Clinical Epidemiology and Global Health最新文献

{"title":"Effect of community-based health insurance on the use of health service and perceived quality of care in Bacho Woreda, central Ethiopia: A mixed method study","authors":"Chala Damena Heyi , Anagaw Derseh (Dr) , Berhan Tassew (Ms)","doi":"10.1016/j.cegh.2025.102055","DOIUrl":"10.1016/j.cegh.2025.102055","url":null,"abstract":"<div><h3>Background</h3><div>Ethiopia has made a significant contribution towards Community Based Health Insurance (CBHI). However, evidence on the effect, use, and perceived quality of CBHI in the study area was scanty. Hence, this study aimed to assess the effects of a community-based health insurance scheme on the utilization of outpatient care, to assess factors affecting enrollment in the CBHI scheme, and explore the perception of the enrollee on the quality of care they received in Bacho Woreda, South West Shoa, Ethiopia.</div></div><div><h3>Methods</h3><div>A facility-based Mixed method was conducted in Bacho District, central Ethiopia from December 2021 to May 30/2022. Quantitative data was collected using a structured questionnaire among a randomly selected sample of 386 (126 member and 240 non-members) household heads. While, qualitative information was gathered using focus group discussions among purposively selected CBHI members to complement the findings from the household survey. A logistic regression model was used to assess factors affecting enrollment in the CBHI scheme and to assess the effect of CBHI on outpatient service utilization. A bi-variable analysis of explanatory variables, including CBH scheme membership status, with the outcome variable of the study was computed. Then, all the independent variables that were significant in the bi variable analysis were taken for multiple logistic analysis. The qualitative data was summarized and presented concurrently alongside the quantitative data by using the thematic analysis technique.</div></div><div><h3>Result</h3><div>A total of 386 respondents with a response rate of 95.3 %. The majority 219(56.7 %) of the study participants's’ age range from 18 to 35 years with a mean of 36.096 + 13.51796(33). Around half 191(49.5 %) of the study participants were farmers. The result revealed that there is a significant association between CBI participation and outpatient service utilization (AOR; 4.207, 95 % CI; 2.112, 8.380). In addition to this marital status of never married is significantly associated with OPD service utilization (AOR; 0.097, 95 % CI; 0.010, 0.970). The satisfaction of respondent with the service they received during their visit was also assessed and 60 (47.6 %) and 48(38.1 %) was very satisfied with the overall quality of service and availability of drug/medical supplies, respectively. 49(38.9 %) and 50(39.7 %) of respondents were satisfied with the availability of diagnostics and the cleanliness of the facility.</div></div><div><h3>Conclusion</h3><div>The Members of CBHI were highly utilized in their health care and more likely to attend health care providers even for simple sickness. The perception of the respondents regarding improvement in service quality after the facility had been contracted by the CBHI scheme there was improvement in overall quality of service. Regarding to factor affects the incidence of participation in CBHI scheme has been assessed and it re","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102055"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070656","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":"Perception and predictors of antenatal services utilization by left-behind wives of marginal solo outmigrants-empirical evidence from India","authors":"Fahad Afzal ,&nbsp;Arindam Das ,&nbsp;Rupinder Sahota","doi":"10.1016/j.cegh.2025.102062","DOIUrl":"10.1016/j.cegh.2025.102062","url":null,"abstract":"<div><h3>Background</h3><div>Although antenatal care (ANC) services are offered free of charge at public healthcare facilities in India, Bihar state has a low ANC utilization rate due to service quality gaps. This study examines these gaps from the perspective of Left-Behind Wives (LBWs) residing in urban low socioeconomic environments in the absence of husbands. The research also aims to identify the predictors for efficient use of ANC services at government health centres and the effect of source of information on perception towards ANC services.</div></div><div><h3>Method</h3><div>A cross-sectional survey was carried out to capture responses from 165 respondents residing in low socioeconomic regions of two administrative blocks of the Patna district of India. Effective utilization was measured as a binary variable, based on antenatal check-ups, iron-folic acid consumption, institutional delivery, and tetanus vaccination. Regression analysis was used to assess the predictors of utilization of ANC services. Analysis of Variance (ANOVA) was used to analyze the effect of source of information on perception towards ANC services.</div></div><div><h3>Results</h3><div>The most significant aspect that predicts the efficient use of ANC services at government health centres was ‘human resource’ (AOR = 3.35, R² = 0.80), followed by ‘counselling service’ (AOR = 2.41) and ‘infrastructure and equipment condition’ (AOR = 1.76). There was no significant effect of source of information on perception (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study reveals reasons for underutilization, perception, and opportunities related to ANC services at government centres. It also provides vital insights for policymakers for the development of maternal healthcare in underperforming states of India, ultimately contributing to the health empowerment of LBWs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102062"},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070655","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":"Exploring the relationships of Metabolic Syndrome with sociodemographic factors, weight status, dietary and lifestyle behaviors in Moroccan adults","authors":"Daoud Daoudi ,&nbsp;Abderrahmane Moufid ,&nbsp;Nouriya Elghoulam ,&nbsp;Aichetou Bouh ,&nbsp;Khalid El Kari ,&nbsp;Baha Rabi ,&nbsp;Houda El Hsaini ,&nbsp;Souad Benaich ,&nbsp;Saber Boutayeb ,&nbsp;Hassan Aguenaou ,&nbsp;Slimane Mehdad","doi":"10.1016/j.cegh.2025.102058","DOIUrl":"10.1016/j.cegh.2025.102058","url":null,"abstract":"<div><h3>Background and aim</h3><div>Metabolic syndrome (MetS) is a significant risk factor for cardiovascular diseases, type 2 diabetes, and other health complications. Its prevalence is rising globally, particularly in low- and middle-income countries. This study aimed to estimate the prevalence of MetS and identify its associated risk factors among adults from the Fez-Meknes and Beni Mellal-Khenifra regions of Morocco.</div></div><div><h3>Methods</h3><div>We used data from the 2017 Morocco STEPS survey on risk factors for non-communicable diseases. Data collection was based on the WHO STEPwise approach to surveillance (STEPS). A total of 1048 adults aged ≥18 years were included in our analysis. MetS was classified using the International Diabetes Federation criteria.</div></div><div><h3>Results</h3><div>The prevalence of MetS was 39.5 %. Men, residents of the Beni Mellal-Khenifra region, individuals under 31 years of age, and those with primary education or more had significantly lower odds of MetS than women, residents of the Fes-Meknes region, and individuals aged 31 years or older, respectively. Overweight/obese individuals and low consumers of fruit/vegetables were significantly more likely to have MetS compared to non-overweight peers and consumers of recommended amounts of fruits/vegetables (AOR = 17.8, 95 %CI: 10.7–29.5, and AOR = 1.48, 95 %CI: 1.07–2.04, respectively). Moreover, current smokers and alcohol drinkers had a lower likelihood of MetS than never-smokers and non-drinkers, respectively.</div></div><div><h3>Conclusion</h3><div>The high prevalence of MetS among Moroccan adults highlights its public health significance. Female sex, older age, lower education, overweight/obesity, and insufficient fruit/vegetable intake were key predictors. Region-specific strategies are urgently needed to prevent and manage MetS, focusing on vulnerable populations.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102058"},"PeriodicalIF":2.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942635","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":"“Awareness on rights of older adults, attitudes and perception toward ageism among college students in coastal Karnataka: A cross-sectional study\"","authors":"Angel Thomas ,&nbsp;Charlet Jasmine Vaz ,&nbsp;Anil Raj Assariparambil","doi":"10.1016/j.cegh.2025.102060","DOIUrl":"10.1016/j.cegh.2025.102060","url":null,"abstract":"<div><h3>Introduction</h3><div>Ageism is a phenomenon occurring rapidly worldwide and has led stakeholders to consider strategies that can be planned for the welfare of elderly individuals. Policymakers, healthcare sector leaders, and leaders must take rapid steps to improve elderly care because of the predicted increase in the elderly population. For that reason, the first is always the baseline assessment of the scenario at hand; hence, the present study intends to assess the level of awareness among the young generation regarding the rights of the elderly and their attitudes and perceptions towards ageism.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 700 students. Jamovi version 2.3 was used to analyse the data.</div></div><div><h3>Results</h3><div>The study results revealed that college students’ level of awareness of the rights of the elderly was poor (10.5 ± 2.688), yet they had positive attitudes (73.64 ± 8.315) and favourable perceptions (56.31 ± 6.914) toward ageism. The study revealed a weak negative correlation between awareness of the rights of elderly people and attitudes toward ageism (<em>r = -0.178, p=0.01</em>) and perception toward ageism (<em>r = -0.108, p=0.01</em>).</div></div><div><h3>Conclusion</h3><div>Even though awareness of the rights of the elderly was poor among college students, their attitudes and perceptions towards ageism were positive and favourable.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102060"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072733","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":"Comparative study of bone mineral density using quantitative computed tomography to establish a local population reference standard and comparison with existing osteoporosis Standards: Insights from south India","authors":"Hemanth Kumar Deevi ,&nbsp;Sanjay Kini B ,&nbsp;Manjula A ,&nbsp;Prakashini Koteshwara","doi":"10.1016/j.cegh.2025.102030","DOIUrl":"10.1016/j.cegh.2025.102030","url":null,"abstract":"<div><h3>Background</h3><div>Early identification of reduced bone mineral density (BMD) and providing appropriate measures depending on BMD values, lead to early prevention and treatment of osteoporosis-related complications effectively. Quantification of osteoporosis can also be done by quantitative computed tomography (qCT). The present study was conducted to derive a reference standard BMD using phantomless qCT software for our local population of South India.</div></div><div><h3>Methods</h3><div>A hospital-based cross-sectional study was conducted among patients &gt;20 years of age who were undergoing a CT study which included T12, L1 &amp; L2 vertebrae and were free of obvious bone pathology. The axial CT series was used to calculate the BMD. Using the average BMD, we obtained from the patients in the age group of 20–39 years, an average and a standard deviation were calculated. Later we recalculated the T scores for patients across all age groups using cross-tabulations to identify how many people were under the osteoporosis group in each of the standards [US standards ie; the University of California, San Francisco (UCSF) standards, World Health Organization (WHO) standards and locally derived standards).</div></div><div><h3>Results</h3><div>The mean BMD for the age group of 20–39 years were obtained for both males and females as 149.4 mg/cc² and 152.5 mg/cc² respectively. Based on the bone attenuation in CT we found that attenuation &gt;120 Hounsfield units (HU) did not have any osteoporosis and attenuation &gt;200 HU did not have any osteopenia according to our reference standards. Similarly, when we considered the values of UCSF standards we found that attenuation &gt;180 HU did not have any osteoporosis and attenuation &gt;240 HU did not have any osteopenia whereas according to WHO standards attenuation &gt;130 HU did not have any osteoporosis and attenuation &gt;210 HU did not have any osteopenia.</div></div><div><h3>Conclusion</h3><div>Given the enormous patient volume of body CT scanning currently performed in older adults for a wide variety of clinical indications, this represents a unique opportunity to expand osteoporosis screening.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102030"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942636","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":"Mortality and clinical outcomes of ceftazidime/avibactam vs best available therapy in treating carbapenem-resistant enterobacterales infections: A retrospective cohort study","authors":"Nada Alhamed ,&nbsp;Mai Hashhoush ,&nbsp;Raghad Al-Omari ,&nbsp;Marwa Alomani ,&nbsp;Reem S. AlOmar","doi":"10.1016/j.cegh.2025.102061","DOIUrl":"10.1016/j.cegh.2025.102061","url":null,"abstract":"<div><h3>Objective</h3><div>The epidemiology of infectious diseases shows that antimicrobial resistance (AMR) is a global health issue. This study aimed to compare 14-day mortality in patients with confirmed Carbapenem-resistant Enterobacterales (CRE) infections treated with Ceftazidime/Avibactam (CAZ-AVI) to the best available therapies (BAT) in the Kingdom of Saudi Arabia where there is a predominance of the OXA-48 gene.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult patients with confirmed CRE infections treated with CAZ-AVI or BAT between 2018 and 2021. The Cox proportional hazards model was applied to derive both unadjusted and adjusted hazard ratios for 14-days and 30-day mortality. Bivariate analyses included chi-squared tests for categorical data, t-tests and Mann-Whitney tests for continuous data.</div></div><div><h3>Results</h3><div>The study included 157 patients; of those, 88 (56 %) were males, 63 (40.1 %) had malignancy, and the mean age was 54.85 years. Seventy (44.59 %) received CAZ-AVI. Bacteraemia (28 %) and urinary tract infections (27.3 %) were the most common sources. Klebsiella pneumonia (126, 80.25 %) was the predominant pathogen, with OXA-48 gene identified in 35.67 % of cases. The risk of 14-day mortality for patients treated with Ceftazidime/Avibactam was significantly lower compared to patients treated with the best available therapies (adjusted HR = 0.45, 95 % CI = 0.22–0.92).</div></div><div><h3>Conclusion</h3><div>CRE represents a global threat and is associated with high mortality and morbidity. Ceftazidime/Avibactam was associated with a lower risk of 14-day mortality in patients treated for CRE infections. Larger-scale prospective trials to confirm the outcomes of this study are needed.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102061"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942634","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":"Health-related quality of life of patients with rifampicin-resistant/multidrug-resistant tuberculosis in Vietnam: a prospective follow-up study","authors":"Nguyen Vu Anh Thu ,&nbsp;Cao Nguyen Hoai Thuong ,&nbsp;Trinh Hoang Duy ,&nbsp;Ngo Thi Thuy Dung","doi":"10.1016/j.cegh.2025.102054","DOIUrl":"10.1016/j.cegh.2025.102054","url":null,"abstract":"<div><h3>Background</h3><div>Currently, the management of rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB) primarily focuses on clinical characteristics and microbiological indicators. However, the disease also negatively impacts patients' psychological, economic, and social well-being. Thus, shifting our attention toward health-related quality of life (HRQOL) is essential.</div></div><div><h3>Method</h3><div>This was a prospective follow-up study conducted within government programmatic management of drug-resistant tuberculosis clinics in seven provinces of Vietnam. HRQOL was assessed at the baseline and after six months of treatment using the SF-36 version 2.0 questionnaire.</div></div><div><h3>Result</h3><div>A total of 180 patients with RR/MDR-TB completed the SF-36 version 2.0 survey at two time points. The physical component summary (PCS) scores at these two time points were 42.0 ± 8.4 and 44.2 ± 10.5, while the mental component summary (MCS) scores were 41.7 ± 9.0 and 49.8 ± 11.4, respectively. Following multivariable analysis, educational level and marital status were found to be associated with changes in PCS scores from baseline to six months of treatment. Conversely, age, comorbidity, and tuberculosis treatment category were related to changes in MCS scores.</div></div><div><h3>Conclusion</h3><div>Treatment for RR/MDR-TB has a positive impact on the HRQOL of patients. However, the PCS score after six months of treatment remained low. Therefore, incorporating appropriate exercise regimens, physical therapy measures, and rehabilitation strategies tailored to the needs and capabilities of each patient is essential to enhance their physical health.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102054"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935646","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":"Interconnections of physical activity, cognition, functional health and social connectivity with perceived happiness among rural adults: Population based study","authors":"AmitaSamal,&nbsp;Varalakshmi Manchana","doi":"10.1016/j.cegh.2025.102056","DOIUrl":"10.1016/j.cegh.2025.102056","url":null,"abstract":"<div><h3>Background</h3><div>Successful aging, within the context of a life course approach, emphasizes the direct proportionality of happiness with physical, cognitive, mental, and social well-being. Subjective well-being is a robust predictor of the overall health and functioning of individuals. The current study examines the association of happiness with physical activity, cognition, social connectivity, and functional health in middle and old-age populations from rural communities.</div></div><div><h3>Method</h3><div>A cross-sectional design was applied to collect data among 270 adults (40–90years), under the purview of Patancheru rural health center on happiness (Oxford Happiness Questionnaire-OHQ), physical activity (International Physical Activity Questionnaire-IPAQ), Cognition (Montreal Cognitive Assessment-MoCA), Social connectivity (Duke Social Support Index-DSSI) and overall functional health by using standard tools. Association was measure using chi-square test of independence and Spearman's correlation was used and results were derived at a 95 % confidence interval with a significance level set at 0.5, 0.01, and 0.001.</div></div><div><h3>Results</h3><div>Findings of the study highlight a positive association between socio-demographic variables such as age, education, marital status, occupation, and income with happiness. Cognition was a strong correlate of happiness (0.473) followed by physical activity (PA) (0.2195) while social connectivity showed a weaker association (0.0469).</div></div><div><h3>Conclusion</h3><div>Outcomes of the study indicates an overall positive relationship of happiness with multidimensional components of health and wellbeing in aging population. Promoting physical and cognitive interventions, integrating social component from midlife will be a sustainable approach to promote healthy and active aging in aging population in general and in rural adults in specific for sustainable and healthy societies.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102056"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947018","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 and enablers of using a clinical decision support algorithm to consult sick children at primary health facilities: A qualitative study from Uttar Pradesh, India","authors":"Mansi Tyagi ,&nbsp;Divas Kumar ,&nbsp;Kovid Sharma ,&nbsp;Fenella Beynon ,&nbsp;Gaurav Kumar ,&nbsp;Hélène Langet ,&nbsp;Gillian A. Levine ,&nbsp;Michael A. Ruffo ,&nbsp;Mira Emmanuel Fabula ,&nbsp;Valérie D'Acremont ,&nbsp;Kaspar Wyss ,&nbsp;Leah F. Bohle ,&nbsp;Shally Awasthi","doi":"10.1016/j.cegh.2025.102038","DOIUrl":"10.1016/j.cegh.2025.102038","url":null,"abstract":"<div><h3>Introduction</h3><div>In Indian public health system, adherence to Integrated Management of Childhood Illness (IMNCI) guidelines is low due to inadequate capacity building, high workload and shortage of healthcare providers (HCPs). Objective was to explore barriers and enablers experienced by HCPs using a digital clinical decision support algorithm (CDSA) for consultation of sick under-five children at primary healthcare facilities in Uttar Pradesh, India.</div></div><div><h3>Method</h3><div>From nine facilities, ten HCPs were trained on IMNCI guidelines and CDSA use. In-depth interviews (IDIs) of HCPs were conducted at three weeks (early phase) and five months (late phase), after intervention initiation.</div></div><div><h3>Result</h3><div>From July-to-December 2022, nine IDIs were conducted in early and eight in late phase. One HCP was paediatrician, five were trained in modern medicine and remaining in Indian traditional medicine systems. Their median clinical experience was 11 years. High patient load, HCP's shortage, multiple responsibilities and lack of supervisory support were identified as facility related barriers to CDSA implementation. Additionally, software glitches, substantial time requirements to complete consultation with CDSA and manual data entry were identified as device-related barriers. Low patient load, perceived value of CDSA by HCPs and ability of CDSA to work offline were identified as enablers. From early to late phase, no strong differences were identified on views about CDSA, with some of the barriers however being stronger.</div></div><div><h3>Conclusion</h3><div>CDSA can enhance access to evidence-based guidelines and improve awareness of assessment and management, as highlighted by HCPs. To fully realize these benefits, system challenges and technological barriers must be addressed.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"34 ","pages":"Article 102038"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084604","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":"Management of ST-segment elevation acute coronary syndromes in the emergency department of Gabes","authors":"Samet Amal ,&nbsp;Rahma Kallel ,&nbsp;Hichem Denguir ,&nbsp;Imene Rejeb","doi":"10.1016/j.cegh.2025.102005","DOIUrl":"10.1016/j.cegh.2025.102005","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute coronary syndromes (ACS) are one of the leading causes of morbidity and mortality in Tunisia. Timely and effective management in the emergency department is crucial to improving patient outcomes, particularly in cases of ST-segment elevation myocardial infarction (STEMI).</div></div><div><h3>Objective</h3><div>To study the prognosis and management of acute coronary syndromes in the emergency department.</div></div><div><h3>Methods</h3><div>A retrospective, monocentric, cross-sectional, descriptive, and analytical study was conducted at the critical emergency unit of Mohamed Ben Sassi University Hospital in Gabes. The study covered a period from January 1, 2020, to December 31, 2022, lasting 36 months.</div></div><div><h3>Results</h3><div>The mean age of patients was 65.2 ± 13.52 years, with a male-to-female ratio of 3.08. Forty-eight percent of patients were from Gabes city. In 80 % of cases (n = 269), at least one comorbidity was observed, including diabetes (152 patients), hypertension (124 patients), and coronary artery disease (28 patients). Chest pain was the most common symptom, noted in 95.3 % of cases (n = 323). Only 33 patients (9.73 %) had first medical contact within 1 h. Antithrombotic therapy was administered to 97.34 % of patients, and morphine was used in 18 % of cases. Thrombolysis was performed in 36.3 % of cases, with a success rate of 82.9 %. Angioplasty was performed in 10.02 % of cases. Of the patients, 90.26 % were transferred to a coronary care unit (CCU), while 3.53 % were transferred to intensive care, and 6.19 % died.</div></div><div><h3>Conclusion</h3><div>Predictive factors for thrombolysis failure in the acute phase of STEMI are critical for improving emergency management strategies.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102005"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900044","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}