Tropical Medicine & International Health最新文献

{"title":"Epidemiological and clinical profile of viral respiratory infections in children under 5 years at pre- and post-COVID-19 era in Praia, Cabo Verde.","authors":"Wilson Correia, Roberto Dorta-Guerra, Mitza Sanches, Basilio Valladares, Isabel Inês M de Pina-Araújo, Emma Carmelo","doi":"10.1111/tmi.14125","DOIUrl":"10.1111/tmi.14125","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease-19 (COVID-19) pandemic has affected global health, influencing the prevalence of different respiratory pathogens. The aim of this study is to evaluate the distribution of agents causing acute respiratory infections in children under 5 years old before and after the COVID-19 pandemic in Praia, Cabo Verde, and to describe associated clinical variables.</p><p><strong>Methods: </strong>Conducted at the University Hospital Dr. Agostinho Neto, this study replicated methods from a previous work from 2019 (Correia et al. 2021). Nasopharyngeal samples were analysed using FilmArray® Respiratory Panel 2.1 (BioFire) to identify agents of acute respiratory infections. Molecular identification of human respiratory syncytial virus subtypes was performed using a real-time duplex reverse transcription polymerase chain reaction. Statistical analysis was performed using IBM SPSS version 29 and R 3.5.1 software.</p><p><strong>Results: </strong>In 2022, 86.5% (83/96) of nasopharyngeal samples were positive for at least one pathogen. Human rhinovirus/human enterovirus was the most frequent agent, followed by human respiratory syncytial virus, adenovirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Co-infections were observed in 43.3% of positive cases. Infection rates were significantly higher in children under 1 year of age, particularly for SARS-CoV-2 and human respiratory syncytial virus. Seasonal variations were observed, with human respiratory syncytial virus predominating in November, SARS-CoV-2 in January and human parainfluenza virus-4 in May. Molecular analysis of human respiratory syncytial virus revealed a shift in subtype prevalence, with both human respiratory syncytial virus-A and -B co-circulating in the pre-pandemic period, whereas only human respiratory syncytial virus-B was detected in the post-pandemic period.</p><p><strong>Conclusion: </strong>Our data indicate changes in the distribution of respiratory viruses in the post-pandemic period compared to pre-pandemic period. The high prevalence of co-infections highlights the complexity of acute respiratory infection aetiology, emphasising the need for enhanced respiratory virus surveillance systems in Cabo Verde. Identifying seasonal trends and risk factors can contribute to targeted interventions and improved public health strategies to mitigate the burden of acute respiratory infections in young children.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"694-703"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102790","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":"Risk factors for Taenia solium taeniasis: A case-control study in Lao PDR.","authors":"Andrew Larkins, Davina Boyd, Vatsana Duangmala, Bounnaloth Insisiengmay, Malavanh Chittavong, Amanda Ash","doi":"10.1111/tmi.70001","DOIUrl":"https://doi.org/10.1111/tmi.70001","url":null,"abstract":"<p><strong>Introduction: </strong>Neurocysticercosis due to Taenia solium is the leading cause of epilepsy in low and middle-income countries yet remains under investigated in Lao PDR (Laos). People shedding T. solium eggs or proglottids from the adult tapeworm are the source of infection for those with cysticercosis.</p><p><strong>Methods: </strong>A matched case-control study of T. solium taeniasis was conducted in northern Laos. Cases were identified by rrnS PCR and sequencing. Risk factor data were collected by standardised questionnaire. Conditional logistic regression assessed the significance of risk factors.</p><p><strong>Results: </strong>Eighteen cases and 36 controls participated in the study. Only raw pork and undercooked grilled pork were significant risk factors (p < 0.05), however, fermented pork was very close to being significant (p = 0.05). Income, food insecurity, education, being a household head and the number of household members were clearly not significant (p ≥ 0.20).</p><p><strong>Conclusions: </strong>Raw and undercooked pork have different sources in northern Laos. Raw pork is almost only consumed from wild pigs that are opportunistically caught, whereas undercooked pork is consumed throughout the year from wild, local and commercial pigs. Food safety activities must consider these differences in supply chains.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529950","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":"Understanding vaccine recommendation behaviours among healthcare workers in Senegal: A cross-sectional analysis.","authors":"Sébastien Cortaredona, Pierre Verger, Jean Constance, Aldiouma Diallo, El-Hadj Ba, Gwenaelle Maradan, Cheikh Sokhna, Patrick Peretti-Watel","doi":"10.1111/tmi.70002","DOIUrl":"https://doi.org/10.1111/tmi.70002","url":null,"abstract":"<p><strong>Background: </strong>Despite the pivotal role of healthcare workers in vaccination programs, there is limited understanding of the factors influencing their vaccine recommendations, particularly in low-resource and rural settings. This study examines the determinants of vaccine recommendation practices among healthcare workers in Senegal.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in 2024 among 302 healthcare workers in Senegal. A vaccine recommendation score was constructed to assess how frequently healthcare workers recommended vaccines. A typology of psychosocial determinants of healthcare workers' vaccination behaviour was developed using the short version of the Health Professionals Vaccine Confidence and Behaviours questionnaire. Multivariable log-binomial regression was used to identify factors associated with systematic vaccine recommendations.</p><p><strong>Results: </strong>Vaccine recommendation practices among healthcare workers were high, with 60.6% achieving the highest score. The Professionals Vaccine Confidence and Behaviours typology classified healthcare workers into three clusters: 'Highly confident' (57.3%), 'Moderately hesitant' (14.2%), and 'Specific hesitant' (28.5%). Healthcare workers with more than 3 years of experience and those in urban areas were significantly more likely to systematically recommend vaccines. Conversely, healthcare workers displaying higher complacency, lower openness to patients, reduced commitment to vaccination, and limited self-efficacy were less consistent in their recommendations.</p><p><strong>Conclusion: </strong>While healthcare workers in Senegal demonstrate high vaccine confidence and vaccine recommendation practices, disparities between urban and rural settings highlight the need for targeted interventions. Efforts should focus on enhancing training, resources, and support for healthcare workers in rural areas to address barriers and strengthen vaccine promotion. Future research should explore contextual factors shaping healthcare workers' vaccination attitudes and practices to inform tailored strategies for equitable vaccination uptake.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529951","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":"School-based mental health and psychosocial support interventions for children and adolescents with developmental disabilities in low- and middle-income countries: A systematic review.","authors":"Maria Jose Alpuche De Lille, Renata da Teixeira da Silva, Tracey Smythe","doi":"10.1111/tmi.70000","DOIUrl":"https://doi.org/10.1111/tmi.70000","url":null,"abstract":"<p><strong>Objectives: </strong>To identify and evaluate the characteristics and reported effects of school-based mental health and psychosocial support interventions targeting children and adolescents with neurodevelopmental disorders (NDDs) in low- and middle-income countries, as well as those involving their parents, teachers or peers.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, EMBASE, ERIC, Global Health and PsycINFO was conducted in October 2024. Eligible studies included randomised controlled trials, quasi-experimental and qualitative research on school-based interventions in low- and middle-income countries for children and adolescents with NDDs (including attention deficit hyperactivity disorder [ADHD], autism, intellectual disabilities, epilepsy, cerebral palsy and foetal alcohol syndrome), as well as those involving their caregivers, teachers or peers. Only studies published in English, Spanish or Portuguese were included. A narrative synthesis was performed.</p><p><strong>Results: </strong>A total of 2158 titles were screened, with 29 studies from 13 countries included. Most studies used a quasi-experimental design (n = 19, 66%). Nearly half focused on children and adolescents with NDDs only (n = 14, 48%), with intellectual disabilities being the most targeted condition (n = 12, 34%), followed by autism (n = 8, 23%) and ADHD (n = 8, 23%). Intervention strategies included multimodal approaches (n = 6, 21%) and educational workshops (n = 6, 21%). Targeted outcomes were social skills (n = 7, 16%) and knowledge attitudes and practice (n = 5, 12%). Lifelong learning (n = 11, 33%) and educational system-strengthening interventions (n = 10, 31%) were the primary content areas. The majority of studies exhibited a moderate to high risk of bias.</p><p><strong>Conclusions: </strong>Schools offer strategic platforms for delivering mental health and psychosocial support interventions to children and adolescents with NDDs in low- and middle-income countries, involving families, teachers and peers. While improvements in social skills and knowledge, attitudes and practices were reported, heterogeneity and methodological limitations constrain the generalisability of findings. Future research should address long-term impacts and expand to underrepresented conditions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486213","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":"Effect of glycemic control on tuberculosis treatment outcomes among patients with tuberculosis and diabetes mellitus: A systematic review and meta-analysis.","authors":"Maham Zahid, Saima Afaq, Kashif Shafique, Fatima Khalid Qazi, Urooj Khan, Muhammad Asim, Shaista Nooreen, Sofia Shehzad","doi":"10.1111/tmi.14140","DOIUrl":"https://doi.org/10.1111/tmi.14140","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) and diabetes mellitus comorbidity can lead to poor TB treatment outcomes, particularly with uncontrolled blood glucose levels. Understanding the impact of glycemic control on TB treatment outcomes is essential.</p><p><strong>Objective: </strong>To synthesise evidence on the association between glycemic control and TB treatment outcomes in patients with TB and diabetes mellitus.</p><p><strong>Methodology: </strong>A systematic review was conducted using Medline, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar for all types of studies published between 1975 and May 2024, including adult TB patients of >18 years of age, with or without diabetes mellitus for whom blood glucose testing along with TB treatment outcome comparison with glucose levels (low/high) was reported were considered for inclusion. A random-effects model was used for meta-analysis, heterogeneity was assessed using I-squared statistics, subgroup and sensitivity analysis was performed followed by publication bias assessment.</p><p><strong>Results: </strong>Of 576 identified studies, 12 met the inclusion criteria, analysing 2320 cases (1572 with uncontrolled high blood glucose [≥7% HbA1c] and 748 with controlled low blood glucose [<7% HbA1c]). Low certainty evidence shows that patients with uncontrolled high glucose had a 1.91 times higher risk of TB treatment failure (risk ratios [RR] = 1.91, 95% confidence interval [CI] 1.81-3.07, p = 0.008), and a 2.97 times higher risk of sputum positivity at 3 months (RR = 2.97, 95% CI 1.10-8.07, p = 0.03). Subgroup and sensitivity analyses showed significant improvement in pooled effects, lowering of heterogeneity and narrower CIs. For overall pooled effect, substantial heterogeneity was observed; therefore, the interpretation and generalisation of results should be done with caution.</p><p><strong>Conclusion: </strong>A low certainty evidence shows that uncontrolled high blood glycemic level significantly impacts TB treatment outcomes, increasing treatment failure and sputum positivity among TB patients with diabetes mellitus.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476982","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":"Temporal trend and spatial analysis of oral cancer cases in Brazil: Correlation between socioeconomic factors and delay in diagnosis and treatment.","authors":"Deane Cristina da Rocha Rodrigues de Oliveira, Wandklebson Silva da Paz, Márcio Bezerra-Santos, Priscila Lima Dos Santos, Débora Dos Santos Tavares","doi":"10.1111/tmi.14141","DOIUrl":"https://doi.org/10.1111/tmi.14141","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the temporal trend and spatial distribution of oral cancer cases in Brazil, and to evaluate the relationship between oral cancer cases and socioeconomic conditions.</p><p><strong>Methods: </strong>Data on oral cancer cases, between 2013 and 2019, were extracted from the Painel-Oncologia website, and the socioeconomic indicators selected were Municipal Human Development Index and Social Vulnerability Index. The endpoints were late diagnosis (staging III and IV) and delay in treatment (>60 days), along with oral cancer prevalence. Spearman's correlation was done between oral cancer cases and Municipal Human Development Index/ Social Vulnerability Index. Temporal trends were evaluated using a segmented linear regression model. As for spatial analysis, global and local Moran indices were applied, together with spatiotemporal scan statistics, to detect risk clusters.</p><p><strong>Results: </strong>In the period studied, there was a prevalence of 5.3 oral cancer cases/100,000 inhabitants. A significant inverse correlation was found with the Social Vulnerability Index, and a direct correlation linking the Municipal Human Development Index and oral cancer cases, delayed treatment, and diagnosis cases too. An increasing trend of oral cancer prevalence rate and a stable trend of delayed diagnosis and treatment cases were observed in the country. There was a concentration of oral cancer cases in the South and Southeast regions. A high-risk oral cancer cluster was identified covering the South and Southeast regions, and part of the Midwest region and four secondary clusters of delayed treatment cases in the Northeast region.</p><p><strong>Conclusion: </strong>There was no short-term improvement in data related to oral cancer in Brazil, since the prevalence trend was increasing and there was a correlation with socioeconomic conditions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369308","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":"The epidemiology of hospitalisations from four key environmentally sensitive zoonotic diseases in Queensland, 2012-2019.","authors":"Tatiana Proboste, Colleen L Lau, Nicholas Clark, Paul Jagals, Peter D Sly, Stephen B Lambert, Gregor Devine, Guido Zuccon, Ricardo J Soares Magalhães","doi":"10.1111/tmi.14139","DOIUrl":"https://doi.org/10.1111/tmi.14139","url":null,"abstract":"<p><p>Zoonotic diseases whose transmission processes are sensitive to environmental characteristics represent an important public health burden in Australia, particularly in Queensland. This study aimed to analyse the epidemiology of hospitalisations from the four main environmental zoonotic diseases-leptospirosis, melioidosis, Q fever, and Ross River virus-from 2012 to 2019 in Queensland. Our analyses reveal an increasing trend of hospitalisation incidence for melioidosis, stable incidence for Q fever and Ross River virus infection, and a declining trend for leptospirosis. We identified sex and age disparities in hospitalisations, with males being more likely to be hospitalised for leptospirosis, melioidosis, and Q fever compared to females. We also uncovered discrepancies between hospitalisation and notification data, which could be attributed to diagnostic and reporting criteria. The findings of this study show that the epidemiological patterns of hospitalisation are different to the notification for the same diseases and underscore the importance of accurate recording and reporting of zoonoses-related hospitalisations to inform environmental public health interventions.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310452","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":"Air pollution and lung function in asthmatic and non-asthmatic children: A cross-sectional study with a nested case-control analysis in Ho Chi Minh City.","authors":"Quynh Nhat Nguyen, Thao Phuong Mai, An Le Pham, Linh Le Tran, Tram T N Truong, Thuong T H Do, Hong H T C Le, Dang Ngoc Tran, Vinh Nhu Nguyen","doi":"10.1111/tmi.14135","DOIUrl":"https://doi.org/10.1111/tmi.14135","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the association of air pollution and spirometry indicators, and fractional exhaled nitric oxide in stable asthmatic and non-asthmatic children.</p><p><strong>Methods: </strong>A cross-sectional study with a nested case-control analysis was conducted in Ho Chi Minh City (1 December 2022 to 31 January 2023), involving 36 asthmatic children conveniently recruited from a pulmonary clinic and 170 non-asthmatic students randomly selected from two districts, all aged 12-14. After propensity score matching on key covariates, the final sample included 36 asthmatic and 81 non-asthmatic participants. Data on spirometry, fractional exhaled nitric oxide, and air pollution exposures, including fine particulate matter levels, were collected via surveys and direct measurements.</p><p><strong>Results: </strong>Multivariate regression found significant associations between air pollution exposures and spirometry indicators; specific exposures linked to larger lung-function declines and fractional exhaled nitric oxide increases in asthmatic versus non-asthmatic children. In asthmatics, mosquito-coil use (≥1/week) was associated with a 5.46% FEV₁/FVC drop (p = 0.043; p_(diff) = 0.020); a 16.69% FEF_25-75 decline (p = 0.029; p_(diff) = 0.010); and an 18.30 ppb fractional exhaled nitric oxide rise (p = 0.038; p_(diff) = 0.016)-none significant in non-asthmatics. In non-asthmatic children, each 1 μg/m³ PM_2.5 increase was tied to a 0.113% FEV₁/FVC fall (p = 0.043; p_(diff) = 0.037) and window opening to a 5.18% FEF_25-75 drop (p = 0.045; p_(diff) = 0.041), effects absent in asthmatics.</p><p><strong>Conclusions: </strong>Air pollution was associated with reduced lung function and elevated airway inflammation in children, with certain exposures having stronger effects in those with asthma. These findings underscore the urgency to reduce both indoor and outdoor air pollution to protect children's respiratory health.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310451","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":"Lymphopenia: An early indicator of Crimean-Congo haemorrhagic fever.","authors":"Hatice Bozkurt Yavuz, Hüseyin Haydar Kutlu","doi":"10.1111/tmi.14138","DOIUrl":"https://doi.org/10.1111/tmi.14138","url":null,"abstract":"<p><strong>Objectives: </strong>Crimean-Congo haemorrhagic fever is a lethal tick-borne disease characterised by initially nonspecific symptoms. While thrombocytopenia and leucopenia are established diagnostic markers, there is a need for earlier indicators. This study evaluates lymphopenia as a marker for Crimean-Congo haemorrhagic fever.</p><p><strong>Methods: </strong>This retrospective study analysed patients admitted with arthropod bites from 2018 to 2021. Patients were classified based on initial leucocyte and platelet counts into Group 1 (normal values) and Group 2 (low values). Within Group 1, patients were classified as Group 1B if they developed thrombocytopenia and leucopenia during follow-up, whereas those with stable counts were designated as Group 1A. Variance and ROC curve analysis were used to evaluate blood counts.</p><p><strong>Results: </strong>Of 914 evaluated patients, 870 with normal CBCs were categorised into Group 1, and 44 with low counts into Group 2. Within Group 1, 16 patients subsequently developed thrombocytopenia and leucopenia (Group 1B), while the rest remained stable (Group 1A). All patients in Groups 1B and 2 were later confirmed to have Crimean-Congo haemorrhagic fever via RT-PCR. Initial lymphocyte counts varied significantly, with 2.7 × 10⁹/L in Group 1A, 0.52 × 10⁹/L in Group 1B, and 0.42 × 10⁹/L in Group 2, with notable reductions observed in Group 1B and Group 2 (p < 0.001). ROC analysis showed lymphocyte counts below 1.19 × 10⁹/L were the most sensitive and specific for Crimean-Congo haemorrhagic fever (area under curve is 0.976 [95% CI: 0.957-0.995]), exceeding traditional markers.</p><p><strong>Conclusions: </strong>Lymphocyte depletion precedes changes in leucocyte and platelet counts, affirming its potential as an early diagnostic marker for Crimean-Congo haemorrhagic fever. Early detection through lymphocyte monitoring could improve patient management and reduce transmission in endemic areas.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286635","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":"Identification of gaps in the continuum of maternal and neonatal care in a high-mortality setting: An observational study in rural Guinea-Bissau.","authors":"Sabine Margarete Damerow, Anita Magdalena Zalisz, Kimberly Raisa Nehal, Paula Marise Silva, Oides Furtado, Ane Bærent Fisker","doi":"10.1111/tmi.14136","DOIUrl":"https://doi.org/10.1111/tmi.14136","url":null,"abstract":"<p><strong>Objectives: </strong>Coverage of the continuum of maternal and neonatal care, including antenatal care (ANC), childbirth and early postnatal care (PNC), is critically low across sub-Saharan Africa. Meanwhile, related monitoring remains neglected. We quantified coverage gaps along the continuum of maternal and neonatal care in rural Guinea-Bissau and assessed background factors associated with continuum-of-care completion.</p><p><strong>Methods: </strong>In a cross-sectional study using data from the Bandim Health Project's nationally representative rural health and demographic surveillance system (HDSS), we assessed individual-level obtainment of ≥1, ≥4 and ≥8 ANC contacts (ANC1/4/8), facility-based childbirth and PNC within 24 h postpartum for HDSS-registered births between 1 February 2023 and 31 January 2024. Among facility births, we also assessed postpartum admission ≥24 h. We defined continuum-of-care completion as the obtainment of ANC4, facility-based childbirth and PNC within 24 h and investigated associations between background factors (household assets, maternal age, education, parity, region, ethnicity, health facility distance and recall time) and continuum-of-care completion in regression models.</p><p><strong>Results: </strong>Among 2258 births, 35% (n = 798) completed the continuum of care; 22% (n = 494) obtained none of the contributing services. Individual service coverage ranged from 6% (ANC8, n = 128) to 99% (ANC1, n = 2236). Individual coverage of the services included in the continuum-of-care assessment was 62% (n = 1403) for ANC4, 56% (n = 1268) for facility-based childbirth and 52% (n = 1167) for PNC. Continuum-of-care completion differed by region and ethnicity. Living near a health facility, higher maternal education, more household assets, low parity and longer recall time were associated with higher continuum-of-care completion.</p><p><strong>Conclusions: </strong>Continuum-of-care completion is low in rural Guinea-Bissau and not fully reflected by individual coverage indicators. This calls for a higher focus on continuum-of-care coverage and related gaps, both locally and globally. Meanwhile, the identified higher reporting of continuum-of-care completion with longer maternal recall questions the use of survey data and beckons for monitoring based on timely routine data.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249932","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}