Journal of Global Health最新文献

{"title":"Effects of the COVID-19 pandemic on maternal, newborn, and child health service coverage in Burkina Faso.","authors":"Abdoulaye Maïga, Moussa Bougma, Emily Wilson, Théodore S Kaboré, Gildas G Tou, Melinda K Munos, Almamy M Kanté, Safia S Jiwani, Kelsey Zack, Aveika Akum, Neff Walker, Robert E Black, Agbessi Amouzou","doi":"10.7189/jogh.14.05037","DOIUrl":"10.7189/jogh.14.05037","url":null,"abstract":"<p><strong>Background: </strong>While countries' coronavirus disease 2019 (COVID-19) emergency contingency and response plans aimed to prevent and control the spread of the virus, they also caused major disruptions to health services. We assessed the effects of COVID-19 on coverage and inequalities in select maternal, newborn, and child health services in Burkina Faso.</p><p><strong>Methods: </strong>We analysed data from two cross-sectional household surveys conducted in two provinces, one rural and one urban. The first survey of 3375 households was conducted immediately before the pandemic (February to March 2020) and the second survey in the same areas two years after the pandemic (May to June 2022) using a similar methodology. We compared the coverage of maternal, newborn, and child health interventions and care-seeking between the two surveys to assess the effects of the pandemic on maternal, newborn, and child health services.</p><p><strong>Results: </strong>Our findings did not show significant disruptions in coverage of antenatal service, postnatal care for mothers and babies, child routine vaccination, and care-seeking for sick children during the pandemic. However, there was a dramatic drop of the number of women (23 percentage points) accompanied by their partners for delivery as well as the number of caesarean-section deliveries in urban areas. The shortage of health staff, facility congestion, fear of getting COVID-19 after a caesarean-section admission, and prioritisation of critical health services such as emergency caesarean-section to the detriment of elective cases may explain the decline of caesarean-section rates.</p><p><strong>Conclusions: </strong>COVID-19 did not cause major reversals in the coverage of maternal, newborn, and child health services in Burkina Faso, except for caesarean sections. We also saw no substantial increases in service coverage. In the absence of a counterfactual, we could not attribute the stagnation to the pandemic. However, the very low proportion of women reporting disruption in care-seeking suggests some resilience of the health systems to mitigate the negative impacts of the pandemic.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05037"},"PeriodicalIF":4.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865875","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":"Multimorbidity in elderly patients with or without T2DM: A real-world cross-sectional analysis based on primary care and hospitalisation data.","authors":"Yang Li, Shasha Geng, Huixiao Yuan, Jianli Ge, Qingqing Li, Xin Chen, Yingqian Zhu, Yue Liu, Xiaotong Guo, Xiaoli Wang, Hua Jiang","doi":"10.7189/jogh.14.04263","DOIUrl":"10.7189/jogh.14.04263","url":null,"abstract":"<p><strong>Background: </strong>Shanghai's high level of ageing has given rise to a considerable number of elderly patients with type 2 diabetes mellitus (T2DM) who are confronted with the challenge of managing multimorbidity. We aimed to determine the prevalence of multimorbidity in elderly T2DM patients in a representative Pudong New Area community and critically evaluate current guidelines' inclusiveness in addressing major comorbidities.</p><p><strong>Methods: </strong>Through the Shanghai Health Cloud platform, we extracted medical records of residents in the Huamu community (Pudong New Area, Shanghai) to screen elderly patients with at least three outpatient visits or one hospitalisation per year between 2019 and 2022. According to International Classification of Disease, 10th edition codes and personal identification number, we identified the status of T2DM and 12 other common chronic diseases, matched T2DM patients and non-T2DM patients 1:1 by age and gender, and then calculated the prevalence of multimorbidity status and annual prevalence of each comorbidity. We analysed associations between T2DM and specific chronic diseases using logistic regression models.</p><p><strong>Results: </strong>More than 90% of elderly T2DM patients had at least one additional chronic disease. Multimorbidity was more frequent in women and older patients. Hyperlipidemia, hypertension, and ischaemic heart disease were the most prevalent comorbidities. The diagnosis of T2DM was significantly associated with both cardiovascular-kidney-metabolic and neuropsychiatric diseases. In addition, a higher prevalence and risk of chronic obstructive pulmonary disease (COPD) were consistently detected in elderly patients with T2DM, regardless of age and gender.</p><p><strong>Conclusions: </strong>Multimorbidity in elderly patients with T2DM needs broader acknowledgement. Current guidelines focus more on cardiovascular-kidney-metabolic and neuropsychiatric diseases with inadequate guidance on COPD management. Hence, the pleiotropic effects of glucose-lowering drugs on COPD should be further investigated to optimise the comprehensive management strategy for this population.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04263"},"PeriodicalIF":4.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865922","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 barriers to global multidisciplinary stakeholder inclusivity: Lessons from global orofacial cleft research priority setting.","authors":"Niki Kouvroukoglou, Sanita Sandhu, Barbara Delage, Debbie Sell, Nicola Stock, Gareth Davies, Marina Campodonico, Bruce Richard, Zipporah Njeri Gathuya, Mekonen Eshete, Felicity V Mehendale","doi":"10.7189/jogh.14.04261","DOIUrl":"10.7189/jogh.14.04261","url":null,"abstract":"<p><strong>Background: </strong>Inclusivity in research priority setting is fundamental to capturing the opinion of all stakeholders in a research area. Globally, experienced healthcare workers often have deep insights that could impactfully shape future research, and a lack of their involvement in formal research and publications could mean that their voices are insufficiently represented. We aimed to modify the well-established Child Health and Nutrition Research Initiative (CHNRI) methodology to address barriers to inclusivity, which are particularly relevant in healthcare that requires highly multidisciplinary care.</p><p><strong>Methods: </strong>This global research priority-setting exercise for orofacial clefts adapted the CHNRI methodology to include research experts, clinicians from multiple disciplines, and non-technical stakeholders (i.e. patients and parents and non-governmental organisations (NGOs)) on a global basis. A multidisciplinary international steering group proposed and discussed methodological changes to improve inclusivity, including survey edits, subgroups for research questions, a demographics section, translation in French and Spanish, phrasing adaptation, and alternative dissemination techniques.</p><p><strong>Results: </strong>We received 412 responses and 1420 questions, spanning 78 different countries and 18 different specialties/groups. Challenges remain to improve representation of all groups, with the vast majority of answers (30%) being from surgeons and a comparatively small proportion from patient/parent groups (9%). This also includes managing responses in three languages, effective dissemination, and responses that were not worded as research questions.</p><p><strong>Conclusions: </strong>This is one of the first CHNRI exercises to involve patients and parents, clinicians, and researchers in its first question submission stage, and the first ever to do so on a global scale. We describe our approach to addressing inclusivity challenges and report related demographic data to serve as a benchmark upon which we hope future CHNRI exercises will improve.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04261"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819789","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 between ambient particulate matter and latent tuberculosis infection among 198 275 students.","authors":"Zhongqi Li, Zhan Wang, Peng Lu, Jingxian Ning, Hui Ding, Limei Zhu, Xiaohua Pei, Qiao Liu","doi":"10.7189/jogh.14.04244","DOIUrl":"10.7189/jogh.14.04244","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have estimated the impact of outdoor particulate matter (PM) on tuberculosis risk. Nevertheless, whether there is an association between ambient PM and latent tuberculosis infection (LTBI) risk remains uncertain.</p><p><strong>Methods: </strong>We collected the basic information and LTBI test results of students who underwent freshmen enrolment physical examinations in 68 middle schools from six prefecture-level cities located in eastern China between 2018 and 2021. We also extracted data on air pollutant concentrations and meteorological factors in six cities between 2015 and 2021. We applied the generalised additive model (GAM) to assess the effect of PM on LTBI risk.</p><p><strong>Results: </strong>We included 198 275 students in the final analysis, of whom 11 721 were diagnosed with LTBI. The LTBI group had higher proportions of males (P < 0.001), individuals of Han nationality (P < 0.001), and body mass index compared to the non-LTBI group (P < 0.001). For each 1-μg/m³ increase in PM₁₀ concentration, the LTBI risk increased by 0.82% (95% confidence interval (CI) = 0.65-1.00), 0.90% (95% CI = 0.73-1.08), and 0.86% (95% CI = 0.69-1.03) when lagged at one, two, and three years, respectively. For PM_2.5, the LTBI risk increased by 0.91% (95% CI = 0.63-1.20), 1.05% (95% CI = 0.75-1.36), and 1.32% (95% CI = 0.96-1.69) when lagged at one, two, and three years, respectively.</p><p><strong>Conclusions: </strong>Outdoor PM concentration was positively correlated with LTBI risk. Considering that many developing countries are facing the dual challenges of high LTBI rates and serious ambient air pollution, reducing outdoor PM concentration would contribute to alleviating their tuberculosis burden.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04244"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819802","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":"Hypertonic saline nasal irrigation and gargling for suspected or confirmed COVID-19: Pragmatic randomised controlled trial (ELVIS COVID-19).","authors":"Osman M Yusuf, Sandeep Ramalingam, John Norrie, Catriona Graham, Ahmad Kakakhail, Aimal T Rextin, Ramsha T Baig, Shahida O Yusuf, Bakhtawar Ahmad, Summan Zahra, Aziz Sheikh","doi":"10.7189/jogh.14.05027","DOIUrl":"10.7189/jogh.14.05027","url":null,"abstract":"<p><strong>Background: </strong>In a previous pilot randomised controlled trial conducted on UK adults, we found that hypertonic saline nasal irrigation and gargling (HSNIG) reduced common cold symptoms, the need for over-the-counter medications, viral shedding, and the duration and transmission of the illness. It is unclear whether HSNIG improves outcomes of the coronavirus disease 2019 (COVID-19). Hypertonic saline can be prepared and HSNIG performed at home, making it a safe and scalable intervention, particularly well-suited for low- and middle-income countries.</p><p><strong>Methods: </strong>We conducted a pragmatic randomised controlled trial in Pakistan on adults with suspected or confirmed COVID-19, initially within 48 hours of symptom onset, later extended to within five days due to recruitment challenges. Participants were randomised to one of two groups: the intervention group received instructions on preparing a 2.6% hypertonic saline solution for HSNIG, while the control group was instructed on performing ablution for Muslim prayers (wudu), which involves nasal washing and gargling with tap water. Our primary outcome was the time to symptom resolution, measured by two consecutive days of scoring zero on relevant questions from the validated, self-reported, adapted short form of the Wisconsin Upper Respiratory Symptom Survey (WURSS-24). Secondary outcomes included the severity of all symptoms, the severity and time to resolution of individual symptoms, health care contacts (GP/physician, emergency contacts), hospital attendance (and length of stay if admitted), over-the-counter (OTC) medication (frequency and cost), and transmission to household contacts. The analysis was conducted on an intention-to-treat basis. Logistic regression was used to calculate adjusted odds ratios (aORs) of improvement and Cox regression to calculate adjusted hazard ratios (aHRs) for the time to improvement with accompanying 95% confidence intervals (CIs).</p><p><strong>Results: </strong>We randomised 576 people: 279 to the HSNIG group and 297 to the control group. Among those, 10 out of 279 (3.6%) in the HSNIG had symptom resolution, compared with 11 out of 297 (3.7%) in the control group (aOR = 1.20, 95% CI = 0.46- 3.22). The time-to-event analysis also showed no significant benefit (aHR = 1.23, 95% CI = 0.51-2.97). Excluding the 127 participants with no data on the primary outcome (who did not complete the study), 10 out of 222 (4.5%) in the HSNIG group had symptom resolution, compared to 11 out of 227 (4.8%) in the control group.</p><p><strong>Conclusions: </strong>HSNIG was not effective for individuals with suspected or confirmed COVID-19 who began the intervention within five days of symptoms onset and therefore cannot be recommended for use. Further investigation is needed for interventions started within 48 hours of illness onset.</p><p><strong>Registration: </strong>ClinicalTrials.gov (NCT05104372).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05027"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819935","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":"Magnitude, determinants, and adverse outcomes of unintended pregnancy among pregnant mothers in low- and middle-income countries: An umbrella review of systematic review and meta-analysis.","authors":"Gizachew Yilak, Tegene Atamenta Kitaw, Biruk Beletew Abate, Alemu Birara Zemariam, Addis Wondmagegn Alamaw, Eyob Shitie Lake, Mulat Ayele, Alemayehu Sayih Belay, Addisu Getie, Befkad Derese Tilahun","doi":"10.7189/jogh.14.04253","DOIUrl":"10.7189/jogh.14.04253","url":null,"abstract":"<p><strong>Background: </strong>To date, findings from systematic reviews and meta-analyses on unintended pregnancies in low-income and middle-income countries (LMICs) are inconsistent, posing challenges for preventive efforts. Therefore, the aim of this study is to determine the magnitude, determinants, and adverse outcomes of unintended pregnancy among pregnant mothers in LMICs: an umbrella review of systematic review and meta-analysis.</p><p><strong>Methods: </strong>PubMed, Scopus, Science Direct, Web of Science, as well as databases specific to systematic reviews, such as the Cochrane Database, have investigated the magnitude, risk factors, and adverse outcomes of unintended pregnancy in LMICs. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates from the included studies regarding the magnitude and predictors of unintended pregnancy were then pooled and summarised using random-effects meta-analysis models.</p><p><strong>Results: </strong>We included 13 systematic review and meta-analysis (SRM) studies involving 1 446 122 women. The summary estimate for the magnitude of unintended pregnancy was 28.38% (95% CI = 23.06-33.7%, I² = 100%). From the umbrella review, the reported factors and complications of statistical significance were as follows: maternal illiteracy (AOR = 3.79; 95% CI = 1.36-8.94), being unmarried (AOR = 12.98; 95% CI = 1.88-27.85), lack of communication with the husband about family planning (AOR = 3.43; 95% CI = 1.68-5.19), inability to attend antenatal care (AOR = 1.4; 95% CI = 0.62-2.17), never using family planning (AOR = 1.4; 95% CI = 0.62-2.17), maternal depression (AOR = 1.72; 95% CI = 0.81-2.64), stunting (AOR = 1.76; 95% CI = 1.25-2.48), and parity 3.83 (AOR = 1.3; 95% CI = 1.3-11.3).</p><p><strong>Conclusions: </strong>The pooled magnitude of unintended pregnancies in LMICs was high. Therefore, it is crucial to integrate family planning and maternal health care services to prevent unintended pregnancy. Additionally, interventions targeting rural, unmarried, less-educated, and adolescent women are important for preventing unintended pregnancies in LMICs.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04253"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819946","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":"'From rhetoric to action: Moving policy, research, and practice' - The 29^th Canadian Conference on Global Health in 2023.","authors":"Michelle Amri, Margaret J Mutumba-Nakalembe, Johanna C Manga, Colleen M Davison","doi":"10.7189/jogh.14.02001","DOIUrl":"10.7189/jogh.14.02001","url":null,"abstract":"","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"02001"},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819927","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":"Eliciting parents' decision-making to antibiotic use for upper respiratory tract infections: A discrete choice experiment.","authors":"Lixia Duan, Rujiao Lin, Dan Wang, Xi Wang, Xinyi Zhang, Liping Ding, Chenxi Liu","doi":"10.7189/jogh.14.04220","DOIUrl":"10.7189/jogh.14.04220","url":null,"abstract":"<p><strong>Background: </strong>Addressing antibiotic resistance is important for reducing parents' self-medication of antibiotics for children's upper respiratory tract infections (URTIs). However, the decision-making process for parents who irrationally use such antibiotics is still unclear. In this study, we aimed to explore the reasons why parents self-medicate antibiotics for children's URTIs based on a discrete choice experiment.</p><p><strong>Methods: </strong>We conducted a systematic review and in-depth interviews to identify the key attributes of choices when parents self-medicate antibiotics for children's URTIs. We developed and applied a discrete choice experiment in Wuhan and Chongqing, China. We used a mixed logit model to determine the impact of various attributes on parents' decisions, while we applied latent class logit models to explore different decision-making patterns within populations.</p><p><strong>Results: </strong>A total of 400 valid responses were returned from parents. It was shown that symptom severity was the most important in parents' decision-making to self-medicate antibiotics for children's URTIs, followed by risk of side effects or resistance, duration, total cost, onset time of antibiotic, and antibiotic effectiveness. More severe and longer symptoms, perceived higher effectiveness, and fewer side effects of antibiotics consistently were significantly associated with parents' more likely to self-medicate with antibiotics for children's URTIs. There are also different patterns of decision-making of parents, including 'symptoms-oriented,' 'safety-oriented,' and 'comprehensive consideration.' Parents' gender and educational level were associated with decision-making patterns.</p><p><strong>Conclusions: </strong>Parents' self-medication of antibiotics for children's URTIs was mainly driven by symptoms, followed by perceived antibiotic value. We recommend a multi-faceted intervention strategy to enhance parents' ability to differentiate mild from severe URTIs, as well as their knowledge of antibiotics.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04220"},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802903","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":"Leadership, cohesion, and stress in primary care facilities and retention in chronic care in rural northeast South Africa before and during the COVID-19 pandemic: A longitudinal study.","authors":"Hannah H Leslie, Morelearnings Sibanda, Kathleen Kahn, Stephen M Tollman, Nkosinathi Masilela, F Xavier Gómez-Olivé, Sheri A Lippman, Chodziwadziwa W Kabudula","doi":"10.7189/jogh.14.05035","DOIUrl":"10.7189/jogh.14.05035","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV) and hypertension are major contributors to morbidity and mortality in South Africa. Effective management of these conditions is critical to population health, yet patient management and retention varies by facility for reasons that are not fully understood. We assessed whether measures of clinic leadership, cohesion, and stress were associated with retention for HIV and hypertension in a cohort of patients in northeast South Africa before and during the Coronavirus disease 2019 pandemic.</p><p><strong>Methods: </strong>We quantified nursing capacity and service readiness within primary health care facilities in the Bushbuckridge sub-district in Mpumalanga province South Africa. We administered brief scales on facility leadership, cohesion, and stress from January to March 2019, and tested scales for individual and facility-level agreement. We extracted clinical records for patients with HIV and/or hypertension from 2019 to 2021 and quantified treatment retention by quarter. We used generalised estimating equations to assess individual and clinic factors associated with retention in each treatment programme prior to (2019-first quarter 2020) and during (second quarter 2020-2021) the pandemic.</p><p><strong>Results: </strong>The nine facilities had a median of 12 nurses on staff and scored 0.83 out of 1.0 on basic service readiness. We collected responses to leadership, cohesion, and stress scales from 54 nurses and counsellors. Scales showed high inter-item agreement and moderate within-facility agreement. From 2019 to 2021, 19 445 individuals were treated for HIV and/or hypertension across seven participating facilities. Two-year retention was 91% for those with both conditions, 82% for those in treatment for HIV alone and 77% for those in treatment for hypertension alone, with 10-15% differences between facilities and high retention during the pandemic period. In addition to those with both conditions, women and adults aged 60-69 were more likely to be retained. Clinic factors were inconsistently associated with patient retention.</p><p><strong>Conclusions: </strong>While measures of clinic leadership, cohesion, and stress were generally reliable at individual and facility levels, we found limited evidence supporting a link between these factors and better retention in care. Retention was stable during the Coronavirus disease 2019 pandemic. Men, the youngest and oldest adults, and those without known multimorbidity should be prioritised for retention interventions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05035"},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802906","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 health and economic burden of rare endocrine disease: Often ignored, always important.","authors":"Luna Liu, Yingzhou Shi, Yuchen Li, Wanhong Wu, Yang Tian, Xiude Fan, Chao Xu","doi":"10.7189/jogh.14.04249","DOIUrl":"10.7189/jogh.14.04249","url":null,"abstract":"<p><strong>Background: </strong>Rare endocrine diseases (RED) often pose chronic and life-threatening challenges, yet their economic costs and societal impact remains have not been precisely quantified.</p><p><strong>Methods: </strong>We obtained patient data from the 2018 Nationwide Inpatient Sample (NIS) and the Nationwide Readmissions Database (NRD), identifying RED patients through International Classification of Diseases, 10th revision codes. The difference of economic burden between RED patients and the control group, including hospital length of stay, hospitalisation costs, and readmission rates, was assessed using chi-square tests.</p><p><strong>Results: </strong>We extracted 638 083 (2.98%) RED-related records from the NIS database. Compared to patients with common conditions, RED patients showed an exceedingly high burden of disease, including significantly extended hospital stays (P < 0.05), elevated total charges (P < 0.05), and heightened mortality rates (P < 0.05). They also had a substantially increased 30-day all-cause readmission rate based on the NRD database (P < 0.05). Although the different subgroups of RED patients had varying patterns of health care utilisation and economic burdens, they all surpassed those of patients with common conditions.</p><p><strong>Conclusions: </strong>There is a need for novel strategies aimed at mitigating the substantial RED-related burdens borne by individuals, families, and society in general, as well as funding for research and clinical trials.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04249"},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802907","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}