Journal of Global Health最新文献

{"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}

{"title":"Community engagement strategies for preventing recurrent Nipah virus outbreaks in Bangladesh and India: adapting a framework for outbreak preparedness and response.","authors":"Shuma Banik, Md Zakiul Hassan, Bipin Adhikari","doi":"10.7189/jogh.16.03024","DOIUrl":"https://doi.org/10.7189/jogh.16.03024","url":null,"abstract":"<p><p>The Nipah virus (NiV) infection is a highly fatal zoonotic disease with pandemic potential which has led to recurrent outbreaks in Bangladesh and India. While transmission pathways, including contaminated date palm sap and human-to-human spread, are increasingly identified, significant uncertainties remain. With no approved therapeutics or vaccines, prevention depends on addressing ecological and behavioural drivers of transmission. This viewpoint draws on selected evidence from NiV outbreaks and response to other zoonotic disease epidemics, such as Ebola, rabies, and the Marburg virus disease, we seek to foster discussion on why community engagement could be central to NiV prevention and preparedness. We highlight the relevance of community engagement through a spectrum of its intensity, which distinguishes between community-oriented, community-based, community-managed, and community-owned approaches. Adapting an existing model, we discuss how community engagement principles can be applied to tackle recurring NiV outbreaks in Bangladesh and India. By aligning interventions with sociocultural realities, community engagement can improve acceptability, enhance early detection, strengthen outbreak response, and support preparedness for future vaccine and therapeutic research. However, evidence specific to NiV remains limited and lessons from other diseases should be applied judiciously. In the absence of medical countermeasures, participatory, locally grounded approaches offer a sustainable pathway to reduce recurrent outbreaks and prevent future spillover events.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03024"},"PeriodicalIF":5.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800089","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":"Mapping the landscape of congenital anomaly registries worldwide: what role do health and economic factors play?","authors":"Martina Schatz, Felicity Vidya Mehendale","doi":"10.7189/jogh.16.04263","DOIUrl":"https://doi.org/10.7189/jogh.16.04263","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies (CAs) are structural or functional changes occurring during intrauterine life. The World Health Organization data indicate that about 295,000 babies die within the first four weeks of birth due to CAs every year. It has been estimated that approximately 94% of severe CAs occur in low- and middle-income and low-income countries. While the use of a national congenital anomaly registry (CAR) can help improve healthcare quality, access, and planning for families and children born with CAs, few countries report using such a system. We aimed to evaluate the correlation of health and economic indicators with the existence of national CARs.</p><p><strong>Methods: </strong>We compiled data on individual countries' reported CAR status from regional networks, the International Clearinghouse for Birth Defects Surveillance and Research, the Modell database, and a literature search. We classified countries according to the reported CAR status into those that reported having a national CAR with or without regional CAR, only a regional CAR, and no CAR data available. Using the Kruskal-Wallis test, we analysed whether a country's CAR status was correlated with health and economic data from UNICEF and the World Bank.</p><p><strong>Results: </strong>Of the 202 countries in our sample, 30 reported having a national CAR, 19 only a regional CAR, and 153 no CAR. Country income group-level analysis showed that 35.4% of high-income, 13.2% of upper middle-income, and 0% of low- and middle-income, and 0% low-income countries were reported to have national CARs. Countries lacking a national CAR tended to have a lower gross domestic product (P < 0.001), increased infant mortality rates (P < 0.001), and lower birth registration rates (P < 0.001).</p><p><strong>Conclusions: </strong>While the importance of CARs for improving global health is widely recognised, most LMICs and LICs still do not report having a national CAR. Our study suggests that countries without CARs face greater economic and health systems challenges. Collaborations to develop national CARs need to consider the impact of these wider economic and health systems challenges.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04263"},"PeriodicalIF":5.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799937","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":"DNA methylation informs adult cardiovascular risk and prevention for low birthweight individuals.","authors":"John Yen Tang, Nicole Ying Ting Ng, Alice Wing Sze Kwok, Christopher Chun Yu Mak, Yiu-Fai Cheung, Brian Hon Yin Chung","doi":"10.7189/jogh.16.04242","DOIUrl":"https://doi.org/10.7189/jogh.16.04242","url":null,"abstract":"<p><strong>Background: </strong>Barker's hypothesis posits that adverse in utero exposures, often reflected by low birthweight, increase adult cardiovascular disease (CVD) risk. However, underlying mechanisms remain unclear; identifying potentially causal mediators is crucial for developing effective interventions. Emerging research suggests epigenetic modifications may influence CVD traits from early life. We aimed to identify DNA methylation (DNAm) signatures that mediate birthweight and CVD traits and to establish their biological relevance across three developmental time points using multi-omics integration.</p><p><strong>Methods: </strong>We identified DNAm mediators using epigenetic Mendelian randomisation (MR). The exposures were 261 birthweight-associated CpG sites (BW-CpGs) from epigenome-wide association studies, instrumented by cis-methylation quantitative trait loci (cis-mQTLs) in European-ancestry participants from the Accessible Resource for Integrative Epigenomic Studies measured at three developmental time points: birth (mean gestational age = 40 weeks), childhood (mean age = 7.49 years), and adolescence (mean age = 17.14 years). The outcomes included adult cardiovascular events and lipid traits from genome-wide association studies (n = 98,048-547,261). Sensitivity analyses included colocalisation, Steiger's test, Cochran's Q, and pleiotropy-robust methods. We interrogated DNAm persisting across development using omics datasets.</p><p><strong>Results: </strong>Using cis-mQTLs measured at birth, we found 230 associations between 216 BW-CpGs and CVD traits, including coronary artery disease, hypertension, stroke, cholesterol, and triglycerides (false discovery rate-corrected P < 0.05), with effect size directions consistent with Barker's hypothesis. A total of 42 associations were robust following sensitivity analyses. Persistent DNAm changes across development were observed at ASGR1 and KDM2B. Multi-omics interrogation prioritised a promising therapeutic candidate (ASGR1).</p><p><strong>Conclusions: </strong>Although Barker's hypothesis is well-established, this is the first study to explore its causal pathway using a rigorous, multi-time-point epigenetic MR framework with multi-omic integration. This represents a major advancement over previous observational and DNAm studies. The Barker-consistent hypothesis-free discovery approach identified novel and known candidate genes that, with future validation, may serve as therapeutic targets, identify high-risk individuals, and support clinical trial recruitment.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04242"},"PeriodicalIF":5.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763438","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":"The association between personal hygiene and mental health, and the modifying roles of the universal health coverage index in children and adolescents: a comparative analysis from multiple countries.","authors":"Yuwei Zhang, Hongzhi Zhou, Yi Liang, Xuanyu Shi, Zhi Li, Wenjie Wang, Xueling Wang","doi":"10.7189/jogh.16.04184","DOIUrl":"https://doi.org/10.7189/jogh.16.04184","url":null,"abstract":"<p><strong>Background: </strong>Personal hygiene and mental health are both core determinants of adolescent well-being, yet their interplay and the modifying role of national health system coverage remain largely unexplored in cross-national populations. Therefore, we aimed to investigate associations between personal hygiene behaviours and mental health outcomes in adolescents and the modifying factors of the universal health coverage (UHC) index across multiple countries.</p><p><strong>Methods: </strong>We analysed data on 153,413 adolescents aged 12-17 from 51 countries collected through the Global School-based Student Health Survey between 2013 and 2019. Self-reported hygiene behaviours included toothbrushing and handwashing, and mental health outcomes included suicide ideation, bullying, being lonely, worry-related sleep disorders, and having no close friends. We examined associations using binary logistic regression models, stratified by sex and UHC index groups.</p><p><strong>Results: </strong>We found that all four hygiene behaviours were generally associated with improved mental health outcomes in boys and girls (P < 0.001). For boys, differences between UHC groups in hygiene scores were associated with mental health outcomes, particularly with suicide ideation (lower UHC: odds ratio (OR) = 0.88; 95% confidence interval (CI) = 0.85-0.91; higher UHC: OR = 0.82; 95% CI = 0.79-0.85), bullying (lower UHC: OR = 0.84; 95% CI = 0.82-0.86; higher UHC: OR = 0.78; 95% CI = 0.76-0.80), being lonely (lower UHC: OR = 0.91; 95% CI = 0.89-0.93; higher UHC: OR = 0.88; 95% CI = 0.86-0.90), and having no close friends (lower UHC: OR = 0.82; 95% CI = 0.79-0.85; higher UHC: OR = 0.77; 95% CI = 0.74-0.80). For girls, higher hygiene scores were only associated with lower odds of being lonely in UHC groups, with a significant difference between groups (lower UHC: OR = 0.88; 95% CI = 0.86-0.90; higher UHC: OR = 0.81; 95% CI = 0.79-0.83, P-value for difference ≤0.001).</p><p><strong>Conclusions: </strong>Our analysis indicates that individual hygiene practices are associated with reduced risks of adverse mental health outcomes in adolescents. The UHC index seems to play a modifying role in this context, with amplified associations in higher UHC coverage countries, particularly for boys.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04184"},"PeriodicalIF":5.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762412","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":"Orofacial cleft research and the Sustainable Development Goals: a bibliometric study.","authors":"Anna Chiara Corriero, Felicity Vidya Mehendale","doi":"10.7189/jogh.16.04264","DOIUrl":"https://doi.org/10.7189/jogh.16.04264","url":null,"abstract":"<p><strong>Background: </strong>Orofacial clefts (OFC) are common congenital conditions occurring in 1 of 700 births. They have lifelong nutritional, educational, and psychosocial impacts, and require multidisciplinary care from the antenatal period into adulthood. In 2010, the World Health Organization resolved to strengthen responses to congenital conditions, aligning with the United Nations Sustainable Development Goals (SDGs) 2030 targets. In this bibliometric mapping exercise based on inferred SDG themes from metadata, we evaluate the extent to which OFC research mentions these SDGs, examining differences across country income groups.</p><p><strong>Methods: </strong>We conducted a keyword search and content analysis of OFC articles published between 1842 and 2024 using a Python script developed by Elsevier. The script inferred SDG themes directly from titles, abstracts, and keywords. We analysed SDG mentions, thematic relevance, and the World Bank income classifications of publishing institutions, and used Spearman's rank correlation to calculate the statistical significance of the correlation between SDG mentions and the income group of the country of the authors.</p><p><strong>Results: </strong>Of 39,176 publications, 5,598 (14.0%) referenced at least one SDG, yielding 6,096 unique mentions. Additionally, 4,896 (87.5%) of SDG-related OFC papers were successfully linked to an author country income group. SDG 3 ('good health) was most cited (n = 4,255 references, 69.8%). Its frequency decreased significantly as country group GDP decreased. SDG 17 ('partnerships') became increasingly frequent as country income decreased, suggesting the fundamental role of partnerships in low-income countries. SDG 4 ('education') was mentioned more frequently in higher-income countries, but less in lower-income ones. Lastly, nutrition was mentioned more frequently in lower-income countries than higher-income ones, reflecting varying patient needs.</p><p><strong>Conclusions: </strong>This is the first bibliometric mapping study of SDGs in OFC care. The frequency of mentions of different SDGs varied by country income groups, suggesting different priorities and challenges to consider across global OFC research as we seek to achieve the SDGs by 2030.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04264"},"PeriodicalIF":5.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762963","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}