Journal of Global Health最新文献

{"title":"Country-specific key lifestyle factors and health outcomes for resource allocation in the general population: a network analysis across 29 countries.","authors":"Jiaying Li, Daniel Yee Tak Fong, Kris Yuet Wan Lok, Janet Yuen Ha Wong, Mandy Man Ho, Edmond Pui Hang Choi, Vinciya Pandian, Patricia M Davidson, Wenjie Duan, Marie Tarrant, Jung Jae Lee, Chia-Chin Lin, Oluwadamilare Akingbade, Khalid M Alabdulwahhab, Mohammad Shakil Ahmad, Mohamed Alboraie, Meshari A Alzahrani, Anil S Bilimale, Sawitree Boonpatcharanon, Samuel Byiringiro, Muhammad Kamil Che Hasan, Luisa Clausi Schettini, Walter Corzo, Josephine M De Leon, Anjanette S De Leon, Hiba Deek, Fabio Efficace, Mayssah A El Nayal, Fathiya El-Raey, Eduardo Ensaldo-Carrasco, Pilar Escotorin, Oluwadamilola Agnes Fadodun, Israel Opeyemi Fawole, Yong-Shian Shawn Goh, Devi Irawan, Naimah Ebrahim Khan, Binu Koirala, Ashish Krishna, Cannas Kwok, Tung Thanh Le, Daniela Giambruno Leal, Miguel Ángel Lezana-Fernández, Emery Manirambona, Leandro Cruz Mantoani, Fernando Meneses-González, Iman Elmahdi Mohamed, Madeleine Mukeshimana, Chinh Thi Minh Nguyen, Huong Thi Thanh Nguyen, Khanh Thi Nguyen, Son Truong Nguyen, Mohd Said Nurumal, Aimable Nzabonimana, Nagla Abdelrahim Mohamed Ahmed Omer, Oluwabunmi Ogungbe, Angela Chiu Yin Poon, Areli Reséndiz-Rodriguez, Busayasachee Puang-Ngern, Ceryl G Sagun, Riyaz Ahmed Shaik, Nikhil Gauri Shankar, Kathrin Sommer, Edgardo Toro, Hanh Thi Hong Tran, Elvira L Urgel, Emmanuel Uwiringiyimana, Tita Vanichbuncha, Naglaa Youssef","doi":"10.7189/jogh.15.04011","DOIUrl":"10.7189/jogh.15.04011","url":null,"abstract":"<p><strong>Background: </strong>We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements.</p><p><strong>Methods: </strong>From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network.</p><p><strong>Results: </strong>Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).</p><p><strong>Conclusions: </strong>In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.</p><p><strong>Keywords: </strong>global; across-country comparisons; lifestyle; health outcomes; network analysis.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04011"},"PeriodicalIF":4.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957302","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":"Machine learning-assisted construction of COPD self-evaluation questionnaire (COPD-EQ): a national multicentre study in China.","authors":"Yiming Ma, Zijie Zhan, Yahong Chen, Jing Zhang, Wen Li, Zhiyi He, Jungang Xie, Haijin Zhao, Anping Xu, Kun Peng, Gang Wang, Qingping Zeng, Ting Yang, Yan Chen, Chen Wang","doi":"10.7189/jogh.15.04052","DOIUrl":"10.7189/jogh.15.04052","url":null,"abstract":"<p><strong>Background: </strong>Approximately 70% of chronic obstructive pulmonary disease (COPD) is underdiagnosed worldwide. We aimed to develop and validate a COPD self-evaluation questionnaire (COPD-EQ) that is better suited for COPD screening in China.</p><p><strong>Methods: </strong>We developed a primary version of COPD-EQ based on the Delphi method. Then, we conducted a nationwide multicentre prospective to validate our novel COPD-EQ screening ability. To improve the screening ability of COPD-EQ, we used a series of machine learning (ML)-based methods, including logistic regression, XgBoost, LightGBM, and CatBoost. These models were developed and then evaluated on a random 3:1 train/test split.</p><p><strong>Results: </strong>Through the Delphi approach, we developed the primary version of COPD-EQ with nine items. In the following prospective multicentre study, we recruited 1824 outpatients from 12 sites, of whom 404 (22.1%) were diagnosed with COPD. After the score assignment assisted by ML models and the Shapley Additive Explanation method, six of nine items were retained for a briefer version of COPD-EQ. The scoring-based method achieves an AUC score of 0.734 at a threshold of 4.0. Finally, a novel six-item COPD-EQ questionnaire was developed.</p><p><strong>Conclusions: </strong>The COPD-EQ questionnaire was validated to be reliable and accurate in COPD screening for the Chinese population. The ML model can further improve the questionnaire's screening ability.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04052"},"PeriodicalIF":4.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923448","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 mediating effects of gestational diabetes mellitus and hypertensive disorders of pregnancy between maternal advanced age, previous caesarean section and the risk of small- or large-for-gestational-age newborns: a multicentric prospective cohort study in southern China.","authors":"Lihua Lin, Bin Sun, Xiaomei Wang, Ronghua Zhang, Juan Lin, Jianying Yan","doi":"10.7189/jogh.15.04053","DOIUrl":"10.7189/jogh.15.04053","url":null,"abstract":"<p><strong>Background: </strong>Maternal obstetric characteristics have a key role in determining the occurrence of pregnancy-related disorders and subsequent neonatal outcomes. We aimed to investigate the mediating impact of gestational diabetes mellitus (GDM) and hypertensive disorder of pregnancy (HDP) on the relationship between maternal advanced age, previous caesarean section, and the risk of either large for gestational age (LGA) or small for gestational age (SGA) infants.</p><p><strong>Methods: </strong>We used data from a prospective multicentre cohort study conducted through China's National Maternal Near-miss Surveillance System from January 2012 to December 2021. We performed univariate and multivariate logistic regression analyses to examine the connections between maternal advanced age, previous caesarean section, GDM and HDP, and the risks of LGA and SGA, as well as mediation analyses to assess the mediating effect of GDM and/or HDP on the relationship between maternal advanced age, previous caesarean section, and the risks of LGA and SGA.</p><p><strong>Results: </strong>We included 482 458 women in our study, of whom13.5% were classified as advanced age, 51.4% as multipara, and 16.3% had a history of uterine scarring. Following adjustments for covariates, we found statistically significant associations between maternal advanced age and GDM (adjusted odds ratio (aOR) = 1.79; 95% confidence interval (CI) = 1.75, 1.83), maternal advanced age and HDP (aOR = 1.93; 95% CI = 1.86, 2.01), previous caesarean section and GDM (aOR = 1.13, 95% CI = 1.11, 1.16), previous caesarean section and HDP (aOR = 1.24; 95% CI = 1.20, 1.28), GDM and LGA (aOR = 1.32; 95% CI = 1.30, 1.35), and HDP and SGA (aOR = 3.93; 95% CI = 3.75, 4.12). The influence of maternal advanced age on SGA was significantly mediated by HDP, accounting for 68.96% of the mediation effect. Furthermore, GDM and HDP served as significant mediators in the relationship between previous caesarean section and the risks of LGA and SGA, with mediation proportions of 5.62% and 4.49%, respectively.</p><p><strong>Conclusions: </strong>We found HDP has a mediating role in the impact of maternal advanced age and previous caesarean section individually on SGA risk, while GDM acts as a mediator in the connection between previous caesarean section and LGA risk.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04053"},"PeriodicalIF":4.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923458","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 male and female clinicians' intentions for a third child in China: A cross-sectional survey analysis with gender-specific insights.","authors":"Dandan Zhang, Fen Liu, Tianxin Cui, Xinqi Zhuang, Jianzhong Zhang, Xiaoyu Lei, Yin-Ping Zhang","doi":"10.7189/jogh.15.04001","DOIUrl":"10.7189/jogh.15.04001","url":null,"abstract":"<p><strong>Background: </strong>As fertility rates decline and population ageing intensifies, the conflict between career and childbearing continues to impact clinicians, especially women. Exploring gender differences in the fertility intentions of male and female clinicians could help with identifying barriers to childbearing, developing effective policies to support work-life balance, and addressing the gap in research on gender disparities in this field.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among health care personnel in Chinese public hospitals. Through cluster sampling from highly active WeChat groups, we gathered 698 responses from clinicians to the third fertility intention questionnaire online. We then used descriptive statistics and χ² tests for analysis.</p><p><strong>Results: </strong>Men (28.28%) had higher intentions of having a third child than women (20.71%) (P = 0.013). In terms of reasons, female clinicians were more concerned than male clinicians about the impact on their career development (P = 0.002), difficulties in job hunting (P = 0.039), and physical injuries caused by multiple births (P < 0.001), and whether the elderly can help (P = 0.001). Conversely, men's apprehensions centred on economic factors such as real house costs (P < 0.001), policy support (P = 0.036), and wives' disagreement (P < 0.001). In discussing governmental interventions, men showed a higher level of interest in policies related to child care (P < 0.001), employment stability for women (P < 0.001), extended maternity leave (P < 0.001), and financial assistance than women (P < 0.001).</p><p><strong>Conclusions: </strong>Our findings show substantial gender-specific differences in third-child fertility intentions among clinicians. To address this, the government should consider divisions in family roles, future societal needs, and women's career development. Policies should focus on balancing work and family by offering affordable childcare, flexible parenting leave, financial incentives, and career support, ensuring childbirth does not negatively impact women's professional growth, and fostering gender equality in parenting.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04001"},"PeriodicalIF":4.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923452","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":"Double-blind randomised trial of saline solution for gargling and nasal rinsing in SARS-CoV-2 infection.","authors":"Sebastian R Espinoza, Lexton Trauffler, Amir Shamshirsaz, Alireza Shamshirsaz, Andres Espinoza, Jimmy Espinoza, Alice O'Brien","doi":"10.7189/jogh.14.05044","DOIUrl":"10.7189/jogh.14.05044","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).</p><p><strong>Methods: </strong>Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days. The low-saline solutions contained 2.13 g of salt dissolved in eight ounces of warm water, while the high-saline solution contained six grams of salt dissolved in eight ounces of warm water. Participants gargled and rinsed their nasal passages four times a day for 14 days. Primary outcomes assessed included frequency and duration of SARS-CoV-2 symptoms, while secondary outcomes included hospital or intensive care unit (ICU) admission, need for mechanical ventilatory support, or mortality rates. Exclusion criteria included chronic hypertension or participation in other interventional studies.</p><p><strong>Results: </strong>Fifty-eight individuals were allocated to the low (n = 27) or high (n = 28) saline regimens; with three lost to follow-up. There were no significant differences in primary or secondary outcomes between these groups. Comparatively, during the study period, 9398 individuals with confirmed SARS-CoV-2 infection by positive PCR test were observed as a reference group. Hospitalisation rates in the low-saline (18.5%) and high-saline (21.4%) regimens were significantly lower than in the reference group (58.8%; P < 0.001), while no significant differences were observed in other outcomes among these groups.</p><p><strong>Conclusions: </strong>Low and high saline regimens for gargling and nasal rinsing show similar effectiveness in reducing the frequency and duration of symptoms related to SARS-CoV-2 infection. Both saline regimens are associated with lower hospitalisation rates compared to individuals not using gargling or nasal rinsing in those infected by SARS-CoV-2.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05044"},"PeriodicalIF":4.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068888","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":"Prediction of inpatient mortality in hospitalised children in low- and middle-income countries: An external validation of paediatric mortality risk scores.","authors":"Daniella Brals, Ananda Pradhan, Amelie von Saint Andre-von Arnim, Assaf P Oron, Moses Ngari, Narshion Ngao, Ezekiel Mupere, Mohammod J Chisti, Christopher Lwanga, Farzana Afroze, Robert Bandsma, Judd L Walson, James A Berkley, Wieger Voskuijl","doi":"10.7189/jogh.14.04235","DOIUrl":"10.7189/jogh.14.04235","url":null,"abstract":"<p><strong>Background: </strong>Risk prediction tools for acutely ill children have been developed in high- and low-income settings, but few are validated or incorporated into clinical guidelines. We aimed to assess the performance of existing paediatric early warning scores for use in low- and middle-income countries using clinical data from a recent large multi-country study in Africa and South-Asia.</p><p><strong>Methods: </strong>We used data (children across three nutritional strata) from the Childhood Acute Illness and Nutrition (CHAIN) Network cohort study (n = 3101). We assessed 10 scores where similar predictor variables were available in the CHAIN cohort. We evaluated performance using the area under the receiver operating curve (AUC) (primary outcome), sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio (secondary outcomes).</p><p><strong>Results: </strong>Most scores showed poor discrimination, and all scores had low sensitivity. The paediatric early death index for Africa (AUC = 0.80; 95% confidence interval (CI) = 0.77-0.83), respiratory index of severity in children (AUC = 0.77; 95% CI = 0.74-0.81), and respiratory index of severity in children in Malawi (AUC = 0.78; 95% CI = 0.75-0.82) showed acceptable/good overall discrimination. Among children without wasting, most scores had acceptable/good performance, some even excellent. Poor discrimination was found for most scores among children with moderate and severe wasting or kwashiorkor.</p><p><strong>Conclusions: </strong>All scores demonstrated lower validation performance than originally reported. Among children without wasting, most risk prediction scores performed acceptably whilst in malnourished children they performed poorly. There is a need for a malnutrition specific score. Further research is needed on specific actions in responding to scores. Integration into future guidelines will require acknowledging staffing, resources and workflows.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04235"},"PeriodicalIF":4.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068890","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":"Quantitative assessment of Public Health and Social Measures implementation and relaxation on influenza transmission during COVID-19 in China: SEIABR and GBDT models.","authors":"Yuxi He, Kaiwei Luo, Han Ni, Wentao Kuang, Liuyi Fu, Shanghui Yi, Yuan Lv, Wenting Zha","doi":"10.7189/jogh.14.05038","DOIUrl":"10.7189/jogh.14.05038","url":null,"abstract":"<p><strong>Background: </strong>Since 2019, China has implemented Public Health and Social Measures (PHSMs) to manage the coronavirus disease 2019 (COVID-19) outbreak. As the threat from SARS-CoV-2 diminished, these measures were relaxed, leading to increased respiratory infections and strained health care resources by mid-2023.</p><p><strong>Methods: </strong>The study utilised WHO's FluNet and Oxford's COVID-19 Government Response Tracker to assess how policy shifts have affected influenza. It examined changes in influenza incidence, subtype prevalence, and epidemic cycles over three periods: pre-COVID-19 and pre-PHSMs, during COVID-19 and PHSMs, and post-COVID-19 and post-PHSMs. The SEIABR model estimated the transmission probability () and real-time reproduction number () across these periods, while a gradient boosting decision tree (GBDT) analysed the effects of PHSM indicators on influenza transmission.</p><p><strong>Results: </strong>Results indicate that before PHSMs, the average incidence was 4.87 per 100 000, with a β-value of (7.95 ± 1.27) × 10^-10 and R_t-value of 1.21 ± 0.16. During PHSMs, incidence dropped to 2.55 per 100 000, and β decreased to (3.17 ± 0.75) × 10^-10 (R_t-value of 0.86 ± 0.20). Post-PHSMs, the incidence surged to 17.00 per 100 000, with β rising to 8.36 × 10^-10 (R_t-value of 2.25). The GBDT model identified testing policies, public information campaigns, and workplace closures as the most impactful PHSM indicators.</p><p><strong>Conclusions: </strong>PHSMs effectively mitigated the spread of influenza, providing a foundation for future policy development to prevent respiratory diseases.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"05038"},"PeriodicalIF":4.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899818","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":"Postpartum family planning counselling during maternity care visits in Bangladesh and its effect on contraceptive initiation.","authors":"M Moinuddin Haider, Md Mahabubur Rahman, Shusmita Khan, Tasnuva Khan Efa, Mizanur Rahman","doi":"10.7189/jogh.14.04246","DOIUrl":"10.7189/jogh.14.04246","url":null,"abstract":"<p><strong>Background: </strong>Postpartum family planning (PPFP) is an essential component of birth care that helps avert maternal and newborn health hazards by preventing short-spaced births. Many Asian and African studies found PPFP counselling during antenatal care (ANC) and postnatal care (PNC) effective in increasing PPFP uptake. Studies in Bangladesh, however, provided limited evidence of the feasibility and effectiveness of integrating PPFP in maternal health services. The national action plan integrated PPFP services (counseling and providing methods) in maternal health care and immunisation programmes. However, no study has examined the availability of PPFP counselling, an essential component of PPFP, in maternity care points and its effectiveness in increasing PPFP initiation. We explore the prevalence and correlates of PPFP counselling during ANC and PNC and investigate whether PPFP counselling during ANC and PNC increases PPFP initiation.</p><p><strong>Methods: </strong>We used nationally representative data from the 2017-18 Bangladesh Demographic and Health Survey to analyse whether women having the last live birth in the past three years received PPFP counselling during ANC or PNC visits. We included women's other characteristics as covariates in a multivariable logistic regression. Finally, we analysed the 12-month PPFP initiation by PPFP counselling during ANC and PNC visits. The PPFP initiation analysis used self-reported contraceptive calendar data, a life table technique, and a proportional hazards model.</p><p><strong>Results: </strong>The prevalence of PPFP counselling was 12% during ANC and 22% during PNC. Women with higher education, higher birth order, upper household wealth quintiles, and living in the Khulna division compared to Chattogram (i.e. the division with the lowest PPFP counselling prevalence) were more likely to receive PPFP counselling during ANC and PNC. Three-fourths of the women initiated FP within 12 months postpartum. PPFP initiation was higher for women receiving PPFP counselling during PNC than those who did not receive it during PNC. We did not find evidence of increased PPFP initiation among women receiving PPFP counselling during ANC.</p><p><strong>Conclusions: </strong>The higher PPFP initiation among women receiving PPFP counselling during PNC is encouraging. Although we did not find evidence supporting increased PPFP initiation among women receiving PPFP counselling during ANC, further investigation on the quality of PPFP counselling during ANC may guide this necessary intervention's implementation and scale-up.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04246"},"PeriodicalIF":4.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865924","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":"Community-based flood mitigation in Malaysia: Enhancing public participation and policy effectiveness for sustainable resilience.","authors":"Sheikh Kamran Abid, Noralfishah Sulaiman, Ahmed M Al-Wathinani, Krzysztof Goniewicz","doi":"10.7189/jogh.14.04290","DOIUrl":"10.7189/jogh.14.04290","url":null,"abstract":"<p><strong>Background: </strong>Flooding is a frequent and devastating hazard in Malaysia, exacerbated by the country's tropical climate and rapid urbanisation. Traditional flood management strategies, predominantly focused on engineering solutions, have proven inadequate in addressing evolving flood risks. Community-based flood mitigation (CBFM) has emerged as an alternative approach, leveraging local knowledge and public participation to enhance flood resilience. This study aims to evaluate the role of CBFM in Malaysia, focusing on the effectiveness of public involvement and policy implementation in flood risk management.</p><p><strong>Methods: </strong>We conducted 20 in-depth interviews with stakeholders, including government officials, community members, and representatives of non-governmental organisations (NGOs), using a qualitative methodology. The data were analysed using thematic analysis to identify key themes surrounding public participation, policy challenges, and successful community-led flood mitigation initiatives.</p><p><strong>Results: </strong>The findings highlight the critical role of public involvement in improving flood preparedness and resilience. Communities that actively participated in mitigation efforts, such as early warning systems and nature-based solutions, demonstrated enhanced resilience. However, significant challenges remain, including inadequate funding, outdated infrastructure, and bureaucratic delays. Public awareness and education on flood preparedness, especially in rural areas, were found to be insufficient, hindering the effectiveness of flood management strategies.</p><p><strong>Conclusions: </strong>The study concludes that while CBFM initiatives in Malaysia show promise, their success depends on stronger policy enforcement, increased public engagement, and sustained investments in both green and grey infrastructure. Greater collaboration between local communities, NGOs, and government agencies is essential for improving flood risk management and building long-term resilience, particularly in the face of increasing climate-driven disasters.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04290"},"PeriodicalIF":4.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865872","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":"Efficacy of probiotics for treatment of acute or persistent diarrhoea in children from birth till 10 years: Systematic review and meta-analysis.","authors":"Anmol Minaz, Ridwa Alam, Uswa Jiwani, Khadija Vadsaria, Ahmad Khan, Aqsa Ishaq, Samar Sultan, Marium Mohsin, Ashraf Sharif, Yasir Bin Nisar, Jai K Das, Sajid Soofi, Shabina Ariff","doi":"10.7189/jogh.14.04236","DOIUrl":"10.7189/jogh.14.04236","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have investigated the efficacy of probiotics in treating acute and persistent diarrhoea. However, probiotics have not been established as a recommended management option for diarrhoeal illness by the World Health Organization (WHO). Therefore, we conducted a systematic review of randomised controlled trials to assess the efficacy of probiotics for the management of acute and persistent diarrhoea in children.</p><p><strong>Methods: </strong>A systematic search on PubMed, CINAHL, Wiley Cochrane Library, Scopus, Clinicaltrials.gov, and WHO International Clinical Trials Registry Platform (ICTRP) was performed. All studies published in the year 2000 and onwards that assessed the use of probiotics in the management of acute and persistent diarrhoea in children aged 0-10 years were included. The risk of bias was assessed using the Cochrane Risk of Bias II (RoB-2) tool and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. This review was commissioned by WHO for revision of their guidelines for childhood diarrhoea management.</p><p><strong>Results: </strong>The review included 98 studies with a total of 17 236 participants. Studies were categorised based on the WHO definition of diarrhoea or author-specified definition. In studies considering the WHO definition of diarrhoea, the probiotics group was more likely to achieve clinical cure (risk ratio = 1.12 (95% confidence interval (CI) = 1.01, 1.24, studies = 14)) and reduce the duration of diarrhoea (mean difference = -13.27 hours (95% CI = -16.72, -9.83, studies = 33)) than the control group in children with acute diarrhoea. However, the effect size was small, and statistical heterogeneity was very high, leading to low certainty of evidence. In children with persistent diarrhoea, probiotics reduced the duration of diarrhoea by 95 hours (mean difference = -96.45 (95% CI = -110.53, -82.37, studies = 2)), but the certainty of the evidence was very low.</p><p><strong>Conclusions: </strong>The results from this systematic review suggest low certainty of evidence for the effect of probiotics on clinical cure and duration of diarrhoea in children. There was significant diversity in the genus, species, dosages, and duration of treatment in the trial and administration. High levels of heterogeneity reduced the certainty of evidence. Large-scale randomised clinical trials are needed to evaluate specific probiotic strains and doses. In addition, cost-effective analysis studies are needed to be explored in future research.</p><p><strong>Registration: </strong>The protocol for this review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023449200).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04236"},"PeriodicalIF":4.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865882","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}