Journal of Global Health最新文献

{"title":"Exercise intervention improves fertility outcomes in females and males: an umbrella review of meta-analyses.","authors":"Lai Kwan Lam, Bekalu Kassie Alemu, Margie H Davenport, Chi Chiu Wang, Yiu Leung Chan, Yao Wang","doi":"10.7189/jogh-16-04282","DOIUrl":"10.7189/jogh-16-04282","url":null,"abstract":"<p><strong>Background: </strong>Infertility is a major global health burden, yet scalable lifestyle strategies to improve reproductive outcomes remain limited. Exercise is low cost and biologically plausible, but evidence on its association with fertility-related outcomes is dispersed across multiple meta-analyses. We therefore conducted an umbrella review of meta-analyses of randomised controlled trials evaluating exercise and fertility-related outcomes in females and males.</p><p><strong>Methods: </strong>Six databases (PubMed, Cochrane Library, Web of Science, Scopus, EBSCOhost, and Google Scholar) were searched from database inception to 24 November 2025. Eligible studies were systematic reviews with meta-analyses of randomised controlled trials. Overlap among reviews was managed using citation matrices. Methodological quality, risk of bias, and certainty of evidence were assessed using AMSTAR 2, ROBIS, and GRADE, respectively.</p><p><strong>Results: </strong>Thirteen meta-analyses were included, covering 24,470 females and 8068 males. In females, exercise showed positive effects in reproductive hormonal profiles, including sex hormone-binding globulin and anti-Müllerian hormone. It also associated with higher ovulation rate, pregnancy rate and clinical pregnancy rate. In males, exercise was linked to amelioration in sperm quality, regarding concentration, morphology, count, and semen volume. Moreover, exercise in male participants was accompanied by higher pregnancy rate in their female partners.</p><p><strong>Conclusions: </strong>Exercise is associated with improved fertility and reproductive health outcomes in both females and males, supporting its potential role as an adjunctive, low-cost, noninvasive component of fertility management. However, the certainty of evidence ranged from high to very low across outcomes, with most evidence rated as low or very low certainty. Heterogeneity across populations and exercise intervention components also limited confidence in these findings. Further high-quality trials are needed to clarify optimal exercise prescriptions and strengthen the certainty of evidence.</p><p><strong>Registration: </strong>PROSPERO: CRD42025638675.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04282"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841379","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":"Current burden, incidence trends, and future projections of pancreatic cancer in adults worldwide.","authors":"Haiyan Guo, Yong Ling, Enhui Zhang, Shaona Li, Qin Zhao","doi":"10.7189/jogh.16.04278","DOIUrl":"10.7189/jogh.16.04278","url":null,"abstract":"<p><strong>Background: </strong>Adult pancreatic cancer has a high mortality burden and poor survival. This study aimed to assess the current burden, geographic and socioeconomic differences, past incidence trends, and future burden.</p><p><strong>Methods: </strong>Publicly available data were obtained from the Global Cancer Observatory 2022 (GLOBOCAN 2022), Cancer Incidence in Five Continents Plus (CI5plus), the Global Burden of Disease study (GBD), Human Development Reports, the United Nations M49 classification, and World Population Prospects 2024. Adults aged 20 years and older were included. GLOBOCAN 2022 was used to estimate the disease burden in 2022. National Human Development Index values were correlated with age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR) using Spearman correlation analysis. CI5plus data from 2000 to 2017 were used to assess sex-specific incidence trends using estimated annual percentage change. GBD data and World Population Prospects 2024 were used to project future burden from 2024 to 2045 using a Bayesian age-period-cohort model.</p><p><strong>Results: </strong>In 2022, there were 510,529 new cases and 467,290 deaths from pancreatic cancer worldwide among adults. Eastern Asia recorded the largest numbers of new cases and deaths. Western Europe had the highest ASIR and ASMR, while South Central Asia had the lowest. Countries with a very high Human Development Index (HDI) had the greatest burden, whereas those with a low HDI had the lowest. Adults aged 60-74 years accounted for the largest numbers of new cases and deaths. National Human Development Index was associated with ASIR and ASMR. Incidence trends from 2000 to 2017 varied across cancer registries and by sex. Projections showed increasing new cases and deaths from 2024 to 2045.</p><p><strong>Conclusions: </strong>Adult pancreatic cancer remains a major global health burden. The burden is projected to continue increasing. These findings may be useful for adult pancreatic cancer prevention in different regions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04278"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841064","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":"Performance of automated respiratory rate counters for respiratory rate assessment to support pneumonia detection among children under five years of age in low- and middle-income settings: a systematic review of qualitative and quantitative evidence.","authors":"Sifat Binte Ibrahim, Kazi Sazzadul Haque, M Z E M Naser Uddin Ahmed, Md Jasim Uddin, Salahuddin Ahmed, Saima Sultana, Ahad Mahmud Khan","doi":"10.7189/jogh.16.04281","DOIUrl":"https://doi.org/10.7189/jogh.16.04281","url":null,"abstract":"<p><strong>Background: </strong>Accurate respiratory rate (RR) assessment is essential for pneumonia identification under World Health Organization Integrated Management of Childhood Illness (IMCI) guidelines; however, manual RR counting is often inaccurate and difficult in routine care. Automated RR counters have been developed to address these challenges, but evidence on their diagnostic performance and implementation in low- and middle-income countries (LMICs) remains limited. This systematic review evaluated the accuracy, usability, acceptability and time efficiency of automated RR counters for RR assessment to support identifying pneumonia in children aged 0-59 months in LMICs.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, Web of Science, and Scopus for studies published between 1 January 2014 and 15 July 2025. Studies conducted in LMICs assessing automated RR counters in children aged 0-59 months were eligible, including quantitative, qualitative, and mixed-methods designs. Study quality was assessed using the Joanna Briggs Institute appraisal tools. Quantitative findings were synthesised narratively, and qualitative findings were analysed thematically.</p><p><strong>Results: </strong>Fourteen studies from seven LMICs were included. Two automated RR counters - Masimo Rad-G and ChARM - were evaluated. Masimo Rad-G showed variable performance across studies (sensitivity = 75.9%-95.4%; specificity = 93.8%-98.3%; kappa = 0.55-0.85, n = 3), while ChARM demonstrated high diagnostic performance (sensitivity = 95.8%; specificity = 93.5%; kappa = 0.74-0.86, n = 2). Usability studies reported generally positive user experiences, though performance was affected by child movement, adherence to measurement procedures, and device design. Health workers and caregivers perceived automated tools as more reliable than manual counting, with visual indicators improving confidence in clinical decisions. Reported challenges included battery life, maintenance, workflow disruption, and the need for continuous training and supervision.</p><p><strong>Conclusions: </strong>Although the available evidence remains limited, automated RR counters show promise for RR assessment in LMIC settings to support pneumonia identification. Future studies are needed to confirm their effectiveness and implementation feasibility across diverse routine-care settings. Successful adoption is likely to depend on adequate training, device optimisation, and integration into existing health-system workflows.</p><p><strong>Registration: </strong>PROSPERO: CRD420251080564.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04281"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800008","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":"Comparative neuroprotective effects of antidiabetic medications on Parkinson's disease risk: a Bayesian network meta-analysis.","authors":"Soo Hyeon Lee, Yujin Rho, Sangyoon Lee, Sooyoung Shin, Yeo Jin Choi","doi":"10.7189/jogh.16.04187","DOIUrl":"https://doi.org/10.7189/jogh.16.04187","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is recognised as a risk factor for Parkinson's disease (PD); however, comparative evidence regarding PD risk across antidiabetic drug classes remains limited and inconsistent. We aimed to compare the risk of PD across different antidiabetic classes, with stratified analyses by age, sex, and cardiovascular disease (CVD) status.</p><p><strong>Methods: </strong>We searched the Cochrane Library, Embase, and PubMed until August 2025 for studies assessing the association between antidiabetic drugs and PD incidence. We performed a Bayesian network meta-analysis, estimating effect sizes as risk ratios with 95% credible intervals. We performed prespecified subgroup analyses according to age, sex, and CVD status.</p><p><strong>Results: </strong>We included nine observational cohort studies, totalling 712 287 patients. No antidiabetic class demonstrated a statistically significant difference in PD risk. Rank probability analyses suggested that sodium-glucose co-transporter-2 inhibitors (SGLT2i) tended to rank lowest in PD risk among older adults (≥75 years), while glucagon-like peptide-1 receptor agonist (GLP-1RA) ranked lowest in patients aged <75 years. In patients with CVD, metformin showed relatively higher-ranking probabilities for PD risk compared with SGLT2i. In contrast, metformin, sulfonylureas, and α-glucosidase inhibitors were consistently associated with higher ranking probabilities for PD risk compared to newer agents.</p><p><strong>Conclusions: </strong>Our analysis suggests that antidiabetic drugs may exert effects beyond glycaemic control and could influence neurodegenerative risk. Furthermore, SGLT2i and GLP-1RA were consistently associated with lower PD risk, suggesting potential neuroprotective effects. While our results indicate the potential importance of antidiabetic drug selection in patients at risk for neurodegenerative diseases, further large-scale, controlled studies should validate these associations and clarify potential mechanisms.</p><p><strong>Registration: </strong>PROSPERO: CRD420251130232.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04187"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799705","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":"Has the decline ended? A concerning shift in infant mortality trends in Europe: an urgent analysis.","authors":"Adolfo Romero-Arana, Elena Arroyo-Bello, Paloma Rodríguez-Gómez, José Abad-Valle, Elena Carrión Navarro, Belén González-Tejerina, Estela Álvarez-Gómez, Juan Gómez Salgado","doi":"10.7189/jogh.16.04247","DOIUrl":"https://doi.org/10.7189/jogh.16.04247","url":null,"abstract":"<p><strong>Background: </strong>Recent years have shown an unexpected increase in infant mortality in Spain, raising concerns about maternal, socioeconomic, and healthcare factors.</p><p><strong>Methods: </strong>We performed a retrospective analysis of national and European infant mortality data from 2009 to 2024. Joinpoint regression was used to detect trend changes. Socioeconomic, maternal age, and healthcare access factors were analysed to identify potential contributing elements.</p><p><strong>Results: </strong>The analysis identified a significant upward trend in infant mortality from 2019 onwards. Delayed maternal age, socioeconomic disparities, and reduced healthcare system satisfaction appear associated with this increase. Cross-country comparison indicates that these trends are not unique to Spain.</p><p><strong>Conclusions: </strong>The rise in infant mortality in Spain and Europe may have multifactorial causes, including delayed motherhood, post-pandemic healthcare strain, and socioeconomic inequities. Public health policies should urgently address these factors to prevent further increases.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04247"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799953","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":"Leveraging the private sector for health system development in sub-Saharan Africa.","authors":"Faraan O Rahim, Johara Ahmed, Abigail Bekele, Blen Yohannes, Nam T Nguyen, Elshaday Million, Ellen Mkondya-Senkoro, Bernice Brempong, Sangu Delle, Lia Tadesse Gebremedhin","doi":"10.7189/jogh.16.03021","DOIUrl":"https://doi.org/10.7189/jogh.16.03021","url":null,"abstract":"<p><p>Development assistance has historically supported major gains in health and health-system development in sub-Saharan Africa, but recent reductions in development assistance have intensified financing and service-delivery pressures across the region. As governments seek more durable and domestically sustained strategies, the private health sector may play a larger role in expanding financing, specialised care, innovation, workforce retention, and public-private partnerships. However, private sector expansion alone is not sufficient and may worsen inequities if it remains disconnected from national financing frameworks, accreditation systems, quality standards, and public accountability. Here, we argue that private providers should be incorporated into well-regulated mixed health systems that align commercial incentives with universal health coverage, equity, and public health goals. Experiences from Ghana and Kenya have shown that integration depends on timely reimbursement, efficient accreditation, and deliberate efforts to reach underserved populations. Private-sector engagement should therefore complement, not substitute for, strong public health systems.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03021"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799996","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 smoking and second-hand smoke exposure with obesity and obstructive sleep apnoea risk in Tuvalu.","authors":"Chia-Chen Lin, Po-Jen Lin, Yu-Tien Hsu, Chia-Rui Chang, Chih-Wei Shih, Chin-Chien Kuo, Shi-Chian Shiau, Yuan-Hung Lo, Natano Elisala, Julie Elisala, Fineaso Tehulu, José Francisco López-Gil, Wen-Yi Lee, Maria Soledad Hershey, Shan-Han Chang, Jack Yu-Shuo Lu, Chien-Te Pan, Chih-Fu Wei","doi":"10.7189/jogh.16.04250","DOIUrl":"https://doi.org/10.7189/jogh.16.04250","url":null,"abstract":"<p><strong>Background: </strong>Tobacco use and second-hand smoke (SHS) exposure remain highly prevalent in Pacific Island nations, but evidence on their health consequences is limited. We aim to describe the prevalence of smoking and SHS exposure in Tuvalu, their associations with body measurements and sleep-related outcomes, and the heterogeneity by island of residence and age group.</p><p><strong>Methods: </strong>COMmunity-based Behaviour and Attitude surveys were conducted in Tuvalu between 2020 and 2025 among 4,066 participants from Funafuti and outer islands. Smoking status was assessed in all survey years, and SHS exposure was assessed in 2022, 2023, and 2025. Body composition (body mass index (BMI), waist and neck circumference) and obstructive sleep apnoea (OSA)-related outcomes in STOP-Bang scores were measured. We assessed the associations with multivariable linear and logistic regression, with stratified analyses by age group and island of residence.</p><p><strong>Results: </strong>Overall, 26.1% of participants were people who currently smoke and 60.7% reported SHS exposure. The mean BMI was 32.1 kg/m², and 23.7% of participants had a STOP-Bang score ≥3. Current smoking (odds ratio (OR) = 1.80; 95% confidence interval (CI) = 1.30, 2.48) and SHS exposure (OR = 2.15; 95% CI = 1.54, 3.02) were associated with obesity, higher STOP-Bang scores and increased odds of STOP-Bang ≥3, which varied by island of residence.</p><p><strong>Conclusions: </strong>In Tuvalu, both active smoking and SHS exposure were associated with obesity and OSA-related outcomes, with variation by island of residence. These findings indicate the importance of strengthening the implementation and enforcement of comprehensive tobacco control for sleep health and non-communicable disease prevention in Pacific Island populations.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04250"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800120","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":"Posture management for neck pain: identification and quantification of associated factors based on a multicentre cross-sectional study in China.","authors":"Guangqi Lu, Hanze Mao, Xinran Chen, Xinyue Sun, Yakun Liu, Mingming Ma, Jing Li, Shuaiqi Zhou, Jiaming Hu, Guoliang Ma, Zhizhuang Wang, Xin Xiu, Minghui Zhuang, Bin Tang, Liguo Zhu, Jie Yu","doi":"10.7189/jogh.16.04240","DOIUrl":"10.7189/jogh.16.04240","url":null,"abstract":"<p><strong>Background: </strong>Neck pain (NP) is a leading musculoskeletal disorder globally. Posture management is crucial for its prevention; however, population-level evidence quantifying the associated factors in real-world settings remains limited. We aimed to identify and quantify threshold effects of key factors related to posture management associated with NP among Chinese adults.</p><p><strong>Methods: </strong>We conducted a multicentre, cross-sectional study across six Chinese cities. We collected data via face-to-face interviews using a questionnaire covering demographics, occupational factors, electronic device use, sleep, transportation, and exercise. Multivariable logistic regression identified factors associated with NP. We used restricted cubic splines to model nonlinear relationships, and applied the Akaike information criterion to determine dichotomisation cutoffs for continuous variables. Propensity score matching assessed the robustness of these associations, and subgroup analyses by sex and age assessed heterogeneity.</p><p><strong>Results: </strong>We included a total of 6,969 adults (≥18 years), comprising 2,662 (38.2%) with NP and 4,307 (61.8%) without. Identified associated factors included: computer use time for work ≥2 hours/day (odds ratio (OR) = 1.39; 95% confidence interval (CI) = 1.16-1.67, P < 0.001), smartphone use time for work ≥3 hours/day (OR = 1.21; 95% CI = 1.03-1.42, P = 0.022), smartphone screen height below horizontal eye level (OR = 1.16; 95% CI = 1.00-1.34, P = 0.043), and firm mattress (OR = 1.19; 95% CI = 1.04-1.37, P = 0.012) were associated with increased odds of NP. Sleeping time ≥7 hours/day (OR = 0.79; 95% CI = 0.69-0.89, P < 0.001), supine sleeping (OR = 0.87; 95% CI = 0.76-0.99, P = 0.039) and walking as the primary mode of transportation (OR = 0.80, 95% CI = 0.70-0.91, P < 0.001) were associated with decreased odds of NP.</p><p><strong>Conclusions: </strong>This study identified and quantified threshold effects of key factors associated with NP among Chinese adults, including electronic device use, sleep habits, and commuting patterns. These quantified thresholds offer actionable benchmarks for posture management of NP in clinical practice and public health interventions.</p><p><strong>Registration: </strong>Chinese Clinical Trial Registry: ChiCTR2400093567.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04240"},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799964","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":"Containing outbreaks at their source: an illustrative example of partial economic returns to US global health security funding.","authors":"Deliana Kostova, Jill Kuhn, Muhammad Jami Husain, Sarah Pallas, Walter Ochieng, Benjamin Park","doi":"10.7189/jogh.16.03023","DOIUrl":"https://doi.org/10.7189/jogh.16.03023","url":null,"abstract":"<p><p>Following the 2014-2016 West Africa Ebola epidemic, the US expanded funding for global health security (GHS) to strengthen outbreak prevention, detection, and response capacity across countries. In this viewpoint, we offer an illustrative comparison between one narrow category of economic benefit to the US - avoided losses in merchandise exports - and US GHS funding directed to the region between 2016 and 2023. Using a transparent accounting identity, we compared US export losses plausibly averted through the local containment of ten Ebola outbreaks during this period against estimated regional GHS appropriations of USD 2.52 billion, applying the 2014 losses as a benchmark and a range of scenarios to reflect uncertainty in the scale of disruption averted. Under the benchmark scenario, each USD of funding corresponded to approximately USD 4.64 in avoided export-related losses. This scoping exercise is intended to convey the order of magnitude of potential returns, rather than a measured economic return or causal attribution, and it deliberately excludes broader benefits. Even through this narrow trade-based lens, the findings suggest that the economic value of containing outbreaks abroad may be large enough to warrant consideration in U.S. budget discussions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03023"},"PeriodicalIF":5.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799878","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":"Folate and global health: part 5. syntheses on neuropsychiatric disorders.","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, Peter Mossey, 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.16.04286","DOIUrl":"10.7189/jogh.16.04286","url":null,"abstract":"<p><strong>Background: </strong>The global burden of neuropsychiatric disorders has been increasing rapidly. Folate has been studied in the context of these disorders due to its role in cellular methylation capacity, which is crucial for normal neuronal gene expression and neurotransmitter syntheses. Epidemiological evidence linking folate and neuropsychiatric disorders is growing, yet 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 between folate exposure and any neuropsychiatric disorders. Two independent reviewers screened the syntheses in two stages and extracted relevant data. Evidence was categorised into unique associations (unique exposure measure - unique outcome - unique setting). We identified evidence for each category of unique associations. We evaluated the risk of bias of all included syntheses using ROBIS and assessed the credibility of evidence using predefined criteria.</p><p><strong>Results: </strong>From a total of 76 syntheses, we identified 44 unique associations from meta-analyses and 18 unique associations from qualitative syntheses across 14 outcome categories. Most of the reviews consisted of case-control studies or cross-sectional studies, and most were at high risk of bias. We identified two associations at a suggestive level of credibility: folic acid supplementation during or before pregnancy was associated with a reduced risk of perinatal depression, while prenatal maternal folic acid use was associated with a reduced risk of autism spectrum disorder in offspring. Seven associations were downgraded to weak due to unavailable data. Other associations were at a weak level of credibility due to insufficient statistical power.</p><p><strong>Conclusions: </strong>The available evidence on the relationship between folate status and neuropsychiatric disorders primarily comprised data from observational studies, limiting causal inference on folate exposure and the risk of onset or progression of neuropsychiatric disorders. Prospective studies and sex-stratified analyses could add to the evolving knowledge on this topic.</p><p><strong>Registration: </strong>PROSPERO: CRD42021265041.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04286"},"PeriodicalIF":5.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799902","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}