Public Health in Practice最新文献

{"title":"Factors influencing type of contraceptive use among Ghanaian males: Insights from the 2022 Ghana demographic and health survey","authors":"Christiana Lokko ,&nbsp;Jonathan Sackey ,&nbsp;Francis Lokko","doi":"10.1016/j.puhip.2025.100623","DOIUrl":"10.1016/j.puhip.2025.100623","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the socio-demographic, media, and health-related factors influencing contraceptive use among men of reproductive age in Ghana.</div></div><div><h3>Study design</h3><div>The 2022 GDHS consists of three datasets which are nationally representative cross-sectional data that elicited the demographic and health indicators of children 0–59 months, women 15–49 years of age, mean aged 15–59 years old as well as households.</div></div><div><h3>Methods</h3><div>This study utilised the 2022 Ghana Demographic and Health Survey (GDHS) men recode file, analysing a sample of 7044 men aged 15–59 years. The dependent variable, contraceptive use, was categorised into modern, traditional, and no method. Data were weighted and cleaned, and multinomial logistic regression was used to identify factors associated with contraceptive use.</div></div><div><h3>Results</h3><div>Among the respondents, 16.6 % used modern contraceptives, 4.3 % used traditional methods, and 79.0 % used no method. Significant predictors of contraceptive use included age, education, ethnicity, region, marital status, wealth index, number of wives/partners, and media exposure (p &lt; 0.05). Men aged 15–54 were more likely to use modern methods, while those with lower education levels were more likely to use no method. Ethnic differences were observed, with Mole-Dagbani men more likely to use modern methods. Media exposure, particularly frequent radio and television consumption, was positively associated with modern contraceptive use.</div></div><div><h3>Conclusions</h3><div>The persistently low uptake of modern contraceptives among men in Ghana hampers efforts to achieve universal access to family planning. Tackling socio-demographic disparities and strengthening media-driven awareness can foster greater male involvement. These findings highlight the need for targeted strategies to enhance male contraceptive use and support shared responsibility in family planning.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100623"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the malaria centre program on malaria incidence in Papua Province","authors":"Eni Setianingsih ,&nbsp;Eny Sulistyaningrum","doi":"10.1016/j.puhip.2025.100625","DOIUrl":"10.1016/j.puhip.2025.100625","url":null,"abstract":"<div><h3>Objective</h3><div>The goal of eliminating malaria in Indonesia by 2030 faces significant challenges, particularly due to the stagnation of malaria cases in recent years. This issue is exacerbated by the high concentration of cases in Eastern Indonesia, with Papua Province alone contributing to 86 % of the national malaria cases. To address this, the Malaria Centre Programme has been implemented to eradicate malaria in highly endemic regions. This study aims to evaluate the impact of the malaria centre program on the prevalence of malaria in Papua.</div></div><div><h3>Study design</h3><div>a mixed-method approach.</div></div><div><h3>Method</h3><div>First, fixed effects analysis effectively evaluates program impacts shaped by pre-existing attributes. Second, in-depth interviews help identify potential impacts, analyze mechanisms, and assess benefits to beneficiaries.</div></div><div><h3>Result</h3><div>The findings indicate that the malaria centre program has successfully reduced the annual parasite incidence (API) in Papua Province by 31.81 cases per 1000 population. Additionally, controlling for healthcare facilities, especially the ratio of community health centres, significantly lowers malaria incidence by 430.695 cases. However, the availability of hospitals does not significantly impact malaria incidence in the province.</div></div><div><h3>Conclusion</h3><div>The malaria centre program has had a significant impact on reducing malaria incidence in Papua Province. Implementing the program has effectively lowered malaria cases in several regencies, including Keerom, Nabire, Boven Digoel, and Jayapura.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100625"},"PeriodicalIF":2.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic partnership for Health in All Policies and sustainable transport in Scotland: a case study evaluation","authors":"Margaret J. Douglas ,&nbsp;Anna Gale ,&nbsp;Rok Hrzic ,&nbsp;Timo Clemens ,&nbsp;Adrian L. Davis","doi":"10.1016/j.puhip.2025.100624","DOIUrl":"10.1016/j.puhip.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Health in All Policies aims to ensure policy decisions across sectors improve health and health equity. Principles of a Health in All Policies approach have been defined as Governance, Comprehensive approach to health, Collaboration, Equity, Participation, Evidence-based and Sustainability. Intersectoral partnerships are a recognised mechanism for Health in All Policies but few evaluations study partnerships that aim to influence policy. This case study evaluation studied a national Partnership focused on transport policy in Scotland. The evaluation aimed to assess the extent to which the Partnership meets the principles of Health in All Policies and informs policy and practice. It also identified actions to improve its impact.</div></div><div><h3>Study design</h3><div>Anonymous self-completion survey of members of the Partnership and its wider Learning Network.</div></div><div><h3>Methods</h3><div>The survey used Likert scales to assess respondents’ views on whether the Partnership was meeting its aims and supporting principles of Health in All Policies. Respondents also recorded whether the Partnership had increased their knowledge, supported wider collaboration or informed decision making. The Partnership used structured discussion in groups and an online poll to generate and prioritise improvement actions.</div></div><div><h3>Results</h3><div>A vast majority of respondents scored the Partnership highly for Comprehensive approach to health (82 %), and being Evidence-based (78 %). Most rated it highly for Governance (63 %), Collaboration (62.5 %) Equity (63 %) and Sustainability (57 %). However, less than half (43 %) scored it highly for Participation. Respondents indicated a range of ways the Partnership impacted on their knowledge and practice. The top actions identified by the Partnership to improve its impact were to investigate car culture and identify specific national transport policies to influence.</div></div><div><h3>Conclusions</h3><div>A national sector-specific Partnership can provide a constructive platform for a Health in All Policies approach to improve health and health equity, but further mechanisms are needed to support participation of affected populations.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100624"},"PeriodicalIF":2.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effective analysis after patient communication training in obstetrics - Evaluating economic efficiency","authors":"Beate Hüner ,&nbsp;Anand Kumar Vinayak ,&nbsp;Martina Schmiedhofer ,&nbsp;Christina Derksen ,&nbsp;Frank Reister ,&nbsp;Christoph Scholz ,&nbsp;Sonia Lippke","doi":"10.1016/j.puhip.2025.100618","DOIUrl":"10.1016/j.puhip.2025.100618","url":null,"abstract":"<div><h3>Background</h3><div>In obstetrics, teamwork among healthcare professionals and effective communication with expectant parents are key to prevent adverse events during childbirth. These events can have lasting impacts on families and lead to significant costs for both the healthcare system and the affected families. The aim of this study is to evaluate the cost effectiveness of a training intervention for expectant mothers, focusing on improving effective communication in obstetrics.</div></div><div><h3>Study design and methods</h3><div>An experimental intervention study was conducted with 76 pregnant women in the intervention group receiving patient training, and 88 in the control group. Cost effectiveness of the obstetric data was collected and evaluated with the Diagnosis Related Groups (DRG) classification, the internal cost of medical treatment and reimbursement by health insurance. In addition, patient characteristics, co-morbidities, and risk factors were assessed.</div></div><div><h3>Results</h3><div>We found meaningfully lower costs per patient following patient training including communication training (patients with complications and in the intervention group 3053 Euros vs. with complications but in the control group 4523 Euros; patients without complications 2168 vs. 2418 Euros). The training significantly impacted patient safety in terms of a reduced average patient costs by 30 % only in case where women experienced complications.</div></div><div><h3>Conclusion</h3><div>The results demonstrate the positive impact of communication training on enhancing patient safety while simultaneously reducing costs. The implementation of a patient training program focusing on communication skills for expectant parents effectively merges economic efficacy with a progressive approach in obstetrics. Furthermore, effective communication training could improve the articulation of needs, thereby bridging the gap between potentially exacerbated health inequalities for pregnant women with social risk factors.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100618"},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to breast cancer treatment in Brazil: A study on migration and regional disparities","authors":"Marcelo Antonini ,&nbsp;Gabriela Moreira Santos ,&nbsp;André Mattar ,&nbsp;Marina Diogenes Teixeira ,&nbsp;Andressa Gonçalves Amorim ,&nbsp;Marina Fleury de Figueiredo ,&nbsp;Marcellus do Nascimento Moreira Ramos ,&nbsp;Francisco Pimentel Cavalcante ,&nbsp;Eduardo Camargo Millen ,&nbsp;Antonio Luis Frasson ,&nbsp;Felipe Zerwes ,&nbsp;Odair Ferraro ,&nbsp;Fabricio Palermo Brenelli ,&nbsp;Juliana Francisco ,&nbsp;Luiz Henrique Gebrim","doi":"10.1016/j.puhip.2025.100614","DOIUrl":"10.1016/j.puhip.2025.100614","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is one of the most prevalent cancers globally, with 2.3 million new cases annually in 2023. In Brazil, it is estimated that there are 74,000 new cases per year, representing 20.3 % of cancers in women in the country. Limited access to adequate treatment forces patients to seek care elsewhere, straining the healthcare system and delaying treatment initiation. This study aimed to determine the migration rate of BC patients in Brazil and specifically to analyze migration rate by stage and treatment modality, as well as its costs and possible reasons for delays.</div></div><div><h3>Study design</h3><div>A cross-sectional observational ecological study was conducted using retrospective data on the prevalence of breast cancer in Brazil, including the number of diagnoses and treatments in each state. The study evaluated patient migration rate for treatment, with information obtained from the DATASUS - SISCAN/Cancer Information System database. The selected analysis period was from 2017 to 2022, during which all necessary variables were available.</div></div><div><h3>Results</h3><div>Among the 275,140 cases analyzed, 98.18 % were women. The national migration rate was 2.12 %, ranging from 0.35 % in the Northeast to 9.31 % in the Midwest. Stage IV had the highest migration rate (1.74 %), and migration rate for radiotherapy was significant in some states, reaching 100 % in specific cases.</div></div><div><h3>Conclusion</h3><div>The migration rate of BC patients for treatment in Brazil shows significant regional variations, with higher rates in the Midwest and lower rates in the South. Some states exhibited a 100 % migration rate for access to radiotherapy. Stage IV patients are the most prone to migrate, and the search for radiotherapy can lead patients to move to other states. These results highlight the need for specific health policies to ensure access to treatment across the country.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100614"},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Global Scale for Early Development (GSED) for children 0 to 36 months of age in the Pacific: protocol","authors":"S. Howells ,&nbsp;B. Lam ,&nbsp;D. Kakiakia ,&nbsp;B. Temakei Tebano ,&nbsp;R. Tekeraoi ,&nbsp;R. Katokita ,&nbsp;S.A. Brinkman","doi":"10.1016/j.puhip.2025.100615","DOIUrl":"10.1016/j.puhip.2025.100615","url":null,"abstract":"<div><h3>Objectives</h3><div>Early childhood starting at conception is a period of rapid development and has implications for health and well-being throughout the life-course. Validated measures are critical for countries interested in population level monitoring of child development and to evaluate policies and services aimed at enhancing children's health and development. This project aims to address this need for children aged 0–36 months in Kiribati, a small and widely dispersed island nation in the central Pacific Ocean, by adapting and validating the Global Scale for Early Development Short Form (GSED SF). This study contributes uniquely to the literature as it is the first time that the GSED has been adapted and applied in the Oceania-Pacific region.</div></div><div><h3>Study design</h3><div>Psychometric validation study of the GSED SF in Kiribati.</div></div><div><h3>Methods</h3><div>The Global Scale for Early Development Short Form (GSED SF) adaptation and validation study will involve 500 children, 100 each from five randomly selected villages in South Tarawa, Kiribati. Validity testing will involve established steps: face validity, cultural and context neutrality, test-retest reliability, inter-rater reliability, construct validity and discriminant validity. We will evaluate measurement invariance including differential item functioning and differential test functioning to ensure that the GSED SF is fair and unbiased.</div></div><div><h3>Conclusions</h3><div>This project will provide Kiribati with a tool for monitoring and evaluation of early child development in children from birth to 36 months at the national and programmatic level. The study will also provide the first validation of the GSED SF in the Pacific region.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100615"},"PeriodicalIF":2.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving coastal safety for international visitors to Australia","authors":"William A. Koon ,&nbsp;Robert W. Brander ,&nbsp;Jasmin C. Lawes ,&nbsp;Amy E. Peden","doi":"10.1016/j.puhip.2025.100613","DOIUrl":"10.1016/j.puhip.2025.100613","url":null,"abstract":"<div><h3>Objectives</h3><div>International visitors are a high-risk group for drowning and other fatalities at Australian coastal locations due to lower visitation and familiarity than the resident population. This review of pre-COVID-19 (2005–2019) Australian international visitor coastal fatalities aimed to assess changes in mortality rates and evaluate differences between international visitor and resident death profiles to inform safety measures.</div></div><div><h3>Study design</h3><div>Descriptive, retrospective epidemiological analysis.</div></div><div><h3>Methods</h3><div>Analysis of unintentional coastal fatalities among international visitors to Australia from 2005 to 2019 was conducted using coronial data for fatalities and short-term visitor arrival data. Descriptive analysis comprised demographic, and incident-based variables, while cumulative (2005–2019) and annual fatality rates and 95 % confidence intervals per 100,000 short-term arrivals were calculated. Length of stay was incorporated into the risk measurement per 100,000 visitor-years. Joinpoint regression analysed trends in annual visitor coastal fatality rates.</div></div><div><h3>Results</h3><div>Among coastal deaths 62 % were due to drowning; 12.8 % were international visitors; 7.83 residents died for each visitor fatality with an annual average of 22.5 visitor deaths. The cumulative visitor coastal fatality rate was 0.37 deaths per 100,000 international arrivals (95 %CI: 0.33–0.42), which decreased at a statistically significant level by an annual average of 5.8 % (95 %CI: 9.5 % to −1.9 %; p = 0.007) from 2005 to 2019. Visitors record an exposure-adjusted coastal fatality rate of 6.0/100,000 visitor-years. Visitor coastal deaths occurred in higher proportions in Queensland, at offshore locations, in more remote areas, while snorkelling, and during organised activities.</div></div><div><h3>Conclusions</h3><div>Sustained efforts will require focus on high-risk visitor groups by diverse sectors including tourism, government, and water safety practitioners.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100613"},"PeriodicalIF":2.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility tele-stroke in adults with acute ischemic stroke. A systematic review","authors":"Luis Alberto López-Romero ,&nbsp;Dora Inés Parra ,&nbsp;Alexandra Cortés Aguilar ,&nbsp;Fabio Alberto Camargo Figuera","doi":"10.1016/j.puhip.2025.100617","DOIUrl":"10.1016/j.puhip.2025.100617","url":null,"abstract":"<div><h3>Introduction</h3><div>Tele-Stroke has been proposed as a solution to increase access to thrombolytic therapy in acute ischemic stroke. <strong>Objective</strong>: Synthesise the evidence of the cost-effectiveness of Tele-Stroke. <strong>Study Design</strong>: Systematic Literature Review.</div></div><div><h3>Methods</h3><div>Systematic review of cost-effectiveness economic evaluations of Tele-Stroke from the Centre for Reviews and Dissemination of the University of York, International HTA Database, PubMed, EMBASE, Cochrane Library, Cost-Effectiveness Analysis Registry, National Institute for Health and Care Excellence, The European Network of Health Economic Evaluation Databases Project and grey literature. Quality assessment, data selection and data extraction were performed by two reviewers. A qualitative synthesis was conducted.</div></div><div><h3>Results</h3><div>Twelve studies, published between 2008 and 2022 in high-income countries were included; 50.00 % were conducted from a health system perspective and the most frequent discount rate was 3 %. Spoke/Hub ratio ranged from 1:1 to 17:2. In 5/12 studies Tele-Stroke was found to be highly cost-effective (dominant intervention: lower cost and higher effectiveness) and only two acceptable (lower cost and lower effectiveness). Incremental Cost Effectiveness Ratio (ICER) per Quality-Adjusted Life Years (QALY) gained ranged from US$ 290,368.77 to US$ 327.44 in 2022. <strong>Conclusions</strong>: Most of the studies showed that the Tele-Stroke programme could be a cost-effective strategy, both from a social and health system perspective; however, most of the studies were from middle-and-high-income countries, which requires analysis before implementation in low-income countries.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100617"},"PeriodicalIF":2.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Financialization of Healthcare in France: Trends and implications","authors":"Benjamin Marchandot ,&nbsp;Olivier Morel","doi":"10.1016/j.puhip.2025.100620","DOIUrl":"10.1016/j.puhip.2025.100620","url":null,"abstract":"<div><div>The healthcare system in France, once celebrated for its universal coverage and accessibility, now grapples with profound transformations driven by corporatization, polarization, and financialization. Initially founded on principles of solidarity and government support, the system provided ample opportunities for doctors to practice either in public hospitals or private settings, with fees regulated to ensure affordability. However, recent decades have seen a shift towards agreements that allow specialists to charge additional fees beyond standard rates, which are covered by private insurance or paid directly by patients. The landscape is further complicated by demographic shifts such as an aging population and rising incidences of chronic diseases, exacerbating healthcare demand while the supply of medical professionals stagnates. Urbanization has concentrated medical services, leading to dominant practices in certain specialties and longer waiting times, especially in rural areas. Financialization has emerged as a pivotal force, with private investors increasingly influencing healthcare delivery. This trend is evident in sectors like medical biology and radiology, where consolidation and profit maximization strategies may prevail, potentially compromising care quality and access. While financial influx may temporarily address funding gaps, it also risks eroding professional autonomy and patient care standards. These developments mark a schism from traditional values of the French healthcare as a public good, raising concerns about equity, regulation, and the ethical implications of intertwining medical practice with financial imperatives in France.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100620"},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of drug-resistant tuberculosis in Sabah, Malaysia – a retrospective cohort study","authors":"Y.L. Lew ,&nbsp;M.M.D. Goroh ,&nbsp;S.T. Yerkovich ,&nbsp;A.M.H. Seow ,&nbsp;G.S. Rajahram ,&nbsp;R. Teo ,&nbsp;A.B. Chang ,&nbsp;C. Lowbridge","doi":"10.1016/j.puhip.2025.100616","DOIUrl":"10.1016/j.puhip.2025.100616","url":null,"abstract":"<div><h3>Objectives</h3><div>Addressing drug-resistant tuberculosis (DR-TB) is a priority of the tuberculosis (TB) programme. People with DR-TB frequently have worse outcomes and require more costly and complex management, compared with those with drug-sensitive TB (DS-TB). Our study examined the epidemiology of DR-TB in Sabah, Malaysia, a state with high TB burden. We aimed to identify factors associated with poor treatment outcomes.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Data were derived from a national registry of TB patients from Sabah. Descriptive analyses were used to characterise DR-TB epidemiology, including annual trends. Multivariable logistic regression was used to identify factors associated with poor DR-TB treatment outcomes.</div></div><div><h3>Results</h3><div>Between 2016 and 2021, there were 29,337 registered TB patients, of whom 158 (0.54 %) had DR-TB. The proportion of people with DR-TB between 2016 and 2019 was between 0.32 % and 0.47 % of annual total TB, increasing to 0.97 % in 2021. The proportion of people with DR-TB who were cured or completed treatment (63.1 %) was lower compared with DS-TB (86.0 %). In multivariable analysis, poor DR-TB treatment outcomes (death, lost to follow-up, failed treatment, transferred out &amp; lost) were significantly associated with non-citizen status (adjusted odds ratio [aOR] = 2.49; 95 %CI 1.23–5.13) and male sex (aOR = 2.34; 95 %CI 1.15–4.94).</div></div><div><h3>Conclusions</h3><div>There was an increase in the proportion of TB that was DR-TB, coinciding with the COVID-19 pandemic in Sabah. Non-citizens and male sex were the most significant predictors of poor treatment outcomes among those with DR-TB.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100616"},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}