Journal of Global Health最新文献

{"title":"The longitudinal relationship between night-time sleep duration, midday napping, and frailty among middle-aged and older people in China: a prospective analysis.","authors":"Dongfeng Tang, Chengxu Long, Yilin Wei, Shangfeng Tang","doi":"10.7189/jogh.15.04059","DOIUrl":"10.7189/jogh.15.04059","url":null,"abstract":"<p><strong>Background: </strong>Frailty is an important issue presented by ageing. Night-time sleep and midday napping are important modifiable factors influencing health, but their impacts on frailty remain unclear.</p><p><strong>Methods: </strong>We used five waves of data from the China Health and Retirement Longitudinal Study (2011-20), with 15 333 participants in the baseline sample. We used fixed effects regression models to explore longitudinal relationships between night-time sleep duration, midday napping, and frailty index (FI). We added interaction terms of sleeping and napping to the regression model to explore their combined effects. We further used the Cox proportional regression model to quantify risks for frailty.</p><p><strong>Results: </strong>Compared to sleeping seven to nine hours, sleeping <6 hours (FI = 0.016), six to seven hours (FI = 0.004), and >9 hours (FI = 0.005) were significantly associated with a mean increase in FI separately. Napping >90 minutes significantly increased FI by 0.003 compared to non-nappers. Effects of sleeping six to seven hours and >9 hours on frailty were separately enhanced by napping >90 minutes and any napping duration (except 60-90 minutes). Sleeping <6 hours and six to seven hours increased frailty risk by 44% (hazard ratio (HR) = 1.44) and 12% (HR = 1.12), respectively. Frailty risk was increased by napping >90 minutes by 14% (HR = 1.14) compared to non-nappers.</p><p><strong>Conclusions: </strong>Short (<7 hours) or long (>9 hours) sleep and prolonged midday napping (>90 minutes) were associated with frailty among the Chinese middle-aged and older population. The compensation effect of napping for short night-time sleep was not found in this study, and certain napping durations even increased risks of sleeping six to seven hours and >9 hours for frailty.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04059"},"PeriodicalIF":4.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525008","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":"Causes and preventive measures for fire-related injuries in intensive care units: a systematic review.","authors":"JiaFang Wu, YuQing Yao, XiuLing Shang","doi":"10.7189/jogh.15.04043","DOIUrl":"10.7189/jogh.15.04043","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) fires are a significant public health concern which often receives insufficient attention. However, they notoriously challenging to manage, with a high risk of casualties and substantial economic damage. Despite their severity, research on ICU fires remains scarce.</p><p><strong>Methods: </strong>In this systematic review, we queried PubMed, Cochrane, Embase, Web of Science, and Web of Baidu Academic for studies on ICU or hospital fires published from the inception of each database to 5 July 2024. We then narratively summarised the causes of ICU fires and the details of ICU fire prevention and evacuation.</p><p><strong>Results: </strong>We examined 2602 articles, of which 30 met our inclusion criteria. We summarised the causes and injuries of 18 ICU fires. The most common causes were electrical faults and oxygen cylinder faults, while the prevention and response strategies for ICU fires included regular maintenance of electrical and oxygen equipment, installation of automatic fire fighting systems, reasonable arrangement of patient beds, vertical and horizontal evacuation route planning, online and offline fire safety training, and intelligent evacuation simulation.</p><p><strong>Conclusions: </strong>We found that the primary causes of fires in ICUs are electrical malfunctions and oxygen-related incidents. It is essential to implement preventive measures such as regular inspection of electrical equipment, proper maintenance of wiring, and ensuring all oxygen systems are handled according to strict safety protocols. Additionally, ensuring that all ICU staff are adequately trained in emergency response protocols can significantly improve patient outcomes in the event of a fire.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04043"},"PeriodicalIF":4.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525002","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":"Relationship of perinatal outcomes to the competence and quantity of contact with community health workers.","authors":"Mark Tomlinson, Mary Jane Rotheram-Borus, Linnea Stansert Katzen, William Gertsch, Ingrid le Roux, Elaine Dippenaar, Karl le Roux","doi":"10.7189/jogh.15.04094","DOIUrl":"10.7189/jogh.15.04094","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of perinatal home visits by community health workers (CHWs) often diminishes when large regional or national programmes are implemented. To address this gap, we aimed to identify which CHW behaviours influence maternal and child outcomes.</p><p><strong>Methods: </strong>We randomised all government-funded CHWs at eight deeply rural clinics (n = 43) by clinic to usual care, which consisted of home visits (control group; four clinics, 23 CHWs, 392 mothers), or to home visiting, which included improved monitoring and supervision (intervention group; four clinics, 20 CHWs, 423 mothers). Since fewer than 7% of CHWs in the control group ever implemented home visits and no data was available on the frequency of visits, we focussed on the CHWs in the intervention group. We monitored the number and timing of home visits over time and documented it by paper and mobile phone records. Supervisors who conducted at-home observations of visits completed competency ratings on each CHW. We evaluated the associations between the competency of the CHW and the number and timing of CHWs' visits with 13 maternal/child outcomes using multiple regression analyses.</p><p><strong>Results: </strong>Consistent home visits by CHWs reached the threshold at about 9-12 months, with the frequency reducing because of COVID-19. There were two significant outcomes (antiretroviral therapy adherence and securing the child grant) associated with the number of home visits in the intervention group, but insufficient to demonstrate efficacy. The CHW competency was unrelated to any maternal/child outcome. Moreover, CHWs visited 7% of mothers during the first two days of their infants' lives, 26% during the first week, 57% within the first month, and 90% by the first three months of life.</p><p><strong>Conclusions: </strong>Current standards for training and monitoring of paraprofessional home visitors are highly unrealistic. Substantial and ongoing investments are needed for visits to occur consistently over time. However, hiring and selection criteria are likely as important as training and monitoring. CHW programmes must be embedded in organisational contexts that are well functioning and have management and support structures that are operational to ensure their success.Keywords.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04094"},"PeriodicalIF":4.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525007","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":"Using calculations from the Lives Saved Tool in other global health modelling tools.","authors":"Timothy Roberton, Robert McKinnon, Thomas Podkowiak, Jared Schmidt, William Winfrey, Neff Walker","doi":"10.7189/jogh.15.03012","DOIUrl":"10.7189/jogh.15.03012","url":null,"abstract":"<p><p>The Lives Saved Tool (LiST) is a widely used software package for modelling changes in child, neonatal, and maternal mortality. Until recently, it has mainly been used as a standalone tool that people manipulate using its desktop or online interface. The developers of LiST have now created a web-based application programming interface (API) allowing other software programmes to interact directly with LiST to use its internal calculations. This opens the door for using LiST within more complex models, for which coverage-to-mortality calculations are only a part, or for building topic-specific tools with a custom interface. The API also allows other software programmes to access the data that has been gathered and maintained by the LiST team on the effectiveness and coverage of 70+ interventions, along with data on mortality rates, cause-of-death structures, and child nutritional status in low- and middle-income countries. In this viewpoint, we describe how we see the API being used and give examples of tools that are already using it. Our hope is that others can now take full advantage of LiST and its 20+ years of development to build their own tools for effective data use in global health.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03012"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469443","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 efficiency and productivity-changing trend of PHCIs since the 2009 health reform in China based on a three-stage DEA and Malmquist Productivity Index.","authors":"Ling Liu, Jia Peng, Sumit Kane, Chenkai Wu, Yumei Liu, Jiayan Huang","doi":"10.7189/jogh.15.04045","DOIUrl":"10.7189/jogh.15.04045","url":null,"abstract":"<p><strong>Background: </strong>In China, most primary health care institutes (PHCIs) support ground-level medical services which are essential to residents' health levels. The Chinese government implemented a health reform in 2009 to strengthen PHCIs through increased fiscal inputs. However, how efficiently these inputs were converted into PHCIs' services remains unclear. We aimed to examine the efficiency of PHCIs' medical services and investigate if any changes occurred following the implementation of the health reform.</p><p><strong>Methods: </strong>We aggregated data from PHCIs from Hainan's 18 districts (2011-21), treating those from the same district as one decision-making unit (DMU). We used three-stage data envelopment analysis (DEA) to assess the efficiencies of these PHCIs, adjusting the approach for environmental factors, managerial ineffectiveness, and statistical errors potentially arising from the background variability of measured data that deviates from the input and output values, allowing all DMUs to be compared in a homogeneous environment. We used the adjusted efficiency scores to evaluate the efficiency of PHCIs in Hainan each year and the Malmquist Productivity Index (MPI) to explore the productivity change of PHCIs over time.</p><p><strong>Results: </strong>After adjusting for environmental factors between 2011-21, technical efficiency (TE) decreased from 0.825 to 0.745, pure technical efficiency (PTE) increased from 0.936 to 0.954, and scale efficiency (SE) decreased from 0.883 to 0.783. Seven districts had full PTE (1.0) and two districts had full TE (1.0) after adjustment. The mean MPI from 2011 to 2021 was 0.9430, indicating a 5.7% decrease in PHCIs' efficiency. After excluding the low productivity index possibly influenced by COVID-19 (2019 to 2021), PHCIs' efficiency decreased by 0.49%, with a mean MPI of 0.9951.</p><p><strong>Conclusions: </strong>The efficiency of PHCIs in Hainan has declined slightly since the health reform. Low level of scale efficiency posed a significant impact on the overall efficiency of the medical services in PHCIs. Among potential inefficient technological performances, future policy formulation might focus more on the imbalanced allocation of resources in less-developed regions and PHCIs' lack of attractiveness to local patients.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04045"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469347","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":"Cost-effectiveness of preventive COVID-19 interventions: a systematic review and network meta-analysis of comparative economic evaluation studies based on real-world data.","authors":"Xiaoyu Tang, Sun Sun, Mevludin Memedi, Ayako Hiyoshi, Scott Montgomery, Yang Cao","doi":"10.7189/jogh.15.04017","DOIUrl":"10.7189/jogh.15.04017","url":null,"abstract":"<p><strong>Background: </strong>There is a knowledge gap regarding the effectiveness and utility of various preventive interventions during the COVID-19 pandemic. In this study, we aimed to evaluate the cost-effectiveness of various COVID-19 preventive interventions, including non-medical interventions (NMIs) and vaccination programs, using real-world data across different demographic and socioeconomic contexts worldwide.</p><p><strong>Methods: </strong>We searched Medline, Cochrane Library, Embase, and Web of Science Core Collection from December 2019 to March 2024. We identified 75 studies which compared 34 COVID-19 preventive interventions. We conducted a network meta-analysis to assess the incremental net benefits (INB) of these interventions from both societal and health care system perspectives. We adjusted purchasing power parity (PPP) and standardised willingness to pay (WTP) to enhance the comparability of cost-effectiveness across different economic levels. We performed sensitivity and subgroup analyses to examine the robustness of the results.</p><p><strong>Results: </strong>Movement restrictions and expanding testing emerged as the most cost-effective strategies from a societal perspective, with WTP-standardised INB values of USD 21 050 and USD 11 144. In contrast, combinations of NMIs with vaccination were less cost-effective, particularly in high-income regions. From a health care system perspective, vaccination plus distancing and test, trace, and isolate strategy were highly cost-effective, while masking requirements were less economically viable. The effectiveness of interventions varied significantly across different economic contexts, underlining the necessity for region-specific strategies.</p><p><strong>Conclusions: </strong>In this study, we highlight significant variations in the cost-effectiveness of COVID-19 preventive interventions. Tailoring strategies to specific regional economic and infrastructural conditions is crucial. Continuous evaluation and adaptation of these strategies are essential for effective management of ongoing and future public health threats.</p><p><strong>Registration: </strong>PROSPERO: CRD42023385169.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04017"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469589","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 treatment responses among different inhalation therapies for GOLD group E patients with chronic obstructive pulmonary disease.","authors":"Qing Song, Ling Lin, Tao Li, Ping Zhang, Yuqin Zeng, Dingding Deng, Rong Yi, Dan Liu, Yan Chen, Shan Cai, Ping Chen, Cong Liu","doi":"10.7189/jogh.15.04055","DOIUrl":"10.7189/jogh.15.04055","url":null,"abstract":"<p><strong>Background: </strong>The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 revised the combined chronic obstructive pulmonary disease (COPD) assessment, merging groups C and D into group E, and revised the initial inhalation therapy recommendation. We aimed to evaluate the treatment responses among different inhalation therapies in GOLD group E patients stratified by the COPD assessment test (CAT) scores and forced expiratory volume in one-second percentage of predicted (FEV1%pred).</p><p><strong>Methods: </strong>In this retrospective cohort study, we included patients with COPD registered in the Real World Research of Diagnosis and Treatment of COPD (RealDTC) study between January 2017 and June 2023. According to the GOLD 2023 report, we enrolled patients assigned to GOLD group E based on exacerbations in the past year (≥2 exacerbations or ≥1 hospitalisation) in this study. We classified them into the FEV1%pred <50% and FEV1%pred ≥50% groups, or CAT<10 and CAT≥10 groups. Subsequently, we divided all groups into four subgroups: long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS. All patients finished one year of follow-up, during which we collected data on exacerbations, frequent exacerbations, hospitalisations, and all-cause mortality. We defined frequent exacerbations as ≥2 exacerbations per year.</p><p><strong>Results: </strong>We enrolled a total of 3173 patients in this study. During one year of follow-up, there were no significant differences in exacerbations, frequent exacerbations, hospitalisations, and all-cause mortality among LAMA, LABA + LAMA, LABA + ICS, and LABA + LAMA + ICS in the FEV1%pred ≥50% and CAT<10 groups. However, the patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbations and frequent exacerbations compared with the patients treated with LAMA or LABA + ICS in the FEV1%pred <50% and CAT≥10 groups (P < 0.05).</p><p><strong>Conclusions: </strong>Patients with COPD in GOLD group E should be further stratified to determine the appropriate initial inhalation therapy. This approach may provide more precise treatment for GOLD group E patients.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04055"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469265","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":"Evidence of rapid rise in population immunity from SARS-CoV-2 subclinical infections through pre-vaccination serial serosurveys in Pakistan.","authors":"Junaid Iqbal, Zahra Hasan, Muhammad Atif Habib, Asma Abdul Malik, Sajid Muhammad, Kehkashan Begum, Rabia Zuberi, Muhammad Umer, Aamer Ikram, Sajid Bashir Soofi, Simon Cousens, Zulfiqar A Bhutta","doi":"10.7189/jogh.15.04078","DOIUrl":"10.7189/jogh.15.04078","url":null,"abstract":"<p><strong>Background: </strong>Understanding factors associated with protective immunity against emerging viral infections is crucial for global health. Pakistan reported its first COVID-19 case on 26 February 2020, but experienced relatively low COVID-19-related morbidity and mortality between 2020 and 2022. The underlying reasons for this remain unclear, and our research aims to shed light on this crucial issue.</p><p><strong>Methods: </strong>We conducted a serial population-based serosurvey over 16 months (rounds 1-4, July 2020 to November 2021) across households in urban (Karachi) and rural (Matiari) Sindh, sampling 1100 households and 3900 individuals. We measured antibodies in sera and tested a subset of respiratory samples for COVID-19 using polymerase chain reaction (PCR) and antigen tests, also measuring haemoglobin (Hb), C-reactive protein (CRP), vitamin D, and zinc in round 1.</p><p><strong>Results: </strong>Participants showed 23% (95% confidence interval (CI) = 21.9-24.5) antibody seroprevalence in round 1, increasing across rounds 2-4 to 29% (95% CI = 27.4-30.6), 49% (95% CI = 47.2-50.9), and 79% (95% CI = 77.4-80.8), respectively. Urban residents had 2.6 times (95% CI = 1.9-3.6) higher odds of seropositivity than rural residents. Seropositivity did not differ between genders. Individuals aged 20-49 years had 7.5 (95% CI = 4.6-12.4) times higher odds of seropositivity compared to children aged 0-4 years. Most participants had no symptoms associated with COVID-19, with no reported mortality. Vitamin D deficiency was linked to seroprevalence. COVID-19 was confirmed in 1.8% of individuals tested via RT-PCR and antigen tests.</p><p><strong>Conclusions: </strong>The data suggests a steady increase in humoral immunity in Pakistan, likely due to increased transmission and associated asymptomatic disease. Overall, this reflects the longitudinal trend of protection against severe acute respiratory syndrome coronavirus 2, leading to the relatively low morbidity and mortality observed in the population.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04078"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469591","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":"Spatial patterns and temporal trends in stillbirth, neonatal, and infant mortality: an exploration of country-level data from 2000 to 2021.","authors":"Andrea Maugeri, Martina Barchitta, Gaia Schillaci, Antonella Agodi","doi":"10.7189/jogh.15.04034","DOIUrl":"10.7189/jogh.15.04034","url":null,"abstract":"<p><strong>Background: </strong>Despite significant progress in improving child survival and health, substantial disparities persist and are being increasingly threatened by a complex and dynamic global environment. In this ecological study, we investigated spatial patterns, temporal trends, and key determinants of disparities in stillbirth, neonatal, and infant mortality rates across 195 countries from 2000 to 2021.</p><p><strong>Methods: </strong>We sourced our data from two publicly available databases: the United Nations Children's Fund Data Warehouse for mortality indicators and the World Bank for World Development Indicators. We conducted spatial analysis to assess spatial autocorrelation and identify geographical clusters of countries and applied joinpoint regression to evaluate temporal trends in mortality indicators, reported as annual percentage change. We also used forward regression analysis to determine the primary indicators influencing stillbirth, neonatal, and infant mortality rates.</p><p><strong>Results: </strong>The average stillbirth rate in 2021 was 10.9 per 1000 total births, a significant decrease from 16.3 per 1000 in 2000. Neonatal mortality also declined from 23.6 to 13.5 per 1000 live births during the same period, while infant mortality dropped from 45.0 to 22.5 per 1000 live births. Despite these improvements, spatial analysis showed notable positive spatial autocorrelations for stillbirth, neonatal, and infant mortality rates, indicating that high mortality rates were geographically clustered, particularly in African countries forming hot-spot clusters. Conversely, developed countries in Europe and Asia formed cold-spot clusters characterised by low mortality indicators. Some countries, identified as low-high or high-low clusters, stood out due to dissimilar mortality rates compared to their neighbours, warranting further investigation. Key determinants of mortality rates included the young-age dependency ratio, prevalence of undernourishment, the percentage of women aged 15 and older living with HIV, the incidence of tuberculosis, and the adolescent fertility rate - all of which showed a positive association with higher mortality rates. In contrast, factors such as the use of at least basic sanitation services, mean years of schooling, and government effectiveness had an inverse relationship, contributing to lower mortality rates.</p><p><strong>Conclusions: </strong>By identifying hotspots and outliers, this study highlights the need for targeted health interventions and efficient resource allocation. This approach ensures that efforts are strategic and impactful, focussing on areas with the greatest need.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04034"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469218","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 patterns and influencing factors in older Chinese adults: a national population-based cross-sectional survey.","authors":"Xinyu Xue, Ziyi Wang, Yana Qi, Ningsu Chen, Kai Zhao, Mengnan Zhao, Lei Shi, Jiajie Yu","doi":"10.7189/jogh.15.04051","DOIUrl":"10.7189/jogh.15.04051","url":null,"abstract":"<p><strong>Background: </strong>This study aims to develop specific multimorbidity relationships among the elderly and to explore the association of multidimensional factors with these relationships, thereby facilitating the formulation of personalised strategies for multimorbidity management.</p><p><strong>Methods: </strong>Cluster analysis identified chronic conditions that tend to cluster together, and then association rule mining was used to investigate relationships within these identified clusters more closely. Stepwise logistic regression analysis was conducted to explore the relationship between influencing factors and different health statuses in older adults. The results of this study were presented by network graph visualisation.</p><p><strong>Results: </strong>A total of 15 045 individuals were included in this study. The average age was 73.0 ± 6.8 years. The number of patients with multimorbidity was 7426 (49.4%). The most common binary disease combination was hypertension and depression. The four major multimorbidity clusters identified were the tumour-digestive disease cluster, the metabolic-circulatory disease cluster, the metal-psychological disease cluster, and the age-related degenerative disease cluster. Cluster analysis by sex and region revealed similar numbers and types of conditions in each cluster, with some variations. Gender and number of medications had a consistent effect across all disease clusters, while aging, body mass index (BMI), waist-to-hip ratio (WHR), cognitive impairment, plant-based foods, animal-based foods, highly processed foods and marital status had varying effects across different disease clusters.</p><p><strong>Conclusions: </strong>Multimorbidity is highly prevalent in the older population. The impact of lifestyle varies between different clusters of multimorbidity, and there is a need to implement different strategies according to different clusters of multimorbidity rather than an integrated approach to multimorbidity management.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04051"},"PeriodicalIF":4.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469593","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}