n = 47) or abandoned treatment (n = 5) before the end of remission induction. The main causes of death during this period were infections and bleeding complications. The median EFS was 9 months and 2-year EFS was 36%. Oedema, non-early rapid responder, and non-remission were associated with short EFS in the multivariable analysis.</p><p><strong>Conclusions: </strong>The number of new paediatric ALL admissions at MNH has doubled in the past decade. The prevention of early deaths is critical to improve the long-term survival of paediatric ALL in Tanzania.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"76"},"PeriodicalIF":3.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162076","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":"Community perception and preventive practices regarding malaria in low-endemicity regions on Indonesian Kalimantan border adjacent to high-endemicity zoonotic malaria in Malaysian Borneo.","authors":"Diana Natalia, Willy Handoko, Sari Rahmayanti, Tri Wahyudi, Khamisah A Kadir, Zulkarnain Md Idris, Ayu A A Rashid, Paul C S Divis","doi":"10.1186/s41182-025-00757-x","DOIUrl":"10.1186/s41182-025-00757-x","url":null,"abstract":"<p><strong>Background: </strong>Indonesia aspires to completely eliminate malaria by 2030. Malaria cases have fallen drastically due to the implementation of national strategic plans and policies, and the Ministry of Health has granted certification of elimination status to various areas, including Kalimantan. However, this low prevalence contrasts sharply with the continued high prevalence (18.9%, totalling 3290 cases) of Plasmodium knowlesi infections in Malaysian Borneo. Assessing the knowledge and preventive practices regarding malaria and attitudes towards zoonotic malaria within communities along the Kalimantan border is essential to understanding the low endemicity (API < 1) of malaria in this region.</p><p><strong>Methods: </strong>Between February and April 2021, a structured questionnaire was administered to respondents who lived in villages with recent malaria cases (P. vivax and P. falciparum infections) across the West, East, and North Kalimantan provinces bordering Malaysian Borneo. The questionnaire collected demographic information, knowledge, prevention practices, illness management, and attitudes towards contributing factors of zoonotic malaria. Data were analysed using descriptive statistic and the association between variables was determined using logistic regression. A P value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 639 respondents, 47.6% had completed primary education, and 49.1% worked in the agricultural sector. More than half of the respondents had good knowledge (58.2%) and good practice (51%) regarding malaria's cause, symptoms and prevention. A notable 58.9% could identify at least two classic symptoms of malaria (fever and shivering), and 78.6% associated the disease with mos quito bites. More than half of the respondents (53.7%) owned bed nets and stated using them every night on a regular basis (49.3%). However, more than half of these bed nets were not insecticide-treated. Indoor residual spraying by the health authority was uncommon. A common practice was that 84% of respondents sought treatment at health facilities when suspecting malaria (fever and shivering). Regarding the potential for acquiring zoonotic malaria, 36.2% of respondents lived near the forest, and 15.8% reported encountering monkeys within 500 m of their house. Multivariate analysis showed that an increase in education level significantly predicted good knowledge of malaria. Meanwhile, good malaria practices were significantly associated with women (aOR = 2.25; P < 0.001), age 25-64 (aOR = 2.64; P < 0.001), and age over 65 (aOR = 3.06; P = 0.004).</p><p><strong>Conclusions: </strong>This study observed an exceptional level of malaria awareness among these communities. However, it is crucial to emphasise the importance of continuous malaria surveillance within this community for maintaining the current low malaria cases and achieving the goal of malaria-free status in the country by 2030.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"75"},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133248","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":"Toward achieving the WHO 2030 target in the mitigation of snakebite envenoming: the fundamental challenges in addressing the unmet needs.","authors":"Swati Allen, Joy Kumar Chakma","doi":"10.1186/s41182-025-00754-0","DOIUrl":"10.1186/s41182-025-00754-0","url":null,"abstract":"<p><p>Snakebite envenoming represents a significant public health challenge, particularly in regions where venomous snakes are prevalent. Globally, it has been estimated that every year 81,000-1,38,000 people die due to venomous snakebites along with enormous morbidity and physical disability to the survivors. Almost 70% of estimated global snakebite deaths are from South Asia Region. However, more than half of the global burden due to snakebite is alone from India with an estimated annual average of about 58,000 deaths. Thus, this is a significant public health problem for a developing country like India compared to the other Low- and Middle-Income Countries (LMICs). Considering the problem of snakebites in developing and tropical countries, which contributes almost 95% of the total snakebites of the world, the World Health Organization (WHO) has re-designated snakebite as a priority Neglected Tropical Disease (NTD) in 2017. However, there is a little more than a 5-year window left for reducing mortality and morbidity due to snakebite envenoming by 50%, in aligning with the WHO 2030 target. Thus, for achieving this target within the span of half a decade, for this decades-old problem, there is an urgent need to recognize the fundamental challenges for addressing the unmet needs and recognizing the opportunities.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"74"},"PeriodicalIF":3.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120948","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 quality performance scorecard scores and health indicators: an ecological study in the Northern provinces of the Lao People's Democratic Republic.","authors":"Vixayyang Chayvangmanh, Noudéhouénou Credo Adelphe Ahissou, Khamsay Detleuxay, Daisuke Nonaka","doi":"10.1186/s41182-025-00748-y","DOIUrl":"10.1186/s41182-025-00748-y","url":null,"abstract":"<p><strong>Background: </strong>The Ministry of Health, Lao People's Democratic Republic (Lao PDR), surveyed health centers using the Quality Performance Scorecard (QPS) tool in 2021 to assess the quality of healthcare services at health centers. To validate the QPS tool, this study assessed the association between the QPS scores obtained from each health center and outpatient department (OPD) visits, antenatal care (ANC) coverages, and under-five mortality rates (U5MR) in the health centers' catchment area.</p><p><strong>Methods: </strong>This ecological study assessed the association between the QPS scores as an independent variable and OPD visits, coverage of ANC at least one visit (ANC1), coverage of ANC four or more visits (ANC4) and U5MR as a dependent variable, using secondary data collected from the 234 health centers and 31 district health offices in the four northern provinces, such as Huaphan, Xiengkhuang, Oudomxay and Phongsaly. Mixed-effect linear regression was used to assess the association between the independent variable and dependent variables while adjusting for covariates.</p><p><strong>Results: </strong>The mean value (standard deviation) was 64.9/100 (14.3) for QPS score, 3.3 (3.6) for U5MR (per 1,000 under-five population), 0.7 (0.5) for OPD visits (per population), 9.6 (6.0) for ANC1 coverage (per estimated number of reproductive-aged women) and 5.7 (4.4) for ANC4 coverage. The QPS scores were significantly independently associated with U5MR (unstandardized regression coefficient: -0.225 and standardized regression coefficient: -0.894), OPD visits (-0.004 and -0.114) and ANC4 coverage (-0.036 and -0.117).</p><p><strong>Conclusion: </strong>This study shows that with increasing level of quality of healthcare services as measured by QPS, the U5MR was decreasing. The association demonstrated the ability of the QPS tool to capture the quality of healthcare services at health centers. Although the QPS scores were also negatively associated with OPD visits and ANC4 coverage, these associations were weak and likely confounded by unmeasured factors, or explained by quality care potentially reducing patients' perceived need for frequents visits. To further validate the QPS tool, a longitudinal study is recommended to confirm the findings and address unmeasured factors.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"73"},"PeriodicalIF":3.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120947","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 wet-bulb globe temperature and epilepsy: a space-time-stratified case-crossover study in Taiwan.","authors":"Yu-Tzu Chang, Yu-Ting Lin, Bao-Ru Chuang, Wen-Hsuan Chuang, Bing-Fang Hwang, Chau-Ren Jung","doi":"10.1186/s41182-025-00755-z","DOIUrl":"10.1186/s41182-025-00755-z","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a common neurological disorder characterized by an enduring predisposition to generate epileptic seizures, along with its neurobiological, cognitive, psychological, and social consequences. Although a few studies have assessed the associations of meteorological factors, such as temperature, atmospheric pressure, and relative humidity, with epilepsy, their findings remain inconsistent. In this study, we used the wet-bulb globe temperature (WBGT), an integrated heat stress index closely aligned with human thermal perception, to assess its associations with epilepsy risk.</p><p><strong>Methods: </strong>This study employed a space-time-stratified case-crossover study design, analyzing 187,657 epileptic seizures recorded in emergency department visits in the Taiwan Health Insurance Research Database between 2007 and 2017. Daily WBGT values at individuals' residential addresses were estimated using a 1-km resolution spatiotemporal model. The effects of an interquartile range (IQR) increase in WBGT on the day of epileptic seizures were compared to 3-4 reference days within the same month using conditional logistic regressions combined with distributed lag non-linear models (DLNMs).</p><p><strong>Results: </strong>The lag-response relationship indicated a significant positive association between WBGT and epilepsy risk at lag 0 day (odds ratio [OR] = 1.083, 95% confidence interval [CI]: 1.061-1.105), whereas significant negative associations were observed at lag 1 and lag 2 day, suggesting a harvesting effect. The cumulative effect of heat persisted for 2 days. Additionally, the exposure-response relationship between WBGT and epilepsy at lag 0 day was linear, with no apparent threshold observed.</p><p><strong>Conclusion: </strong>Our findings suggest that heat exposure may trigger epilepsy, resulting in short-term clustering of epilepsy cases. As precision medicine continues to gain prominence, incorporating precise heat stress indicator, such as WBGT, into individualized epilepsy management strategies may enhance patient care and seizure prevention.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"72"},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112175","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":"Mental health and COVID-19 vaccine hesitancy among health-related university students: a cross-sectional multi-center study.","authors":"Thanawat Khongyot, Amy Takyi, Dympna Siysila Ndzeshang, Karl Gwei Njuwa Fai, Tin Zar Win, Latdavanh Vorlasane, Gibson Omwansa Javes, Satoshi Kaneko, Taeko Moriyasu","doi":"10.1186/s41182-025-00751-3","DOIUrl":"10.1186/s41182-025-00751-3","url":null,"abstract":"<p><strong>Background: </strong>The mental health problems during the coronavirus disease 2019 (COVID-19) pandemic may have influenced their decision to receive the COVID-19 vaccine among health-related university students, with potential differences across countries. This study elucidated the association between mental health and COVID-19 vaccine hesitancy of health-related university students in Thailand, Laos, and Japan. We additionally examined the other factors that might relate to COVID-19 vaccine hesitancy.</p><p><strong>Methods: </strong>The study conducted an online survey from February 4 to 27, 2021, among undergraduate students enrolled in health-related programs at University of Health Sciences (Lao PDR), Walailak University (Thailand), and Nagasaki University (Japan) using a non-probability convenience sampling method. The data were analyzed using multiple logistic regression to identify associations between mental health and self-reported COVID-19 vaccine hesitancy and other potential factors.</p><p><strong>Results: </strong>This study analyzed data from 841 students. Japanese students attended hybrid classes (82.45%), while those in Laos and Thailand had entirely online courses. All mental health assessment scores (depression, anxiety, and stress) were higher in Thailand and Laos compared to Japan. Students with very high-stress scores had the highest odds of vaccine hesitancy (aOR 2.67, 95% CI 1.45-4.93). Fear of COVID-19 increased hesitancy, while unbelief in vaccine protection significantly increased it (aOR 2.59, 95% CI 1.86-3.59). Females displayed about two times greater hesitancy (adjusted odds ratio, aOR 2.43, 95% CI 1.68-3.51), which correlated with higher mental health scores.</p><p><strong>Conclusions: </strong>We highlighted a significant association between mental health and self-report COVID-19 vaccine hesitancy. Interventions, including tailored support, awareness campaigns, and psychological services, can foster trust and vaccine uptake.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"71"},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102814","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 incidence of common sexually transmitted infections at the global, regional and national levels, 1990-2021: results of the Global Burden of Disease 2021 study.","authors":"Miao Deng, Jiaxi Chen, Zhi Wang, Rubin Zheng, Wenyi Pang, Rui Sun, Zhixun Bai","doi":"10.1186/s41182-025-00744-2","DOIUrl":"10.1186/s41182-025-00744-2","url":null,"abstract":"<p><strong>Background: </strong>Sexually transmitted diseases (STDs) are prevalent globally and represent a significant public health challenge. This study aims to evaluate the most recent estimates of the burden of common sexually transmitted infections (STIs) at global, regional, and national levels, which will aid in the development of more effective prevention strategies.</p><p><strong>Methods: </strong>Data for this study were obtained from the Global Burden of Disease (GBD) 2021 study via the Global Health Data Exchange (GHDx) query tool ( https://vizhub.healthdata.org/gbd-results/ ). We extracted the data in accordance with GBD operational guidelines, selecting the most recent results from the 2021 GBD study. The latest GBD study results provided data on incidence, prevalence, and disability-adjusted life years (DALYs) for 21 regions and 204 countries. We extracted the number of cases, incidence, and age-standardized incidence of sexually transmitted diseases (STDs) by sex, age group, and location, following GBD usage guidelines. The data were categorized into five groups based on sociological demographic indices (SDIs).</p><p><strong>Results: </strong>In 2021, the total number of STDs was ~ 289.17 million, reflecting an increase of about 58.38% compared to 1990. While the total number of cases was higher in males, the increase was more pronounced in females. Syphilis exhibited the highest age-standardized rate (ASR) in Equatorial Guinea (EAPC 0.57, 95% CI [- 2.97, 4.24]). Trichomoniasis had the greatest ASR in Tanzania (EAPC - 1.24, 95% CI [- 4.97, 2.64]). Gonococcal (EAPC - 0.52, 95% CI [- 4.33, 3.44]) and chlamydial infections (EAPC - 0.52, 95% CI [- 4.33, 3.44]) showed the highest ASR in South Africa, while genital herpes (EAPC - 1.3, 95% CI [- 4.89, 2.44]) had the greatest ASR in Zimbabwe. HIV/AIDS had the highest ASR in Lesotho (EAPC - 0.33, 95% CI [- 3.99, 3.46]), and the combined ASR for HIV/AIDS and STIs was highest in South Africa (EAPC - 0.47, 95% CI [- 0.58, 0.37]).</p><p><strong>Conclusion: </strong>The burden of STDs remains high and has been steadily increasing; the burden of STIs is more severe in low SDI areas and among young and middle-aged people; the prevalence, incidence, and disability-adjusted years of STIs during the period 1990-2021 are attributable to three main factors: population, disease epidemiology, and aging.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"70"},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086688","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 monoclonal antibodies against SARS-CoV-2 nucleocapsid protein for COVID-19 antigen detection.","authors":"Maurine Mumo Mutua, Bernard N Kanoi, Steven Ger Nyanjom, Sebastian Musundi, Mark Makau, Shingo Inoue, Samoel Ashimosi Khamadi, Jesse Gitaka, Ernest Apondi Wandera","doi":"10.1186/s41182-025-00756-y","DOIUrl":"10.1186/s41182-025-00756-y","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic underscored the global need for reliable diagnostic tools with quick turnaround time for effective patient management and mitigation of virus spread. This study aimed to express severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein and produce monoclonal antibodies (mAbs) against the expressed protein.</p><p><strong>Methods: </strong>Following successful expression and purification of His-tagged SARS-CoV-2 N protein using a wheat germ cell-free protein expression system (WGCFS), BALB/c mice were immunized, and generated hybridomas screened for mAb production. Indirect and sandwich ELISA were used to screen the reactivity of the monoclonal antibody against both our recombinant antigen and commercial antigen. The mAbs were also assessed for their performance using RT-PCR confirmed positive samples with varying cycle threshold (CT) values and their specificity screened using virus isolates of other respiratory viruses.</p><p><strong>Results: </strong>Our mAb demonstrated high reactivity against our recombinant antigen, commercial antigen, SARS-CoV-2 Beta and Omicron variants. There was no significant difference in the binding affinity of our mAb and commercial mAb against the study recombinant (p = 0.12) and commercial (p = 0.072) antigens. Our mAb detected SARS-CoV-2 from clinical samples with varying CT values and exhibited no cross-reactivity against other respiratory viruses.</p><p><strong>Conclusions: </strong>We successfully expressed SARS-CoV-2 N protein leveraging WGCFS in a resource-limited setting. Our mAb had a high binding affinity to the recombinant antigen, making it a suitable candidate for antigen detection kit development. Beyond diagnostics, the mAb holds potential for therapeutic applications as well as use in clinical and environmental surveillance platforms.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"69"},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040031","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, regional, and national burden of congenital musculoskeletal and limb anomalies, 1990-2021: a systematic analysis of the global burden of disease in 2021.","authors":"Yu Luo, Rubin Zheng, Jiaxi Chen, Miao Deng, Ziyang Zhang, Zhouke Tan, Zhixun Bai","doi":"10.1186/s41182-025-00750-4","DOIUrl":"10.1186/s41182-025-00750-4","url":null,"abstract":"<p><strong>Background: </strong>Congenital musculoskeletal and limb (CML) anomalies are uncommon, multifactorial conditions whose global incidence trends remain underexplored. This study delineates the epidemiology and temporal evolution of CML anomalies from 1990 to 2021.</p><p><strong>Methods: </strong>We extracted data from the 2021 global burden of disease (GBD) Study, stratifying by sex, region, country and socio-demographic index (SDI). We calculated age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and estimated annual percentage change (EAPC). Decomposition analysis quantified the contributions of population growth, aging, and epidemiological change. Projections to 2031 were made using an autoregressive integrated moving average (ARIMA) model. Health inequities were assessed via the slope index of inequality (SII) and concentration index (CI).</p><p><strong>Results: </strong>Global epidemiological patterns of CML anomalies exhibited significant disparities between 1990 and 2021. Brunei Darussalam demonstrated the highest ASIR, while Afghanistan and the United Mexican States recorded the highest ASMR and ASPR, respectively. Absolute case and death burdens predominantly clustered in populous nations, with India and China reporting the highest absolute numbers. ARIMA modeling projected a 0.85% increase in incident cases (from 2,437,890.12 to 2,458,596.45), a 25.46% decrease in mortality (from 13,599.83 to 10,137.02), and a 3.55% increase in prevalence (from 18,549,408.27 to 19,207,414.19) by 2031. Decomposition analyses revealed that population growth was the primary driver of increased cases in middle SDI regions, whereas epidemiological transitions and aging were the main contributors to mortality reductions. In lower-middle SDI regions, concurrent demographic expansion and epidemiological changes amplified case burdens. Health inequality significantly increased, with the incidence CI rising from 0.28 to 0.35 and the mortality CI from 0.34 to 0.42 between 1990 and 2021. Significant correlations were observed between EAPC and baseline ASIR/ASMR, with declining trends in mortality and rising prevalence driven by population growth and epidemiological transitions.</p><p><strong>Conclusion: </strong>From 1990 to 2021, CML anomalies' incidence and mortality exhibited divergent trends across SDI strata, with less favorable outcomes in lower-SDI countries. Tailored interventions are essential to mitigate the growing burden in these settings.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"68"},"PeriodicalIF":3.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019648","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":"Ownership and utilization of mosquito bed net among pregnant women in Ghana: a national population-based survey.","authors":"Wise Awunyo, David Gameli Agbleta, Mary Adaeze Udeoha, Matilda Mawusi Kodjo, Agani Afaya","doi":"10.1186/s41182-025-00739-z","DOIUrl":"https://doi.org/10.1186/s41182-025-00739-z","url":null,"abstract":"<p><strong>Background: </strong>Despite mosquito bed net use being among the many evidence-based safe and successful interventions to avert plasmodium infection during pregnancy, its use remains low among pregnant women due to various barriers. This study, therefore, examined the factors associated with mosquito bed net utilization and ownership among pregnant women in Ghana.</p><p><strong>Methods: </strong>Data from the 2022 Ghana Demographic and Health Survey were analyzed for this cross-sectional study. A representative sample of 1111 pregnant women from the 16 regions of Ghana were included in the study. Multivariate logistic regression analysis was used to determine the factors associated with mosquito bed net ownership and utilization among pregnant women of reproductive age.</p><p><strong>Results: </strong>The prevalence of mosquito bed net ownership among pregnant women was 80.1% [CI 76.8-83.0] and that of mosquito bed net utilization was 47.6% [CI 43.9-51.4]. We also found that pregnant women with 1-3 children [aOR = 2.07, 95% CI 1.25-3.43] and 4 or more children [aOR = 2.52, 95% CI 1.38-4.59], had a partner with secondary level education [aOR = 2.11, 95% CI 1.10-4.06] and higher educational status [aOR = 2.47, 95% CI 1.06-5.74] had higher odds of mosquito bed net use. However, pregnant women who belonged to middle wealth quintiles [aOR = 0.41, 95% CI 0.21-0.82], richer wealth quintiles [aOR = 0.19, 95% CI 0.09-0.41], and richest wealth quintiles [aOR = 0.09, 95% CI 0.03-0.25] had decreased odds of mosquito bed net use. In addition, pregnant women who had female household heads [aOR = 1.73, 95% CI 1.03-2.91], resided in the rural areas [aOR = 1.97, 95% CI 1.12-3.49], had 1-3 children [aOR = 1.65, 95% CI 1.05-2.58] and 4 or more children [aOR = 2.08, 95% CI 1.03-4.20] had higher odds of mosquito bed net ownership. Meanwhile, pregnant women with active health insurance [aOR = 0.29, 95% CI 0.10-0.80] had lesser odds of mosquito bed net ownership.</p><p><strong>Conclusion: </strong>The rate of mosquito bed net ownership was high among pregnant women. However, the effective utilization of mosquito bed net among pregnant women was low. Considering the low utilization of mosquito bed nets, public health practitioners and clinicians should develop awareness and educational interventions tailored toward improving mosquito bed net use among pregnant women.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"53 1","pages":"66"},"PeriodicalIF":3.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035870","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}