Journal of Global Health最新文献

{"title":"The epidemiology of snakebites, treatment-seeking behaviour, and snakebite management in the department of Ogooué et des Lacs, Gabon, Central Africa: a cross-sectional community and health facility-based survey.","authors":"Rica Artus, Jade Rae, Friederike Hunstig, Ghyslain Mombo-Ngoma, Alex Hounmenou Zinsou, Dearie Glory Okwu, Wilfrid Ndzebe Ndoumba, Rella Zoleko Manego, Michael Ramharter, Bertrand Lell, Peter Gottfried Kremsner, Moses Banda Aron, Jörg Blessmann, Benno Kreuels","doi":"10.7189/jogh.15.04062","DOIUrl":"https://doi.org/10.7189/jogh.15.04062","url":null,"abstract":"<p><strong>Background: </strong>Snakebite envenoming is a neglected public health problem in many tropical countries, resulting in over 100 000 deaths and 400 000 disabilities worldwide each year. In Gabon, where venomous snakes are abundant, studies on the epidemiology and treatment of snakebites are lacking.</p><p><strong>Methods: </strong>Between October 2022 and June 2023, we conducted a cross-sectional community survey in the department of Ogooué et des Lacs in central Gabon to estimate the snakebite incidence, describe clinical presentations and treatment-seeking behaviours, and describe the burden of snakebites to animal populations in rural and urban communities. We also surveyed health facilities in the department to describe treatment practices and the availability of antivenom.</p><p><strong>Results: </strong>The standardised annual incidence rate was 246 snakebite cases per 100 000 person-years (95% confidence interval (CI) = 138-438). Of the 175 snakebite cases reported in the five years prior to the survey, 18% showed signs of envenomation, predominantly with cytotoxic signs. The mortality among the bitten population was 3%. Snakebite treatment was first sought at a formal health facility in 55% of cases, from traditional healers in 22%, and with self-treatment or no treatment in the remaining 23%. Of snakebite patients treated at a formal health facility in the five years prior to the survey, 81% received antivenom, 41% received antibiotics, and 51% received corticosteroids. Almost one in six households reported animal deaths due to snakebites in the previous 12 months.</p><p><strong>Conclusions: </strong>This study provides the first robust epidemiological estimates of the burden of snakebites in Gabon and highlights the importance of community-based surveys in accurately assessing this high burden. Training health care workers, developing treatment guidelines, and ensuring the availability of effective and affordable antivenom are important steps to improving the outcome for snakebite victims.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04062"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054610","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 of sleep disturbances among medical students in the Middle East and North Africa: a systematic review and meta-analysis.","authors":"Sonia Chaabane, Karima Chaabna, Salina Khawaja, Jasmine Aboughanem, Ravinder Mamtani, Sohaila Cheema","doi":"10.7189/jogh.15.04099","DOIUrl":"https://doi.org/10.7189/jogh.15.04099","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances and their associated health issues are common among medical students. Despite this, the epidemiology of sleep disturbances among medical students in the Middle East and North Africa (MENA) region remains inadequately understood. Our objective was to synthesise the prevalence of sleep disturbances, including poor sleep quality, insufficient sleep duration, and excessive daytime sleepiness (EDS), and their variation in relation to academic performance and stress levels.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis. Two independent reviewers searched PubMed, Web of Science, Google Scholar, and the reference lists of relevant studies and reviews up to May 2024. We assessed the quality of the included studies using a risk of bias tool. We performed meta-analyses using random-effects models and used Cochran's Q between-subgroups statistic to test for differences across subgroups. We used the I² statistic to assess the statistical heterogeneity. Further, we assessed the publication bias using Doi plots.</p><p><strong>Results: </strong>We included 150 studies conducted in 16 MENA countries. We found that 59.1% of medical students suffer from poor sleep quality (Pittsburgh Sleep Quality Index mean (x̄) = 8.5; 95% confidence interval (CI) = 7.0-10.1), 59.8% have insufficient sleep duration (<7 hours per night) averaging 6.1 hours per night (95% CI = 5.4-6.9), and 38.4% experience EDS (Epworth Sleepiness Scale x̄ = 8.6; 95% CI = 8.0-9.1). Our results indicate a significantly higher prevalence of poor sleep quality among students with moderate or high stress levels during the preclinical training period and in low-income MENA countries. A significantly higher prevalence of insufficient sleep duration was found among students during preclinical academic years. A significantly higher prevalence of EDS was found among students in public medical schools and those in low-income MENA countries. We observed no differences in poor sleep quality and EDS between students with poor and good academic performance.</p><p><strong>Conclusions: </strong>Our findings highlight the substantial prevalence of sleep disturbances among MENA medical students. Medical schools must address this critical issue with targeted, locally informed, and culturally appropriate interventions. Further research is needed to assess the association between sleep disturbances and identify factors for tailored interventions that mitigate the adverse consequences on medical students' health and well-being.</p><p><strong>Registration: </strong>Open Science Framework BF2A6.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04099"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046674","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":"Treatment-seeking practices of caregivers for children aged less than five years old with diarrhoea in low- and middle-income countries: a systematic review and meta-analysis.","authors":"Gedefaw Abeje Fekadu, Muluemebet Abera Wordofa, Firmaye Bogale Woldie, Robera Olana Fite, Kassahun Alemu, Alemayehu Worku, Lisanu Taddesse, Delayehu Bekele, Getachew Tolera, Grace J Chan, Damen Hailemariam","doi":"10.7189/jogh.15.04080","DOIUrl":"https://doi.org/10.7189/jogh.15.04080","url":null,"abstract":"<p><strong>Background: </strong>Diarrhoeal diseases in children aged <5 years require immediate medical attention. However, previous studies conducted on treatment-seeking practices of caregivers for children aged <5 years with diarrhoea in low- and middle-income countries (LMICs) were inconsistent and inconclusive. We aimed to estimate the pooled treatment-seeking practice of caregivers for children aged <5 years with diarrhoea in LMICs.</p><p><strong>Methods: </strong>We used the 2020 PRISMA guidelines to conduct this systematic review and meta-analysis. We included both published and unpublished articles in English that reported treatment-seeking practices from health facilities in LMICs between 2010-22. We searched CINAHL, Medline/PubMed, Web of Science, Embase, and grey literature sources. We assessed the eligible articles using the Newcastle-Ottawa Scale quality appraisal checklist and Begg's test for the presence of publication bias. Further, we used the regression-based Egger test to test for a small study effect. Moreover, we used a narrative synthesis to characterise the studies. We estimated the pooled treatment-seeking practice using a random-effect model. We conducted a subgroup analysis considering the articles' publication status, residence, World Bank income category, study design and approach, and study setting. We presented the results using tables, figures, forest plots, and funnel plots.</p><p><strong>Results: </strong>We included 76 articles in the analysis. The overall treatment-seeking practices of caregivers were 52.84% (95% confidence interval (CI) = 47.51-58.17). Healthcare-seeking practices in low-income countries (58.12%), lower-middle-income countries (48.41%), and upper-middle-income countries (51.44%) were not statistically different. The pooled treatment-seeking practice for diarrhoea varied by study site: 29.80% (95% CI = 25.00-34.60) in peri-urban, 54.20% (95% CI = 44.71-63.70) in rural, and 47.76% (95% CI = 34.47-61.06) in urban settings. A cross-sectional design was employed in 72 studies, and 71 were quantitative.</p><p><strong>Conclusions: </strong>Treatment-seeking practice for diarrhoea among children aged <5 years in LMICs remained low. There was no statistically significant difference in treatment-seeking practice for children with diarrhoea by the country's income classification. We recommend further studies to identify factors affecting treatment-seeking practices for diarrhoea among children aged <5 years in LMICs and to act on findings and recommendations.</p><p><strong>Registration: </strong>PROSPERO: CRD42022290180.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04080"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041345","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":"Understanding maintenance, repair, and replacement of prosthetic limbs using routinely-collected data: a retrospective study over three decades in Cambodia.","authors":"Alex Dickinson, Lucy Gates, Cheryl Metcalf, Charlotte Spurway, Sisary Kheng, Thearith Heang, Bunthoeun Sam, Carson Harte, Sam Simpson, Peter Worsley, Chantel Ostler, Maggie Donovan-Hall, Amos Channon","doi":"10.7189/jogh.15.04135","DOIUrl":"https://doi.org/10.7189/jogh.15.04135","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic limbs deliver major quality of life and socioeconomic benefits for people with amputation, particularly in low-resource settings. The value of administrative data analysis is established for enabling sustainable health care improvement, but there has been limited research into the maintenance, repair, and replacement of prosthetic limbs. Survivorship data are sparse and highly variable, and rarely addresses differences between demographic groups.</p><p><strong>Methods: </strong>We investigated the distribution of time between device delivery, maintenance/repair, and replacement for a Cambodian cohort, considering the influence of a range of service delivery, user demographics, and health characteristics. We conducted Kaplan-Meier survival analysis and used a Cox model to compare repair and replacement likelihood between groups.</p><p><strong>Results: </strong>We explored 14 822 device deliveries to 6986 clients, with a median of three devices per person (interdecile range (IDR) = 1-9), and 22 878 repairs, with a median of one repair/device (IDR = 0-4). The median device survival before repair was 237 days (IDR = 38-854), and replacement was 727 days (IDR = 208-2154). Devices used by children and people in more active occupations were replaced earlier than those used by the population as a whole, upper-limb devices were replaced later than lower-limb devices, and devices were replaced earlier for volume change than for wear and tear. We observed several less intuitive trends. such as different preferences or capacities for device repair vs. replacement between clinics, and earlier device repair and replacement for women than men.</p><p><strong>Conclusions: </strong>Prosthetic limb maintenance, repair, and replacement are influenced both by the device's durability and the user's access to well-resourced physical rehabilitation services. A device that is worn-out and repaired or replaced early may indicate poor quality, or the opposite, i.e. that it fitted well and enabled great mobility. However, such analysis may enable us to identify groups who are less well-served by current devices or rehabilitation models and contribute to cost-effectiveness analysis of current services. Furthermore, the findings represent benchmark data against which engineers could measure new technologies, to ensure that innovation justifies its inherent risk by offering a genuine improvement which balances functionality, cost, and durability.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04135"},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052662","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":"Mobile phone ownership among young adults in seven Southern African countries.","authors":"Abigail R Greenleaf, Monique Millington, Laura Robles-Torres, Fred Asiimwe, Huguette Diakabana, Sarah D Francis, Tendayi Mharadze, Jessica Justman","doi":"10.7189/jogh.15.04123","DOIUrl":"https://doi.org/10.7189/jogh.15.04123","url":null,"abstract":"<p><strong>Background: </strong>In sub-Saharan Africa, mHealth interventions and phone-based data collection are increasingly popular but little is known about who can be reached by these programmes. We used national probability surveys to examine characteristics of youth (15-24 years) mobile phone owners in seven Southern African countries: Botswana, Eswatini, Lesotho, Malawi, Mozambique, Zambia, and Zimbabwe.</p><p><strong>Methods: </strong>Population-based HIV Impact Assessment surveys are cross-sectional, nationally representative household-based surveys conducted between November 2019 and February 2022. Data were analysed using multivariable logistic regression.</p><p><strong>Results: </strong>Eighty-four percent of youth in Eswatini, 83% in Botswana, 76% in Lesotho, 61% in Zimbabwe, 47% in Mozambique, 46% in Zambia and 32% in Malawi were mobile phone owners. In all countries, odds of phone ownership were higher amongst persons ages 20-24 (compared to 15-19) and those with secondary education or higher. In the three countries with ownership less than 50%, women had lower odds of owning a phone than men, and all wealth quintiles had higher odds of ownership than the lowest wealth quintile.</p><p><strong>Conclusions: </strong>Mobile phone ownership was consistently higher among certain demographic groups. Public health practitioners employing mobile phones for youth health programmes in Sub-Saharan Africa may not reach the general youth population.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04123"},"PeriodicalIF":4.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052907","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":"Evaluation of changes in price, volume and expenditure of PD-1 drugs following the government reimbursement negotiation in China: a multiple-treatment period interrupted time series analysis.","authors":"Hongbin Yi, Mengtian Cai, Xiaoxia Wei, Yingdan Cao, Liping Kuai, Dongyan Xu, Yue Qiu, Sheng Han","doi":"10.7189/jogh.15.04069","DOIUrl":"https://doi.org/10.7189/jogh.15.04069","url":null,"abstract":"<p><strong>Background: </strong>Government reimbursement negotiation (GRN) is an important policy tool to increase the accessibility of drugs. In China, the impact of GRN implementation on programmed death-1 (PD-1) drugs price, procurement volume, and expenditure is unknown.</p><p><strong>Methods: </strong>This study used a multiple-treatment period interrupted time series design covering the period from the first-time recorded in Chinese Medical Economic Information database to 2022 to examine changes in hospital procurement price, volume and expenditure of PD-1 drugs after the implementation of GRN in China. Data were obtained from 698 public hospitals of 30 provinces in China.</p><p><strong>Results: </strong>A total of four PD-1 drugs have been selected in the National Reimbursement Drug List via GRN between March 2019 and 2022. After the implementation of the first-time GRN, the prices of all PD-1 drugs decreased significantly, with Camrelizumab experiencing the largest reduction in price and the largest increase in volume and expenditure. The Camrelizumab's price decreased by 1151.75 Chinese Yuan (CNY) (β₂ = -1151.75; 95% confidence interval (CI) = -1254.534, 1048.96), volume increased by 159.549 thousand defined daily doses (β₂ = 159.549; 95% CI = 119.12, 199.979) and expenditure increased by 11.172 million CNY (β₂ = 11.172; 95% CI = 1.653, 20.692). Following the implementation of the second-time of GRN, Sintilimab showed the largest decrease in price, with price decreased by 164.099 CNY (β₄ = -164.099; 95% CI = -171.867, 156.331), Tislelizumab had the largest increase in volume and expenditure, with the volume increased by 102.185 thousand defined daily doses (β₄ = 102.185; 95% CI = 47.862, 156.509) and expenditure increased by 4.119 million CNY (β₄ = 4.119; 95% CI = -3.808, 12.047).</p><p><strong>Conclusions: </strong>The GRN policy improved the accessibility and affordability of PD-1 drugs. Health insurance policy-makers need to consider the legitimate interests of PD-1 drug manufacturers while ensuring the sustainability of the basic health insurance fund.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04069"},"PeriodicalIF":4.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056370","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":"Unravelling behavioural contributions to IBS risk: evidence from univariate and multivariate Mendelian randomisation.","authors":"Hongyu Chu, Yumin Zhong, Jiayi Zhao, Yuezhan Shan, Xuedong Fang","doi":"10.7189/jogh.15.04112","DOIUrl":"https://doi.org/10.7189/jogh.15.04112","url":null,"abstract":"<p><strong>Background: </strong>While numerous studies have investigated the link between behavioural factors and irritable bowel syndrome (IBS), the causal relationships remain unresolved. This study applied Mendelian randomisation (MR) analysis to assess the causal impact of specific behavioural factors on IBS risk.</p><p><strong>Methods: </strong>Bidirectional Mendelian randomisation analysis was employed to evaluate the causal relationships between behavioural factors and IBS risk. A genome-wide significance threshold (P < 5e^-6) was applied to identify associations between genetic variants and behaviour-related traits, ensuring robust selection of instrumental variables for evaluating potential causal effects. Genetic correlations with IBS were sourced from extensive genome-wide association studies (GWASs). Various statistical methods were applied to estimate the causal effects.</p><p><strong>Results: </strong>This study employed both univariate and multivariate Mendelian randomisation analyses to investigate the causal relationships between specific behavioural factors and the risk of irritable bowel syndrome (IBS). The results indicated that body mass index (BMI) (odds ratio (OR) = 1.074; 95% confidence interval (CI) = 1.025-1.125, P = 0.031), insomnia (OR = 1.986; 95% CI = 1.652-2.389, P < 0.001), duration of mobile phone use (OR = 1.120; 95% CI = 1.018-1.232, P = 0.021), and weekly mobile phone usage time in the past three months (OR = 1.148; 95% CI = 1.016-1.298, P = 0.021,) were associated with an increased risk of IBS. In contrast, usual walking speed (OR = 0.756; 95% CI = 0.621-0.920, P < 0.001), non-smoking status (OR = 0.779; 95% CI = 0.645-0.941, P < 0.001), and weekly alcohol consumption (OR = 0.862; 95% CI = 0.743-0.999, P = 0.015) were associated with a reduced risk of IBS. Furthermore, in the multivariate Mendelian randomisation analysis, no statistically significant causal associations were found for BMI, usual walking pace, length of mobile phone use, and smoking status. Weekly mobile phone usage time in the past three months (OR = 1.439; 95% CI = 1.126-1.840, P = 0.0037,) and insomnia (OR = 1.468; 95% CI = 1.076-2.003, P = 0.0156) were identified as risk factors, while weekly alcohol intake (OR = 0.813; 95% CI = 0.677-0.975, P = 0.0257) acted as a protective factor.</p><p><strong>Conclusions: </strong>This study identified BMI, insomnia, duration of mobile phone use, and weekly mobile phone usage time in the past three months as risk factors for IBS. In contrast, weekly alcohol consumption, usual walking pace, and non-smoking status were observed as protective factors. Additionally, in multivariable analysis, weekly mobile phone use, insomnia, and weekly alcohol consumption showed a direct influence on IBS risk when considered simultaneously.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04112"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064393","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":"Comparison of excess deaths and laboratory-confirmed COVID-19 deaths during a large Omicron epidemic in 2022 in Hong Kong.","authors":"Hualei Xin, Alexandra H T Law, Justin K Cheung, Yun Lin, Peng Wu, Zhongjie Li, Benjamin J Cowling, Weizhong Yang, Jessica Y Wong","doi":"10.7189/jogh.15.04105","DOIUrl":"https://doi.org/10.7189/jogh.15.04105","url":null,"abstract":"<p><strong>Background: </strong>Using an elimination strategy, Hong Kong was able to minimise COVID-19 mortality in 2020 and 2021, but a large epidemic caused by the Omicron variant occurred in 2022. We aimed to estimate the overall, age-, sex-, epidemic period- and cause-specific excess mortality in 2022 in Hong Kong and compare excess mortality to laboratory-confirmed COVID-19 mortality.</p><p><strong>Methods: </strong>We used negative binomial regression analysis to model time series of weekly all-cause and cause-specific deaths from 2010 to 2021 to predict the weekly number of deaths in 2022 against counterfactual baselines projected from the trends in the absence of a pandemic. The estimated excess deaths were compared with laboratory-confirmed COVID-19 deaths overall and by age and epidemic period.</p><p><strong>Results: </strong>We estimated that there were 13 500 (95% confidence interval (CI) = 13 400, 13 600) excess deaths in 2022, which was slightly higher than the 12 228 deaths recorded with laboratory-confirmed COVID-19, with the majority of the excess deaths and laboratory-confirmed deaths occurring among older adults. The increased number of excess deaths over laboratory-confirmed COVID-19 deaths was most substantial from February to April 2022 (a difference of 847 deaths), when the most prominent Omicron wave peaked. Most of the excess deaths (78%) were from respiratory causes, while 10% were from cardiovascular causes. A slight reduction in malignant neoplasm mortality was identified among older adults in 2022.</p><p><strong>Conclusions: </strong>A substantial increase in population mortality was identified in 2022 in Hong Kong, slightly larger than the laboratory-confirmed COVID-19 deaths. Deaths from COVID-19 may have displaced some deaths that would otherwise have occurred due to other causes.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04105"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026667","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":"Assessing the cost of illness of RSV and non-RSV acute respiratory infections in Nepali children.","authors":"Neele Rave, Arun K Sharma, Ram H Chapagain, Rupesh Shrestha, An Nguyen, Clint Pecenka, Farina L Shaaban, Prakash Joshi, Louis J Bont","doi":"10.7189/jogh.15.04092","DOIUrl":"https://doi.org/10.7189/jogh.15.04092","url":null,"abstract":"<p><strong>Background: </strong>Low- and middle-income countries (LMICs) bear the greatest burden of the global respiratory syncytial virus (RSV) morbidity and mortality, but lack cost data to evaluate the health-economic impact of RSV burden on families, the healthcare system, and society. This prospective observational study was performed by the RSV GOLD III - Health Economic Research Group and estimated the costs associated with RSV illness in Nepal.</p><p><strong>Methods: </strong>We collected healthcare resource utilisation data from children <2 years old fulfilling the World Health Organization (severe) acute respiratory infections ((S)ARI) case definition over one local respiratory season (July to November 2023) at two public hospitals in Nepal. We used hospital records and caregiver interviews to collect direct medical, direct non-medical, and indirect cost data to generate total per-patient costs.</p><p><strong>Results: </strong>We included 730 patients with a mean age of 6.8 (standard deviation = 5.8) months. RSV infection was confirmed in 72.6% of the inpatients (n/N = 469/646) with SARI. The mean total cost per RSV episode was USD 43 (95% confidence interval (CI) = 25-62) for non-severe, USD 312 (95% CI = 293-332) for severe, and USD 664 (95% CI = 381-947) for life-threatened patients. Of the total costs, the healthcare system incurred USD 16 (36.3%), USD 58 (18.6%), and USD 57 (8.6%) in each category of illness. Household-level costs were 1.4% (USD 19) of the country's gross domestic product per capita for non-severe, 15.1% (USD 200) for severe, and 35.7% (USD 472) for life-threatened patients, with costs for inpatients often reaching catastrophic levels.</p><p><strong>Conclusions: </strong>Our findings show a significant healthcare and economic burden of RSV illness in Nepal, highlighting the need to prioritise RSV prevention strategies. Our cost burden data can inform the modelling of costs and benefits of future RSV interventions in Nepal.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04092"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993029","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":"Effective coverage for maternal health: operationalising effective coverage cascades for antenatal care and nutrition interventions for pregnant women in seven low- and middle-income countries.","authors":"Ashley Sheffel, Emily Carter, Rebecca Heidkamp, Aniqa Tasnim Hossain, Joanne Katz, Sunny Kim, Tsering Pema Lama, Tanya Marchant, Jamie Perin, Jennifer Requejo, Shelley Walton, Melinda K Munos","doi":"10.7189/jogh.15.04041","DOIUrl":"https://doi.org/10.7189/jogh.15.04041","url":null,"abstract":"<p><strong>Background: </strong>Efforts to improve maternal health have focused on measuring health and nutrition service coverage. Despite improvements in service coverage, maternal mortality rates remain high. This suggests that coverage indicators alone do not fully capture the quality of care and may overestimate the health benefits of a service. Effective coverage (EC) cascades have been proposed as an approach to capture service quality within population-based coverage measures, but the proposed maternal health EC cascades have not been operationalised. This study aims to operationalise the effective coverage cascades for antenatal care (ANC) and maternal nutrition services using existing data from low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>We used household surveys and health facility assessments from seven LMICs to estimate EC cascades for ANC and maternal nutrition services provided during ANC visits. We developed theoretical coverage cascades, defined health facility readiness and provision/experience of care scores and linked the facility-based scores to household survey data based on geographic domain and facility type. We then estimated the coverage cascade steps for each service by country.</p><p><strong>Results: </strong>Service contact coverage for at least one ANC visit (ANC1) was high, ranging from 80% in Bangladesh to 99% in Sierra Leone. However, there was a substantial drop in coverage from service contact to readiness-adjusted coverage, and a further drop to quality-adjusted coverage for all countries. For ANC1, from service contact to quality-adjusted coverage, there was an average net decline of 52 percentage points. For ANC1 maternal nutrition services, there was an average net decline of 48 percentage points from service contact to quality-adjusted coverage. This pattern persisted across cascades. Further exploration revealed that gaps in service readiness including lack of provider training, and gaps in provision/experience of care such as limited nutrition counselling were core contributors to the drops in coverage observed.</p><p><strong>Conclusions: </strong>The cascade approach provided useful summary measures that identified major barriers to EC. However, detailed measures underlying the steps of the cascade are likely needed to support evidence-based decision-making with more actionable information. This analysis highlights the importance of understanding bottlenecks in achieving health outcomes and the inter-connectedness of service access and service quality to improve health in LMICs.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04041"},"PeriodicalIF":4.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993030","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}