Journal of Global Health最新文献

{"title":"Moderate full-fat and low-fat yoghurt consumption correlates with reduced mortality risk: a large-scale prospective analysis.","authors":"Zhengjun Lin, Min Zeng, Zijian Sui, Yanlin Wu, Xianzhe Tang, Tang Liu","doi":"10.7189/jogh.15.04014","DOIUrl":"https://doi.org/10.7189/jogh.15.04014","url":null,"abstract":"<p><strong>Background: </strong>Yoghurt is a commonly consumed fermented food recommended by many guidelines. Yoghurt consumption can contribute to the intake of multiple nutrients and reduce the risk of several diseases. However, prospective evidence is limited on the associations between full/low-fat yoghurt consumption and mortality risk. In this prospective cohort study, we aimed to assess the dose-dependent associations between full/low-fat yoghurt intake and all-cause or cause-specific mortality.</p><p><strong>Methods: </strong>We enrolled 186 168 participants from the UK Biobank who had joined the study between 2006 and 2010 and were followed up until 2022. We obtained data on self-reported intake of full/low-fat yoghurt and mortality from all causes and specific causes of death, including cancers and cardiovascular diseases (CVDs). We then used Cox proportional hazard models to calculate the hazard ratio (HR) and 95% confidence interval (CI) to evaluate the associations between full-fat and low-fat yoghurt intake and mortality. Lastly, we conducted subgroup and sensitivity analyses to examine the robustness of our findings.</p><p><strong>Results: </strong>A total of 9402 deaths occurred during a mean follow-up of 13.4 years, including 1687 CVD-related and 5073 cancer-related deaths. Relative to non-consumers, the HRs (95% CIs) for all-cause mortality risk in participants consuming >0-50, 50-100, and >100 g of full-fat yoghurt a day were 0.82 (95% CI = 0.72, 0.93), 0.97 (95% CI = 0.86, 1.09), and 0.96 (95% CI = 0.84, 1.1) respectively. The corresponding HR estimates relative to non-consumers for participants consuming low-fat yoghurt were 0.88 (95% CI  = 0.81, 0.95), 0.91 (95% CI = 0.85, 0.98), and 0.95 (95% CI = 0.89, 1.01), respectively. Subgroup analysis indicated women who had moderate consumption of full-fat yoghurt had lower all-cause mortality risk, while men consuming low-fat yoghurt had lower all-cause mortality risk.</p><p><strong>Conclusions: </strong>Moderate consumption of full-fat and low-fat yoghurt was correlated with decreased all-cause mortality. Future cohort studies are warranted to verify the potential of adopting yoghurt consumption as part of a healthy diet to reduce mortality.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04014"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014618","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":"Geographic variations, temporal trends, and equity in healthcare resource allocation in China, 2010-21.","authors":"Shaohua Yin, Zhenlin Liu, Sujuan Yu, Ying Li, Ji An, Dong Wang, Hongjia Yan, Ying Xiao, Feng Xu, Yun Tian, Xiaoxiao Luan","doi":"10.7189/jogh.15.04008","DOIUrl":"10.7189/jogh.15.04008","url":null,"abstract":"<p><strong>Background: </strong>Inequity in healthcare resources has been identified as a global public health priority, yet the geographic variations and temporal trends in distribution and inequity in China remain unclear. We aimed to investigate these variations and temporal trends in healthcare resources and evaluate inequity in healthcare resource allocation in China.</p><p><strong>Methods: </strong>In this nationwide descriptive study, we used provincial-level data on healthcare infrastructure, human, and service resources from 31 provinces of mainland China, publicly released by the National Health Commission of China between 2010-21. We assessed the spatial autocorrelation of healthcare infrastructure, human, and service resources using Moran's I index, and identified spatial clusters of resource allocation. We evaluated the equity in healthcare resource allocation using the Lorenz curve, Gini coefficient, and Theil index by population and geographic dimensions.</p><p><strong>Results: </strong>Between 2010-21, the density of healthcare infrastructure and human resources in China increased, with the average stay decreasing from 10.5 to 9.2 days. There were substantial regional disparities, with higher resource density exhibited in eastern regions compared to western regions. Spatial autocorrelation was more pronounced for the density of practising (assistant) physicians (Moran's I = 0.465; P < 0.001), practising physicians (Moran's I = 0.351; P < 0.001), and bed occupancy rate (Moran's I = 0.256; P < 0.001), with significant geographic clusters of resource allocation. Lorenz curves showed that healthcare resource allocation was closer to the absolute equity by population but not geographic dimension, with Gini coefficients indicating severe inequity (>0.6) by geographic dimension compared to perfect equity (<0.2) by population dimension. Intraregional Theil index by population was higher than the inter-regional index, with contribution rates exceeding 60%.</p><p><strong>Conclusions: </strong>Per capita access to healthcare resources in China has improved, but significant geographic variations and clustering exist, particularly with higher resource density in eastern regions. While resource allocation by population showed better equity than by geographic area, substantial intra-regional disparities highlight the need for targeted strategies to enhance equitable distribution, particularly in the western regions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04008"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014607","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 trends in household food insecurity, dietary diversity, and stunting among children under five in Asia: a systematic review.","authors":"Binish Islam, Tasiu Ibrahim Ibrahim, Tingting Wang, Mingyang Wu, Jiabi Qin","doi":"10.7189/jogh.15.04049","DOIUrl":"10.7189/jogh.15.04049","url":null,"abstract":"<p><strong>Background: </strong>Household food insecurity (HFI) and poor dietary diversity (DD) are major public health challenges in Asia, greatly contributing to stunting among children under five. While previous research has focussed primarily on African regions, this systematic review provides novel insights into the association between HFI, DD, and stunting within the Asian context.</p><p><strong>Methods: </strong>We searched across six major databases for studies published between 2019 and 2023 exploring the association between HFI, DD, and stunting in children under five across Asia. We then extracted their characteristics, evaluation methods, and outcomes related to stunting for analysis.</p><p><strong>Results: </strong>From 3215 records, 37 met the inclusion criteria. Most studies were from South Asia (n = 22), followed by Southeast Asia (n = 8), with fewer from West (n = 4), East (n = 2), and Central Asia (n = 1), highlighting geographical research gaps. We found high stunting rates among children under five, especially in South and Southeast Asia. Stunting was strongly linked to HFI and poor DD, suggesting that these factors are critical in addressing malnutrition. Socioeconomic factors, maternal education, and access to clean water also influence stunting outcomes.</p><p><strong>Conclusions: </strong>Current research on HFI, DD, and stunting in Asia shows substantial variation, with the highest stunting rates in South and Southeast Asia. Limited data from Central and East Asia highlights the need for more comprehensive research in these regions. Addressing HFI and improving DD is critical for reducing stunting and achieving global nutrition targets by 2030.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04049"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014606","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":"Association of steatotic liver disease with all-cause and cardiovascular mortality among prehypertensive or hypertensive patients.","authors":"Shiwei Yan, Qian Li, Wenzhe Cao, Haolong Pei, Shihan Zhen, Qingyao Wu, Xueli Yang, Fengchao Liang","doi":"10.7189/jogh.15.04003","DOIUrl":"https://doi.org/10.7189/jogh.15.04003","url":null,"abstract":"<p><strong>Background: </strong>Prehypertension and hypertension often coexist with non-alcoholic fatty liver disease (NAFLD) during the progression of cardiovascular disease (CVD). International academic liver societies have recently reached a consensus to replace NAFLD with the new term 'steatotic liver disease' (SLD). In this study, we aimed to evaluate the impact of different SLD subtypes on all-cause and CVD mortality in individuals with prehypertension or hypertension.</p><p><strong>Methods: </strong>We included 6074 adults from the National Health and Nutrition Examination Survey (2003-18). The US fatty liver index was used as the diagnostic criterion for SLD, and participants were classified into no SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-associated and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD). For cases of MASLD, MetALD, and ALD, we further assessed advanced fibrosis using the fibrosis-4 (FIB-4) index. Additionally, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression models to assess the associations of SLD subtypes and advanced fibrosis with all-cause and CVD mortality.</p><p><strong>Results: </strong>There were 3505 (57.7%) participants with no SLD, 1284 (21.1%) with MASLD, 777 (12.8%) with MetALD, and 508 (8.4%) with ALD. During a median follow-up period of 8.2 years, the risk of all-cause and CVD mortality progressively increased in participants with MASLD (HR = 1.28; 95% CI = 1.01-1.63 and HR = 1.55; 95% CI = 1.04-2.33, respectively), MetALD (HR = 1.41; 95% CI = 1.05-1.88 and HR = 1.78; 95% CI = 1.10-2.87, respectively), and ALD (HR = 1.83; 95% CI = 1.32-2.53 and HR = 1.80; 95% CI = 1.01-3.19, respectively). Among the individuals with MASLD, MetALD, and ALD, advanced fibrosis was also associated with an increased risk of all-cause and CVD mortality.</p><p><strong>Conclusions: </strong>Individuals with MASLD, MetALD, and ALD had a higher risk of all-cause and CVD mortality than those without SLD. Therefore, early intervention strategies targeting SLD prevention and management may help individuals with prehypertension and hypertension to improve their long-term health.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04003"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014604","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 impact of long-term prescription policy on primary care utilisation and costs among hypertensive patients in China: a six-year longitudinal study.","authors":"Chunlu Yu, Lei Zhang, Luying Zhang, Wen Chen","doi":"10.7189/jogh.15.04021","DOIUrl":"https://doi.org/10.7189/jogh.15.04021","url":null,"abstract":"<p><strong>Background: </strong>China has recently implemented a long-term prescription policy as a component of the family doctor system in order to strengthen chronic disease management. In this study, we evaluated the net policy impact on health care utilisation and costs at community health centres (CHCs) among hypertensive patients.</p><p><strong>Methods: </strong>The study population included 164 857 hypertensive patients from a provincial capital city in Eastern China, with an average age of 69.93 years in 2014. We collected their health care utilisation and costs from 1 January 2014 to 31 December 2019 from the medical insurance claims database. The long-term prescription policy, implemented in 2018, allows patients registered with family doctors to obtain up to three-month prescriptions. We applied the multi-stage difference-in-differences model to examine the policy's impact, comparing health care utilisation and costs between those eligible and for the long-term prescription policy and those who are not.</p><p><strong>Results: </strong>The long-term prescription policy significantly reduced hypertensive patients' annual outpatient visits by 2.47 at CHCs and 0.18 at pharmacies, as well as prolonged the interval of prescriptions by 3.10 days at CHCs. It decreased the annual drug costs at pharmacies by 47%, but there was no significant effect on the annual outpatient costs at CHCs. Meanwhile, we did not observe the impact of the long-term prescription policy on patients' annual number of hospitalisations.</p><p><strong>Conclusions: </strong>The long-term prescription policy mainly affected patients' health care utilisation at CHCs and did facilitate patients with chronic diseases to refill drugs conveniently. The policy impact on patient health outcomes needs to be further observed and more attention should be given to the factors that may influence family doctors' behaviour in delivering the long-term prescription service.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04021"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014623","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":"Population attributable fractions for modifiable risk factors of neonatal, infant, and under-five mortality in 48 low- and middle-income countries.","authors":"Kedir Y Ahmed, Subash Thapa, Getiye D Kibret, Habtamu M Bizuayehu, Jing Sun, M Mamun Huda, Abel F Dadi, Felix A Ogbo, Shakeel Mahmood, Muhammad J A Shiddiky, Fentaw T Berhe, Setognal B Aychiluhm, Anayochukwu E Anyasodor, Allen G Ross","doi":"10.7189/jogh.15.04015","DOIUrl":"https://doi.org/10.7189/jogh.15.04015","url":null,"abstract":"<p><strong>Background: </strong>Identifying the modifiable risk factors for childhood mortality using population-attributable fractions (PAFs) estimates can inform public health planning and resource allocation in low- and middle-income countries (LMICs). We estimated PAFs for key population-level modifiable risk factors of neonatal, infant, and under-five mortality in LMICs.</p><p><strong>Methods: </strong>We used the most recent Demographic and Health Survey data sets (2010-22) from 48 LMICs, encompassing 35 sub-Saharan African countries and 13 countries from South and Southeast Asia (n = 506 989). We used generalised linear latent mixed models to compute odds ratios (ORs), and we calculated the PAFs adjusted for commonality using ORs and prevalence estimates for key modifiable risk factors.</p><p><strong>Results: </strong>The highest PAFs of neonatal mortality were attributed to delayed initiation of breastfeeding (>1 hour of birth) (PAF = 23.9; 95% confidence interval (CI) = 23.1, 24.8), uncleaned cooking fuel (PAF = 6.2; 95% CI = 6.4, 7.8), infrequent antenatal care (ANC) visits (PAF = 4.3; 95% CI = 3.3, 5.9), maternal lack of formal education (PAF = 3.9; 95% CI = 2.7, 5.3), and mother's lacking two doses of tetanus injections (PAF = 3.0; 95% CI = 1.9, 3.9). These five modifiable risk factors contributed to 41.4% (95% CI = 35.6, 47.0) of neonatal deaths in the 48 LMICs. Similarly, a combination of these five risk factors contributed to 40.5% of infant deaths. Further, delayed initiation of breastfeeding (PAF = 15.8; 95% CI = 15.2, 16.2), unclean cooking fuel (PAF = 9.6; 95% CI = 8.4, 10.7), mothers lacking formal education (PAF = 7.9; 95% CI = 7.0, 8.9), infrequent ANC visits (PAF = 4.0; 95% CI = 3.3, 4.7), and poor toilet facilities (PAF = 3.4; 95% CI = 2.6, 4.3) were attributed to 40.8% (95% CI = 36.4, 45.2) of under-five deaths.</p><p><strong>Conclusions: </strong>Given the current global economic climate, policymakers should prioritise these modifiable risk factors. Key recommendations include ensuring that women enter pregnancy in optimal health, prioritising the presence of skilled newborn attendants for timely and proper breastfeeding initiation, and enhancing home-based care during the postnatal period and beyond.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04015"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014620","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 of osteoporosis and associated factors among Chinese adults: a systematic review and modelling study.","authors":"Yi Liu, Xuanyin Huang, Ke Tang, Jing Wu, Jiali Zhou, He Bai, Liying Zhou, Shiyi Shan, Zeyu Luo, Jin Cao, Peige Song, Igor Rudan","doi":"10.7189/jogh.15.04009","DOIUrl":"https://doi.org/10.7189/jogh.15.04009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Osteoporosis is a degenerative disease of bone metabolism. The epidemiology of osteoporosis varies by age, sex, and geography. There is a lack of information on the prevalence of osteoporosis among Chinese adults. In this study, we aimed to estimate the prevalence of osteoporosis among Chinese adults by age, sex, and skeletal sites and explore the main associated factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched six bibliographic databases to identify epidemiological studies that reported the prevalence of osteoporosis among Chinese adults published between January 1990 and February 2022. We applied a multilevel mixed-effects meta-regression to estimate the age-specific prevalence of osteoporosis. We presented the age-specific prevalence of osteoporosis by sex, diagnostic criteria (World Health Organization (WHO) and Chinese (CHN) diagnostic criteria), and specific skeletal site (the lumbar spine, femoral neck, and ward's triangle). We used the population data from the seventh National Census of Mainland China to estimate the number of Chinese adults with osteoporosis in 2020. Major associated factors for osteoporosis were pooled by a random-effects meta-analysis. We also estimated the regional prevalence and cases of osteoporosis among 31 provinces in mainland China in 2020 using an 'associated factor-based model.'&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 129 articles in this systematic review and modelling study. 32 were based on the WHO diagnostic criteria and 17 on the CHN diagnostic criteria. Additionally, we included 83 articles in the associated factor analysis. The prevalence of osteoporosis increased with age and was consistently higher in females than males, regardless of diagnostic criteria and skeletal sites. Whether based on the WHO criteria (13.54%, 95% confidence interval (CI) = 10.25, 18.11) or the CHN criteria (29.49%, 95% CI = 18.29, 43.5), the prevalence of osteoporosis among Chinese adults aged 20-89 years in 2020 was highest when measuring the ward's triangle, which translated to 145.86 million (95% CI = 110.41, 195.03) and 317.54 million (95% CI = 196.95, 468.47) affected adults, respectively. The prevalence of osteoporosis was the highest in Northeast China under both the WHO criteria (15.50%, 95% CI = 11.78, 20.59) and the CHN criteria (32.36%, 95% CI = 20.33, 46.8), with the ward being the measured skeletal site. Marital status, current smoking, underweight, hypertension, fracture history, longer menopause years and menopause were positively associated with osteoporosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Osteoporosis remains a significant public health concern in China, particularly among females and the elderly. Meanwhile, the prevalence of osteoporosis varies considerably by region, skeletal site and diagnostic criteria. It is essential to establish clear and unified diagnostic criteria and implement high-quality epidemiological studies for osteoporosis in China. Additionally, tar","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04009"},"PeriodicalIF":4.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014621","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":"Primary care functional features and their health impact on patients enrolled in the Shanghai family doctor service: a mixed-methods study.","authors":"Yang Wang, Hua Jin, Hui Yang, Yang Zhao, Yi Qian, Dehua Yu, Hai Fang","doi":"10.7189/jogh.15.04007","DOIUrl":"10.7189/jogh.15.04007","url":null,"abstract":"<p><strong>Background: </strong>While research in multiple countries confirms that primary care functional features significantly improve patient health, China's primary care system differs markedly due to unique structural and contextual factors. This study aims to measure and explore the functional features experienced by patients received family doctor contract service in the past year, evaluating the impacts and pathways of these primary care features on health outcomes.</p><p><strong>Methods: </strong>We employed a mixed-methods explanatory sequential design. In the quantitative phase, we randomly selected 2118 residents from 12 primary care institutions. The intensity of functional features was assessed using the Person-Centered Primary Care Measure (PCPCM), and their association with levels of EuroQol Visual Analogue Scale (EQ VAS) was evaluated through multilevel modelling. In the qualitative phase, a qualitative description approach was used, conducting 24 focus groups with a total of 85 patients to gather in-depth information about their experiences with functional features and perceived health impacts. Finally, the quantitative and qualitative data were integrated using meta-synthesis and joint display methods to validate, interpret, and expand the results.</p><p><strong>Results: </strong>The average PCPCM score was 3.65, with subdomain scores ranging from 3.39 to 3.83. Qualitative findings confirmed the quantitative results regarding the intensity and manifestation of features like accessibility, coordination, and relationship-building. However, discrepancies were noted in features such as comprehensiveness, integration, and family and community context. Additionally, two new functional features, 'being appreciated' and 'being cared for,' were identified. The quantitative results also showed that higher PCPCM scores were positively associated with EQ VAS levels (odds ratio (OR) = 1.18; 95% confidence interval (CI) = 1.03-1.35, P < 0.001). Furthermore, qualitative results revealed six key pathways supporting the beneficial effects of local primary care functional features on health maintenance and improvement.</p><p><strong>Conclusions: </strong>This study demonstrates high functional scores for Shanghai's family doctor services and highlights a positive association between primary care functionality and population health. These features and their health benefits are deeply shaped by the local social and health care context. This confirms the progress of Shanghai's primary care development and underscores the need for further exploration of primary care functional features across China, along with the development of tools tailored to local conditions to better measure and improve primary care quality and health outcomes.</p><p><strong>Keywords: </strong>primary healthcare; primary care; quality measurement; population health; mixed method research; China.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04007"},"PeriodicalIF":4.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957305","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":"Epidemiology, risk factors, and awareness of mycetoma among residents in Eastern Sinnar locality, Sudan, 2021.","authors":"Mogahid Gadallh A Abdallh, Sahar Hemeda, Mohammed Elmadani, Bashir Ibrahim, Abd Elbasit Elawad Ahmed","doi":"10.7189/jogh.15.04005","DOIUrl":"10.7189/jogh.15.04005","url":null,"abstract":"<p><strong>Background: </strong>Mycetoma is a chronic granulomatous disease affecting the skin, subcutaneous tissues, and bones, particularly in tropical and subtropical regions. Sudan, especially its Eastern Sinnar locality, experiences a significant burden due to environmental conditions and limited access to healthcare, while the population's lack of awareness and understanding often leads to delays in diagnosis and treatment.</p><p><strong>Methods: </strong>We conducted a descriptive cross-sectional, community-based study in Eastern Sinnar, Sudan, to investigate the prevalence, risk factors, and awareness of mycetoma among local residents. Using Cochran's formula, we calculated a required sample size of 400 participants from a total population of 245 201. Then, we randomly selected these participants from five villages chosen through stratified sampling. Data were collected via a validated questionnaire assessing sociodemographic characteristics and mycetoma-related information, a review of medical records to confirm infection types and prevalence, and interviews with the Directorate of the Mycetoma Centre in Sinnar. We used χ² tests for associations in our analysis, with P-values ≤0.05 indicating statistical significance.</p><p><strong>Results: </strong>The mycetoma prevalence was 5.4%, with males comprising 76.4% of infected cases. However, the difference in infection rates between genders was not statistically significant (P = 0.248). While infection rates were higher among certain occupational groups, such as farmers and shepherds, the association between occupation and mycetoma infection was non-significant (P = 0.107). We also found no significant associations with educational level (P = 0.104) or age (P = 0.514), but did detect significant associations for family history of infection (P < 0.001), animal ownership (P = 0.004), and not wearing shoes during work (P = 0.05). Awareness of mycetoma was relatively high, with 78.3% of respondents acknowledging the disease, though knowledge gaps remained, especially regarding its transmission, with only 36.1% believing it to be transmissible.</p><p><strong>Conclusions: </strong>The study highlights the need for targeted health education programmes, particularly emphasising protective footwear and safe animal-handling practices. These findings are crucial for informing public health strategies aimed at reducing the burden of mycetoma in endemic regions such as Eastern Sinnar.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04005"},"PeriodicalIF":4.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957303","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":"Health system and environmental factors affecting global progress towards achieving End TB targets between 2015 and 2020.","authors":"Haileab Fekadu Wolde, Archie Ca Clements, Kefyalew Addis Alene","doi":"10.7189/jogh.15.04004","DOIUrl":"10.7189/jogh.15.04004","url":null,"abstract":"<p><strong>Background: </strong>Health system and environmental factors play a significant role in achieving the World Health Organization (WHO) End Tuberculosis (TB) targets. However, quantitative measures are scarce or non-existent at a global level. We aimed to measure the progress made towards meeting the global End TB milestones from 2015 to 2020 and identify health system and environmental factors contributing to the success.</p><p><strong>Methods: </strong>We obtained data from ten different online data repositories and used principal component analysis to create domain-specific health system performance measures. We used radar charts and dumbbell plots to show the country's progress in ending TB with their health systems. Lastly, we used a linear regression model to identify key health systems and environmental predictors of the percent reduction in TB incidence and mortality.</p><p><strong>Results: </strong>There was a high variation in TB incidence and mortality reduction between countries and WHO regions. Of all countries included, 75 (39.3%) achieved more than a 20% reduction in TB incidence between 2015 and 2020. However, only 31 (16.2%) reached a 35% reduction in TB mortality. The European Region achieved the highest incidence reduction, exceeding the 2020 milestone with a 25% reduction. The African Region also made notable progress, achieving an 18% mortality reduction despite its relatively poor health systems. Health system factors, such as TB financing, TB-specific health service delivery, access to medicine, and governance, were significantly associated with TB mortality reduction between 2015 and 2020. Environmental factors, such as average annual temperature and air particulate matter concentration, were found to have a significant negative effect on TB incidence and mortality reduction.</p><p><strong>Conclusions: </strong>Weak health systems were identified as major barriers to achieving the End TB milestones in most high-burden countries. Hence, strengthening health systems with a special focus on TB financing, service delivery, and access to medicine in these countries should be prioritised to achieve global TB mortality reduction targets. Countries should follow WHO's air quality guidelines and rapidly reduce carbon dioxide and other greenhouse gas emissions to mitigate the impact of environmental factors.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04004"},"PeriodicalIF":4.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957304","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}