Tropical Medicine & International Health最新文献

{"title":"Factors Associated With Tuberculosis Treatment Failure Among Hill Tribe and Stateless People in Chiang Rai Province, Thailand: A Case-Control Study.","authors":"Panupong Upala, Tawatchai Apidechkul, Fartima Yeemard, Onn Laingeon, Manassawin Kumpun, Wachareewan Apidechkul, Danupon Yodkham","doi":"10.1111/tmi.70150","DOIUrl":"10.1111/tmi.70150","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a global public health challenge, especially for those who are living in economically disadvantaged families and have difficulty accessing health care services. The hill tribe and stateless people living in the border areas of northern Thailand have been identified as a population vulnerable to TB. This study aimed to determine the factors associated with tuberculosis treatment failure amongst hill tribe and stateless people in Chiang Rai, Thailand.</p><p><strong>Methods: </strong>A case-control study was performed to collect data from TB patients who were registered in one of 18 district hospitals in Chiang Rai Province, Thailand, between 2019 and 2023. The cases were hill tribe and stateless, with TB treatment failure, while the controls were TB successful treatment outcomes. A validated questionnaire was used to collect data between June and August 2024. Backward stepwise logistic regression was used to determine the factors that were significant at α = 0.05.</p><p><strong>Results: </strong>A total of 133 cases and 267 controls were included in the study: 56.5% were males, 41.8% were aged 61 years and older, 55.3% were Akha and Lahu members, 23.0% were nonThai, 73.8% had never attended school, 46.5% worked as farmers and 51.3% had an annual family income ≤ 10,000 baht ($332). In the multivariate model, eleven variables were found to be associated with tuberculosis treatment failure amongst the hill tribe and stateless TB patients: those who were females (AOR = 3.83; 95% CI = 1.77-8.29), those aged 61 years and over (AOR = 4.63; 95% CI = 1.62-13.23), those who were non-Thai citizens (AOR = 4.36; 95% CI = 1.74-10.87), those who had an annual family income of 5001-10,000 (AOR = 8.63; 95% CI = 2.55-29.18), those who had a family income of 10,001 baht and above (AOR = 4.28; 95% CI = 1.32-13.91), those who visited a TB clinic alone (AOR = 3.00; 95% CI = 1.33-6.78), those who ever missed a medical appointment (AOR = 21.06; 95% CI = 4.32-102.58), those who had side effects from TB medication (AOR = 7.88; 95% CI = 1.76-35.25), those who had a family member with TB (AOR = 2.80; 95% CI = 2.29-18.97), those who used traditional materials for their housing (AOR = 2.91; 95% CI = 1.76-4.80), those who experienced stress (AOR = 9.95; 95% CI = 2.85-34.80) and those who had little knowledge of TB prevention and control (AOR = 6.60; 95% CI = 2.81-16.57) had greater odds of having a TB treatment failure than those with opposite characteristics.</p><p><strong>Conclusions: </strong>Hill tribe and stateless people who are female, are older, are non-Thai citizens, have missed appointments, have side effects from medication, are experiencing stress, used traditional materials for their housing and have poor knowledge of TB prevention and control are more likely to experience tuberculosis treatment failure. These findings strongly suggest that clinical staff who are working at TB clinics should focus on patients with","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1043-1056"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783081","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":"Assessment of Antimicrobial Resistance in M. leprae Strains From Kiribati.","authors":"Patrick O Campbell, Temea Bauro, Erei Rimon, Nabura Ioteba, Trevor Anderson, Arturo Cunanan, Taulanga Naniseni, Jacqui Gardner, Emma Trowbridge, Nicholas M Douglas, Stephen T Chambers","doi":"10.1111/tmi.70146","DOIUrl":"10.1111/tmi.70146","url":null,"abstract":"<p><strong>Objectives: </strong>Kiribati has one of the highest rates of leprosy worldwide. A nationwide screening and chemoprophylaxis program for household leprosy contacts was introduced in 2018. In 2022, population-wide screening and rifamycin-based treatment or chemoprophylaxis for leprosy and tuberculosis was introduced as part of the PEARL and COMBINE studies. Largescale rifamycin use theoretically risks selection of resistant Mycobacterium leprae strains. This study aimed to elucidate the baseline antimicrobial resistance (AMR) profile of M. leprae isolates in Kiribati using a novel molecular method.</p><p><strong>Methods: </strong>Mycobacterium leprae genomes from skin biopsies of patients clinically diagnosed with leprosy in Kiribati between 2017 and 2024 were analysed. We used an M. leprae specific repetitive element (RLEP) PCR to confirm the presence of M. leprae DNA. Samples with sufficient DNA (cycle threshold (CT) value < 30) proceeded for resistance testing. A combination of nested and heminested PCR assays was used to amplify the drug resistance determining regions (DRDR's) for dapsone (folP1), rifampicin (rpoB) and fluoroquinolones (gyrA) followed by DNA Sanger sequencing.</p><p><strong>Results: </strong>216 skin biopsies (multibacillary [MB], n = 155, paucibacillary [PB], n = 61) underwent confirmatory testing. 192/216 (89%) samples were PCR positive (median Ct value 24.5 [range 12.0-44.4]), including 145 MB cases (median CT 21.1 [range 12.0-42.0]) and 47 PB cases (median CT 34.0 [range 14.8-37.0]). Twenty-four (11%) samples were PCR negative and 21 of these underwent histopathological testing, with 12 (57%) showing changes consistent with leprosy. 116 (60%) positive samples proceeded to AMR testing (MB, n = 106; PB, n = 10). In 10 cases (9%), dapsone resistance-conferring mutations were identified in the folP1 region. No mutations were identified in the rpoB or gyrA genes.</p><p><strong>Conclusion: </strong>Molecular analysis of skin biopsies revealed moderate-level dapsone resistance but no rifampicin resistance in Kiribati. Establishing this baseline AMR profile will enable a before-versus-after intervention analysis of antimicrobial resistance in M. leprae isolates in Kiribati.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"1035-1042"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783122","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":"Task-Shifting to Nurses for Hypertension Control in Rural Sub-Saharan Africa: A Narrative Review of Effectiveness and Implementation Challenges.","authors":"Aime Ishimwe Mugisha, Olivier Uwishema, Lydia Daniel Bisetegn, Hubert Uwisanze, Boluwatife Samuel Fatokun, Subham Roy","doi":"10.1111/tmi.70155","DOIUrl":"10.1111/tmi.70155","url":null,"abstract":"<p><strong>Background: </strong>Rising cardiovascular morbidity and mortality in rural sub-Saharan Africa are largely attributable to insufficient awareness, treatment and control of hypertension. The delivery of care is further constrained by health system limitations, including shortages of physicians, inadequate infrastructure, challenges in medication supply chains and geographical barriers to access. As a tactic to increase access, adherence and continuity of care, task-shifting hypertension management to nurses-often with the assistance of community health workers-has become popular. The evidence on the efficacy and implementation difficulties of nurse-led hypertension therapies in rural Sub-Saharan African settings is compiled in this narrative review.</p><p><strong>Methods: </strong>To investigate task-shifted and nurse-led hypertension care in rural SSA, a narrative evaluation was carried out. Terms associated with task-shifting, nurse-led care, hypertension and rural SSA were used to search PubMed, Scopus, Web of Science and Embase. Studies that met the eligibility requirements reported implementation results or patient outcomes. The effectiveness of the intervention, implementation difficulties and enabling variables were highlighted in the narrative synthesis of the data.</p><p><strong>Results: </strong>In rural Sub-Saharan Africa, nurse-led and task-shifted treatments enhanced medication adherence, blood pressure control and continuity of care. Protocol-driven nurse management, patient education, follow-up monitoring and assistance from mobile health tools or community health professionals were common elements. Drug stockouts, scope-of-practice limitations, inadequate training, supervision and partial integration into primary care were among the implementation obstacles. Alignment with current health systems, community involvement and structured mentoring were among the facilitators.</p><p><strong>Conclusion: </strong>Evidence from rural Sub-Saharan Africa indicates that task-shifting hypertension care to nurses is feasible and, when adequately supported, can improve key care processes and outcomes. To optimize the potential benefit of nurse-led hypertension management in rural settings, it is imperative to address health system bottlenecks, improve training and supervision and align regulatory frameworks with task-shifting strategies.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"953-965"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783102","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":"Vaccine Targets and Antimicrobial Resistance of Streptococcus agalactiae Recovered From Pregnant Women in Brazil.","authors":"Clarissa Campos Barros, Fabíola C Oliveira Kegele, Maria Francisca da S N Soares, Douglas Guedes Ferreira, Geraldo Renato de Paula, Rosana Rocha Barros","doi":"10.1111/tmi.70212","DOIUrl":"https://doi.org/10.1111/tmi.70212","url":null,"abstract":"<p><strong>Objectives: </strong>The available measure to prevent Streptococcus agalactiae (Group B Streptococcus, GBS) neonatal infection is intrapartum antibiotic prophylaxis (IAP), but it is threatened by bacterial resistance. Therefore, this study aimed to investigate antimicrobial resistance and bacterial targets of vaccines at the most advanced stage of development.</p><p><strong>Methods: </strong>GBS isolates (n = 222) recovered from pregnant women between 2019 and 2024 were subjected to capsular polysaccharides and alpha-like proteins investigation and antimicrobial susceptibility testing. Macrolide and fluoroquinolone resistance determinants and genetic diversity of multidrug-resistant (MDR) isolates were also investigated.</p><p><strong>Results: </strong>The main capsular types were Ia (78, 35.1%), III (42, 18.9%), V (39, 17.6%) and II (32, 14.4%). Vaccines based on hexavalent capsular polysaccharides and alpha-like proteins would have 97.3% and 87.5% of predicted efficacy, respectively. Isolates were categorized as not susceptible (NS), that is, intermediate and resistant, to levofloxacin (5, 2.3%), clindamycin (11, 5%), erythromycin (58, 26.1%) and tetracycline (171, 77%). Among erythromycin NS isolates, the M phenotype/mef(A) gene predominated (47, 81%). All levofloxacin-resistant isolates showed amino acid substitutions in both GyrA (S81L) and ParC (S79F). MDR isolates (10, 4.5%) had distinct genetic backgrounds.</p><p><strong>Conclusions: </strong>Both immunization approaches would be effective in the population. Although the elevated erythromycin resistance rate, one of the highest reported in the country, clindamycin remains an efficient option in IAP. MDR isolates have not resulted from the dissemination of a single clone, but instead showed a polyclonal origin.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631723","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":"Rabies, Coronavirus, and Hantavirus Surveillance in Bats From the Atlantic Forest of Northeastern Argentina.","authors":"Marcelo D Gamboa, Eliana F Burgos, María G Piccirilli, Stella M Hirmas, Daniel M Cisterna, Santiago R Carrizo, Sebastián Kehl, Valeria Martínez, Daniel O Salomón, Isabel E Gómez Villafañe, María V Vadell","doi":"10.1111/tmi.70205","DOIUrl":"https://doi.org/10.1111/tmi.70205","url":null,"abstract":"<p><p>Bats are increasingly recognized as reservoirs of numerous emerging and re-emerging zoonotic pathogens. However, little is known about the distribution of most hosts and viruses and the role of each bat species in transmission, particularly in South America. This study screened for orthohantavirus, rabies, and coronavirus infection, and characterized bat communities from Misiones Province, Argentina, during 2022-2025. At least 14 bat species were captured 1214 times. Blood samples were tested for orthohantavirus-specific antibodies by ELISA. Buccopharyngeal swabs were screened by two separate real-time RT-PCR assays: a pan-lyssavirus assay and a pan-coronavirus assay. Lyssavirus rabies RNA was detected in two individuals (Sturnira lilium and Artibeus lituratus), representing the first confirmed record in S. lilium in Argentina. Coronavirus RNA was detected in two Sturnira lilium, one Carollia perspicillata, and one Artibeus lituratus. Two of these samples, corresponding to C. perspicillata and A. lituratus, were successfully characterized as Alphacoronavirus. No antibodies against orthohantavirus were detected. These findings confirm high bat diversity and viral circulation in frugivorous bats, supporting integrated surveillance.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631771","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":"Implementability of Point-of-Care Ultrasound for Paediatric Tuberculosis Diagnosis in Resource-Constrained Settings: Experiences and Perspectives From Uganda.","authors":"Julia van den Brink, Martien Humblet, Emmanuel Nasinghe, Grace Paul Kisitu, Emmanual Tenywa, Rinn Song, Nora Engel, Francesca Wanda Basile, Else Margreet Bijker","doi":"10.1111/tmi.70210","DOIUrl":"10.1111/tmi.70210","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood tuberculosis (TB) remains a significant global health challenge, with a substantial number of cases going undiagnosed, particularly among children under five. Early diagnosis and intervention are crucial to reduce TB-associated morbidity and mortality. Point-of-Care Ultrasound (POCUS) represents a promising technology that could enhance TB diagnosis, especially in resource-constrained settings. This qualitative study assessed the acceptability and feasibility of POCUS implementation in the TB diagnostic evaluation in children under 5 years of age in Uganda, by exploring the perspectives and experiences of local healthcare professionals.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with clinicians at two different sites and stakeholders involved in paediatric TB policy and programmes in Uganda. Interviews focused on exploring participants' perspectives on the acceptability and feasibility of POCUS implementation for diagnosing paediatric TB. Thematic analysis was used to analyse interview data, aiming to identify key themes related to POCUS implementation in the local healthcare context.</p><p><strong>Results: </strong>Participants highlighted POCUS as a potentially valuable tool for improving paediatric TB diagnosis, as it enables immediate imaging and interpretation, bypassing the delays and accessibility barriers associated with X-rays. Potential barriers identified for large-scale implementation include limited diagnostic accuracy, usability, lack of equitable access, need for capacity building and durability of POCUS devices.</p><p><strong>Conclusion: </strong>This study underscores the potential role of POCUS in the management of children with presumed TB in resource-constrained settings like Uganda. Addressing identified barriers through targeted interventions and further research will be essential for the successful implementation of POCUS in local healthcare practices.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621320","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":"Pathways to Care for Patients With Severe Chronic NCDs: A Cross-Sectional Survey of Inpatients in Neno Malawi.","authors":"Chantelle Boudreaux, Maryam Mansoor, Moses Banda Aron, Medson Boti, Gene Bukhman, Stellar Chibvunde, Kingsley Kanzoole, Kenwood Kumwenda, Henry Ndindi, Junious Mabo Sichali, Todd Ruderman, Ada Thapa, Alma J Adler, Emily B Wroe","doi":"10.1111/tmi.70211","DOIUrl":"https://doi.org/10.1111/tmi.70211","url":null,"abstract":"<p><strong>Objectives: </strong>Severe chronic non-communicable diseases (NCDs) place a significant burden on low- and middle-income countries (LMICs), where overburdened and underprepared health systems lead to misdiagnosis, treatment delays and poor outcomes. While prior research has examined health system gaps, little is known about patient experiences navigating care. This study examines the experiences of inpatients living with severe chronic NCDs in Neno District, Malawi, identifying triggers for care, mapping pathways to diagnosis and patient experience navigating care.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among inpatients admitted for severe chronic NCDs at two rural hospitals. Participants were asked about their journey to diagnosis, associated costs of illness and treatment, barriers encountered along their journey, decisions around seeking care and termination of care. Data collection included clinical record reviews and structured surveys documenting patient demographics and detailed clinical timelines (symptoms and careseeking) and costs, followed by open-ended fieldnotes capturing patient narratives.</p><p><strong>Results: </strong>Fifty-two patients were recruited, representing 51% of eligible admissions over the study period. Ages ranged from 2 to 80 years (median: 43.5, IQR: 23.5-62). Diagnoses included heart disease, Type 1 and insulin-dependent Type 2 diabetes, kidney and liver disease, epilepsy and schizophrenia, with nearly half of patients admitted for cardiac conditions. Among paediatric patients, common conditions included congenital heart disease, sickle cell disease and epilepsy. One-third sought care within 3 days of recognizing symptoms, and 60% were admitted with new diagnoses. Time from symptom onset to diagnosis varied widely: Type 1 diabetes was diagnosed within 2 months of initial symptoms, and sickle cell disease often took years. Financial burdens were substantial; 77% of patients reported out-of-pocket costs, and 71% borrowed money for care.</p><p><strong>Conclusion: </strong>Gaps in diagnostic tools and provider expertise contribute to delays in diagnosis and treatment, exacerbating health and financial burdens. Our findings emphasize the need to ensure ongoing patient engagement and to enhance providers' ability to recognize patients who would benefit from the services.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621275","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":"Clinical Characteristics of Mpox and Mpox-HIV Coinfection in Lima, Peru: A Retrospective Multicenter Analysis.","authors":"Neil Rupani, Alberto Mendoza, Jimena Ruiz, Frine Samalvides, Ana M Quintana, Alberto Miranda, Augusto Tarazona, Laura Orellana, Carole Mitnick, Molly F Franke, Renato A Errea","doi":"10.1111/tmi.70209","DOIUrl":"https://doi.org/10.1111/tmi.70209","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the clinical characteristics and outcomes of mpox and mpox-HIV coinfection in Lima, Peru, during the 2022-2023 outbreak. Also, it sought to identify predictors of hospitalisation, particularly related to HIV immunosuppression.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 588 individuals with confirmed mpox across three public referral hospitals in Lima, Peru, between June 2022 and January 2023. Data were extracted from mpox surveillance forms, medical charts, and laboratory systems. Descriptive statistics and bivariate analyses were performed, followed by multivariate logistic regression to identify predictors of hospitalisation.</p><p><strong>Results: </strong>Among the 588 individuals with mpox, the mean age was 32.1 years, and 54.8% were people living with HIV (PLWH). Hospitalisation occurred in 8% of individuals, with a higher rate among PLWH (11.2%) compared to individuals without HIV (4.1%). Proctitis and a CD4 count < 500 cells/μL were significant predictors of hospitalisation (adjusted odds ratio [aOR]: 7.47 and 5.74, respectively). Lesion counts were lower in PLWH, and a distinct rash distribution was observed. Six deaths occurred, all in PLWH, with sepsis being the leading cause.</p><p><strong>Conclusions: </strong>This study highlights the clinical differences of mpox between PLWH and people without HIV in Lima, with even mild HIV-related immunosuppression (CD4 < 500 cells/μL) and proctitis being key factors for hospitalisation. Deaths occurred exclusively in PLWH, emphasising the importance of managing HIV effectively to mitigate severe mpox outcomes. Strengthening HIV care and ensuring access to mpox treatment are critical in response strategies for future outbreaks.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621359","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":"Health Beliefs, Diabetes Education, and Physical Activity Engagement Among Persons Living With Diabetes in Ghana.","authors":"Precious Adade Duodu, Joshua Okyere","doi":"10.1111/tmi.70208","DOIUrl":"https://doi.org/10.1111/tmi.70208","url":null,"abstract":"<p><strong>Background: </strong>From the perspective of the health belief model (HBM), persons living with diabetes' (PLWD) perception about the severity of their condition, their perceived susceptibility, perceived benefits, and perceived barriers could determine their participation in physical activity. This study examined physical activity and its associated factors among PLWD in Ghana.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the Ashanti Region of Ghana. The study involved 398 PLWD. A multivariate linear regression assessed the factors associated with physical activity. The results were presented as coefficients (β) with the corresponding 95% confidence intervals (CIs). Statistical significance was set at < 0.05.</p><p><strong>Results: </strong>The majority of participants exhibited moderate levels of physical activity (M = 6.15, SD = 3.99). After adjusting for covariates, higher perceived susceptibility (β = 1.27, 95% CI: 0.50, 2.05), perceived benefits (β = 1.23, 95% CI: 0.20, 2.27), and perceived barriers (β = 0.67, 95% CI: 0.16, 1.17) were independently associated with higher physical activity scores. A higher waist-to-hip ratio (WHR) was negatively associated with physical activity (β = -5.85, 95% CI: -11.14, -0.56). Compared to males, females had significantly lower physical activity levels (β = -0.89, 95% CI: -1.68, -0.11). Being currently in a union (β = -3.10, 95% CI: -4.64, -1.57) or previously in a union (β = -3.26, 95% CI: -4.92, -1.61) was associated with lower physical activity compared to those who had never married. Regular attendance at diabetes education sessions was strongly associated with higher physical activity (β = 3.01, 95% CI: 1.76, 4.27).</p><p><strong>Conclusion: </strong>Perceived susceptibility, perceived benefits, and perceived barriers emerged as important cognitive determinants of physical activity, underscoring the relevance of health belief constructs in designing interventions. The findings suggest that diabetes management programmes should incorporate behavioural change models and prioritise targeted education and support, particularly for women and those in marital unions, to promote active lifestyles among PLWD in Ghana.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608143","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":"Measles Immunity and Associated Factors Among Healthcare Workers in Bandar Abbas Following the 2025 Outbreak: A Cross-Sectional Study.","authors":"Parivash Davoodian, Behnoush Heidari, Farideh Fakhar, Masoumeh Moosazadeh, Darya Dadvand, MohammadHosein Sheybani-Arani","doi":"10.1111/tmi.70207","DOIUrl":"https://doi.org/10.1111/tmi.70207","url":null,"abstract":"<p><strong>Objectives: </strong>Measles is a highly contagious viral infection that poses significant risks to healthcare workers (HCWs) during outbreaks and can lead to nosocomial transmission. Despite vaccination programmes, immunity gaps persist, as seen in the 2025 Bandar Abbas, Iran, outbreak, necessitating seroprevalence assessments among HCWs in vulnerable regions. To assess measles immunity seroprevalence among Bandar Abbas HCWs following the 2025 outbreak and examine associated demographic factors (age, sex).</p><p><strong>Methods: </strong>This cross-sectional study surveyed 175 HCWs from three hospitals in Bandar Abbas using convenience sampling (January-April 2025). Data included questionnaires on demographics and vaccination, as well as ELISA-based serological IgG testing. Immunity was categorised as positive or not positive (negative/equivocal). Analyses employed Spearman's correlation, the Mann-Whitney U test, the Chi-square test and logistic regression (p < 0.05).</p><p><strong>Results: </strong>Participants had a mean age of 31.54 ± 7.42 years, and 62.9% were female. All reported prior measles vaccination. Seroprevalence of positive immunity was 74.9%, while 25.1% were not positive. Age showed a significant positive correlation with IgG levels (rho = 0.360, p < 0.001) and with immunity status (U = 1763.500, p < 0.001). Logistic regression revealed that each additional year of age increased the odds of positive immunity by 14.3% (OR = 1.143, 95% CI 1.061-1.232, p < 0.001). There was no significant association with sex (p = 0.813). Vaccination history could not be analysed due to insufficient variation.</p><p><strong>Conclusion: </strong>Notable immunity gaps in Bandar Abbas HCWs, especially among younger staff, underscore the need for targeted screening, boosters and enhanced infection control measures.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608119","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}