Tropical Medicine & International Health最新文献

{"title":"Evaluation of itraconazole monotherapy versus its combination with a single dose of pentamidine for treating cutaneous leishmaniasis caused by Leishmania (Viannia) guyanensis in Amazonas state, western Brazilian Amazon.","authors":"Melissa de Sousa Melo Cavalcante, Lara Isabelli Oliveira da Silva, Jessica Vanina Ortiz, Rômulo Freire de Morais, Monica Regina Hosannah da Silva E Silva, Silmara Navarro Pennini, Amanda Bento Dos Santos, Victoria Rosas Marques, Talita Silva Satiro, Gabriel Vinicius Silva de Carvalho, Katia do Nascimento Couceiro, Thamires Batos Pinheiro, André Luiz Leturiondo, Felipe Jules de Araújo Santos, José Ângelo Lauletta Lindoso, Maria das Graças Vale Barbosa Guerra, Jorge Augusto de Oliveira Guerra","doi":"10.1111/tmi.70008","DOIUrl":"https://doi.org/10.1111/tmi.70008","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous leishmaniasis has long been a neglected tropical disease mainly due to therapy limitations. The search for safe and effective alternative treatments, particularly oral medications, has led to the development of second-line treatments, such as azole antifungals, including itraconazole. This study aimed to evaluate and compare the therapeutic effectiveness of itraconazole alone and in combination with pentamidine in patients with cutaneous leishmaniasis, caused by Leishmania Viannia guyanensis.</p><p><strong>Methods: </strong>A randomised clinical trial was conducted at the leishmaniasis outpatient clinic of the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado in Manaus, Amazonas. Ninety eligible patients diagnosed with cutaneous leishmaniasis were selected and randomly assigned to three treatment groups. Control group-Group 1 (G1) received pentamidine isethionate; experimental group-Group 2 (G2) received itraconazole monotherapy; and experimental group-Group 3 (G3) received a combination of itraconazole and one dose of pentamidine isethionate, in standardised doses. Patients were monitored at 30, 60, 90 and 180 days after the completion of treatment. Leishmania species were identified using biomolecular methods.</p><p><strong>Results: </strong>The patients were predominantly males (84.4%), with a mean age of 40.5 ± 12.9 years. 93% of cases originated from the peripheral areas of Manaus, Amazonas. The average duration of skin lesion evolution was 30 days, with 84% presenting as ulcerated lesions. A single lesion was observed in 57% of cases, 41% measured 2 to 3 cm², and were predominantly on the lower limbs. Four species of Leishmania were identified, with L. guyanensis causing 90% of cases, L. brasiliensis causing 6% of cases, L. amazonensis causing 2.5% of cases and L. naiffi causing 1.2% of cases. Among 72 cases of L. (V.) guyanensis, cure rates were 96% with itraconazole + pentamidine, 83% with itraconazole alone and 58% with pentamidine alone. No serious adverse events were observed in terms of toxicity and tolerability. Injection site pain or induration was the most common adverse effect in G1. In terms of efficacy, patients in G2 and G3 experienced more favourable outcomes, with 90-day cure rates of 56% (G1), 73% (G2) and 90% (G3).</p><p><strong>Conclusion: </strong>After 90 days, the itraconazole-pentamidine combination therapy was more effective (90%) than either itraconazole or pentamidine alone against cutaneous leishmaniasis in Amazonas state caused by L. guyanensis.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive voice response surveys as a method for increasing the representativeness of rural respondents in a mortality mobile phone survey: Findings from Malawi.","authors":"Malebogo Tlhajoane, Funny Muthema, Michael Chasukwa, Kelly McCain, Shammi Luhar, Julio Romero Prieto, Jacob Saikolo, Cremildo Manhica, Sarah Walters, Boniface Dulani, Georges Reniers","doi":"10.1111/tmi.70005","DOIUrl":"https://doi.org/10.1111/tmi.70005","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aims to (i) evaluate the yield and costs of a fully automated interactive voice response survey as a screening tool for identifying rural respondents for participation in a mortality mobile phone survey, and (ii) compare mortality survey call outcomes among interactive voice response pre-screened and unscreened numbers.</p><p><strong>Methods: </strong>In order to identify respondents living in rural areas, a short interactive voice response survey was conducted among 24,924 unique mobile phone numbers to determine place of residence (Rural vs. Other). We calculated the proportion of rural numbers derived from the interactive voice response survey among all numbers dialled. Mobile phone numbers screened with interactive voice response were then combined with those generated via random digit dialling and used in a national mortality mobile phone survey in Malawi. Final dispositions for each mobile number dialled were compared for both groups by testing the difference in proportions.</p><p><strong>Results: </strong>Approximately half of all phone numbers dialled in the interactive voice response survey were answered, and among them, 33.9% indicated that they lived in a rural area. The cost per completed interactive voice response was US$8.75 and just under half of the numbers screened by interactive voice response later resulted in a completed mortality mobile phone survey, at a cost of US$17.4 per completed mortality survey. In comparison, less than a quarter of the numbers that were not screened through interactive voice response resulted in a completed mortality survey (45.3% vs. 22.3%, p <0.001). On average, 12 call attempts were required to complete a mortality survey interview in the unscreened group, compared to 6.3 call attempts among the interactive voice response pre-screened numbers.</p><p><strong>Conclusions: </strong>Interactive voice response surveys can be used to increase the representation of rural respondents in mobile phone surveys at an acceptable cost. Modifications to the interactive voice response survey process (e.g., survey timing and number of call attempts) should be explored further to increase engagement.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria and helminths co-infection-Effects on anaemia, iron and folate deficiencies in paediatric population in Ghana.","authors":"Opoku Bempah, Kwasi Baako Antwi, Mutala Abdul-Hakim, Ibrahim Alhadj Moussa Mahamat, Kwadwo Boampong, John Larbi, Kingsley Badu","doi":"10.1111/tmi.70003","DOIUrl":"https://doi.org/10.1111/tmi.70003","url":null,"abstract":"<p><strong>Background: </strong>Helminthiasis co-exists with malaria in endemic areas; this co-existence can influence anaemia, iron, and folate levels in patients. This study was aimed at assessing the effect of malaria, helminthiasis, and co-infection on anaemia, iron, and folate deficiencies in children.</p><p><strong>Methods: </strong>The study participants comprised of 1003 children, from whom venous blood and stool samples were obtained. Structured questionnaires were used to assess sociodemographic and household data. Venous blood from children (aged 1-15 years) was analysed for malaria parasitaemia and full blood count. Kato Katz and formol ether concentration techniques were used to analyse stool samples for intestinal parasites. Indirect ELISA was performed on the serum samples to determine iron and folate levels.</p><p><strong>Results: </strong>Overall, malaria and intestinal helminths prevalence were 54.4% (546/1003) and 15.7% (172/1003), respectively. Ascaris lumbricoides, Taenia spp., hookworm, Trichuris trichiura and Strongyloides stercoralis were identified as mono-infection or in co-infection with malaria (11.4%) or intestinal protozoa (1.5%). These prevalence rates were significantly higher in less urbanised northern study sites (p < 0.0001) and among younger children (p < 0.0001). Malaria (p < 0.0320), intestinal helminths (p < 0.0001) and malaria-helminthiasis co-infection (p < 0.0320) were independent predictors of anaemia. Malaria and intestinal helminths co-infection significantly worsens anaemia (p < 0.001), folate deficiency (p < 0.001) and iron deficiency (p < 0.001) compared to those with malaria only.</p><p><strong>Conclusion: </strong>Malaria and helminthiasis predominantly affect children and are influenced by age, gender, locality, and urbanisation. Co-infection exacerbates the adverse outcomes associated with malaria.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-tuberculosis co-infection in conflict zones of Nigeria.","authors":"Hamisu M Salihu, Hassan A Murtala, Adam M Murtala, Aisha A Abdullahi, Muhammad A Abbas, Abubakar L Yusuf, Muktar H Aliyu, Sani H Aliyu, Ololade D Adeyemi, Deepa Dongarwar, Jordi B Torrelles, Rahila A Mukhtar, Gambo Aliyu","doi":"10.1111/tmi.14112","DOIUrl":"10.1111/tmi.14112","url":null,"abstract":"<p><strong>Background: </strong>Nigeria bears a high burden of infectious diseases, with the second-highest human immunodeficiency virus (HIV) prevalence globally and the largest tuberculosis (TB) burden in Africa. The country faces significant challenges from armed conflicts, insurgency, kidnapping and banditry, which severely strain its healthcare system, particularly for people living with HIV (PLHIV). This study hypothesizes that PLHIV in conflict-affected regions of Nigeria experience a higher burden of TB than those in non-conflict areas.</p><p><strong>Methods: </strong>This cross-sectional household survey utilised a two-stage cluster sampling design to examine HIV/TB co-infection and associated behaviours in Nigeria, based on data from the 2018 Nigeria HIV/ acquired immune deficiency syndrome (AIDS) Indicator and Impact Survey. The sample included adults aged 15 to 64 in the selected households. We mapped the distribution of HIV/TB co-infection across the country and calculated its prevalence, stratified by conflict and non-conflict zones. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) from survey-weighted logistic regression models were used to assess the likelihood of being diagnosed with TB disease among PLHIV.</p><p><strong>Results: </strong>We analysed weighted data from 1,319,719 PLHIV across Nigeria, with 200,201(15.2%) residing in conflict zones and 1,119,518 (84.8%) in non-conflict zones. Overall, the prevalence of HIV/TB co-infection was 40.4% (52,118), with PLHIV residents of conflict zones exhibiting a significantly higher prevalence (59%, 14,976) compared to those from non-conflict zones (36%, 37,413). After adjusting for confounders, PLHIV in conflict zones were more than four times more likely to acquire TB than those from non-conflict zones (AOR: 4.21, 95% CI: 1.72-10.5, p = 0.002).</p><p><strong>Conclusions: </strong>Conflicts amplify the risk of TB among PLHIV in Nigeria, highlighting an urgent need for targeted interventions to strengthen healthcare access in these regions. The efforts are essential in achieving the goals of reducing TB prevalence by 50% and TB mortality by 75% by 2025, as well as meeting the 95-95-95 targets to control HIV by 2030.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"625-632"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and risk factors of drug-resistant tuberculosis in Sichuan, China: An observational study.","authors":"Ning Han, Libo Yan, Man Yuan, Zhu Chen, Yilan Zeng, Hong Tang","doi":"10.1111/tmi.14126","DOIUrl":"10.1111/tmi.14126","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the epidemiological characteristics of drug-resistant tuberculosis (DR-TB) and investigate the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Sichuan, China.</p><p><strong>Methods: </strong>The study involved 5180 clinical isolates collected from Sichuan since 2013, with non-tuberculous mycobacteria excluded. Drug susceptibility testing was conducted using four first-line anti-TB drugs, fluoroquinolones, and second-line injectable agents. Multivariable logistic regression analysis was used to assess risk factors for MDR-TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.</p><p><strong>Results: </strong>Among the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR-TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR-TB. Furthermore, urban living was identified as a protective factor against MDR-TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68-0.94, p = 0.004). Notably, individuals younger than 60 were more likely to develop MDR-TB, especially those aged 32-45 (OR 2.22, 95% CI 1.74-2.83, p < 0.001). In addition, HIV-positive status was identified as a risk factor for MDR-TB (OR 2.06, 95% CI 1.21-3.49, p = 0.008).</p><p><strong>Conclusions: </strong>The study demonstrated that the prevalence of DR-TB among the study subjects exceeded the national level. Patients living in rural areas, those with a history of TB treatment, HIV-positive individuals, and younger patients were more likely to develop MDR-TB.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"704-711"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the performance of verbal autopsy for assigning cause of death in older adults: A population-based cohort study in Karonga, Malawi.","authors":"Milly Marston, Alexandria Chung, Albert Dube, Estelle McLean, Samuel Clark, Amelia Crampin, Clara Calvert","doi":"10.1111/tmi.14120","DOIUrl":"10.1111/tmi.14120","url":null,"abstract":"<p><strong>Background: </strong>Verbal autopsy, where a close caregiver or relative of someone who recently died reports on the signs, symptoms and circumstances preceding death, is useful for producing population-based cause of death estimates. However, the performance of verbal autopsy for older adult deaths is poorly understood.</p><p><strong>Objectives: </strong>To evaluate the performance of verbal autopsy in assigning cause of death for adults aged 50+ in a rural area of Malawi.</p><p><strong>Methods: </strong>Cause of death was assigned to each death with a verbal autopsy in the Karonga Health and Demographic Surveillance site between 2002 and 2017 using two methods: (1) Physician review and (2) in silico verbal autopsy (a Bayesian probabilistic model). We calculated uncertainty in cause of death assignment for each method and calculated disagreement in cause of death between methods. Analyses were stratified by age group and sex.</p><p><strong>Results: </strong>A total of 2378 adult deaths were included (1360 aged 50+). Cause of death assignment showed greater uncertainty at older ages in both methods. For example, 59.7% of men aged 80+ were assigned a specific cause of death using physician review, versus 77.5% of men aged 30-49. Population-level, broad cause of death distributions were similar across methods, but at the individual level there was over 30% disagreement on broad cause of death categories in those aged 50+.</p><p><strong>Conclusions: </strong>Verbal autopsy becomes more uncertain at assigning cause of death at older ages. The inclusion of any reports of medical diagnoses from a doctor and using a two-stage process of cause of death assignment (with simple cause of deaths assigned using algorithms and more complex cases being reviewed by physicians) could improve cause of death ascertainment using verbal autopsy at older ages.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"652-661"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VISITECT® CD4 advanced disease assay in routine use: Diagnostic accuracy and usability, Ethiopia and Indonesia.","authors":"Petra de Haas, Pamela Hepple, Yohannes Babo, Francisca Srioetami, Misikir Amare, Bihil Sherefdin, Andrii Slyzkyi, Denisa Widyaputri, Erni Juwita Nelwan, Jhon Sugiharto, Ahmed Bedru, Edine Tiemersma","doi":"10.1111/tmi.14124","DOIUrl":"10.1111/tmi.14124","url":null,"abstract":"<p><p>We assessed the diagnostic accuracy and usability of the rapid semiquantitative point of care VISITECT® CD4 Advanced Disease Assay, compared to routinely obtained CD4 counts among people living with HIV in Ethiopia and Indonesia. We consecutively enrolled people living with HIV aged ≥10 years who were newly diagnosed, had interrupted antiretroviral treatment for ≥3 months, or were feeling unwell. Venous blood was drawn to obtain CD4 counts on routinely available test instruments and a VISITECT® CD4 Advanced Disease Assay result. The sensitivity of VISITECT® CD4 Advanced Disease Assay was high (97.8%, 95% confidence interval [CI], 94.4-99.4%), but the specificity was low (32.7%, 95%CI, 27.9-37.8%). It significantly increased to 42.5% (95%CI, 33.2-52.1%) after retraining of laboratory staff, but remained low. The low specificity of VISITECT® CD4 Advanced Disease Assay was due to poor capacity in test reading by routine staff. Reading the test strip is error-prone and requires intensive and regular training. Reading aids may improve the usability of this essential point of care test.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"685-693"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal monitoring of cell adhesion molecules in acute Chagas disease patients and prognosis after treatment with benznidazole.","authors":"Victor Vaitkevicius-Antão, Bruno Almeida Silva, Michelle da Silva Barros, Cíntia Nascimento da Costa-Oliveira, Luciane de Freitas Firmino, Wanderley Araújo Soares, Silvia Marinho Martins, Cristina Carrazone, Wilson Oliveira, Michelle Christiane da Silva Rabelo, Virginia Maria Barros de Lorena","doi":"10.1111/tmi.14131","DOIUrl":"10.1111/tmi.14131","url":null,"abstract":"<p><p>Chagas disease is a public health concern endemic to Brazil, with several cases of oral transmission. Detection of patients during the acute phase is rare due to mild, nonspecific symptoms and limitations in diagnostic testing. Some molecules, such as cell adhesion molecules (CAMs), have been highlighted as potential diagnostic and prognostic markers for diseases. The aim of this study was to evaluate CAMs in patients with acute Chagas disease who were treated with benznidazole. In 2019, patients from Pernambuco, in northeastern Brazil, were diagnosed with Trypanosoma cruzi infection. These patients were treated for 60 days and monitored for 2 years. sVCAM-1, sP-selectin, sL-selectin, and sE-selectin were quantified from the serum of patients using a flow cytometer. sVCAM-1 showed significant potential to differentiate between negative and infected individuals before treatment (AUC = 0.875), with a positivity rate of 75%, like the gold standard (parasitological test) and higher than PCR tests. The sP-selectin also yielded good results in monitoring thrombocytopenia and changes in coagulation after treatment. Therefore, we conclude that CAMs are potential biomarkers for Chagas disease during its primary phase.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"730-736"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of modern contraception use among persons with disabilities in low- and middle-income countries: A systematic review and meta-analysis.","authors":"Atika Rahman Chowdhury, Shimlin Jahan Khanam, Mohammad Zahidul Islam, Gulam Khandaker, Md Nuruzzaman Khan","doi":"10.1111/tmi.14130","DOIUrl":"10.1111/tmi.14130","url":null,"abstract":"<p><strong>Background: </strong>People with disabilities have the same need for contraception as the general population. However, their access to modern contraceptive methods is largely underexplored in low- and middle-income countries.</p><p><strong>Objective: </strong>This study aimed to explore the prevalence of modern contraception use among reproductive-aged (15-49 years) persons with disabilities in low- and middle-income countries and identify the key determinants.</p><p><strong>Methods: </strong>In June 2024, we conducted a systematic search across six databases including PubMed, Web of Science, Embase, Global Health, Medline and Scopus to identify studies on disability and modern contraception in low- and middle-income countries. The search terms included a combination of Medical Subject Headings (MeSH) terms and keywords related to disability, modern contraception and low- and middle-income countries integrated using the Boolean operators (AND, OR). All studies published between January 2015 and June 2024, in English, and conducted in low- and middle-income countries were included. The primary outcomes were the prevalence of modern contraception use and its determinants among persons with any disability. Summary estimates were calculated using meta-analysis with a fixed effects model for lower heterogeneity. Random effects meta-analysis was used for mid-level heterogeneity (50%-74%) and high-level heterogeneity (75%-100%).</p><p><strong>Results: </strong>A total of 18 studies from low- and middle-income countries were included, with 11 included in the meta-analysis. The pooled prevalence of modern contraception use among persons with disabilities was 31.4% (95% CI: 26.5, 36.2). Significant heterogeneity was observed across respondent characteristics (I² = 94.55%). Five factors were significantly associated with higher contraception use: being aged over 25 years, having some level of education, being in a higher wealth quintile, having adequate knowledge of family planning and being in a formal marital relationship.</p><p><strong>Conclusion: </strong>This study reveals a significantly lower prevalence of modern contraception use among persons with disabilities in low- and middle-income countries compared to the general population. Improving access to education, addressing social norms and strengthening healthcare systems may contribute to increasing access to contraception and uptake among persons with disabilities in low- and middle-income countries.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"588-597"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge of HIV status among men aged 20-35 years in Lusaka, Zambia: Findings from a pilot time location sampling survey in the \"Yaba Guy Che\" (for the guys) study.","authors":"Mwelwa Muleba Phiri, Lucheka M Sigande, Chisanga Mwansa, Ab Schaap, Sian Floyd, Loyd Kalekanya, Charles Banda, Steve Belemu, Helen Ayles, Musonda Simwinga, Bernadette Hensen","doi":"10.1111/tmi.14128","DOIUrl":"10.1111/tmi.14128","url":null,"abstract":"<p><strong>Objectives: </strong>We conducted a pilot time location sampling survey with young men aged 20-35 years in Lusaka, Zambia and aimed to describe knowledge of HIV status and determine factors associated with knowledge of HIV status.</p><p><strong>Methods: </strong>Hotspots where men congregate were identified in a densely populated community in Lusaka. Hotspots were grouped into five strata (betting shops; car parks/washes; bus stations/taxi ranks; churches; and markets/shopping streets) and day/times when hotspots were frequented by men were listed. Within each stratum, three hotspots were randomly selected. Subsequently, 1 day/time was randomly selected for each hotspot. Men aged 20-35 were approached for participation and data was collected between July and October 2022. We describe participation in the survey, socio-demographics, and sexual behaviours. Using logistic regression, we explored factors associated with knowledge of HIV status.</p><p><strong>Results: </strong>339 men were approached, among whom 304 (90%) were eligible and 297 (98%) consenting to participate. Overall, 61% knew their HIV status. Adjusting for recruitment strata, knowledge of HIV status was similar by age (20-24: 56%; 25-29: 68%; and 30-35: 55%; p = 0.19). Among men reporting sex in the last month, men reporting no condomless sex were more likely to know their HIV status (78.2%) compared to men reporting one condomless sex partner in the past 1 month (55.5%; age-adjusted OR = 3.02; 95%CI 1.07, 8.55; p = 0.07). Knowledge of HIV status was lower among men who thought their friends were testing every 2-5 years (48%; n = 12/29) compared to those assuming that their friends tested more frequently (70.0%; adjOR = 0.28; 95%CI 0.08, 0.98; p < 0.001).</p><p><strong>Conclusion: </strong>The time location sampling survey was acceptable among men, as evidenced by high participation. Overall, 40% of young men did not know their HIV status. A hotspot-driven approach to delivering HIV testing services may prove effective at reaching men. Furthermore, time location sampling surveys should be explored as a tool to evaluate interventions targeting men.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"712-720"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}