International Journal of Environmental Research and Public Health最新文献

{"title":"Pregnancy Termination Among Women of Reproductive Age: Evidence from the Indonesian Demographic and Health Survey.","authors":"Rosnani Rosnani, Rifky Octavia Pradipta, Bayu Satria Wiratama, Nelsensius Klau Fauk, Paul Russell Ward, Heri Kuswanto, Nikson Sitorus, Joni Haryanto, Hidayat Arifin","doi":"10.3390/ijerph22040564","DOIUrl":"https://doi.org/10.3390/ijerph22040564","url":null,"abstract":"<p><p>The consequences associated with pregnancy termination have garnered attention from healthcare professionals, particularly in Indonesia. However, national-level evidence on the factors driving pregnancy termination in Indonesia remains limited. This research aimed to identify patterns and characteristics associated with pregnancy termination among reproductive-age women in Indonesia. A cross-sectional study analyzed secondary data from the 2012 and 2017 Indonesian Demographic and Health Survey, involving women aged 15-49. The weighted sample included 42,269 individuals in 2012 and 47,001 in 2017. Binary logistic regression identified the correlates of pregnancy termination. Among 89,270 women of reproductive age, the prevalence of pregnancy termination was 12.68% in 2012 and 12.95% in 2017. Pregnancy termination was more frequently reported among women aged 44-49 years (adjusted odds ratio (AOR): 4.34, 95% confidence interval (CI): 3.54-5.33), those with secondary education (AOR: 1.29, 95% CI: 1.14-1.46), married women (AOR: 195.40, 95% CI: 114.70-332.90), employed women (AOR: 1.05, 95% CI: 1.00-1.09), individuals with health insurance (AOR: 1.07, 95% CI: 1.02-1.11), those who had experienced domestic violence (AOR: 1.07, 95% CI: 1.02-1.11), and regular television viewers (AOR: 1.10, 95% CI: 1.05-1.15). Conversely, pregnancy termination was less commonly reported among women with 1-2 living children (AOR: 0.80, 95% CI: 0.74-0.87), those who expressed no preference for having more children (AOR: 0.89, 95% CI: 0.84-0.94), and women using modern contraception (AOR: 0.76, 95% CI: 0.72-0.80). The findings revealed that the prevalence did not observe any changes in the incidence of pregnancy terminations between 2012 and 2017. Further evaluation by healthcare professionals is crucial to understanding the reasons behind pregnancy termination, especially among women of reproductive age. Insights into factors related to pregnancy termination, especially sociodemographic factors, can help mitigate the pregnancy termination in this population.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Benefits of Nature in Diverse Populations.","authors":"Joy L Hart, Kandi L Walker, Cameron K Stopforth, Anna Simpson, Aruni Bhatnagar, Rachel J Keith","doi":"10.3390/ijerph22040563","DOIUrl":"https://doi.org/10.3390/ijerph22040563","url":null,"abstract":"<p><p>The relationship between socioeconomic and demographic characteristics and health effects of green spaces has been studied, suggesting that certain groups may reap more health benefits from exposure to nature. However, the link between the perceived benefits of nature and socioeconomic and demographic characteristics remains a gap in the literature. We used a subsample (<i>n</i> = 711, 2018-2019) from an environmental cardiovascular risk cohort to investigate the perceived benefits of nature. Participants completed an 11-item survey about their perceptions of the benefits of nature at in-person visits. Socioeconomic and demographic characteristics including income, education, race, biological sex at birth, and age, were self-reported. Generalized linear models were used to evaluate associations between the perceived benefits of nature and demographic and socioeconomic factors; odds ratios and 95% confidence intervals (CIs) are reported. Both unadjusted and fully adjusted models for race, age, sex, and education are reported. Our results suggest that participants who identified as male, a member of a minoritized population, and/or completing less education perceived nature as less beneficial. Although additional research is needed to better understand contributors to these perceptions, access to convenient, safe, and multi-use green spaces may be important in encouraging time in nature and shifting perceptions of the benefits of greenness.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Modeling for Pandemic Forecasting: A COVID-19 Study in New Zealand and Partner Countries.","authors":"Oras Baker, Zahra Ziran, Massimo Mecella, Kasthuri Subaramaniam, Sellappan Palaniappan","doi":"10.3390/ijerph22040562","DOIUrl":"https://doi.org/10.3390/ijerph22040562","url":null,"abstract":"<p><p>This study proposes a data-driven approach to leveraging large-scale COVID-19 datasets to enhance the predictive modeling of disease spread in the early stages. We systematically evaluate three machine learning models-ARIMA, Prophet, and LSTM-using a comprehensive framework that incorporates time-series analysis, multivariate data integration, and a Multi-Criteria Decision Making (MCDM) technique to assess model performance. The study focuses on key features such as daily confirmed cases, geographic variations, and temporal trends, while considering data constraints and adaptability across different scenarios. Our findings reveal that LSTM and ARIMA consistently outperform Prophet, with LSTM achieving the highest predictive accuracy in most cases, particularly when trained on 20-week datasets. ARIMA, however, demonstrates superior stability and reliability across varying time frames, making it a robust choice for short-term forecasting. A direct comparative analysis with existing approaches highlights the strengths and limitations of each model, emphasizing the importance of region-specific data characteristics and training periods. The proposed methodology not only identifies optimal predictive strategies but also establishes a foundation for automating predictive analysis, enabling timely and data-driven decision-making for disease control and prevention. This research is validated using data from New Zealand and its major trading partners-China, Australia, the United States, Japan, and Germany-demonstrating its applicability across diverse contexts. The results contribute to the development of adaptive forecasting frameworks that can empower public health authorities to respond proactively to emerging health threats.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12026713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine as an Approach to the Mental Health of Healthcare Workers in Angola.","authors":"Edmilson Serra, Teresa Magalhães","doi":"10.3390/ijerph22040565","DOIUrl":"https://doi.org/10.3390/ijerph22040565","url":null,"abstract":"<p><strong>Introduction: </strong>African healthcare professionals face significant mental health challenges; therefore, telemedicine can overcome geographical barriers and improve access to mental healthcare.</p><p><strong>Objective: </strong>The objective of this study was to identify the key factors influencing the adoption of telemedicine as a tool to support healthcare workers' mental health in an Angolan healthcare network and develop a telemedicine model tailored to this context.</p><p><strong>Methodology: </strong>This mixed-method study collected quantitative data from a questionnaire applied to healthcare workers (n = 275), which were analyzed using descriptive statistics and logistic regressions. Qualitative data were obtained through structured interviews (n = 5) with psychologists and psychiatrists, and analyzed using thematic analysis in MAXQDA (Version 2022, VERBI Software, Germany), to identify recurring patterns and themes. The data were triangulated to ensure the rigor and consistency of the findings. Participation was anonymous and voluntary, and informed consent was obtained from all participants.</p><p><strong>Results: </strong>Previous experiences with mental health consultations, perceptions of teleconsultations, and doctor-patient relationship were significant in influencing telemedicine adoption by workers. The thematic analysis revealed four themes: perception and ease of telemedicine use, intention to use, and the perception of mental health in Angola. The key adoption factors for providers included project feasibility, management support, training, payment policies, and adherence to legal, ethical, and deontological standards.</p><p><strong>Conclusions: </strong>The adoption of telemedicine for occupational mental health requires culturally adapted interventions and compliance with technological and data protection standards. Hospital management must address infrastructure challenges and mental health perceptions, and implement sustainable strategies that promote occupational well-being within the organization.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Influences on Indoor and Outdoor SVOC Exposure.","authors":"Brianna N Rivera, Lisa M Bramer, Christine C Ghetu, Diana Rohlman, Kaley Adams, Katrina M Waters, Kim A Anderson","doi":"10.3390/ijerph22040556","DOIUrl":"https://doi.org/10.3390/ijerph22040556","url":null,"abstract":"<p><p>Americans spend approximately 90% of their time indoors, with more than 66% of that time spent in residential buildings. Factors pertaining to household behavior or environmental factors may influence types of semi-volatile organic compounds (SVOC) found indoors. Paired indoor and outdoor passive samplers were deployed at twenty-four locations across the United States. Samples were analyzed for >1500 SVOCs to identify common patterns in exposure profiles and investigate influences of household behavior and environmental factors. Unique differences between indoor and outdoor profiles were identified, with indoor air typically having greater frequency and concentration of SVOCs relative to outdoor air. A significant relationship between fragrance chemicals and scented consumer products was identified. When considering a multifactorial approach, chemical exposures were most influenced by environmental and demographic factors. Our data highlights specific groups of chemicals identified at higher concentrations indoors and their potential influences, as well as the complexity of identifying specific sources of chemical exposures.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking Household and Service Provisioning Assessments to Estimate a Metric of Effective Health Coverage: A Metric for Monitoring Universal Health Coverage.","authors":"Veenapani Rajeev Verma, Shyamkumar Sriram, Umakant Dash","doi":"10.3390/ijerph22040561","DOIUrl":"https://doi.org/10.3390/ijerph22040561","url":null,"abstract":"<p><strong>Background: </strong>The framework of measuring effective coverage is conceptually straightforward, yet translation into a single metric is quite intractable. An estimation of a metric linking need, access, utilization, and service quality is imperative for measuring the progress towards Universal Health Coverage. A coverage metric obtained from a household survey alone is not succinct as it only captures the service contact which cannot be considered as actual service delivery as it ignores the comprehensive assessment of provider-client interaction. The study was thus conducted to estimate a one-composite metric of effective coverage by linking varied datasets.</p><p><strong>Methods: </strong>The study was conducted in a rural, remote, and fragile setting in India. Tools encompassing a household survey, health facility assessment, and patient exit survey were administered to ascertain measures of contact coverage and quality. A gamut of techniques linking the varied surveys were employed such as (a) exact match linking and (b) ecological linking using GIS approaches via administrative boundaries, Euclidean buffers, travel time grid, and Kernel density estimates. A composite metric of effective coverage was estimated using linked datasets, adjusting for structural and process quality estimates. Further, the horizontal inequities in effective coverage were computed using Erreygers' concentration index. The concordance between linkage approaches were examined using Wald tests and Lin's concordance correlation.</p><p><strong>Results: </strong>A significantly steep decline in measurement estimates was found from crude coverage to effective coverage for an entire slew of linking approaches. The drop was more exacerbated for structural-quality-adjusted measures vis-à-vis process-quality-adjusted measures. Overall, the estimates for effective coverage and inequity-adjusted effective coverage were 36.4% and 33.3%, respectively. The composite metric of effective coverage was lowest for postnatal care (10.1%) and highest for immunization care (78.7%). A significant absolute deflection ranging from -2.1 to -5.5 for structural quality and -1.9 to -8.9 for process quality was exhibited between exact match linking and ecological linking.</p><p><strong>Conclusions: </strong>Poor quality of care was divulged as a major factor of decline in coverage. Policy recommendations such as bolstering the quality via the effective implementation of government flagship programs along with initiatives such as integrated incentive schemes to attract and retain workforce and community-based monitoring are suggested.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report on How BOAM Offers a Brief Family-Based Treatment by Integrating Psychoeducation and Self-Diagnostics.","authors":"Eva S Potharst, Damiët Truijens, Francisca J A van Steensel, Steve Killick, Susan M Bögels","doi":"10.3390/ijerph22040559","DOIUrl":"10.3390/ijerph22040559","url":null,"abstract":"<p><p>BOAM is a family-based method in which children and parents together create an explanatory, personal and systemic diagnosis. Based on ten playful and visual models, the therapist provides universal psychoeducation to gain insight into the personal, relational and contextual causes of the child's problems for a shared understanding of how to approach them. This case report describes a seven-session BOAM trajectory in a family with a 6-year-old child with emotional and behavioural dysregulation, such as frequent temper tantrums, hitting her infant sister, and threatening with knives. In this case report, the course of the sessions is described, including the way the family applied the BOAM models within their (cultural) family values. The mother completed questionnaires on child psychopathology (Child Behaviour Checklist), executive functioning (Behaviour Rating Inventory of Executive Function), parenting stress (Parenting Stress Index) and partner relationship (Family Functioning Questionnaire) at baseline, pretest, post-test, and 3- and 5-month follow-up, and the father completed questionnaires on child psychopathology and parenting stress at baseline and 5-month follow-up. Parents reported clinically significant improvements, as calculated with reliable change indexes, in child externalising psychopathology, self-regulation, and parenting stress (post-test and 3- and 5-month follow-up). BOAM is a short and accessible method for psychoeducation, diagnostics and treatment. BOAM seems to be an effective intervention for this family; however, more research is necessary to demonstrate its effectiveness. This case report painted a vivid picture of how family conversations can be structured and targeted using the models.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Sport and Physical Recreation Participation for Children and Youth with Disabilities: A Systematic Review.","authors":"Georgina Leigh Clutterbuck, Eugeenia Wen, Sara Petroccitto","doi":"10.3390/ijerph22040557","DOIUrl":"https://doi.org/10.3390/ijerph22040557","url":null,"abstract":"<p><p>Accurate measurement of participation in sport/physical recreation for children with disabilities is important due to decreased physical activity in this population. This review examines the psychometric properties of relevant assessments. Four databases were searched for studies investigating assessments of participation in sport/physical recreation for children and youth with disabilities. The assessment content was analyzed by the proportion of items relevant to sport/physical recreation and the inclusion of participation elements (attendance or involvement). The evidence quality was evaluated using COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklists and summarized according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Nine assessments (46 papers) met criteria. Only the Children's Assessment of Participation and Enjoyment measured attendance and involvement. Five assessments measured attendance (12-90% items related to sport/physical recreation) and three context-dependent assessments measured involvement. Only the Measure of Experiential Aspects of Participation and Self-reported Experiences of Activity Settings (involvement) were recommended by GRADE. No assessment adequately measured attendance and involvement in sport/physical recreation for children and youth with disabilities. While existing assessments may continue to be used to measure global participation, a comprehensive assessment of sport and physical recreation should be developed with and evaluated for children and youth with disabilities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of the Trace Element Composition of Drinking Water in Almaty City and Human Health Risk Assessment.","authors":"Marina Krasnopyorova, Igor Gorlachev, Pavel Kharkin, Mariya Severinenko, Dmitriy Zheltov","doi":"10.3390/ijerph22040560","DOIUrl":"https://doi.org/10.3390/ijerph22040560","url":null,"abstract":"<p><p>This research investigates the elemental composition of 78 drinking water samples collected during the summer, autumn, and winter of 2023 in different districts of Almaty city. Seasonal average concentrations and standard deviations were calculated for a range of chemical elements, including arsenic (As), beryllium (Be), cobalt (Co), cadmium (Cd), copper (Cu), lithium (Li), molybdenum (Mo), nickel (Ni), lead (Pb), selenium (Se), uranium (U), mercury (Hg), aluminum (Al), barium (Ba), chromium (Cr), iron (Fe), manganese (Mn), strontium (Sr), vanadium (V), zinc (Zn), calcium (Ca), potassium (K), magnesium (Mg), and sodium (Na), across three distinct datasets. The sites of sampling represent various categories of drinking water sources. The quality of drinking water was assessed by comparing the obtained data with current national, international, and World Health Organization (WHO) standards. Drinking water contaminant indices for the heavy metal groups were calculated and the water quality compliance with the hygienic criteria adopted in the Republic of Kazakhstan was determined. With the exception of two sampling points, the levels of non-carcinogenic risk remained below the acceptable threshold. The predominant pathway for exposure for both adults and children was identified as the oral ingestion of hazardous elements. Carcinogenic risks linked to Ni, Pb, and Cr presence in the drinking water of Almaty were identified, with risk values at the majority of sampling sites categorically classified within the \"high risk\" designation. No substantial differences in carcinogenic risk levels were detected between adults and children. These results underscore the necessity for enhanced water purification methodologies and ongoing surveillance to protect public health.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Direct Medical Costs of Colorectal Cancer in Antigua and Barbuda: A Prevalence-Based Cost-of-Illness Study.","authors":"Andre A N Bovell, Jabulani Ncayiyana, Themba G Ginindza","doi":"10.3390/ijerph22040552","DOIUrl":"https://doi.org/10.3390/ijerph22040552","url":null,"abstract":"<p><p>Colorectal cancer burden is a threat to health systems in several countries. As the cost of diagnosing, treating, and managing this cancer is unknown in Antigua and Barbuda, this study aimed to estimate its direct medical cost in this country. We used the prevalence-based cost-of-illness methodology to study data on patients diagnosed with colorectal cancer between 2017 and 2021. Data record abstraction was carried out to determine the five-year prevalence, and a top-down and bottom-up approach was employed to estimate the direct medical costs for colorectal cancer care components. All costs were computed at 2021 price levels and are reported in United States dollars. The total annual direct medical costs for colorectal cancer were estimated at USD 1.14 million (ranging between USD 0.85 million and USD 1.42 million). Major cost drivers were treatment (USD 613,650.01) and post-treatment side-effects care (USD 402,234.50). The overall estimated direct medical unit costs were USD 139,295.58, with the main drivers being surgery (USD 43,467.10), other complications of treatment (USD 28,469.21), and immunotherapy (USD 19,200.00). This study provides evidence of the economic burden of colorectal cancer in Antigua and Barbuda. The estimates of annual direct medical costs are substantial. Our findings could help in the development of health policy and aid in resource allocation related to local colorectal cancer management.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"22 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}