Clinical Epidemiology and Global Health最新文献

{"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}

{"title":"Determinants for migration among medical, dental and allied health sciences students- Unveiling brain drain","authors":"S. Vineetha ,&nbsp;Himani Kotian ,&nbsp;Rishit Anand","doi":"10.1016/j.cegh.2025.102051","DOIUrl":"10.1016/j.cegh.2025.102051","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>\"Brain drain\" refers to the migration of healthcare professionals from low- and middle-income countries to higher-income countries. The study aims to understand the determinants influencing the migration of healthcare professionals, students' perceptions towards determinants of migration, to determine the proportion of students wanting to migrate and to associate socio-demographic characteristics of the study participants with the determinants responsible for professional migration.</div></div><div><h3>Methodology</h3><div>A cross-sectional study among 196 medical, dental, and allied health students in Mangaluru used a validated questionnaire. Data were collected via Microsoft Forms and analyzed in SPSS v29.0, with chi-square tests (p &lt; 0.05). Ethical approval and informed consent were obtained.</div></div><div><h3>Results</h3><div>The study found that 75 % of participants considered migrating abroad, with 52.1 % planning to take international exams. While 43.3 % intended to migrate for education and training, 40 % aimed for long-term career development. Key factors influencing migration included financial remuneration (36.3 %) and poor working conditions in India (38.1 %). A significant association was observed between students with close family abroad and migration plans (p &lt; 0.001), as well as those who actively discussed migration (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The study highlights a strong inclination among medical, dental, and allied health students to migrate abroad, primarily for education, career growth, and better financial prospects. Poor working conditions and financial remuneration were key motivators. Close family abroad and discussions about migration significantly influenced migration decisions.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102051"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904430","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":"Cardiometabolic self-care and their determinants among older adults in India: evidence from the Longitudinal Ageing Study of India","authors":"Shubhanjali Roy ,&nbsp;Arka Ghosh ,&nbsp;Saurav Basu","doi":"10.1016/j.cegh.2025.102053","DOIUrl":"10.1016/j.cegh.2025.102053","url":null,"abstract":"<div><h3>Background</h3><div>Cardiometabolic syndrome (CMS) is a major public health issue in India, driven by urbanization, unhealthy dietary shifts, and sedentary lifestyles. Optimal cardiometabolic self-care, as defined by the Healthy Longevity Heart Code (HLHC), is critical to slowing cardiovascular aging and improving health outcomes.</div></div><div><h3>Objective</h3><div>To assess the prevalence and determinants of cardiometabolic self-care practices among older adults in India using HLHC proxies derived from the Longitudinal Ageing Study in India (LASI).</div></div><div><h3>Methods</h3><div>This study conducted a cross-sectional analysis of 66,606 participants aged ≥45 years from LASI (2017–2018). HLHC proxies included dietary habits, physical activity, waist circumference, smoking, alcohol consumption, sleep quality, mental exercises, and social interactions. Logistic regression analysis was used to identify predictors of optimal self-care, and mediation analysis assessed the role of wealth in modulating these outcomes.</div></div><div><h3>Results</h3><div>Only 34.3 % of participants exhibited optimal cardiometabolic self-care, with higher prevalence among females (40.04 %) compared to males (28.52 %). Predictors of optimal self-care included higher education, socioeconomic status, and urban residence. Wealth significantly mediated the relationship between socioeconomic factors and cardiometabolic health. Suboptimal practices such as high central obesity (64.13 % males; 41.59 % females) and poor mental and social engagement were prevalent. Tobacco use and alcohol consumption were notably higher among males, while females demonstrated better adherence to dietary and physical activity guidelines.</div></div><div><h3>Conclusions</h3><div>Suboptimal cardiometabolic self-care remains a significant challenge among Indian adults aged ≥45 years, with notable gender and socioeconomic disparities. Interventions should prioritize education, equitable access to resources, and gender-specific strategies to enhance adherence to HLHC guidelines and improve cardiometabolic health outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102053"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908228","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":"Public awareness about infant prematurity and its related health issues: A national-based survey in Jordan","authors":"Reem Ali ,&nbsp;Karimeh Alnuaimi ,&nbsp;Buthyna Alnasarat","doi":"10.1016/j.cegh.2025.102046","DOIUrl":"10.1016/j.cegh.2025.102046","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of premature birth is high in Jordan, with no significant lowering of figures seen during the past decades. The knowledge of the associated high morbidity and mortality rate among preterm infants makes prematurity a high priority for the healthcare system in Jordan. This study aims to assess public awareness about prematurity, preterm infants’ health challenges and developmental disorders.</div></div><div><h3>Methods</h3><div>A national-based survey was employed to collected data on people's level of awareness. Online questionnaires were distributed across the country using proportional clusters protocol which was based on the geographical distribution of the population in Jordan.</div></div><div><h3>Results</h3><div>3048 Jordanians, aged from 18 to 77 years, completed the questionnaires; the majority of them were females and held married status. Results showed that 69.9 % of respondents gave a correct definition of prematurity. The average percentages of correct answers regarding the seriousness of prematurity, risks, and health and developmental problems were 71.5 %, 74.4 %, and 62.5 %, respectively. People generally failed to accurately identify premature infants’ long-term health and developmental problems. ANOVA results showed that the levels of awareness are significantly higher among people who have high family income (p &lt; 0.001), are well-educated (p &lt; 0.001), and employed in medical fields (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Educational initiatives are needed to enhance public awareness, particularly among the poor and less educated sectors of society. Lectures could be given by healthcare professionals at hospitals, and posted via social media, to educate people about prematurity and premature infants' health-related issues, with attention paid to infants’ long-term health and developmental problems.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102046"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886493","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 overview of rehabilitation practices and action plans for byssinosis: A holistic review","authors":"K. Vaishali ,&nbsp;Sarasa Meenakshi ,&nbsp;Mukesh Kumar Sinha ,&nbsp;Nitesh Kumar ,&nbsp;Revati Amin ,&nbsp;Krishna Murti","doi":"10.1016/j.cegh.2025.102050","DOIUrl":"10.1016/j.cegh.2025.102050","url":null,"abstract":"<div><h3>Purpose</h3><div>This review aims to outline comprehensive care for byssinosis, covering its pathophysiology, diagnosis, clinical characteristics, and physiotherapist-led interventions.</div></div><div><h3>Materials and methods</h3><div>We conducted a thorough literature review focusing on the pathophysiology, diagnosis, and management of byssinosis. Key components of care were identified through analysis of studies, guidelines, and expert opinions, with particular attention to physiotherapist interventions.</div></div><div><h3>Results</h3><div>Byssinosis progresses through three stages, with varying symptoms, yet its burden in India remains poorly understood, leading to inadequate prevention and management efforts. Treatment involves education, supplemental oxygen, pulmonary rehabilitation, and symptom control, with physiotherapists playing a crucial role in their implementation.</div></div><div><h3>Conclusion</h3><div>Comprehensive care for byssinosis requires a tiered rehabilitation framework, considering its diverse clinical presentation. Physiotherapists are pivotal in delivering essential interventions and enhancing patient outcomes and well-being.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102050"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895645","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":"Pattern and determinants of unintentional injuries in children (<18 years) from rural puducherry: A cross-sectional analytical study","authors":"Burhana Begom Choudhury,&nbsp;S. Ganesh Kumar,&nbsp;Henna K","doi":"10.1016/j.cegh.2025.102039","DOIUrl":"10.1016/j.cegh.2025.102039","url":null,"abstract":"<div><h3>Background</h3><div>Unintentional injuries (UI) among &lt;18 years contributes to a significant public health problem due to their physical and psychological makeup. This study estimated the occurrence of unintentional injuries (UI) and identifies the factors associated with common unintentional injuries among children below 18 years residing in rural areas of Puducherry, India.</div></div><div><h3>Method</h3><div>This cross-sectional study included 596 children below 18 years who are living in the study area. Falls, road traffic injuries, burns, near drowning, poisonings and other injuries reported by participant or care-giver that had happened in last one year or in their entire life time which can be recalled was considered as unintentional Injuries. A pre-tested structured questionnaire was used to collect data regarding injuries. Simple descriptive analysis and the Chi-square test were incorporated in statistical analysis. In order to understand the factors associated with UI, log binomial regression model was performed.</div></div><div><h3>Results</h3><div>The prevalence of UI was found to be 32.6 % (95 %CI: 28.9–36.4) among 596 study participants. The common types of UI reported were accidental falls (34 %), traffic related injuries (20.6 %) and animal bites (17.5 %). It revealed that the socio-demographic characteristics of the study participants were significantly associated with the occurrence of UI such as gender and age of child, educational status of the child and primary caregiver, socio-economic status from which the child belongs to, age of the primary caregiver.</div></div><div><h3>Discussion</h3><div>The study highlights the importance for creating awareness about injury prevention strategies and developing policies to lower the burden of UI in children.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102039"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904431","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 support and coping mechanisms for tribal infertility: A mixed methods study","authors":"Arvind Santu Jadhav ,&nbsp;Dipti Govil","doi":"10.1016/j.cegh.2025.102031","DOIUrl":"10.1016/j.cegh.2025.102031","url":null,"abstract":"<div><h3>Objective</h3><div>The study explores the support mechanisms and coping strategies used by 153 tribal couples to navigate infertility.</div></div><div><h3>Methods</h3><div>The data was collected through quantitative and qualitative surveys and analyzed using descriptive and thematic analysis.</div></div><div><h3>Results</h3><div>The findings suggest that women received both positive and negative support from their spouses and society, while the family was not positive towards their infertility status. The role of formal healthcare providers and harassment from the community were two significant factors in getting high social support. Women resorted to reliance on the treatment of traditional healers, spending time with a relative's child, or keeping themselves engaged in various kinds of work and activities, remaining in isolation and proposing remarriage or fostering as coping strategies.</div></div><div><h3>Conclusions</h3><div>The research contributes to a deeper understanding of the type of social support for infertility issues of tribal infertile women, which may impact their emotional and social well-being. It suggests potential avenues for intervention and support.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102031"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143908229","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":"Food insecurity: A formidable barrier to medication adherence in a vulnerable population with chronic diseases","authors":"Kumar Guru Mishra ,&nbsp;Nabnita Patnaik ,&nbsp;Bobba Harshitha ,&nbsp;Anu Mohandas ,&nbsp;Adrija Roy ,&nbsp;Snigdha Patnaik","doi":"10.1016/j.cegh.2025.102033","DOIUrl":"10.1016/j.cegh.2025.102033","url":null,"abstract":"<div><h3>Background</h3><div>Food insecurity is a global challenge with profound implications for health, particularly among individuals with chronic diseases. This study aimed to assess the prevalence of food insecurity and its association with medication adherence in a rural Indian population with chronic diseases.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 400 individuals aged 30–70 years with chronic diseases in Moinabad, India. Food insecurity was assessed using the Food Insecurity Experience Scale, and medication adherence was measured using the Morisky Medication Adherence Scale. Logistic regression analysis was performed to identify factors associated with low medication adherence.</div></div><div><h3>Results</h3><div>The prevalence of food insecurity was 48.75 %, with 22 % experiencing severe and 26.75 % experiencing moderate food insecurity. Participants aged 30–49 years, unmarried individuals, those with low household income and socioeconomic status (SES), and those with addiction had significantly higher odds of low medication adherence. Severe food insecurity (OR = 16.56, 95 % CI: 7.97–32.61) and moderate food insecurity (OR = 5.76, 95 % CI: 3.65–10.06) were strongly associated with low medication adherence, even after adjusting for confounders.</div></div><div><h3>Conclusion</h3><div>Food insecurity is prevalent among individuals with chronic diseases in rural India and is strongly associated with low medication adherence. Interventions addressing food insecurity and medication adherence barriers are urgently needed to improve health outcomes in this population. Longitudinal studies are warranted to explore the temporal relationships between food insecurity, medication adherence, and health outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102033"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891829","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":"Attack rate and determinants of malaria outbreak in Ethiopia: A systematic review and meta-analysis","authors":"Diriba Etana Tola ,&nbsp;Azeb Haile Tesfaye ,&nbsp;Lencho Kajela Solbana ,&nbsp;Shalama Lekasa Nagari ,&nbsp;Zenebu Begna Bayissa ,&nbsp;Eshetu Ejeta Chaka","doi":"10.1016/j.cegh.2025.102045","DOIUrl":"10.1016/j.cegh.2025.102045","url":null,"abstract":"<div><h3>Background</h3><div>Malaria remains a public health challenge in Ethiopia. Despite progress in reducing cases and deaths, there has been a resurgence. This highlights the need to identify driving factors for malaria outbreaks and sustain progress toward elimination. This study aims to determine the overall attack rate of malaria outbreaks and identify the key determinants.</div></div><div><h3>Methods</h3><div>The study was registered with PROSPERO with the registration code CRD42025645940. Databases, including PubMed, EMBASE, Google Scholar, Google, and Web of Science. Analyzed using R version 4.2.3 and Stata version 17.0.</div></div><div><h3>Results</h3><div>In this study, the pooled estimated attack rate of malaria outbreaks in Ethiopia was 3 % (95 % CI: 2 %–5 %). Presence of stagnant water (OR = 3.45; 95 % CI: 2.06, 4.84), staying outside at night (OR = 3.79; 95 % CI: 2.39, 5.20), not using insecticide-treated bed nets (OR = 3.52; 95 % CI: 3.13, 3.92), lack of knowledge about transmission and preventions methods (OR = 4.73; 95 % CI: 1.67, 7.80), knowing transmission and prevention methods (OR = 0.38; 0.13, 0.64), presence of breeding sites (OR = 3.40; 95 % CI: 1.35, 5.44), not using indoor chemical sprays (OR = 3.19; 1.76, 4.63).</div></div><div><h3>Conclusion</h3><div>To combat these outbreaks, a comprehensive approach is recommended, involving environmental management to eliminate mosquito breeding sites, public health education, and increasing access to preventive tools such as ITNs and indoor residual spraying. Addressing these determinants effectively can reduce malaria outbreaks, leading to a decrease in morbidity and mortality, and improve public health outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"33 ","pages":"Article 102045"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873701","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}