Journal of Global Health最新文献

{"title":"Factors affecting the collection of clinical data for quality improvement at a tertiary centre in Papua New Guinea: a qualitative study.","authors":"Samuel Ja Robinson, Francesca Failing, Waku Albert, Nane Buni, Duta Yema, Teba Anterea, Debra Nestel, Elizabeth McLeod, Maurizio Pacilli, Ramesh Mark Nataraja","doi":"10.7189/jogh.16.04125","DOIUrl":"https://doi.org/10.7189/jogh.16.04125","url":null,"abstract":"<p><strong>Background: </strong>The collection of clinical audit data are important for audit, research and other quality improvement processes. Low- and middle-income countries (LMICs) face a range of challenges to effective data collection and use. In this study, we explored factors affecting the collection of clinical data at a tertiary centre in Papua New Guinea.</p><p><strong>Methods: </strong>This qualitative study was based on semi-structured individual interviews with healthcare workers at a tertiary hospital in Papua New Guinea. Questions focused on participants' experiences and perspectives regarding the collection of clinical data. We transcribed the interviews and analysed them using reflexive thematic analysis. We collected demographics using a short survey. Reporting of the research was guided by COREQ.</p><p><strong>Results: </strong>We conducted 20 interviews with predominantly nursing staff (n/N = 15/20; 75%). Of the participants, 16/20 (80%) had previously collected data for an audit or research project. Five themes and eight subthemes were conceptualised. Themes related to organisational culture, staff workload, data documentation practices, research infrastructure and study procedures. Although participants were motivated to complete data collection, they faced significant challenges that hindered their ability to do so. While staff often had to choose between collecting data and providing patient care, data collection initiatives could also improve patient care by improving communication between healthcare workers.</p><p><strong>Conclusions: </strong>In this study, we revealed numerous factors which affect the success of clinical data collection for audit and research purposes. These factors may be considered in the design of future initiatives. This has significant implications given the public health importance of strengthening data collection in Papua New Guinea, the Pacific Islands and LMICs in other regions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04125"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Folate and global health review series, part 3: syntheses on cardiovascular, cerebrovascular, and metabolic diseases.","authors":"Samantha Yoo, Azita Montazeri, Derrick Bennett, Yacong Bo, Peizhan Chen, Susan Duthie, Natalie Jensen, Atipatsa Kaminga, Jun-Shi Lai, Xue Li, Amanda J MacFarlane, Homero Martinez, Helene McNulty, Franco Momoli, Ron Munger, Rajendra Prasad Parajuli, Monique Potvin Kent, Michele Rubini, Marjanne Senekal, Lindsey Sikora, Alain Stintzi, Evropi Theodoratou, Hui Wang, Ann Yaktine, Julian Little","doi":"10.7189/jogh.16.04160","DOIUrl":"https://doi.org/10.7189/jogh.16.04160","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular and metabolic diseases account for an increasing share of morbidity and mortality globally. Folic acid supplementation has been linked to a lowered risk of stroke and some metabolic indicators due to its involvement in homocysteine and one-carbon metabolism and its role in the production of nitric oxide; however, the evidence on these associations is inconclusive.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, CINAHL, the Cochrane Library, and the Database of Abstracts of Reviews of Effects from inception to February 2024 for systematic reviews and meta-analyses investigating the associations of folate (dietary intake, supplementation, or blood concentrations) with any cardiometabolic outcome. We performed screening, data abstraction, and risk of bias assessment in duplicate, and assessed the credibility of the evidence using predefined criteria.</p><p><strong>Results: </strong>We identified 113 unique associations from 49 reviews. The included syntheses mostly had low risk of bias of and provided pooled risk estimates from intervention trials or prospective cohorts. A larger volume of evidence was available for composite cardiovascular outcomes, coronary heart disease, and stroke compared to other outcomes. No association reached a convincing or highly suggestive level of credibility. Six directional associations and five null associations met the criteria for a suggestive level of credibility. Three dose-response relationships, all at suggestive levels of credibility, supported an association between higher dietary folate intake and a reduced risk of coronary heart disease and stroke.</p><p><strong>Conclusion: </strong>The available evidence on the association between folate status and cardiometabolic outcomes primarily focuses on secondary prevention of cardiometabolic diseases and substantially underrepresents low- and middle-income countries. More large-scale studies are warranted to validate a relationship between folate status and cardiometabolic events or indicators. Overall, the evidence landscape around folate and cardiometabolic diseases appears to be limited both in volume and scope.</p><p><strong>Registration: </strong>PROSPERO: CRD42021265041.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04160"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between the diabetes mellitus duration and the risk of pulmonary tuberculosis in the elderly: evidence from a community-based study in China.","authors":"Yijun He, Yan Qian, Henan Xin, Jiang Du, Xuefang Cao, Juanjuan Huang, Lingyu Shen, Yuanzhi Di, Yaqi Zhao, Zihan Li, Boxuan Feng, Jianguo Liang, Qi Jin, Ping Zhu, Lei Gao","doi":"10.7189/jogh.16.04039","DOIUrl":"https://doi.org/10.7189/jogh.16.04039","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is one of the risk factors for pulmonary tuberculosis (TB) development, and the dual burden of these diseases poses a significant public health challenge. However, the impact of DM duration on the risk of pulmonary TB, which is crucial for developing precise intervention strategies, has not been clarified.</p><p><strong>Methods: </strong>We conducted a retrospective study based on an active case-finding project on pulmonary TB in Quzhou City, Zhejiang Province, in 2022, to explore the association between DM duration and the risk of pulmonary TB among elderly individuals aged ≥65 years. We followed participants from the 2022 baseline screening until the date of pulmonary TB diagnosis, death, or 31 December 2024, whichever came first.</p><p><strong>Results: </strong>Among the 212 616 participants with a median age of 72 (interquartile range = 68-76) years, 724 cases with pulmonary TB were reported during the follow-up of 521 173.131 person-years, with an incidence of 138.917/100 000 person-years in 2022-2024. Participants with DM had a significantly higher risk of developing pulmonary TB compared with those without DM (adjusted sub-distribution hazard ratio (aSDHR) = 1.353; 95% confidence interval (CI) = 1.062-1.724). Notably, participants with a DM duration of 2-5 years had a significantly higher risk of pulmonary TB (aSDHR = 2.125; 95% CI = 1.481-3.047), with no other DM duration groups showing significant associations.</p><p><strong>Conclusions: </strong>We found DM to be a risk factor for the development of pulmonary TB, with a particularly pronounced effect in the subgroup with a disease duration of 2-5 years. Further research is needed to verify this association, elucidate its underlying pathophysiological mechanisms, and conduct targeted cost-benefit analyses to provide a basis for public health decision-making.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04039"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hobby engagement, disability transitions, and life expectancy: a multinational longitudinal study.","authors":"Qian Liu, Fan Yang","doi":"10.7189/jogh.16.04127","DOIUrl":"https://doi.org/10.7189/jogh.16.04127","url":null,"abstract":"<p><strong>Background: </strong>Hobby engagement has been identified as a potentially modifiable determinant of healthy ageing, associated with reduced mortality and better cognitive outcomes. However, its role in functional disability transitions and life expectancy across diverse cultural contexts remains insufficiently characterised. In this study, we aimed to examine associations between hobby engagement and functional disability transitions among middle-aged and older adults across Mexico, UK, China, USA, and Europe, and to further quantify the life expectancy implications of hobby engagement across diverse cultural contexts.</p><p><strong>Methods: </strong>We conducted a prospective cohort study using harmonised data from five major longitudinal ageing surveys, encompassing 127 650 participants aged >50 years from 24 countries. Hobby engagement was assessed as binary participation in activities such as volunteering, clubs, reading, or games. Functional disability states were defined as no disability, mild disability, severe disability, and death. Using continuous-time multi-state Markov models, we analysed transitions between states, with life expectancy difference measures calculated at five-year intervals from ages 50-90.</p><p><strong>Results: </strong>Hobby engagement prevalence varied substantially across regions (25.2-83.3%). Hobby participation was associated with a lower risk of transitioning from no disability to mild disability, a higher likelihood of recovery from severe disability to functional independence, and a lower mortality risk from severe disability across the four countries and Europe. These associations translated into differences in life expectancy. At the age of 50 years, functional life expectancy differences ranged from 4.73-5.17 years, and total life expectancy differences ranged from 2.46-4.64 years across the four countries and Europe, with associations between hobby engagement and life expectancy persisting through age 90 (except in China). Life expectancy differences varied by gender, chronic disease status, and geographic location in some countries.</p><p><strong>Conclusions: </strong>Hobby engagement is consistently associated with favourable functional disability transitions and longer life expectancy across diverse cultural contexts, with findings remaining stable in sensitivity analyses, supporting its consideration in healthy ageing strategies.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04127"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness and cost-effectiveness of cash plus interventions to prevent acute malnutrition in Somalia: evidence from an adaptive cluster randomised control trial.","authors":"Nadia Akseer, Kemish Kenneth Alier, Samantha Grounds, Sydney Garretson, Sagal Mohamud, Qundeel Khattak, Marina Tripaldi, Fabrizio Loddo, Said Aden Mohamoud, Adan Yusuf Mahdi, Mohamoud Ali Nur, Sadiq Mohamed Abdiqadir, Emily Mitchell, Andreas Kees, Mohamed Billow Mahat, Maimun Gure, Dahir Isaq Jibril, Dahir Gedi, Michael Ocircan P'Rajom, Meftuh Omer, Abdullahi Farah, Mohamed Abdirashid Osman, Abdiaziz Mohamed Adan, Farhan Mohamed Mohamoud, Abdullahi Muse Mohamoud, Abdifatah Ahmed Mohamed, Abdulkadir Ali Abdi, Adam Abdulkadir, Shelley Walton","doi":"10.7189/jogh.16.04111","DOIUrl":"https://doi.org/10.7189/jogh.16.04111","url":null,"abstract":"<p><strong>Background: </strong>Acute malnutrition affects millions of children aged <5 years, as well as pregnant and lactating women globally, especially in humanitarian settings. Although cash plus interventions - cash or food transfers combined with complementary components - are widely implemented, evidence remains limited on which combinations and durations are most effective at preventing acute malnutrition.</p><p><strong>Methods: </strong>We conducted a three-arm cluster-randomised trial within the 'Save the Children's Cash Plus for Nutrition' programme in Somalia. Monthly support was provided as cash alone (arm 1), cash plus social and behaviour change communication (arm 2), or cash plus an additional cash top-up (arm 3). Further, we randomised 33 villages across arms, targeting approximately 1500 households. Primary outcomes included the prevalence and incidence of acute malnutrition in children aged 6-59 months and in mothers, assessed at baseline, midline (three months), and endline (six months). We also conducted market monitoring, qualitative data collection, and analysis.</p><p><strong>Results: </strong>Child acute malnutrition prevalence was approximately 15.0% in each arm at baseline. After three months, prevalence declined by 2.0 percentage points in arm 1 to 13.0% (95% confidence interval (CI) = 10.3, 16.1), representing a relative reduction of 13.3%. In arm 2, prevalence declined by 5.9 percentage points to 9.1% (95% CI = 6.8, 11.8), a relative reduction of 39.3%. In contrast, prevalence in arm 3 remained essentially unchanged, increasing to 15.1% (95% CI = 12.1, 18.6). By endline, there was little change from midline in all arms. Maternal malnutrition improved most in arm 2, but differences were not statistically significant. All arms showed improvements in dietary diversity and food security, but only arm 2 achieved sustained nutrition gains. Household livelihood conditions appeared to improve overall, though monthly expenditures nearly doubled. Arm 2 was the most effective and cost-effective.</p><p><strong>Conclusions: </strong>Adding social and behaviour change communication to cash transfers significantly improved child nutrition compared to cash alone, highlighting that integrated approaches can enhance nutritional outcomes and at minimal additional cost in humanitarian settings.</p><p><strong>Registration: </strong>ClinicalTrials.gov: NCT06642012.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04111"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of an integrated versus stand-alone approach to post-validation surveillance for lymphatic filariasis in Niue: a micro-costing study, 2025.","authors":"Adam T Craig, Harriet Ls Lawford, Grizelda Mokoia, Patricia Tatui, Misiona Nicolas, Amanda Murphy, Tonia Marquardt, Son Hong Nghiem, Anderson E Stanciole, Colleen L Lau","doi":"10.7189/jogh.16.04157","DOIUrl":"https://doi.org/10.7189/jogh.16.04157","url":null,"abstract":"<p><strong>Background: </strong>Lymphatic filariasis (LF) is a mosquito-borne parasitic disease which, in cases of chronic infection, may result in lymphoedema, elephantiasis, and hydrocele, imposing significant physical, social, and economic burdens. Global initiatives have reduced the prevalence of this condition, with Niue, a self-governing Pacific Island country, being validated as having eliminated LF as a public-health problem in 2016. To ensure transmission does not re-emerge, the World Health Organization recommends post-validation surveillance. As an integrated approach where LF-PVS is embedded within existing health programmes may reduce financial and labour costs and hence improve feasibility for resource constrained settings, we compare the costs of integrated LF-PVS in Niue with the counterfactual of stand-alone LF-PVS.</p><p><strong>Methods: </strong>We itemised activities and resources and assigned unit costs using a bottom-up micro-costing approach, drawing data from project budgets, accounting records, and staff reports. For the stand-alone scenario, we base LF survey inputs and activities on a recently implemented LF-PVS in a comparable context. For the integrated scenario, we embedded LF-PVS activities within a national STEPwise survey for non-communicable disease risk factors, with two research staff and one Department of Health officer responsible for implementation. All costs are reported in USD 2025 prices.</p><p><strong>Results: </strong>Total provider costs under the integrated scenario were USD 59 488 compared with USD 105 414 for the stand-alone. The integrated cost per participant tested was USD 59 compared to USD 105 for the stand-alone approach, representing a 44% reduction. The required Department of Health staff time was half in the integrated scenario, resulting in savings of approximately four weeks full-time equivalent staff time.</p><p><strong>Conclusions: </strong>This analysis provides evidence that programmatic integration of LF-PVS reduces cost to donors and lessens burden on public health staff. Future LF-PVS in the Pacific and elsewhere should consider integrating with routine health surveys to maximise operational efficiency.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04157"},"PeriodicalIF":4.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between physical activity and cardiovascular-kidney-metabolic syndrome in older Chinese adults: a nationwide, cross-sectional study.","authors":"Qingmei Liu, Ji Shen, Yushan Zhang, Chi Zhang, Guoqing Fan, Lei Wang, Houguang Zhou, Jie Zhang, Hong Shi","doi":"10.7189/jogh.16.04149","DOIUrl":"10.7189/jogh.16.04149","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome represents a new framework to address the non-communicable disease burden in ageing populations. However, evidence on the association between physical activity and the integrated CKM syndrome is scarce, particularly among older Asian adults. We aimed to investigate this association in a large sample of older Chinese adults.</p><p><strong>Methods: </strong>This cross-sectional study utilised data from the China Ageing and Health Survey, including 41 829 community-dwelling adults aged ≥65 years. Physical activity was assessed using the validated Physical Activity Scale for the Elderly (PASE). Cardiovascular-kidney-metabolic syndrome was defined based on the 2023 American Heart Association criteria (Stages 1-4 vs. Stage 0). Multivariable logistic regression models were used to examine the association between PASE quartiles and CKM syndrome prevalence.</p><p><strong>Results: </strong>The prevalence of CKM syndrome was 80.3%. After full adjustment, a significant inverse dose-response relationship was observed between physical activity and CKM syndrome (P for trend <0.001). Participants in the highest physical activity quartile had 21% lower odds of CKM syndrome compared to the lowest quartile (adjusted odds ratio (aOR) = 0.79; 95% CI = 0.74-0.85). This inverse association was consistent across sexes but was strongly age-dependent: it was most pronounced among individuals aged ≥80 years (P for trend <0.001) and non-significant in the 65-69 age group (P for trend >0.05).</p><p><strong>Conclusions: </strong>Higher physical activity is independently associated with a lower prevalence of CKM syndrome in older Chinese adults. This inverse association was strikingly age-dependent and most pronounced in the oldest-old (aged ≥80 years). For aging populations globally, promoting accessible, age-appropriate physical activity may represent a high-priority, low-cost public health strategy to reduce CKM burden, particularly in this most vulnerable demographic.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04149"},"PeriodicalIF":4.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of frailty with the incidence and progression trajectory of cardiometabolic-kidney multimorbidity: insights from multi-state modelling.","authors":"Minghui Han, Jing Zhou, Wenxin Bai, Zhenzhen Wan, Meng Chen, Mengli Yan, Wei Feng, Ge Wang, Jing Zhang, Lina Zhang, Lei Yan, Fengmin Shao, Yue Gu","doi":"10.7189/jogh.16.04133","DOIUrl":"10.7189/jogh.16.04133","url":null,"abstract":"<p><strong>Background: </strong>The American Heart Association recently introduced the cardiovascular-kidney-metabolic concept, but the impacts of frailty status on the disease trajectories remain unknown. We aimed to investigate the role of frailty status in the trajectories from being free of cardiometabolic-kidney disease (CMKD) to first CMKD (FCMKD), then to cardiometabolic-kidney multimorbidity (CMKM), and finally to death.</p><p><strong>Methods: </strong>In this prospective cohort study, we included 392 902 participants aged 37-73 years from the UK Biobank. We assessed frailty using the Fried criteria's frailty phenotype, based on five individual components. We used multistate models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 392 902 participants, 53 845 developed FCMKD, 8025 developed CMKM, and 25 538 died during a median follow-up of 13.49 years. Frailty was associated with a higher risk of transition from healthy to FCMKD (HR = 2.08; 95% CI = 1.99-2.17) than from FCMKD to CMKM (HR = 1.47; 95% CI = 1.34-1.62) (P < 0.001). Frailty showed a stronger association for healthy to death than that of transitions from FCMKD or CMKM to death (HR = 2.52; 95% CI = 2.34-2.72, P < 0.001). When splitting FCMKD into four CMKDs, the risks of disease-specific transitions associated with frailty varied, with the higher risk for chronic kidney disease to CMKM observed than that for other CMKDs to CMKM (HR = 2.11; 95% CI = 1.66-2.68). Consistent associations were also observed for pre-frailty.</p><p><strong>Conclusions: </strong>Both frailty and pre-frailty played key but different roles in disease transitions from healthy to FCMKD, to CMKM, and further to death, and had diverse impacts on disease-specific transitions of CMKDs. Our findings underscore the significance of early detection and interventions for frailty to prompt the comprehensive care of CMKM.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04133"},"PeriodicalIF":4.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and cost-effectiveness of two interventions to prevent paediatric respiratory syncytial virus disease in Cameroon: a modelling approach.","authors":"Farina Leonie Shaaban, Norbert Fuhngwa, Henshaw Mandi, Andrew Clark, Neele Rave, Clint Pecenka, Louis J Bont, Frédéric Debellut","doi":"10.7189/jogh.16.04051","DOIUrl":"10.7189/jogh.16.04051","url":null,"abstract":"<p><strong>Background: </strong>Preventive interventions for respiratory syncytial virus (RSV) disease are emerging and have been approved for support by Gavi, the Vaccine Alliance. However, their cost-effectiveness is under-researched in low- and middle-income countries, where RSV burden remains the highest. We modelled the potential impact and cost-effectiveness of two interventions for the prevention of RSV in young children in Cameroon, a Gavi-eligible country with a gross domestic product (GDP) per capita of USD 1563 in 2022.</p><p><strong>Methods: </strong>We used a static proportionate outcomes model to estimate the health and economic burden of RSV with and without a single dose of long-acting infant monoclonal antibody (mAb, nirsevimab) or maternal vaccine (bivalent RSVpreF) administered year-round over the period 2025-2034. We gathered data from the scientific literature, Demographic and Health Surveys, World Health Organization/UNICEF country profiles, clinical trials, and local experts. We calculated RSV cases, clinic visits, hospital admissions, and deaths for each week of age from birth to five years. The primary outcome measure was the incremental cost per disability-adjusted life year (DALY) averted from a government perspective, compared to no intervention. We explored cost-effectiveness over a range of cost-effectiveness thresholds expressed as proportions of the country's GDP per capita. Due to uncertainty in price per dose and limited country-specific RSV burden data, we ran several deterministic scenarios and performed probabilistic sensitivity analyses.</p><p><strong>Results: </strong>Between 2025 and 2034, we estimated that at USD 5 per dose, the infant mAb (69% coverage, 77% efficacy, 5 months protection) and maternal vaccine (65% coverage, 69% efficacy, 6 months protection) have a notable impact, averting 2267 (27.3%) and 2226 (26.9%) RSV-related deaths among children under five years old, respectively. In this scenario, the incremental cost was similar for both interventions (USD 500 per DALY averted) when compared separately to no intervention, with >90% probability of being cost-effective at a 0.5 GDP per capita (USD 782) threshold. To be cost-effective in Cameroon, at a 0.1 GDP per capita threshold, both interventions must be priced below USD 2.50.</p><p><strong>Conclusions: </strong>Both the infant mAb and maternal vaccine have the potential to be impactful and cost-effective in Cameroon and could be affordable if priced appropriately, with support from Gavi.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04051"},"PeriodicalIF":4.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and types of lower limb conditions in Nepal.","authors":"Lucy Gates, Amos R Channon, Alex Dickinson, Basu D Pandey, Abhinav Vaidya, Binit Vaidya, Yeti Raj Niraula, Rabindra Baskotah, Shweta Nakarmi, Cheryl Metcalf, Kate Ward, Alan Silman, Anthony Woolf, Mahesh C Puri","doi":"10.7189/jogh.16.04098","DOIUrl":"10.7189/jogh.16.04098","url":null,"abstract":"<p><strong>Background: </strong>Lower limb conditions (LLCs) are a major cause of pain, disability, and loss of livelihood globally, yet their prevalence and functional impacts in low- and middle-income countries, including Nepal, remain poorly described.</p><p><strong>Methods: </strong>We conducted a cross-sectional, community-based survey in three Nepali districts representing plains, hills, and mountains. Of 2525 screened households, the first 500 adults with self-selected LLCs were interviewed using structured questionnaires adapted from validated tools (Global Alliance for Musculoskeletal Health, COPCORD, Washington Group, WHODAS 2.0). Descriptive statistics summarised condition type, pain location, activity limitations, employment impact, and comorbidities. χ² tests assessed regional differences in condition types.</p><p><strong>Results: </strong>Of 2525 households, 671 (26.6%, 95% CI = 24.9-28.3) reported a member with an LLC; 11.2% (95% CI = 10.5-12.0) of adults were affected. Among 500 participants surveyed (mean age 57 years; 65% female), pain/discomfort was most common (97%), mainly in the knee (74%) and foot/ankle (48%). Across participants, 628 LLCs were reported; conditions included injury/trauma (19%), deformity (7%), wounds (1%), and amputation (<1%). Prevalence varied by district. Functional limitations were substantial: 82% with pain and all with amputation reported severe activity restriction. Ten percent were unemployed, mostly due to health, and >70% of those doing household work had left other jobs because of their LLC.</p><p><strong>Conclusions: </strong>This study offers preliminary, population-based estimates of person-reported LLCs across three ecological zones in Nepal. Musculoskeletal pain was most common, often multi-site and substantially limiting daily activities and employment. While findings highlight the impact of LLCs on well-being and livelihoods, they remain exploratory due to limited geographic scope and self-reporting. Larger, nationally representative studies are needed to confirm these results, differentiate chronic from transient pain, and guide rehabilitation and prevention strategies.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04098"},"PeriodicalIF":4.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}