Clinical Epidemiology and Global Health最新文献

{"title":"Cross-cultural adaptation of the Moroccan version of the Dizziness Handicap Inventory (DHI-M)","authors":"Sofia Zoukal ,&nbsp;Sara Halily ,&nbsp;Youssef Oukessou ,&nbsp;Sami Rouadi ,&nbsp;Mohamed Roubal ,&nbsp;Mohamed Mahtar","doi":"10.1016/j.cegh.2025.102193","DOIUrl":"10.1016/j.cegh.2025.102193","url":null,"abstract":"<div><h3>Problem considered</h3><div>The main study objective was the translation and validation of the Moroccan dialect version dizziness handicap inventory questionnaire (DHI-M).</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study was conducted between January 2021 and January 2022, in the Otolaryngology Department of Casablanca University hospital, among patients with positional vertigo. The DHI-M questionnaire was translated according to the Forward-Backward method. It was filled before liberation and one week after. Statistical validation consisted in calculating internal consistency with Cronbach alpha α, construct validity, convergent validity, and responsiveness.</div></div><div><h3>Results</h3><div>In total, 40 patients were included. Mean DHI-M score was 43 ± 20. Internal consistency was good for total score (α = 0.90) and individual subscales scores (0.78 emotional, 0.77 physical, 0.74 functional). The total and subscales of DHI-M were strongly correlated with the FES-I (rho = 0.776, 95 % CI [0.58–0.89], p˂0.001). The responsiveness of the DHI-M after one week of maneuver was excellent, with an effect size in all patient's superior to 0.8.</div></div><div><h3>Conclusion</h3><div>The DHI-M demonstrated good psychometric properties for patients with dizziness and can be recommended as a measure of disability and quality of life in Moroccan patients with positional vertigo.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102193"},"PeriodicalIF":1.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221760","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":"High-risk pregnancies according to five risk assessment tools in Northwestern China: Detection and parameters for diagnostic accuracy","authors":"Xiali Yang ,&nbsp;Nadzratulaiman Wan Nordin ,&nbsp;Yanhua Ning ,&nbsp;Bahiyah Abdullah ,&nbsp;Nyi Nyi Naing ,&nbsp;Xin Wee Chen","doi":"10.1016/j.cegh.2025.102191","DOIUrl":"10.1016/j.cegh.2025.102191","url":null,"abstract":"<div><h3>Problem considered</h3><div>High-risk pregnancy can be identified using various risk assessment tools. This study aimed to evaluate the detection and diagnostic accuracy parameters of high-risk pregnancies using five tools.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted in Northwestern China with a sample of 1211 pregnant women from three tertiary hospitals in Ningxia. Data on demographic characteristics, medical and surgical histories, obstetric and gynecological histories were collected at their first antenatal booking to classify participants into high-risk or non-high-risk groups based on five different risk schemes/tools; they are (i) color coding, (ii) modified Nesbitt, (iii) high-risk scoring standard, (iv) antenatal risk assessment, and (v) Coopland's high-risk pregnancy scoring. Maternal or neonatal mortality and morbidity outcomes were obtained from hospital information systems to serve as the gold standard for comparison.</div></div><div><h3>Results</h3><div>Among the 1211 women, 615 (50.8 %, 95 % CI: 48.0–53.6) experienced at least one adverse maternal or neonatal outcome. The detection of high-risk pregnancies ranged from 17.6 % to 46.8 %. Sensitivity ranged from 23.6 % to 52.4 %, while specificity varied between 58.1 % and 88.6 %. All tools demonstrated accuracy levels above 55 %, with the color coding tool showing the highest validity. Nearly half of the women experienced maternal or neonatal complications.</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of integrating pregnancy risk assessment using the color coding tool into routine antenatal care, alongside laboratory and ultrasound investigations at the first booking, to enhance targeted risk management and improve maternal-fetal outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102191"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221758","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 rising threat of early-onset colorectal cancer: A call for urgent preventive measures","authors":"Marium Akter ,&nbsp;Uthman Okikiola Adebayo ,&nbsp;Safayet Jamil","doi":"10.1016/j.cegh.2025.102190","DOIUrl":"10.1016/j.cegh.2025.102190","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102190"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119501","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":"Epidemiological profile of the collective Foodborne Toxi-Infections in Marrakech city (Morocco)","authors":"Ait Melloul Abdelaziz ,&nbsp;Morad Kaddouri ,&nbsp;El Fadeli Sana ,&nbsp;Ouhammou Mourad ,&nbsp;Imane Abbad ,&nbsp;Barakate Mustapha ,&nbsp;Barkouch Yassir ,&nbsp;Omar Ait El Alia ,&nbsp;Khalid Boutoial","doi":"10.1016/j.cegh.2025.102189","DOIUrl":"10.1016/j.cegh.2025.102189","url":null,"abstract":"<div><h3>Problem considered</h3><div>Despite the implementation of food safety regulations in Morocco, Collective Foodborne Toxi-Infections (CFTIs) continue to represent a persistent public health issue. The present study aimed to assess their epidemiological profile in Marrakech city.</div></div><div><h3>Methods</h3><div>The manuscript presents a comprehensive study on the state of food poisoning in Marrakech city, Morocco, from 2018 to 2022. Data were collected from hospital records, epidemiological surveillance reports, and laboratory-confirmed cases to provide a comprehensive analysis. Microbiological analysis of food poisonings was conducted at the Regional Laboratory for Epidemiological Diagnosis, Marrakech.</div></div><div><h3>Results</h3><div>During the study period, CFTIs constituted a substantial public health threat, with 67 recorded outbreaks. The majority of outbreaks occurred in urban areas (86.67 %) and during summer (76.67 %). Most affected were individuals under 30 (56.96 %) and females (60 %), with children and adolescents being highly vulnerable. Dairy and pastry shops were the primary outbreak sites (44.16 %), with vegetables and fruits (31.45 %) being the most commonly implicated food items. Causative agents were identified among 77.79 % of the outbreaks. E<em>scherichia coli</em> (35.56 %), yeast and molds (20 %), and <em>Staphylococcus aureus</em> (16.67 %) were the most prevalent, and outbreaks of polymicrobial contamination were reported.</div></div><div><h3>Conclusion</h3><div>These findings highlight the urgent need to identify contamination sources and enforce hygienic practices. Notably, Morocco demonstrates relatively favorable epidemiological statistics compared to certain European states, alongside marked improvements in food safety indicators versus other developing countries. Enhanced food safety training, improved surveillance systems, and more stringent regulatory controls remain critical to sustain this progress and further reduce outbreak incidence.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102189"},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119500","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":"Geo-temporal analysis of cholera cases in Kathmandu Valley: An outbreak study 2022","authors":"Rudra Prasad Marasini ,&nbsp;Koshal Chandra Subedee ,&nbsp;Avinash K. Sunny ,&nbsp;Dipendra Gautam ,&nbsp;Nishant Thakur ,&nbsp;Pranit Sharma ,&nbsp;Ajit Maharjan ,&nbsp;Deepesh Sthapit ,&nbsp;Allison Gocotano ,&nbsp;Upendra Dhungana ,&nbsp;Anu Shakya ,&nbsp;Sanju Ghimire ,&nbsp;Krishna Prasad Paudel ,&nbsp;Reshika Shrestha ,&nbsp;Ashlesha Chaudhary ,&nbsp;Suzit Bhusal","doi":"10.1016/j.cegh.2025.102168","DOIUrl":"10.1016/j.cegh.2025.102168","url":null,"abstract":"<div><h3>Introduction</h3><div>Cholera is a significant public health problem in Nepal, particularly in Kathmandu valley. Recurrent outbreaks have been recorded in Kathmandu valley almost every year, however there is limited data on the locations of the occurrence. Hence, in this study, we aim to determine the geo-spatial distribution of cholera outbreak cases in Kathmandu valley.</div></div><div><h3>Methods</h3><div>Data on cholera cases reported to Epidemiology and Disease Control Division through the hospital-based surveillance system during the period of June to October of 2022 were included in the study. Households of the cases were visited and the global positioning system (GPS) of the case household were recorded through mobile application. The geolocations were mapped using open-source GIS software (QGIS version 3.32.0).</div></div><div><h3>Results</h3><div>A total of 75 cholera cases within the Kathmandu Valley were analyzed. The majority of cases were male (53.2 %), with a median age of 32 years. The 15–34 age group was most affected. Spatial analysis revealed that most cases were concentrated in the Kathmandu district, particularly in wards 11, 12, and 13, with sporadic distribution patterns. Temporal trends showed a decline in cases in week 28 followed by an increase from week 29, with cumulative cases progressively rising throughout the outbreak.</div></div><div><h3>Conclusion</h3><div>This study highlights the cholera outbreak's demographic, temporal, and spatial dynamics in the Kathmandu Valley. The findings are vital for enhancing public health planning and response strategies for cholera prevention and control in such settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102168"},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100129","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":"Determinants of premature rupture of membrane among pregnant women in Horo Guduru Wallaga zone, Western Oromia, Ethiopia: A case-control study","authors":"Bekan Gudata Gindaba,&nbsp;Damiso Geneti Dinagde,&nbsp;Firaol Manigste Moges","doi":"10.1016/j.cegh.2025.102188","DOIUrl":"10.1016/j.cegh.2025.102188","url":null,"abstract":"<div><h3>Problem considered</h3><div>Premature rupture of membranes (PROM), occurring after 28 weeks of gestation but before labor, is a major obstetric problem linked to poor maternal and neonatal outcomes. Most studies on PROM have used cross-sectional designs, and none have examined its determinants in the Horo Guduru Wallaga Zone. This study, therefore, aimed to identify factors associated with PROM using a case-control design in public hospitals of the zone.</div></div><div><h3>Methods</h3><div>A hospital-based unmatched case-control study was conducted from June 20, 2024, to August 20, 2024, involving 314 samples (80 cases and 234 controls). The cases consisted of pregnant women with premature rupture of membranes between 28 and 42 weeks of gestation, while the controls were pregnant women between 28 and 42 weeks of gestation without premature rupture of membranes. Cases were selected consecutively, and controls were chosen using systematic sampling. Data were entered into Epi-Data version 3.10 and exported to SPSS version 24 for analysis. Candidate variables were identified using binary logistic regression with a p-value &lt;0.25 for multivariable analysis. Statistical significance was determined at a p-value &lt;0.05<strong>.</strong></div></div><div><h3>Results</h3><div>Out of 314 pregnant women, 314 (80 cases and 234 controls) participated in the study. The result of this study showed that history of abortion [(AOR = 2.4,95 % CI: (1.21,4.78)] history of premature rupture of the membrane[(AOR = 3.56,95 %CI:(1.75,7.22)], polyhydramnios [(AOR = 3.53,95 %CI:(1.67,7.43)] and under nutrition [(AOR = 3.00, 95 % CI: (1.62,5.57)] were determinants of premature rupture of the membrane.</div></div><div><h3>Conclusions</h3><div>From this study, the history of abortion, premature ruptures of membrane, polyhydramnios, and undernutrition during pregnancy were potential determinants of premature rupture of membrane. Therefore, women with a history of abortion, polyhydramnios, under-nutrition, and pre-mature rupture of membrane should be paid attention to by health care providers to mitigate the occurrence of premature rupture of membrane.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102188"},"PeriodicalIF":1.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119446","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":"Associations of insomnia with lung function and mortality among asthma patients and the mediating roles of inflammatory biomarkers: a population-based cohort study","authors":"Xiaoxiao Jiang ,&nbsp;Yongqi Liang ,&nbsp;Jinming Zhang ,&nbsp;Shiya Liang ,&nbsp;Dongyu Liu ,&nbsp;Yuhan Du ,&nbsp;Jie Chen ,&nbsp;Yanqun Li ,&nbsp;Liping Huang ,&nbsp;Qi Yu ,&nbsp;Tiantian Liu ,&nbsp;Yimei Gao ,&nbsp;Jinzhong Zhuo ,&nbsp;Haohua Huang ,&nbsp;Shaoxi Cai ,&nbsp;Xianbo Wu ,&nbsp;Hangming Dong","doi":"10.1016/j.cegh.2025.102184","DOIUrl":"10.1016/j.cegh.2025.102184","url":null,"abstract":"<div><h3>Objectives</h3><div>Insomnia often leads to systemic chronic inflammation and is particularly common among asthma patients. However, the specific impact of insomnia on lung function and mortality in asthma patients remains unclear. This study aims to investigate the relationship between insomnia, lung function, and mortality in asthma patients, and further elucidate the potential role of inflammatory biomarkers in this association.</div></div><div><h3>Study design</h3><div>This was a prospective cohort study.</div></div><div><h3>Methods</h3><div>This prospective cohort study using data from the UK Biobank included 37250 participants with asthma. Multiple linear regression and Cox proportional hazards models were separately used to explore the relationships between insomnia, lung function, and mortality. Mediation analysis assessed the mediating effects of inflammatory biomarkers.</div></div><div><h3>Results</h3><div>Compared to those without insomnia, frequent insomnia was associated with a 0.06 decline in FEV1 (Z-score) and a 0.11 reduction in FEV1/FVC (Z-score). The Hazard ratios (HRs) for individuals with frequent insomnia were 1.10 (95 % CI: 1.01–1.19) for all-cause mortality and 1.15 (95 % CI: 1.02–1.29) for cancer-related mortality. Inflammatory biomarkers mediated the association between insomnia and mortality, proportions(%) were WBC (5.86), NEU (11.9), SII (5.71), LCR (15.3) and CRP (13.8).</div></div><div><h3>Conclusion</h3><div>Insomnia in asthma patients is negatively associated with lung function and increases the risks of both all-cause and cancer-related mortality. Inflammatory biomarkers partially mediate this association.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102184"},"PeriodicalIF":1.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221759","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":"Knowledge of cervical cancer, associated risk factors, and practice of cervical cancer screening among female students in higher education institutions in Buea, Cameroon, a cross-sectional study","authors":"Elisabeth Menkem Zeuko'o ,&nbsp;Awungafac Tendem ,&nbsp;Eleonore Ngounou ,&nbsp;Thomas Obinchemti Egbe","doi":"10.1016/j.cegh.2025.102173","DOIUrl":"10.1016/j.cegh.2025.102173","url":null,"abstract":"<div><h3>Problem considered</h3><div>In Cameroon, women's cancer-related mortality is primarily caused by cervical cancer. Young girls of childbearing age are exposed due to little or no knowledge of cervical cancer. This study aims to assess the knowledge of cervical cancer, associated risk factors, and practice of cervical cancer screening among girls in higher institutions of Buea.</div></div><div><h3>Methods</h3><div>The study is a cross-sectional survey conducted among girls enrolled in Buea's higher education institutions from December 1, 2022, to May 31, 2023. A multistage sampling strategy was used to enroll 500 participants in total for the study. Data were gathered using a semi-structured questionnaire that had been pretested. To ascertain their level of knowledge and practices, they were scored. The highest score on this scale was 13 for the level of knowledge, a 50 % cutoff point was used where a score of 7 and above was considered adequate knowledge, while a score of less than 7 was classified as inadequate knowledge. Also, the highest score on this scale was 6 for the practices, a 50 % cutoff point was used where a score of 3 and above was considered good practice, while a score of less than 3 is classified as poor practice.</div><div>Using bivariate and multivariate logistic regression models, factors related to knowledge of cervical cancer were found. A p-value of &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 500 participants took part in the study with about 180 (36 %) having good knowledge with 320(64 %) having inadequate knowledge about HPV. Also, 12 (2 %)were screened for cervical cancer and had good practice of cervical cancer screening with 488(97.6 %) having poor practice. Muslim's participants were at higher risk of inadequate knowledge on cervical cancer than Christians (AOR 15.75; 95 % CI: 1.60,55.28, P = 0.018). About 18 (3.6 %) displayed family history of cervical cancer, 215 (57 %) resulted from smoking, 207 (58.6 %) consumed alcoholic products 207 (41.4 %) used oral contraceptive and 37 (13.6 %) had multiple sexual partners which were lifestyle factors associated with cervical cancer.</div></div><div><h3>Conclusion</h3><div>The level of knowledge on cervical cancer and the practice of cervical cancer screening were poor among participants. Lifestyle factors were family history, smoking, alcohol consumption, oral contraceptive and multiple sexual partners. Therefore, health education campaigns, improving access to screening facilities, addressing barriers like cost and fear is necessary.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102173"},"PeriodicalIF":1.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100118","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":"A multilevel analysis of receipt of adequate antenatal care and its determinants among pregnant women in 11 sub-Saharan African countries: insights from recent demographic and health surveys","authors":"Abdu Hailu Shibeshi ,&nbsp;Getnet Mamo Habtie ,&nbsp;Gezachew Gebeyehu Arega ,&nbsp;Nuru Mohammed Hussen ,&nbsp;Kedir Endris Hamed ,&nbsp;Seid Ali Tareke","doi":"10.1016/j.cegh.2025.102185","DOIUrl":"10.1016/j.cegh.2025.102185","url":null,"abstract":"<div><h3>Background</h3><div>Adequate antenatal care (ANC) is critical for improving maternal and neonatal health, yet its utilization remains insufficient in many sub-Saharan African (SSA) countries. Understanding the factors influencing ANC uptake is essential for informed policy and health system interventions.</div></div><div><h3>Objective</h3><div>This study examined the prevalence and determinants of receiving adequate ANC among pregnant women across eleven sub-Saharan African countries using recent DHS data.</div></div><div><h3>Participants and Setting</h3><div>and Setting: The analysis included 43,323 women aged 15–49 years with recent live births from nationally representative surveys conducted between 2019 and 2024 in 11 SSA countries.</div></div><div><h3>Methods</h3><div>Adequate ANC was defined according to WHO guidelines as eight or more visits with complete service components. We employed three-level mixed-effects logistic regression to examine individual, household, and community-level predictors while accounting for the hierarchical data structure. Model performance was assessed using standard fit statistics including AIC/BIC and ROC-AUC (0.949).</div></div><div><h3>Results</h3><div>The prevalence of adequate ANC was only 3 % (95 % CI: 2.84–3.17 %), ranging from 18.4 % in Ghana to less than 1 % in Burkina Faso and Kenya. Significant predictors included secondary or higher education for both women (AOR = 1.12, 95 % CI:1.01–1.38) and their partners (AOR = 1.41, 1.15–1.73), media exposure (AOR = 1.28, 1.15–1.74), health insurance coverage (AOR = 1.22, 1.02–1.63), family size (AOR = 0.86, 0.69–0.96), urban residence (AOR = 1.24, 1.02–1.52), and recent survey year (2023/24: AOR = 2.59, 1.36–4.89).</div></div><div><h3>Conclusion</h3><div>The findings reveal alarmingly low ANC adequacy in SSA with marked cross-country disparities. Targeted interventions should prioritize women's education, health insurance expansion, and community-based programs in rural areas, while leveraging media for health promotion to address existing inequities in ANC utilization.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102185"},"PeriodicalIF":1.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100126","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":"Control of blood pressure and factors influencing uncontrolled hypertension in hypertensive patients practicing home blood pressure monitoring in primary care clinics in Selangor, Malaysia","authors":"Anusha Manoharan ,&nbsp;Beatrice Jee Ngee Ling ,&nbsp;Hazwan Mat Din ,&nbsp;Vengketeswara Rao Seetharaman ,&nbsp;Noor Diana Ismail ,&nbsp;Yew Mei Lee ,&nbsp;Najwa Aziz","doi":"10.1016/j.cegh.2025.102183","DOIUrl":"10.1016/j.cegh.2025.102183","url":null,"abstract":"<div><h3>Problem considered</h3><div>Home Blood Pressure Monitoring (HBPM) is recognized as an important tool for hypertension management. Despite the widespread adoption of HBPM among hypertensive patients in Malaysia, blood pressure control rates remain suboptimal. This study explored factors influencing uncontrolled BP among hypertensive patients practicing HBPM in primary care clinics in Selangor.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted in March 2024 across five primary care clinics in Selangor, involving 376 hypertensive patients performing HBPM. Data on sociodemographic, medication adherence (MAANS scale), and knowledge, attitudes, and practices (KAP) of HBPM were collected. Logistic regression was used to analyze factors associated with uncontrolled BP.</div></div><div><h3>Results</h3><div>The prevalence of uncontrolled office BP was 44.1 %, while uncontrolled home BP was 27.1 %. Participants younger than 40 years were 6.25 times more likely to have uncontrolled home BP (OR = 6.25, 95 % CI 2.13–16.67, p = 0.001) compared to those aged ≥60 years. Similarly, participants aged 40–59 years were 3.23 times more likely to have uncontrolled home BP (OR = 3.23, 95 % CI 1.27–7.69, p = 0.014) compared to those aged ≥60 years. Patients not advised on HBPM techniques had 2.2 times higher odds of uncontrolled home BP (OR = 2.2, 95 % CI 1.56–3.01, <em>p</em> = 0.044). Unemployed participants had higher odds of uncontrolled office BP (OR = 1.80, 95 % CI 1.10–2.92, <em>p</em> = 0.018). Participants with poor HBPM practices had 1.43 times higher odds of uncontrolled office BP (OR = 1.43, 95 % CI 1.42–1.99, <em>p</em> = 0.021).</div></div><div><h3>Conclusion</h3><div>Gaps in guidance and practices impede HBPM efficacy. Addressing knowledge, attitudes, and practices through tailored interventions and structured education can improve HBPM practices.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"36 ","pages":"Article 102183"},"PeriodicalIF":1.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060705","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}