Annals of Global Health最新文献

{"title":"Mixed Training Team Implementation of the Basic Emergency Care Course in Liberia.","authors":"Nichole Michaeli, Gerald Ekwen, Katie Main, Sarah Anyango, Margi Massa Mabande, Frances Carter, Sterman Toussaint, Shada Rouhani","doi":"10.5334/aogh.5477","DOIUrl":"10.5334/aogh.5477","url":null,"abstract":"<p><p><i>Background:</i> The Basic Emergency Care (BEC) course was developed to improve the management of acute illness and injury in resource-limited settings. Although BEC materials are freely available, formal instructor credentialing requires time and resources that may limit rapid implementation. In remote areas, such as Maryland County, Liberia, innovative approaches to BEC training are needed. <i>Objective:</i> To evaluate the effectiveness of a BEC course delivered by a mixed instructor team consisting of credentialed and non-credentialed facilitators in improving emergency care knowledge and self-efficacy among healthcare providers in Liberia. <i>Methods:</i> We conducted a mixed-methods evaluation of two consecutive five-day BEC courses held in Maryland County, Liberia, in August 2022. Course participants included physicians, medical interns, physician assistants, and nurses. The instructional team included one credentialed BEC Registered Facilitator and four non-credentialed physician specialists. To promote course fidelity, instructors completed an independent review of course materials, participated in a two-day pre-course preparation workshop, and conducted daily planning and debriefing sessions throughout the training. The effectiveness of this model was evaluated by measuring improvements in participants' emergency care knowledge and confidence using pre- and post-course examinations and self-efficacy surveys. <i>Findings:</i> Participants demonstrated significant improvements in emergency care knowledge, with examination scores increasing from 64.0% pre-course to 86.6% post-course (<i>P</i> < 0.001). Self-efficacy surveys also showed substantial gains in participants' comfort, confidence, and preparedness to manage critically ill and injured patients. Structured instructor preparation and ongoing coordination supported consistent course delivery despite the mixed facilitator model. <i>Conclusions:</i> A BEC course delivered by a mixed team of credentialed and non-credentialed instructors significantly improved emergency care knowledge and self-efficacy among Liberian healthcare providers. This pragmatic, resource-conscious approach may offer a scalable strategy for expanding access to BEC training in remote settings while maintaining course quality and educational effectiveness.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"103"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Equity for Global Health Author Teams within the Publishing Ecosystem.","authors":"Ella August, Archana Shrestha, Joseph C Kolars, Pebalo Francis Pebolo, Patricia Garcia","doi":"10.5334/aogh.5265","DOIUrl":"https://doi.org/10.5334/aogh.5265","url":null,"abstract":"<p><p>The global health literature reflects the need to restructure systems that balance power, remove financial barriers, and ultimately enhance equity, but immediate strategies to enhance equity are often underappreciated, particularly with regard to navigating the publishing ecosystem. Our paper describes how researchers can navigate the publishing ecosystem to create greater equity within their author teams, including those related to communication, supporting junior investigators in building their writing and professional skills, selecting journals that prioritize equity, ensuring transparent recognition of all contributors, and understanding institutional requirements for professional advancement. We also suggest changes in the publishing ecosystem to further enhance equity related to the presentation and recognition of joint authorship, developing a system for identifying predatory journals, and how publishing agreements might better promote equity in authorship. Our advice can help research teams position themselves to achieve greater equity among themselves. Additionally, our suggested changes to the publishing ecosystem will encourage future efforts toward equity.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"100"},"PeriodicalIF":5.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Greenness in Heat-Related Mortality: A Systematic Review and Meta-Analysis.","authors":"Ana Perez-Moreno, Maria Martinez-Andres, Blanca Notario-Pacheco, Irene Marcilla-Toribio, Shkelzen Cekrezi, Lidia Lucas-de la Cruz, Antonio Miguel Caraballo-Betancort, Bruno Bizzozero-Peroni","doi":"10.5334/aogh.5216","DOIUrl":"10.5334/aogh.5216","url":null,"abstract":"<p><p><i>Background:</i> Rising temperatures and the frequency of heat waves are challenges that have an impact on the health and mortality of populations. A high level of greenness is emerging as a strategy to mitigate the effects of extreme heat. <i>Objective</i>: To assess whether higher levels of greenness are associated with reduced mortality compared with lower greenness during periods of extreme heat. <i>Methods:</i> In this systematic review and meta-analysis, we searched MEDLINE, SCOPUS, WEB OF SCIENCE, CINHAL, Environment Complete, and GreenFILE. Observational studies were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated via a random-effects model. <i>Results:</i> The systematic review and meta-analysis included 11 articles. These cover data from China, France, Germany, Jordan, Switzerland, and the USA, as well as a global analysis covering 24 countries. The meta-analysis suggested that heat waves significantly increased mortality in areas with the lowest greenness (RR = 1.33; 95% CI: 1.15-1.55; <i>I</i> ² = 99.4%) and in areas with the highest greenness (RR = 1.18; 95% CI: 1.03-1.36; <i>I</i> ² = 97.9%). The pooled ratio of RR (RoR) indicated that the association was significantly stronger in low-greenness areas than in high-greenness areas (RoR = 1.11; 95% CI: 1.06-1.15; <i>I</i> ² = 90.5%), indicating that the heat-mortality association was 11% stronger in low-greenness areas. The pooled associations varied descriptively across subgroup analyses, although no statistically significant differences were observed between geographical regions or study settings. <i>Conclusion:</i> Higher temperatures were associated with increased mortality in both low- and high-greenness areas; however, the heat-mortality association was 11% stronger in low-greenness areas. These findings suggest that greater greenness may attenuate vulnerability to extreme heat, although the limited evidence base and considerable between-study heterogeneity warrant cautious interpretation.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"99"},"PeriodicalIF":5.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disclosure without accountability: Air pollution reporting by major South African industrial companies.","authors":"Lorren Haywood, Phyllis Kalele, Nomfundo Mahlangeni, Thandi Kapwata, Candice Nkambule, Tracey Laban, Caradee Y Wright","doi":"10.5334/aogh.5437","DOIUrl":"https://doi.org/10.5334/aogh.5437","url":null,"abstract":"","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"97"},"PeriodicalIF":5.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Community Health System Activities and Participation into the Primary Healthcare System for Ensuring Effective Community Participation and Achieving Health Goals in Nigeria.","authors":"Enyi Etiaba, Chinelo Obi, Obinna Onwujekwe","doi":"10.5334/aogh.5174","DOIUrl":"10.5334/aogh.5174","url":null,"abstract":"<p><p><i>Introduction:</i> In Nigeria, communities have long organised health and social actions that address local needs but remain weakly integrated into the formal primary healthcare (PHC) system. Understanding these approaches and how they interface with PHC is important for advancing universal health coverage (UHC). <i>Objective:</i> This study examined community-driven health and social actions and explored pathways for their integration into the formal PHC system. <i>Method:</i> A qualitative study was conducted in three purposively selected Nigerian states: Anambra, Akwa Ibom, and Kano. Data were collected through face-to-face in-depth interviews with 11 formal healthcare providers, 31 informal healthcare providers, and 19 traditional and religious leaders, and 12 focus group discussions with community members. Data were analysed deductively using the Expanded Health System Building Blocks and the World Health Organization Operational Framework for Primary Health Care. <i>Results:</i> Communities across the study sites had established diverse, self-organised health and social actions that filled gaps in primary healthcare delivery. These included community-financed drug distribution and insurance schemes, subsidised care by informal providers, health education, sanitation, food support, and community safety initiatives. Led by local leadership structures, these activities were sustained through collective responsibility. Interfaces with the PHC system had emerged in several settings, including PHC-led training of traditional birth attendants and informal providers, revealing a community-generated layer of healthcare delivery with potential for systematic integration. <i>Conclusion:</i> Our findings highlight opportunities to strengthen linkages between existing community initiatives and PHC governance, financing, and accountability structures to better harness community contributions to health and its social determinants and support progress towards UHC.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"96"},"PeriodicalIF":5.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual Care in Serious Illness: A Narrative Review of Low- and Middle-Income Country Evidence.","authors":"Ryan Meachen, Junita Henry, Sabbi Lall, Tracy A Balboni, Constantine S Psimopoulos, Tyler J VanderWeele, Katelyn Long","doi":"10.5334/aogh.5384","DOIUrl":"10.5334/aogh.5384","url":null,"abstract":"<p><p><i>Background:</i> Spiritual care (SC) is a component of person-centered care in serious illness, yet most evidence derives from high-income countries (HICs). Most patients with serious illness live in low- and middle-income countries (LMICs), where religion and spirituality often play distinctive social, cultural, and clinical roles. <i>Methods:</i> We synthesized 46 LMIC studies drawn from the Balboni et al. [1] systematic review of 371 empirical studies on spirituality in serious illness. Eligible studies were conducted in at least one LMIC, used valid spirituality measures, included ≥100 adult participants, and were rated as low or moderate risk of bias using adapted Cochrane criteria. We examined the role of spirituality in coping and outcomes, as well as the approaches used to assess and deliver SC across Asia, the Middle East and North Africa, sub-Saharan Africa, and Latin America. <i>Results:</i> Across the 46 studies, higher spiritual well-being and positive religious coping were consistently associated with better quality of life, lower psychological distress, and stronger family outcomes. Religious or spiritual struggle was associated with poorer mental health. SC was most often delivered by family members and faith communities rather than clinicians. Of the 46 studies, 38 (83%) used HIC-developed measurement instruments. Locally developed instruments from Thailand, Iran, and Nigeria revealed culturally distinctive pathways to spiritual well-being. <i>Conclusion:</i> Across diverse LMIC settings, SC emerges as a generalizable yet locally inflected component of person-centered serious-illness care. We propose a both/and measurement framework retaining validated global tools while integrating locally developed instruments. Health systems in LMICs should integrate SC competencies into clinical curricula while preserving partnerships with family and faith networks.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"98"},"PeriodicalIF":5.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative University and Non-Governmental Organization Partnership in Global Health: Application of the Brocher Declaration to 20 Years of Collaboration in Kenya.","authors":"Marie H Martin, Ash Rogers, Joseph Starnes, Elizabeth S Rose, Harriett Myers, Julius Mbeya, Milton Ochieng', James Nardella, Katherine Carpenter, Frederick Ochieng'","doi":"10.5334/aogh.5383","DOIUrl":"10.5334/aogh.5383","url":null,"abstract":"<p><p><i>Background:</i> Global health partnerships between academic institutions and non-governmental organizations (NGOs) are increasingly recognized as essential mechanisms for strengthening health systems in low-resource settings. Despite their proliferation, few partnerships demonstrate long-term, equitable collaboration grounded in established ethical frameworks. <i>Objectives:</i> To describe and evaluate a 20-year partnership between Lwala Community Alliance, a community-based NGO in western Kenya, and Vanderbilt University in the United States, using the Brocher Declaration principles as an evaluative framework for ethical, sustainable, and mutually beneficial global health collaboration. <i>Methods:</i> We employed a qualitative descriptive case study design, drawing on internal documentation, program records, and publicly available data. The partnership was analyzed across three interdependent pillars-education and training, research, and service-and assessed against each of the six Brocher Declaration principles: mutual partnership with bidirectional learning; empowered host country and community defining needs; sustainable programs and capacity building; compliance with applicable laws and ethical standards; humility and cultural sensitivity; and accountability for actions. <i>Findings:</i> Over 20 years, the partnership engaged 57 graduate students in 33 discrete projects and yielded 12 peer-reviewed publications from a longitudinal household survey encompassing more than 20,000 households. Key outcomes include a reduction in under-five mortality from 105 to 29.5 deaths per 1000 live births, policy reforms formalizing community health worker compensation and digitization across Kenya, and sustained bidirectional capacity strengthening. Adherence to Brocher Declaration principles, including community-led project design, ethical oversight through Kenyan review boards, and structured financial compensation to the host partner, was central to the partnership's longevity and impact. <i>Conclusions:</i> This case illustrates how the Brocher Declaration can be operationalized to evaluate and strengthen long-term academic-NGO collaborations. The Lwala-Vanderbilt model offers a replicable framework for ethical, impactful, and mutually reinforcing global health partnerships that advance health equity in low-resource settings.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"95"},"PeriodicalIF":5.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decolonizing Local Health: Advancing from Participation to Equitable Partnership along the Thailand-Myanmar Border.","authors":"Myat Htoo Razak, Cynthia Maung","doi":"10.5334/aogh.5418","DOIUrl":"10.5334/aogh.5418","url":null,"abstract":"<p><p><i>Background:</i> The movement to decolonize global health has increasingly challenged inequities in funding, leadership, knowledge production, authorship, and representation between global and local actors. However, less attention has been given to power dynamics within local and national health systems and partnerships. We propose extending the decolonization lens to <b>local health:</b> examining who leads, decides, speaks, controls resources, produces knowledge, and benefits within health systems themselves. <i>Perspective:</i> Drawing on decades of experience along the Thailand-Myanmar border, we reflect on the evolution of ethnic health organizations (EHOs), community-based health systems, and their partnerships with donors, governments, international organizations, and intermediary organizations. The border provides a distinctive setting for this discussion: over several decades of conflict, displacement, migration, and political instability, locally developed and sustained health systems have delivered essential services to underserved populations and increasingly assumed roles in health workforce development, health information, disease control, and emergency response. These experiences demonstrate substantial progress toward locally led health systems, but also persistent asymmetries in funding, agenda setting, knowledge production, representation, and risk sharing. In particular, localization of implementation may advance without equivalent transfer of decision-making power. <i>Implications:</i> Decolonizing local health requires moving beyond participation toward equitable partnership. Funding mechanisms should enable greater direct and flexible support to local organizations; partnerships should share governance and decision-making; local actors should receive equitable opportunities for authorship and representation; and accountability and risk should be shared more fairly. The experience of the Thailand-Myanmar border suggests that decolonization is not only about shifting power between global and local actors, but also about redistributing power among actors within local health systems. Ultimately, decolonization should be judged not by whether local actors are invited to participate, but whether they are trusted and empowered to lead.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"94"},"PeriodicalIF":5.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating Burden of Hypertensive Heart Disease in Low- and Lower-Middle-SDI Countries, 1990-2023: The Contribution of Cold Temperature Exposure.","authors":"Mingyang Ruan, Ruixue Zhang, Jinglian Wei, Tiezheng Niu, Shiqi Wang, Wenming Shi, Guangyuan Yang, Tianwei Dong","doi":"10.5334/aogh.5329","DOIUrl":"10.5334/aogh.5329","url":null,"abstract":"<p><p><i>Background:</i> Low- and lower-middle-socio-demographic index (SDI) countries face a rapidly growing burden of hypertensive heart disease (HHD). However, the contribution of non-optimal temperature, particularly cold exposure, remains poorly characterised in these populations. <i>Methods:</i> Using Global Burden of Disease Study 2023 data, we analysed HHD deaths, disability-adjusted life years (DALYs), and age-standardised rates in 79 low- and lower-middle-SDI countries from 1990 to 2023. Temporal trends were assessed using estimated annual percentage change (EAPC), socioeconomic inequality using slope index of inequality (SII) and concentration index, and temperature-attributable burden using the GBD comparative risk assessment framework. Bayesian age-period-cohort models projected burden to 2050. <i>Results:</i> From 1990 to 2023, deaths from HHD in low- and low-middle-SDI countries combined increased by approximately 192% (from 157,950 to 461,110), with corresponding DALYs rising by approximately 171% across these countries. Across all SDI strata, the age-standardizsed mortality rate increased significantly in low-SDI countries (EAPC+ 0.58%; 95% CI: 0.53%-0.63%), whereas the increase in low-middle-SDI countries was not statistically significant (EAPC+ 0.06%; 95% CI: 0.00%-0.12%), with Central Sub-Saharan Africa recording the highest 2023 rate (44.6 per 100,000). Cold temperature consistently contributed a greater temperature-attributable HHD burden than high temperature throughout the study period. Despite the overall increase in HHD burden, the absolute cold-attributable burden increased only modestly, whereas age-standardised cold-attributable rates remained largely stable, particularly in low-SDI settings. Cross-country absolute inequality widened substantially (SII -18.93 to -20.66). Projections indicate that HHD deaths and DALYs will increase markedly by 2050, driven mainly by population ageing among women. <i>Conclusion:</i> Low- and lower-middle-SDI countries face a growing HHD burden, with cold exposure representing an important environmental contributor. Its impact should be considered alongside population ageing, hypertension control, healthcare accessibility, and other cardiovascular determinants. Strengthening hypertension management and implementing low-cost, winter-specific cardiovascular protection strategies may help mitigate projected burden.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"93"},"PeriodicalIF":5.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and Regional Trends in Multiple Sclerosis Incidence with Projections to 2030: A Joinpoint Regression Analysis of the GBD Data 2021 by Socio-Demographic Index and WHO Regions.","authors":"Hamed Delam, Naeimehossadat Asmarian, Haleh Ghaem","doi":"10.5334/aogh.5438","DOIUrl":"10.5334/aogh.5438","url":null,"abstract":"<p><p><i>Background:</i> Multiple sclerosis (MS) constitutes one of the foremost neurological causes of disability among younger and middle-aged populations. <i>Objective:</i> This study aimed to examine global and regional trends in MS incidence from 1990 to 2021, with projections to 2030, using joinpoint regression and back-testing validation to ensure evidence-based scenario selection. <i>Methods:</i> Data were extracted from the Global Burden of Disease (GBD) 2021 study. Joinpoint regression was used to calculate annual percentage changes (APC) and average annual percentage changes (AAPC) for 1990-2021. A retrospective validation (back-testing) was conducted using data from 1990 to 2015 as the training period to project rates for 2016-2021, comparing predictive accuracy using mean absolute percentage error (MAPE) and root mean square error (RMSE). The method with lower error metrics was selected as the primary projection scenario for 2030, with the alternative retained for sensitivity analysis. <i>Findings:</i> Globally, the age-standardized incidence rate (ASIR) decreased slightly from 0.77 to 0.75 per 100,000 (1990-2021), while new cases increased by 49.9%. High socio-demographic index (SDI) (1.66) and EURO (2.57) regions had the highest ASIR in 2021, while low SDI (0.29) and Western Pacific Region (WPRO) (0.15) had the lowest. The back-testing identified APC as the preferred method in 10 of 12 regions (83.3%), with the lowest MAPE in AFRO (0.05%) and the highest discrepancy in South-East Asia Region (SEARO) (APC: 0.36% vs AAPC: 5.45%). Global ASIR is projected to decrease slightly to 0.747 by 2030, while SEARO (+12.3%) and low-middle SDI (+8.2%) regions show the largest increases. Sensitivity analysis confirmed robust projections globally, with trend reversals observed in SEARO and low SDI regions. <i>Conclusion:</i> Global MS incidence is projected to rise in most regions by 2030, particularly in transitioning economies and Southeast Asia. Strengthening diagnostic infrastructure and implementing context-specific health policies are urgently needed.</p>","PeriodicalId":48857,"journal":{"name":"Annals of Global Health","volume":"92 1","pages":"92"},"PeriodicalIF":5.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}