Journal of Global Health最新文献

{"title":"Productivity loss associated with type 2 diabetes in China: the trend and projection from 1990 to 2050.","authors":"Yiwen Zhang, Nianwei Wu, Haojie Zhang, Peige Song, Jing Li, Sheyu Li","doi":"10.7189/jogh.16.04310","DOIUrl":"10.7189/jogh.16.04310","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) has become increasingly prevalent among young adults in their prime working years. This study aimed to estimate the productivity-adjusted life years (PALYs) loss associated with T2D among working-age Chinese adults from 1990 to 2021, with projections to 2050.</p><p><strong>Methods: </strong>Leveraging data from the Global Burden of Disease (GBD) 2021 database, the United Nations, and the China Chronic Disease and Risk Factors Surveillance study, we quantified individual- and population-level PALYs loss associated with T2D between 1990 and 2021 and projected trends through 2050 using a projection model. Loss of PALYs was calculated by combining productivity losses from excess mortality (years of life lost, YLL) with reductions in labour force participation, presenteeism, and absenteeism (years of productivity lost, YPL). Gross domestic product (GDP) loss was estimated by valuing each lost PALY using China's annual GDP per worker.</p><p><strong>Results: </strong>In 2021, 39.8 million working-age Chinese men and 23.3 million women had T2D. Over their working lifetime, T2D was associated with 53.42 (95% uncertainty interval (UI) = 51.25-55.59) million PALYs loss in men and 33.56 (95% UI = 31.59-35.52) million in women, equivalent to 1.34 (95% UI = 1.29-1.40) and 1.44 (95% UI = 1.36-1.53) PALYs loss per man and woman, respectively. Loss of GDP reached USD 1035.31 billion for men and USD 650.38 billion for women. Total PALYs loss is projected to increase from 1990 to 2050, although per-person losses decline in both sexes. Women with T2D experience greater per-person PALYs loss than men in 2030 and 2050.</p><p><strong>Conclusions: </strong>T2D among working-age population is associated with substantial PALY and economic losses, underscoring urgent need for targeted interventions.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04310"},"PeriodicalIF":5.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041503","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":"Best practices for designing interventions to improve health worker performance in low- and middle-income countries.","authors":"Alexander K Rowe, Elisa Roma, Naina J Ahuja, Alice E Pope, Karen Zamboni, Pooja Yerramilli, Samantha Y Rowe, Zunera Gilani, Stephanie Kandasami, Tove K Ryman, Katja Schemionek","doi":"10.7189/jogh.16.03027","DOIUrl":"10.7189/jogh.16.03027","url":null,"abstract":"<p><p>Effective health worker (HW) performance is essential for high-quality healthcare. Yet, many low- and middle-income countries rely on HW performance improvement (HWPI) interventions that often yield modest results, such as stand-alone in-service HW training. This viewpoint identifies more effective HWPI interventions, such as group problem-solving. To encourage use of these approaches, we propose definitions of more effective HWPI interventions and what constitutes a high-quality HWPI investment (i.e. support for a particular intervention in a given context). We examine intervention effectiveness from a large systematic review as part of these definitions. We also present 13 best practices for intervention design and show how HWPI investments could be developed to achieve larger, sustained improvements in HW performance in real-world settings. Some best practices include a minimum expected effectiveness of 15 percentage points above baseline performance and basing the design on a situational analysis. We have formatted the best practices into a simple checklist tool for countries to inform their HWPI actions, including those proposed in grant applications, and for donors when reviewing grants. Our overarching goal is to optimise intervention effectiveness and improve HW performance and healthcare quality.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03027"},"PeriodicalIF":5.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041481","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 relationship between prolonged travel and mortality among women with complicated deliveries in rural Kenya.","authors":"Nicholas Errol Rahim, Margaret E Kruk, Jan E Cooper, David Kapaon, Kennedy Opondo, Kevin Croke","doi":"10.7189/jogh.16.04300","DOIUrl":"10.7189/jogh.16.04300","url":null,"abstract":"<p><strong>Background: </strong>In many low- and middle-income settings, deliveries often take place in primary health facilities that are not equipped to address life-threatening complications. Emergency referral systems seek to rapidly transport women and newborns facing complications but inevitably introduce delays. Estimating the mortality impact of these delays is challenging due to potential selection bias. As an alternative approach, we examine the relationship between delays and adverse outcomes among a sample that is less likely to exhibit selection effects: mothers who started at a low-level facility before transfer to a hospital equipped to provide definitive care (hospital-level).</p><p><strong>Methods: </strong>We leverage demographic, obstetric, and geodata collected through the parent study Service Delivery Reform for Maternal and Newborn Health in Kakamega County, Kenya to explore the relationship between intrapartum travel and whether there was a maternal death, neonatal death, or stillbirth (adverse health outcome). We conducted a series of logistic models estimating the relationship between longer travel distances and probability of an adverse health outcome, with analyses iteratively adjusted for sociodemographic and obstetric covariates.</p><p><strong>Results: </strong>Of the 39,052 mothers with full geodata, 1,928 (4.9%) reported visiting at least one low-level facility before visiting a high-level facility. After restricting to those who experienced upward movement in facility level during delivery and adjusting for relevant covariates, we find that those in the fourth quartile of travel distances (42-436 km) had a 2.60 times higher odds of an adverse health outcome relative to those in the first quartile (2-16 km).</p><p><strong>Conclusions: </strong>Our findings show that Phase 2 delays in the form of intrapartum journeys have a pronounced association with maternal and child mortality when the total distance travelled is long. These findings align with the prior evidence that delays in receiving appropriate and timely delivery care are related to maternal and child mortality and morbidity.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04300"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991846","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 endometriosis and cardiovascular disease: a population-based cohort study.","authors":"Xueyin Wang, Shuting Xie, Huan Yu, Kun Wang, Huairong Wang, Ruotong Yang, Xueying Qin, Yiqun Wu, Yonghua Hu","doi":"10.7189/jogh.16.04326","DOIUrl":"10.7189/jogh.16.04326","url":null,"abstract":"<p><strong>Background: </strong>The relationship between endometriosis and cardiovascular disease (CVD) risk remains unclear. This study aimed to evaluate the association between endometriosis and CVD risk, to examine whether the association was affected by age group, and to exploratorily assess the mediating role of medications in these associations.</p><p><strong>Methods: </strong>A historical, population-based cohort study was conducted based on the Beijing Medical Claim Data for Employees between 2010 and 2017. A total of 19,903 women with endometriosis and 79,612 controls were identified by matching age and year of endometriosis diagnosis in a 1:4 ratio. The primary outcome was the incident diagnosis of any CVD events, and secondary outcomes were major CVD and cerebrovascular disease. The hazard ratios (HRs) were estimated by Cox proportional hazards models representing the association between endometriosis and CVD.</p><p><strong>Results: </strong>Endometriosis was associated with an increased risk of CVD after adjusting for urbanisation, hypertension and diabetes mellitus (HR = 1.69; 95% CI = 1.35-2.12). The adjusted HRs for major CVD and cerebrovascular disease in women with endometriosis were 1.83 (95% CI = 1.32-2.55) and 1.57 (95% CI = 1.12-2.22) compared with controls, respectively. Interaction analyses between endometriosis and age group (18-44 years vs. 45-55 years) yielded P-values of 0.942, 0.552, and 0.211 for all CVD, major CVD, and cerebrovascular disease, respectively, indicating no statistically significant heterogeneity in the associations across age groups. In the overall population, a proportion of the association between endometriosis and all CVD risk was statistically mediated by statins (68.30%) and aspirin (78.15%).</p><p><strong>Conclusions: </strong>Endometriosis was associated with an increased risk of CVD.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04326"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992138","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":"Frontline healthcare worker barriers impacting tuberculosis service demand and access in high burden settings: a scoping review.","authors":"Samyra R Cox, Colleen F Hanrahan, Aye Hnin Moe, Kate Shearer, Canice Christian, Sejal Sethi, Mollie Hudson, Manami Ueshima, Kalee Singh, Jane Dawson, Ketholelie Angami, Nyiko Kubai, Mangala Namasivayam, Priya Shete, Jonathan E Golub, Andrew D Kerkhoff","doi":"10.7189/jogh.16.04243","DOIUrl":"10.7189/jogh.16.04243","url":null,"abstract":"<p><strong>Background: </strong>Extensive literature exists on health-seeking behaviour and barriers related to the uptake of tuberculosis (TB)-related services in high TB burden settings. However, prior reviews have focused on patient- and health facility/systems-level barriers to TB-related care. In this scoping review, we aimed to synthesise frontline healthcare worker (FLHCW)-related barriers that limit individuals' demand for, access to, and retention in TB services.</p><p><strong>Methods: </strong>We searched PubMed for studies describing FLHCW-related barriers that impact demand for and/or access to TB services (preventive treatment, active case finding, diagnosis and treatment initiation, treatment completion, and post-TB care). We included studies that were published between 2010 and 2025 in English, and that reported on original research findings from the World Health Organization lists of high TB burden countries. Two reviewers independently conducted title and abstract screening, and full-text review. We narratively summarised barriers by theme and applied the Capability, Opportunity, Motivation-Behavior (COM-B) framework to facilitate interpretation.</p><p><strong>Results: </strong>We screened a total of 5,306 records, and included 189 studies, most of which were from India, South Africa, and Ethiopia. Among the included studies, most reported barriers were for doctors (n = 101, 53%) and nurses (n = 82, 43%). Studies identified FLHCW-related barriers at every step of the care cascade except for post-TB care. Knowledge and skill gaps leading to missed opportunities to engage or retain individuals in care were the most frequent barriers identified (n = 128 studies). Other major themes included provider-patient communication, discrimination and stigma from FLHCWs, and motivation to provide quality TB clinical care. Mapping barriers onto COM-B identified actionable targets for strategies to improve TB care.</p><p><strong>Conclusions: </strong>FLHCW-related barriers to TB care are pervasive and multifaceted, affecting the care cascade from prevention to diagnosis to treatment initiation and completion. Addressing these barriers will require multi-component implementation strategies that are context-specific and designed to empower FLHCWs as drivers of care.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04243"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992193","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":"Maternal and perinatal outcomes across China's one-child, two-child, and three-child policy periods: a retrospective cohort analysis of 43,439 deliveries.","authors":"Haijuan Li, Dongmei Tang, Dan Yang","doi":"10.7189/jogh.16.04328","DOIUrl":"10.7189/jogh.16.04328","url":null,"abstract":"<p><strong>Background: </strong>China has sequentially implemented the one-child, two-child and three-child policies over the past 15 years, yet long-term effects of these fertility policy adjustments on maternal and perinatal health remain understudied. This study aimed to evaluate such impacts.</p><p><strong>Methods: </strong>A single-centre retrospective cohort analysis was conducted on 43,439 parturients delivering at a Guangxi hospital between 2011 and 2025. All participants were grouped into one-child (OCP), two-child (TCP) and universal three-child (UCP) policy cohorts. Multivariate logistic regression was applied to adjust for confounders and analyse the associations between fertility policies and the risks of caesarean section and postpartum haemorrhage (PPH).</p><p><strong>Results: </strong>Policy relaxation significantly increased maternal mean age (27.58 ± 4.85 to 31.37 ± 5.57 years), advanced maternal age (AMA) proportion (≥35 years, 9.3-30.5%), and in vitro fertilisation (IVF) utilisation (1.3-6.2%), while reducing the primipara ratio (66.3-39.9%) (all P < 0.001). Gestational diabetes mellitus (GDM) prevalence reached 26.7%, placental abruption (0.3-1.6%), caesarean section rate (29.6-39.9%), and emergency admissions (11.9-45.3%) all increased; hospital stay decreased (5.82-4.73 days) (all P < 0.001). Multivariate analysis showed lower caesarean section risk in TCP (adjusted odds ratio (aOR) = 0.91; 95% confidence interval (CI) = 0.86-0.95) but higher in UCP (aOR = 1.08; 95% CI = 1.02-1.15); an increase of one year in age raised caesarean risk by 8% (aOR = 1.08; 95% CI = 1.07-1.09). The TCP period exhibited the highest risk of PPH (aOR = 1.80; 95% CI = 1.55-2.10). Though caesarean delivery correlated with diminished PPH risk (aOR = 0.28; 95% CI = 0.24-0.33), this correlation stemmed from discrepant PPH diagnostic thresholds by delivery mode rather than a genuine protective benefit.</p><p><strong>Conclusions: </strong>Fertility policy relaxation coincided with altered maternal demographic profiles, elevated high-risk pregnancy and obstetric complication burdens, and greater emergency care demand. Such correlations highlight an urgent need for targeted optimisation of maternal healthcare delivery systems.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04328"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992219","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":"Beyond global comparability: why universal health coverage indicators must reflect national contexts.","authors":"Eri Osawa","doi":"10.7189/jogh.16.03032","DOIUrl":"10.7189/jogh.16.03032","url":null,"abstract":"<p><p>Universal health coverage (UHC) is a central objective of the global health agenda, supported by internationally standardised indicators that facilitate monitoring and accountability across countries. Although standardised global UHC indicators, such as the Sustainable Development Goals (SDGs), UHC service coverage index, and out-of-pocket healthcare expenditures, support international accountability and collaboration, they do not fully capture domestic healthcare complexities driven by demographic ageing, epidemiological transitions, and evolving health system challenges. These limitations are particularly evident in countries facing complex population health needs. This viewpoint argues that UHC measurements should be adapted to national contexts, considering demographic characteristics, epidemiological profiles, healthcare delivery and financing structures, and political priorities. National governments, in cooperation with international organisations, must adopt a two-tiered monitoring approach that combines global and country-specific indicators and is underpinned by scientifically rigorous data collection. Such a multilayered framework can strengthen both domestic governance and international efforts to achieve UHC.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03032"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992085","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":"CEEMDAN-decomposed time series forecasting of reported hepatitis B cases using KOA-optimised deep learning: a nationwide study in mainland China (2004-2027).","authors":"Zhende Wang, Fengying Bi, Zhichao Duan, Li Ding, Bin Song, Ke Wang, Jinyu Zhao, Haiying Li","doi":"10.7189/jogh.16.04200","DOIUrl":"10.7189/jogh.16.04200","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B remains a leading notifiable infection in mainland China, with a persistent burden shaped by chronic reservoirs, varied immunity, and shifting surveillance practices. Reliable short- to medium-term forecasts of reported hepatitis B cases are therefore valuable for planning diagnostics, care pathways, antiviral supply, and targeted prevention.</p><p><strong>Methods: </strong>We compiled a national monthly series of hepatitis B notifications from January 2004 to December 2025 and applied Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) to isolate multiscale temporal components. Four modelling approaches - gated recurrent units (GRU), convolutional neural networks (CNN), support vector machines (SVM), and a Transformer encoder - were trained on CEEMDAN-derived features using a sliding 12-month window and recursively extended to 24-month horizons. Hyperparameters were optimised via the Kepler Optimization Algorithm (KOA), while performance was assessed through R², Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), and regression diagnostics across training, validation, and test splits.</p><p><strong>Results: </strong>All models captured dominant trends and seasonality; on the held-out test split, Transformer again delivered the best out-of-sample fit (MAE = 3105.508, MAPE = 0.024, RMSE = 4071.901, and R² = 0.928), while SVM ranked second with MAE, MAPE and RMSE values that were 11.317%, 11.615%, and 9.964% higher than the Transformer model's. CNN performed better than GRU but worse than SVM on the test set, achieving MAE, MAPE and RMSE reductions of 21.985%, 22.178%, and 14.944% relative to GRU, alongside a 6.158% larger R². Forecasts for 2026-2027 remain elevated, signalling little improvement and even possible resurgence.</p><p><strong>Conclusions: </strong>The findings demonstrate that integrating CEEMDAN with KOA optimised machine learning models delivers highly reliable short-term forecasts. This hybrid framework establishes a resilient continuum from epidemiological surveillance to predictive modelling and public health decision making, thereby providing essential foresight to guide optimal resource allocation and proactive intervention strategies for Hepatitis B control.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04200"},"PeriodicalIF":5.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992151","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":"Clinical inertia in cardiovascular risk management: prevalence, associated factors, and impact on outcomes of the OPM study.","authors":"José Abellán Alemán, Pablo Sánchez-Rubio Lezcano, Daniel Escribano Pardo, Luis Castilla Guerra, Rafael Crespo Sabaris, Guillermo Jiménez Portillo, Begoña Rincón Ruiz, Gloria Antón Pérez, Jesús Iturralde Iriso, Pilar Segura, Pedro J Tárraga López, Javier Nieto Iglesias, José Francisco López-Gil","doi":"10.7189/jogh.16.04256","DOIUrl":"10.7189/jogh.16.04256","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Clinical inertia, defined as the failure to initiate or intensify therapy when clinically indicated, represents a major and under-addressed barrier to achieving cardiovascular risk (CVR) factor control in primary care. Despite the availability of evidence-based guidelines and effective pharmacological treatments, many patients with uncontrolled hypertension, diabetes, or dyslipidaemia do not receive appropriate treatment intensification. We aimed to evaluate the prevalence of clinical inertia, identify associated patient-level factors, and assess its impact on CVR factor outcomes in high-risk primary care patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a pre-specified secondary analysis of the Objetivo Punto de Mira (OPM) study, a multicentre, prospective, quasi-experimental interventional study conducted in primary care settings across nine Spanish regions (2024-2025). We included 711 participants with at least one uncontrolled CVR factor at baseline (hypertension, diabetes, or dyslipidaemia). Clinical inertia was operationalised, among therapeutically adherent patients, as the absence of documented pharmacological treatment initiation, dose escalation, or appropriate combination therapy when a risk factor remained uncontrolled. We estimated prevalence with 95% confidence intervals (CIs). Multivariable logistic regression identified factors associated with clinical inertia. Linear mixed-effects models assessed changes in CVR factors from baseline to 90-day follow-up, comparing patients with and without clinical inertia. Risk analysis quantified the association between clinical inertia and persistent uncontrolled status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among patients with uncontrolled conditions at baseline, clinical inertia was observed in 49.3% (n/N = 208/422) for hypertension, 31.1% (n/N = 73/235) for diabetes, and 38.2% (n/N = 217/568) for dyslipidaemia. Overall, 54.3% of participants (n/N = 386/711) exhibited clinical inertia in at least one condition. We found no statistically significant associations between clinical inertia and age, sex, CVR category, or excess weight. Clinical inertia significantly increased the risk of remaining uncontrolled across any condition (relative risk = 1.13; 95% CI = 1.03, 1.24; absolute risk difference = 9.3%; 95% CI = 2.4, 16.2; number needed to harm ≈ 11, P = 0.007), though not for individual conditions separately. At 90-day follow-up, patients with clinical inertia showed significantly smaller reductions in total cholesterol (between-group difference in change = 19.3 mg/dL; 95% CI = 12.4, 26.3, P &lt; 0.001) and low-density lipoprotein cholesterol (15.5 mg/dL; 95% CI = 8.9, 22.0, P &lt; 0.001) compared with patients who received treatment intensification. We also observed a small but statistically significant difference in body mass index reduction (0.25 kg/m&lt;sup&gt;2&lt;/sup&gt;; 95% CI = 0.02, 0.49, P = 0.036). Both groups showed significant within-group reductions in systolic and dia","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04256"},"PeriodicalIF":5.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945914","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":"Global prevalence trends and predictions of Hodgkin lymphoma from 1990 to 2021: age-period-cohort analysis and transnational inequality.","authors":"Wei-Li Wang, Shen-Sui Li, Dan Ma, Shi-Si Huang, Xing-Yi Kuang, Zheng-Long Tang, Qin Fang, Ji-Shi Wang","doi":"10.7189/jogh.16.04199","DOIUrl":"10.7189/jogh.16.04199","url":null,"abstract":"<p><strong>Background: </strong>Hodgkin lymphoma (HL) is a highly curable malignancy with distinctive aetiological subtypes. Given recent therapeutic advances and demographic changes, an up-to-date assessment of the global HL burden is needed to inform evidence-based resource allocation and health policy planning. This study described the global prevalence trend of HL and analysed its age cohort and transnational inequality.</p><p><strong>Methods: </strong>We used data from the Global Burden of Disease 2021 study (204 countries/territories). We analysed age-standardised rates (ASRs) for incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021. An autoregressive integrated moving average (ARIMA) model projected incidence trends to 2050. We used the age-period-cohort (APC) analysis to separate the effects of age, period, and cohort on HL burden. We assessed transnational inequality with the slope index of inequality and the concentration index. All estimates are reported with 95% uncertainty intervals (UI).</p><p><strong>Results: </strong>In 2021, an estimated 65,182 (95% UI = 53,167, 77,143) new HL cases occurred globally. Substantial geographic disparities were observed in ASRs per 100,000 population: prevalence 4.42 (95% UI = 3.75, 5.09), incidence 0.79 (95% UI = 0.64, 0.94), mortality 0.34 (95% UI = 0.25, 0.43), and DALYs 14.82 (95% UI = 10.43, 18.96). The global age-standardised incidence rate (ASIR) declined slightly (estimated annual percentage change = -1.10%; 95% confidence interval (CI) = -1.16, 1.05) from 1990 to 2021, yet absolute incident cases increased by 19.23% (95% CI = 14.14, 22.44), driven by population growth and ageing. We found that HL risk peaked among young (25-29 years) and older adults (65-69 years), with steady declines in relative risk across successive periods and birth cohorts. The burden consistently skewed towards males and high sociodemographic index (SDI) regions. Projections indicated a stable ASIR but a rising prevalence through 2050, alongside continued declines in mortality and DALY rates.</p><p><strong>Conclusions: </strong>We found that the global HL burden is characterised by stable ASIR but growing absolute case numbers, with a disproportionate impact on males and high-SDI countries. These trends, reflecting demographic shifts and therapeutic advances, underscore the necessity for robust diagnostic pathways and multidisciplinary, risk-adapted care models to manage the increasing population of HL survivors effectively.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04199"},"PeriodicalIF":5.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945924","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}