Journal of Global Health最新文献

{"title":"Systemic inflammatory indices for predicting severe placenta accreta spectrum: a retrospective cohort study.","authors":"Xiafen Lu, Xiaoyun Lei, Congcong Guo, Qian Tang, Xiaomei Zhang, Wenting Mai, Ming Mo, Meiling Yuan, Wen Wang, Dazhi Fan","doi":"10.7189/jogh.16.04353","DOIUrl":"10.7189/jogh.16.04353","url":null,"abstract":"<p><strong>Background: </strong>Placenta Accreta Spectrum (PAS) disorders are associated with substantial maternal morbidity, and distinguishing mild from severe forms prenatally remains difficult. Inflammatory indices derived from peripheral blood counts have emerged as promising biomarkers, yet their role in grading PAS severity has been insufficiently investigated. This study aimed to assess the discriminative value of the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and other inflammatory indices for differentiating severe from mild PAS within an already diagnosed PAS population in late pregnancy.</p><p><strong>Methods: </strong>This retrospective single-centre cohort study included 1,276 patients with histopathologically confirmed PAS. Third-trimester neutrophil, lymphocyte, monocyte, and platelet counts were used to derive neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, and SIRI. Multivariable logistic regression, receiver operating characteristic curve analysis, and decision curve analysis (DCA) were conducted.</p><p><strong>Results: </strong>Compared with the mild PAS group (n = 1,060), the severe PAS group (n = 216) showed significantly lower SIRI, SII, NLR, and PLR values (all P < 0.001). SIRI demonstrated moderate discriminative performance (area under the curve = 0.712). DCA suggested its potential clinical usefulness across threshold probabilities.</p><p><strong>Conclusions: </strong>Lower third-trimester SIRI, SII, NLR, and PLR values are associated with severe PAS. SIRI shows moderate diagnostic performance and may serve as a cost-effective adjunct to imaging for prenatal risk stratification. Prospective validation is warranted.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04353"},"PeriodicalIF":5.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220906","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":"Prevalence and determinants of probable dementia in rural India: a cross-sectional study in the APCAPS cohort.","authors":"Jagannadha Rao Basa, Kanokporn Pinyopornpanish, Poppy Ac Mallinson, Papangkorn Inkeaw, Kanokwan Kulprachakarn, Judith Lieber, Santosh Kumar Banjara, Hemant Mahajan, Teena Dasi, Santhi Bhogadi, Srivalli Addanki, Gowri Iyer, Anoop Sv Shah, Om Kurmi, Sureshkumar Kamalakannan, Sanjay Kinra, Chaisiri Angkurawaranon","doi":"10.7189/jogh.16.04339","DOIUrl":"10.7189/jogh.16.04339","url":null,"abstract":"<p><strong>Background: </strong>Dementia poses a growing public health challenge in India. Despite this, epidemiological data on the condition remain largely restricted to adults >60 years of age, despite the convergence of urbanisation-driven cardiometabolic risks and socioeconomic disadvantage in rural India potentially accelerating dementia onset. We investigated the prevalence and determinants of probable dementia in a transitional rural Indian cohort of adults aged ≥45 years.</p><p><strong>Methods: </strong>In this cross-sectional study, we utilised data from the Andhra Pradesh Children and Parents Study cohort from 29 villages near Hyderabad, South India (2021-2023). We collected sociodemographic, occupational, and household asset data through face-to-face, questionnaire-based interviews. Cardiometabolic diseases (diabetes, hypertension, cardiovascular disease, and stroke) were assessed using validated methods. Dementia screening was performed using the Brief Community Screening Instrument for Dementia. We calculated prevalence estimates for dementia and used multivariable logistic regression to identify independent associations of probable dementia with sociodemographic, socioeconomic (education, occupation, household assets), and cardiometabolic factors (diabetes, hypertension, cardiac disease, and stroke).</p><p><strong>Results: </strong>The final sample included 2,163 adults aged ≥45 years. The prevalence of probable dementia (a positive screen on the BCSI-D) was 3.4% (95% confidence interval (CI) = 2.6-4.6) in the 45-59 age group and 7.4% (95% CI = 6.0-9.4) in the ≥60 age group. In the multivariable model, the odds of probable dementia were 2.2 times higher among unemployed or retired participants than among those working in agriculture or animal rearing (adjusted odds ratio (aOR) = 2.23; 95% CI = 1.26-3.95). The odds of probable dementia among literate participants were 0.5 times those among illiterate participants (aOR = 0.54; 95% CI = 0.31-0.89). The odds of probable dementia were 3.8 times higher among participants with a history of stroke than among those without (aOR = 3.77; 95% CI = 1.67-7.94).</p><p><strong>Conclusions: </strong>Our results indicate that the burden of probable dementia in rural India extends into middle age, and that the condition itself is independently associated with a history of stroke and socioeconomic disadvantages. This suggests a need to extend cognitive and vascular risk assessment to adults aged ≥45 years in rural India. However, as all findings reflect positive screening results rather than confirmed diagnoses, longitudinal studies with diagnostic confirmation are needed before population-level screening recommendations can be made.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04339"},"PeriodicalIF":5.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220936","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":"External validation and application of machine learning models for obesity in Chinese children and adolescents per Chinese and WHO growth standards.","authors":"Fangjieyi Zheng, Xiaoqian Wang, Mei Xue, Qiong Wang, Wenqian Zhang, Zhixin Zhang, Wenquan Niu","doi":"10.7189/jogh.16.04299","DOIUrl":"10.7189/jogh.16.04299","url":null,"abstract":"<p><strong>Background: </strong>Childhood and adolescent obesity is a growing global public health challenge, underscoring the need for reliable tools to identify individuals at high risk. We aimed to develop, validate, and deploy machine learning (ML) models for predicting obesity in children and adolescents aged 3-18 years using multi-domain risk factors per Chinese and World Health Organization (WHO) growth standards, with an online tool for clinical and public health translation.</p><p><strong>Methods: </strong>We conducted a population-based cross-sectional study. We used data from 22,555 participants in Beijing (2022, 2024) for training/internal validation, and data from 5,343 participants in Tangshan (2020) for external validation. We defined obesity using both Chinese and WHO growth standards. We analysed 38 features across 5 domains; we selected key predictors using least absolute shrinkage and selection operator regression. We evaluated 4 ML models using 28 performance metrics, with SHapley Additive exPlanations enhancing interpretability.</p><p><strong>Results: </strong>We retained 5 features per the Chinese growth standards and 12 per the WHO growth standards. Age, maternal body mass index (BMI), paternal BMI, screen time, and birthweight were consistent predictors. The neural network achieved optimal performance per Chinese growth standards (area under the receiver operating characteristic curve (AUROC) = 0.735), and eXtreme gradient boosting performed best per WHO growth standards (AUROC = 0.736), with the corresponding external validation AUROCs of 0.699 and 0.707. We subsequently deployed user-friendly online prediction tools for translation.</p><p><strong>Conclusions: </strong>We identified two interpretable ML models for obesity in children and adolescents per both Chinese and WHO growth standards, each demonstrating modest but reliable predictive performance.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04299"},"PeriodicalIF":5.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220796","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":"Prevalence and impacts of breathlessness in South Africa: an exploratory, cross-sectional population study.","authors":"Slavica Kochovska, Vanessa N Brunelli, Sungwon Chang, Irina Kinchin, Danny J Eckert, Joseph D Clark, Jacob Sandberg, Magnus Ekström, David C Currow, Richard N van Zyl-Smit","doi":"10.7189/jogh.16.04229","DOIUrl":"10.7189/jogh.16.04229","url":null,"abstract":"<p><strong>Background: </strong>Chronic breathlessness contributes substantially to the global health burden and healthcare use, yet data on its prevalence and impacts in lower-resource settings remain limited. We investigated the prevalence, self-reported underlying conditions, and impacts of breathlessness at the population level in South Africa.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey in English among community-dwelling adults aged 18 years or older. The sample was stratified by age, sex, and rurality to reflect the 2022 National Census. Self-reported data included sociodemographic characteristics; breathlessness, assessed using the modified Medical Research Council (mMRC) breathlessness scale; employment; activities of daily living, assessed using an item from the London Chest Activities of Daily Living; quality of life, assessed using the EQ-5D-5L and EQ visual analogue scale; and disability, assessed using the 12-item World Health Organization Disability Assessment Schedule 2.0. We analysed the weighted dataset using descriptive statistics.</p><p><strong>Results: </strong>We included 2,828 respondents with a mean age of 37.1 years (standard deviation = 12.4), of whom 52.3% were female. Clinically important breathlessness (mMRC ≥ 2) was reported by 189 respondents (6.7%), with a median duration of 3.1 years (interquartile range = 1.5-5.4). The most commonly reported attributions were lung conditions other than tuberculosis (23.8%), 'other' factors (16.4%), and anaemia (11.6%). Clinically important breathlessness was associated with poorer perceived health, lower quality of life, and higher total disability scores than mild (mMRC 1) or no breathlessness (mMRC 0). Mobility and participation were the most affected disability domains. Among respondents with an mMRC≥2, 64 (33.8%) reported an impact on employment, of whom 49 (76.6%) had ceased full-time work, while 171 (90.3%) respondents reported an impact on daily activities.</p><p><strong>Conclusions: </strong>We estimate that more than four million people in South Africa live with clinically important breathlessness. The symptom is associated with poorer quality of life, greater disability, reduced employment, and impaired function. The life-changing effects of this debilitating symptom among community-dwelling adults should be investigated in longitudinal studies to help inform clinical policy and practice.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04229"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138664","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":"Intergenerational educational mobility and intrinsic capacity in later life: a harmonised analysis of individuals from five countries.","authors":"Lin Guo, Hongjing Wang, Wenjie Teng, Bingyu Bai, Bin Sang, Linlin Zhang","doi":"10.7189/jogh.16.04304","DOIUrl":"10.7189/jogh.16.04304","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization's intrinsic capacity (IC) framework shifts focus from disease to functional ageing. Despite education's role in health, the impact of intergenerational educational mobility (IEM) on IC trajectories remains understudied. We aimed to examine the cross-national association between IEM and IC, its effect on biological ageing rates, and underlying mechanisms.</p><p><strong>Methods: </strong>We analysed harmonised longitudinal data from five nationally representative cohorts: China Health and Retirement Longitudinal Study, Health and Retirement Study (USA), Survey of Health, Ageing and Retirement in Europe, Korean Longitudinal Study of Ageing, and Mexican Health and Aging Study, including 495,028 observations from 100,362 individuals aged ≥50. We standardised IC as a composite of cognition, locomotion, vitality, sensory, and psychological domains. We used a two-stage individual participant data meta-analysis, growth curve modelling, and the Karlson-Holm-Breen mediation method to assess associations, trajectories, and pathways via wealth, behaviours, and chronic conditions.</p><p><strong>Results: </strong>Upward IEM was robustly linked to higher IC (pooled β = 0.25; 95% confidence interval = 0.24, 0.26; P < 0.001). Linear mixed-effects models showed distinct intra-individual ageing patterns: upward mobility significantly decelerated the rate of IC decline ('delayed ageing') in China, Europe, South Korea, and Mexico. Conversely, a 'parallel ageing' pattern emerged in the USA, where mobility massively elevated baseline capacity but did not alter the slope of age-related decline.</p><p><strong>Conclusions: </strong>The IEM confers consistent health advantages across countries, but the magnitude and trajectory of these benefits are context-dependent. The unique 'US exception' of parallel ageing suggests that while mobility elevates early-life health capital, systemic environmental or healthcare factors may equalise subsequent late-life decline. Enhancing mobility remains a critical global strategy for healthy longevity.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04304"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138253","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 between month/season of birth and health outcomes: an umbrella review of systematic reviews and meta-analyses.","authors":"Zhuoya Zhang, Lin Wang, Yinghui Zhou, Jie Zhang, Cheng Tan","doi":"10.7189/jogh.16.04234","DOIUrl":"10.7189/jogh.16.04234","url":null,"abstract":"<p><strong>Background: </strong>The relationship between month or season of birth and long-term health outcomes remains an important but underexplored topic in public health. Evidence suggests that birth timing may influence disease susceptibility and broader health trajectories, reflecting interactions between biological and ecological factors. Clarifying these associations is essential for advancing prevention and a holistic view of health shaped by temporal exposures.</p><p><strong>Methods: </strong>We conducted an umbrella review of systematic reviews and meta-analyses indexed in PubMed, Embase, and Web of Science up to 2 July 2025. Eligible studies reported quantitative estimates for associations between birth month/season and objectively measured health outcomes. We used random-effects models to produce pooled estimates and evaluated heterogeneity, small-study effects, and bias. We graded associations using established class-of-evidence criteria and assessed methodological quality with AMSTAR 2.</p><p><strong>Results: </strong>We included 10 meta-analyses, comprising 614 unique associations (defined as individual pairwise analyses between a specific birth month/season exposure and a distinct health outcome). Of these, 45 associations were statistically significant, and 25 were eligible for evidence grading. No association met class I criteria, but one (January birth and schizophrenia) reached class II. The most consistent findings involved neurodevelopmental and psychiatric outcomes, with winter births linked to a modest increase in schizophrenia risk (odds ratio (OR) = 1.05) and spring births to multiple sclerosis. Most autoimmune, oncological, and perinatal associations were graded as weak (class III-IV) due to small effect sizes or heterogeneity.</p><p><strong>Conclusions: </strong>The strongest evidence for associations between month/season of birth and long-term health outcomes was restricted to specific neuropsychiatric outcomes, with most other associations graded as weak. Grading the credibility of these associations helps distinguish robust signals from exploratory findings, and provides a clear framework for future mechanistic and epidemiological investigations.</p><p><strong>Registration: </strong>PROSPERO: CRD420251110595.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04234"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138841","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":"Ectopic pregnancy-related severe maternal morbidity in Shenzhen: a sentinel indicator for gaps in early pregnancy care systems.","authors":"Yu Dai, Qiaoxuan Wu, Litong Zhu, Weichun Yang, Ping Jin, Shuyan Jin, Fuying Tian, Xiaotian Li","doi":"10.7189/jogh.16.04331","DOIUrl":"10.7189/jogh.16.04331","url":null,"abstract":"<p><strong>Background: </strong>Despite China's progress in reducing maternal mortality, severe maternal morbidity in early pregnancy, particularly ectopic pregnancy, remains a critical challenge in urban settings like Shenzhen. This study examines the clinical presentation scenarios, types, and sociodemographic compositions of ectopic pregnancy -related severe maternal morbidity to map potential structural vulnerabilities within the maternal healthcare continuum and propose interventions aligned with China's 'Healthy Motherhood 2030' agenda.</p><p><strong>Methods: </strong>A retrospective analysis used 2023 data from Shenzhen's Maternal and Child Health Care Management Information System, covering 66 maternity hospitals. A total of 245 ectopic pregnancy-related severe maternal morbidity cases were identified using standard WHO near-miss criteria. Statistical analyses evaluated the descriptive distributions and baseline profiles of clinical outcomes across different initial resuscitation settings.</p><p><strong>Results: </strong>Among 154,000 live births, 1,075 severe maternal morbidity cases (0.70%) included 257 (23.9%) ectopic pregnancy-related emergencies. After exclusions, we analysed 245 cases: 67.35% multiparous women, 31.84% had a junior high education or lower and 95% without prenatal care. Ectopic pregnancy-severe maternal morbidity occurred mostly at home (46.12%), followed by outpatient/emergency (30.20%) and inpatient (23.67%) settings. Among home/emergency presentations, 83.3% of women had lower education and 80.4% were employed. Tubal isthmus pregnancies (42.45%) dominated home-based emergencies, while atypical sites were frequent in clinical settings. Advanced severe complications occurred in only seven cases, limiting meaningful statistical comparisons across settings.</p><p><strong>Conclusions: </strong>In a high-resource, low-MMR urban environment, ectopic pregnancy-related emergencies account for nearly one-quarter of the total SMM burden, with acute crises often concentrated in pre-hospital or frontline care settings. These descriptive patterns suggest that maternal safety strategies should consider shifting focus toward enhancing community health literacy and rapid-response integration at the primary care level. Forward-looking interventions - such as mobile health platforms, clinical simulation training, and formalised early pregnancy emergency networks - warrant prospective evaluation as potential operational pathways to bridge the identified gaps.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04331"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137811","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":"Influenza vaccine protection and contact patterns among outpatients with influenza-like illness during the 2024-2025 season in China: a test-negative case-control study.","authors":"Luping Chen, Jia Mi, Yingxuan Wang, Zhisheng Chen, Juping Wang, Zihao Guo, Haogao Gu, Qiaoge Chi, Lirong Cao, Ruijuan Ji, Kamuranni Luotebula, Shengmei Yang, Yan Kong, Kailu Wang, Sheikh Taslim Ali, Daihai He, Marc Kc Chong, Shi Zhao, Kai Wang, Yuantao Hao, David Sc Hui, Zijian Feng","doi":"10.7189/jogh.16.04253","DOIUrl":"10.7189/jogh.16.04253","url":null,"abstract":"<p><strong>Background: </strong>Continuous monitoring of both influenza vaccine protection and behavioural determinants of infection is important for understanding related risks. Evidence on influenza vaccine effectiveness (VE) in China during the 2024-2025 season, however, remains limited. We aimed to assess influenza VE among healthcare-seeking outpatients with influenza-like illness (ILI) and to examine the contact patterns associated with infection risk.</p><p><strong>Methods: </strong>We enrolled 928 outpatients with ILI from three sentinel hospitals in Ili Kazakh Autonomous Prefecture, China, between December 2024 and March 2025 in a test-negative case-control study. We confirmed influenza infection using reverse transcription-polymerase chain reaction and collected vaccination history and social contact frequency and duration through questionnaires. We estimated VE using logistic regression with covariate adjustment, and otherwise analysed social contact patterns and performed exploratory sequencing of six randomly selected influenza-positive samples.</p><p><strong>Results: </strong>Our full sample comprised 928 participants. We excluded 21 infants younger than 6 months from the VE analysis and included 907 participants, of whom 121 tested positive and 786 tested negative. The overall adjusted VE against medically attended influenza was 42.3% (95% credible interval = 11.1-62.5). In the analysis of social contacts for all 928 participants, test-positive children aged 0-10 years and adults aged 65 years or older reported more frequent and longer social contact than their test-negative counterparts. Exploratory sequencing of six samples suggested no major antigenic mismatch with the vaccine strains, but the very small number of sequenced samples limits the generalisability of this finding.</p><p><strong>Conclusions: </strong>Influenza vaccination provided moderate protection against medically attended influenza, while contact patterns were associated with infection risk among children and older adults. Combined vaccination and behavioural interventions warrant further evaluation, as the observational design of this study and its use of self-reporting data limit causal inference.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04253"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138172","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":"Diagnosis of tuberculous lymphadenopathy: the role of droplet digital PCR.","authors":"Yu-Feng Wei, Ching-Yi Chen, Ping-Huai Wang, Yao-Wen Kuo, Chin-Chung Shu, Bo-Shiun Yan","doi":"10.7189/jogh.16.04244","DOIUrl":"10.7189/jogh.16.04244","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous lymphadenopathy (TB-LAP) is the most common form of extrapulmonary TB and remains diagnostically challenging due to its paucibacillary nature. We evaluated the diagnostic performance of droplet digital PCR (ddPCR) for detecting Mycobacterium tuberculosis (Mtb) DNA in formalin-fixed paraffin-embedded (FFPE) lymph node specimens.</p><p><strong>Methods: </strong>We retrospectively analysed 102 lymph node FFPE specimens with microbiologically confirmed or pathology-suspected TB-LAP. We performed ddPCR targeting the IS6110 gene and correlated it with pathological findings and mycobacterial culture results. Diagnostic performance was assessed using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Pathological findings included granulomatous inflammation (GI) (n = 67), caseating GI (CGI) (n = 22), CGI with acid-fast bacilli (AFB) (n = 7), GI with AFB (n = 1), and atypical findings (n = 5). There was a graded association between ddPCR and pathological severity (P for trend = 0.002), with the highest levels in CGI plus AFB and the lowest in non-TB-LAP cases. Mtb DNA concentration (copies/μL) was significantly higher in AFB-positive specimens (mean (x̄) = 22.9, standard deviation (SD) = 61.5) compared with AFB-negative specimens (x̄ = 0.6, SD = 0.8) (P = 0.044). Among 52 specimens sent for mycobacterial culture, 9 (17%) were culture-positive, and these specimens had significantly higher ddPCR values (P = 0.025). Receiver operating characteristic analysis yielded an area under the curve of 0.715 (95% confidence interval = 0.536-0.894) for AFB positivity. Using a cutoff value of >1.25 copies/μL resulted in 50% sensitivity and 86% specificity. Lowering the cutoff to >0.33 copies/μL increased sensitivity to 88%, but reduced specificity to 51%.</p><p><strong>Conclusions: </strong>We found that ddPCR quantitatively detects Mtb DNA in lymph node FFPE specimens and correlates with pathological severity and culture positivity. Although the overall diagnostic accuracy was moderate, ddPCR demonstrated distinct sensitivity and specificity profiles at different cutoff values and may serve as a useful adjunctive diagnostic tool when interpreted in conjunction with clinical and histopathological findings in TB-LAP.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04244"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138798","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":"Addressing non-communicable diseases and injuries through an equity lens: insights from the Cameroon non-communicable disease and injury (NCDI) Poverty Commission.","authors":"Yauba Saidu, Michael Budzi, Hassan Ben Bachire, Diaby Ousmane, Farida Haoua, Mapa Clarisse, Vaissaba Emmanuel, Marie Solange Ndom, Clarence Mbanga, Ismaila Karimu, Mbiydzenyuy Ferdinant Sonyuy, Emmanuel Mensah, Gene Bukhman, Neil Gupta, Basile Njei, Yazan A Al Ajlouni, Olufunke Fasawe, Suzanne Sap, Eugene Sobngwi, Paul Ndom, Samuel Kingue","doi":"10.7189/jogh.16.04266","DOIUrl":"10.7189/jogh.16.04266","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases and injuries (NCDIs) constitute a leading cause of premature mortality globally, disproportionately affecting low- and middle-income countries (LMICs). To curb the rising burden of NCDIs in Cameroon, the Ministry of Public Health established the National NCDI Poverty Commission to assess the burden of NCDIs, evaluate investments and expenditures related to NCDI services, and generate evidence to guide national policy formulation and resource prioritisation.</p><p><strong>Methods: </strong>We synthesised data from the Global Burden of Disease (GBD) 2019 database and conducted a comprehensive literature review of peer-reviewed and grey literature (2005-2022) to characterise the burden and risk factors of NCDIs in Cameroon. Investments and expenditures related to NCDIs were extracted from the World Health Organization Global Health Expenditure Database and national planning documents. A two-phase priority-setting process was applied to rank NCDI conditions and identify cost-effective, context-appropriate interventions through quantitative scoring and expert consensus.</p><p><strong>Results: </strong>NCDIs accounted for 43% of all deaths in 2019, with nearly 29% occurring among individuals aged <40 years. Disability-adjusted life years (DALYs) from NCDIs have risen steadily since 1990, with almost two-thirds (61%) attributable to conditions beyond the 'big four' disease categories of diabetes, neoplasms, chronic respiratory diseases, and cardiovascular diseases. Over half (51%) of NCDI-related DALYs in Cameroon were not attributable to quantified behavioural or metabolic risk factors in the GBD framework. Despite this high burden, only 6% of disease prevention funding was directed to NCDIs between 2016 and 2020. The Commission identified 49 priority NCDI conditions and 123 interventions for phased implementation across community, primary, and hospital platforms.</p><p><strong>Conclusions: </strong>NCDIs are a major public health burden in Cameroon, heavily impacting the 'economically productive' age group. Rebalancing financing and integrating a prioritised package of NCDI services into Universal Health Coverage (UHC) would be essential to reduce premature mortality and financial hardship.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04266"},"PeriodicalIF":5.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138836","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}