International Journal of Environmental Research and Public Health最新文献

{"title":"Poison Apple-like Fruit Ingestion: A Case Report and Review of Manchineel Fruit Toxicity.","authors":"Amanda K Hempel, Rahel Zewude, Michael Klowak, Tahyreem Shahid, Judith Joshi, Zhongtian Shao, Andrea K Boggild","doi":"10.3390/ijerph23081062","DOIUrl":"10.3390/ijerph23081062","url":null,"abstract":"<p><p>Manchineel dermatitis, caused by the sap of the manchineel tree native to the coastlands of the Caribbean, West Africa, and Central America, has received limited attention in the literature despite significant morbidity. The toxic sap causes a burning, blistering rash and conjunctivitis, while ingestion of the fruit may lead to oropharyngeal pain, hemodynamic instability, and gastrointestinal distress. Tourists unfamiliar with the manchineel tree may be exposed through exposure to the tree's sap, contaminated rainwater, or ingestion of the apple-like fruit. We herein present a case of a patient who experienced prolonged symptoms of manchineel toxicity after ingestion of the manchineel fruit for several weeks. Antihistamines, corticosteroids, and a PPI were ineffective. The symptoms eventually resolved after discarding clothing and towels that had come in contact with the tree, raising the possibility that toxins may linger on fabrics. Travellers to regions in the Caribbean or Central America are at particular risk for toxicity from the Manchineel tree if unfamiliar with the associated dangers and should be counselled to avoid contact with the tree or ingesting any unfamiliar fruit on the ground. When exposures do occur, it may be reasonable to dispose of potentially contaminated fabrics to avoid recurrent exposures, particularly if recurrent symptoms are observed, as in our patient. We further contextualize manchineel toxicity within a comparative review of select tropical foodborne intoxications of plant origin (ackee, lychee, cassava, papain) and marine origin (ciguatera, scombroid, neurotoxic and diarrhetic shellfish poisonings, tetrodotoxin), distinguishing manchineel's local irritant mechanism from the systemic toxidromes of these comparators and underscoring the absence of a specific antidote.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834238","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":"Inter-Reader Variability in the Classification of Pneumoconiosis Using the International Labour Organization International Classification System on Chest Radiographs of Artisanal and Small-Scale Gold Miners Attending a Screening Program in Kwe Kwe District, Zimbabwe.","authors":"Dingani Moyo, Anil Chuturgoon, Eduardo Mello De Capitani, Rajen N Naidoo","doi":"10.3390/ijerph23081060","DOIUrl":"10.3390/ijerph23081060","url":null,"abstract":"<p><p>Pneumoconiosis remains a major problem globally with a much higher burden in low- and middle-income countries (LMICs). There is increased inter-reader variability in the classification of pneumoconiosis in most LMICs. Despite the use of the International Labour Organization (ILO) International Classification System that standardizes reporting of pneumoconiosis on chest radiographs, inter-reader variability persists. We aimed to assess inter-reader concordance in classifying pneumoconiosis using the ILO International Classification System among artisanal and small-scale gold miners (ASGMs) in Zimbabwe. A retrospective cross-sectional study was conducted using 576 eligible chest radiographs (dicom format). Overall agreement for binary classification was moderate (κ = 0.522, 95% CI: 0.475-0.569), with pairwise agreement ranging from moderate to substantial (κ = 0.464, 95% CI: 0.389-0.538 to κ = 0.681, 95% CI: 0.602-0.761). Agreement was consistently higher for radiographs not suggestive of pneumoconiosis, with agreement ranging from 85.9% to 94.4%. Across the four ILO profusion categories, substantial inter-reader agreement was observed, with linear weighted kappa ranging from (κ = 0.554, 95% CI: 0.483-0.625 to κ = 0.668, 95% CI: 0.598-0.739) and quadratic weighted kappa values ranging from (κ = 0.675, 95% CI: 0.604-0.747 to κ = 0.755, 95% CI: 0.685-0.826). Cross-tabulation analyses demonstrated that disagreement occurred predominantly between adjacent profusion categories. Category-specific analyses showed the highest concordance for Categories 0 and 3, while Category 1 demonstrated the poorest agreement, with κ values ranging from (κ = 0.091, 95% CI: 0.004-0.178 to κ = 0.216, 95% CI: 0.067-0.365). Inter-reader agreement was slightly higher among chest radiographs of ASGMs with previous tuberculosis treatment, with κ values ranging from (κ = 0.572, 95% CI: 0.360-0.784 to κ = 0.743, 95% CI: 0.565-0.921) than among those without with κ values ranging from (κ = 0.376, 95%C1: 0.291-0.460 to κ = 0.602, 95% C1: 0.498-0.706). These findings reflect substantial variability in classifying early or borderline pneumoconiotic changes. These findings highlight variability in radiographic interpretation and demonstrate the need for enhanced training, quality control, and consensus reading approaches in ASGMs' screening programs.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834196","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":"Associations Between Male Partner Participation, Women's Autonomy, and Postpartum Care Seeking Among First Time Mothers, 15-24 Years, in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Analysis.","authors":"Madeline Woo, Anastasia J Gage, Julie H Hernandez, Pierre Z Akilimali, Jane T Bertrand","doi":"10.3390/ijerph23081061","DOIUrl":"10.3390/ijerph23081061","url":null,"abstract":"<p><p>The Democratic Republic of the Congo (DRC) has high maternal and neonatal mortality rates and only a third of mothers and newborns have a postpartum or postnatal care visit. Increasing male participation and enhancing women's autonomy are strategies to increase maternal healthcare utilization, but their applicability to first-time mothers (FTMs) in Kinshasa, DRC is unknown. We conducted a secondary analysis using cross-sectional survey data from a maternal and child health project among FTMs and their male partners in Kinshasa. The sample consisted of 1750 FTMs aged 15-24 years. The outcome variables were (1) a postpartum care visit within six weeks of facility discharge for the mother, (2) a postnatal care visit within six weeks of facility discharge for the neonate, and (3) either a postnatal or postpartum care visit within six weeks of facility discharge. Two logistic multivariate regression models were run for each outcome. The first model included all explanatory and demographic variables, and the second model added two interaction terms to test for mediation by in-union status. The male participation in maternal care index was negatively associated with all outcomes and the male participation in childcare index was positively associated with all outcomes. In-union status moderated the relationship between the male involvement indices and postpartum care for the mother but not for postnatal care for the newborn. Our findings show that the type of male participation may be meaningful for increasing postpartum and postnatal care-seeking and male partner participation initiatives need to be contextualized to prevent adverse outcomes.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833924","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":"Mapping the Public Health Landscape in Greece: Governance, Stakeholders, Data Systems, and Policy Frameworks.","authors":"Christos Triantafyllou, Anastasia Ntikoudi, Anastasia Papachristou, Vion Psiakis, Valter R Fonseca, Joao Breda","doi":"10.3390/ijerph23081059","DOIUrl":"10.3390/ijerph23081059","url":null,"abstract":"<p><strong>Background: </strong>Public health in Greece has undergone substantial changes since the COVID-19 pandemic, while challenges related to governance, workforce distribution, regional inequalities and service organization remain. This study aimed to map the current public health landscape in Greece by examining its institutional frameworks, stakeholder roles, policy implementation and public health data systems.</p><p><strong>Methods: </strong>A structured situation analysis combining a review of peer-reviewed and gray literature, policy analysis, and stakeholder mapping was conducted. PubMed, EMBASE, and CINAHL were searched for English- and Greek-language publications issued between 2005 and 2026, supplemented by reports, legislation, and policy documents from the Greek Ministry of Health, the World Health Organization, the Organisation for Economic Co-operation and Development, the European Commission, and other relevant institutions.</p><p><strong>Results: </strong>Public health responsibilities were distributed across multiple national, regional, and local institutions, creating challenges concerning coordination and accountability. Regional and socioeconomic inequalities continued to affect access to services, while workforce shortages and skill-mix imbalances constrained public health capacity. Public health information was dispersed across different institutions and data systems, with limitations concerning standardization, accessibility, and interoperability. Recent legislation, prevention programs, and digital-health initiatives indicated increased policy attention to prevention and population health, although publicly available evidence regarding their implementation and outcomes remained limited.</p><p><strong>Conclusions: </strong>Strengthening public health in Greece requires clearer institutional responsibilities, improved coordination across governance levels, sustainable workforce planning and interoperable data systems that support routine monitoring of program coverage, equity, and population-level outcomes.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833976","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 Data-Driven Exploratory Analysis of the Alcohol-Harm Paradox in South-East Wales.","authors":"Elin H Williams, Daniel Gartner, Paul R Harper, Geraint I Palmer-Liyu","doi":"10.3390/ijerph23081058","DOIUrl":"10.3390/ijerph23081058","url":null,"abstract":"<p><p>Alcohol consumption contributes substantially to global morbidity and mortality. The alcohol-harm paradox describes the phenomenon where more deprived areas experience higher levels of alcohol-related harms despite reporting similar or lower levels of alcohol consumption compared to less deprived areas. This paradox is particularly evident in Gwent, South-East Wales, where more deprived areas experience greater levels of harms despite having lower annual alcohol consumption. This research aims to explore the impacts of various hypothesised contributors to the alcohol-harm paradox in Gwent. Publicly available cross-sectional data sources are used to explore health behaviours, demographics, alcohol outlet density, and proximity to alcohol-related venues. Factors are studied in relation to both annual alcohol consumption and binge drinking prevalence. Alcohol-related harms are considered in terms of alcohol-specific deaths and alcohol-attributable hospital admissions. The findings reinforce the known complexity of the alcohol-harm paradox, and suggest that it is unlikely to be attributable to a single factor. Elevated prevalence of unhealthy behaviours in more deprived areas and proximity to alcohol venues traditionally associated with cheaper alcohol emerged as potential influential factors. These exploratory findings highlight the importance of targeted public health messaging addressing an overall healthier lifestyle and less harmful consumption behaviours, to reduce alcohol-related health inequalities.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833888","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":"Association Between Changes in Perceived Neighborhood and Cognitive Performance Within Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Black Adults.","authors":"Alexa C Allan, Alyssa A Gamaldo, Roland J Thorpe, Jennifer D Roberts, Michele K Evans, Alan B Zonderman","doi":"10.3390/ijerph23081055","DOIUrl":"10.3390/ijerph23081055","url":null,"abstract":"<p><p>Perceived neighborhood characteristics are related to cognitive performance. However, limited studies have examined how changes in neighborhood characteristics relate to cognitive performance, particularly among Black adults who are likely to experience changes in their residential social and physical environments. This study examined the association between changes in perceived neighborhood quality and concurrent, cross-sectional cognitive performance. An analytic sample of 592 Black adults (<i>M_age</i> = 56.22; 58% female) recruited from 13 predetermined neighborhoods in Baltimore City, Maryland, from the ongoing prospective Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, was included. In the adjusted models, uncorrected multivariable regression indicated that increases in neighborhood disorder were associated with worse attention and visual orientation (<i>β</i> = 0.17, <i>p</i> < 0.001), while increases in social cohesion and social control were associated with better performance in several tasks relating to memory, attention, executive function/reasoning, and visual orientation (<i>βs</i> = -0.12--0.10, <i>p</i> < 0.05). Interestingly, increasing social control was also associated with slower performance on a measure of executive functioning and reasoning (<i>β</i> = 0.12, <i>p</i> < 0.05). However, after controlling for multiple comparisons, only the association between neighborhood disorder and attention and visual orientation remained significant. Study findings serve as a springboard for future research linking changes in perceived neighborhood quality and concurrent, cross-sectional cognitive performance. These results may also lend support to the investment in neighborhoods as a pathway toward better understanding the association between neighborhood perception and cognitive performance, which may relate to reductions in cognitive decline and in the likelihood of dementia among Black adults who are at greatest risk for late-course diagnosis.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833867","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":"Cytocompatibility of Aqueous Garlic Extract on Human Cell Lines: Implications for Sustainability Utilization.","authors":"Eva Masciarelli, Laura Casorri, Claudio Beni, Massimiliano Valentini, Marcella Reale, Erica Costantini","doi":"10.3390/ijerph23081056","DOIUrl":"10.3390/ijerph23081056","url":null,"abstract":"<p><p>Pesticides are widely recognized as hazardous chemicals with potential adverse effects on human health and the environment. Directive 2009/128/EC establishes a framework for the European Union to promote the sustainable use of pesticides and the adoption of alternative agricultural techniques. Specifically, aqueous extracts are complex mixtures of various chemical compounds, such as terpenes, alcohols, aldehydes, and phenols, that have potential herbicidal, insecticidal, and fungicidal properties. Therefore, they can be used as an alternative to pesticides. This study examined the cytocompatibility of 100, 10, 1 and 0.1% <i>Allium sativum</i> L. aqueous extract (ASE) on human cell lines. The aim was to evaluate its effects on viability and cell metabolic activity through in vitro testing to verify the absence of adverse effects for operators who, when using garlic extract in agriculture, may be exposed via dermal contact or inhalation. The results showed that 1 to 0.1% do not significantly affect cell proliferation or viability in all examined cell models, while higher concentrations (≥10%) induced cell line-dependent reductions in viability. In summary, the results suggest the potential use of garlic aqueous extract as a potential low-risk alternative to synthetic pesticides and support its safety for occupational exposure of agricultural workers.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833610","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":"Visceral Adiposity Is Independently Associated with Hypertension in Thai Adults: A Case-Control Study.","authors":"Pattaraphorn Srikaew, Surachat Buddhisa, Surada Satthakarn, Nattaphol Prakobkaew, Tadsawiya Padkao, Orachorn Boonla, Piyapong Prasertsri","doi":"10.3390/ijerph23081057","DOIUrl":"10.3390/ijerph23081057","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major public health challenge and a leading contributor to cardiovascular morbidity and mortality worldwide. Although obesity is a well-established risk factor for hypertension, the body composition characteristics most strongly associated with hypertension remain unclear. This study aimed to investigate the associations between body composition parameters and hypertension among Thai adults.</p><p><strong>Methods: </strong>This case-control study included 208 Thai adults aged ≥18 years, comprising 103 normotensive individuals and 105 individuals with hypertension. Blood pressure indices included systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), and rate-pressure product (RPP). Body composition was assessed using bioelectrical impedance analysis (BIA) and included overall and regional body composition parameters, including visceral fat level, fat mass, body fat percentage, and skeletal muscle mass. Differences between groups were examined, and multivariable logistic regression analyses were performed to identify factors independently associated with hypertension.</p><p><strong>Results: </strong>Compared with normotensive participants, individuals with hypertension were significantly older (<i>p</i> < 0.001) and more likely to be male (<i>p</i> = 0.010). They also exhibited significantly greater adiposity-related characteristics, including higher body weight (<i>p</i> = 0.001), body mass index (<i>p</i> = 0.001), body fat percentage (<i>p</i> = 0.023), fat mass (<i>p</i> < 0.001), visceral fat level (<i>p</i> < 0.001), and waist-to-hip ratio (<i>p</i> = 0.037), together with higher SBP, DBP, PP, MAP, and RPP (all <i>p</i> < 0.001). In Model 3, older age (OR = 1.06, 95% CI: 1.04-1.09; <i>p</i> < 0.001), male sex (OR = 5.35, 95% CI: 1.69-16.95; <i>p</i> = 0.004), and higher visceral fat level (OR = 1.16, 95% CI: 1.06-1.26; <i>p</i> < 0.001) were associated with hypertension, whereas skeletal muscle mass was not (OR = 1.03, 95% CI: 0.95-1.12; <i>p</i> = 0.438). Each one-unit increase in visceral fat level was associated with a 16% increase in the odds of hypertension. The final model demonstrated acceptable discrimination (AUC = 0.79, 95% CI: 0.72-0.85).</p><p><strong>Conclusions: </strong>A higher BIA-derived visceral fat level was associated with hypertension among Thai adults after adjustment for age, sex, and skeletal muscle mass, whereas skeletal muscle mass showed no independent association in the same model. These findings suggest that visceral fat distribution may provide complementary information in cardiometabolic assessment. However, prospective studies using imaging-based assessments are required to confirm these findings.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834245","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":"Shifting Public Interest in Liver Health, Hepatotoxic Medications, and Dietary Supplements in Kazakhstan: A Five-Year Google Trends Infodemiology Study.","authors":"Jamilya Saparbay, Zhandos Burkitbayev","doi":"10.3390/ijerph23081054","DOIUrl":"10.3390/ijerph23081054","url":null,"abstract":"<p><p><b>Background:</b> Drug-induced liver injury (DILI) is a leading cause of acute liver failure worldwide, yet epidemiological data from Central Asia remain scarce. Infodemiology-the study of online health information-seeking behavior-offers a novel approach to population-level health surveillance. <b>Objective:</b> Our aim was to investigate online information-seeking behavior related to DILI, hepatotoxic medications, and dietary supplements among the population of Kazakhstan using Google Trends data over a five-year period. <b>Methods:</b> A quantitative, retrospective, observational infodemiology study was conducted using Google Trends data from Kazakhstan (May 2021-May 2026). A total of 21 search terms were organized into five thematic sets: DILI symptoms, hepatotoxic medications, self-treatment and detoxification, liver-related symptoms, and general medication queries. Sets 1-4 were searched in Russian and Set 5 in Kazakh. Descriptive statistics, the Mann-Kendall trend test, and Spearman's rank correlation analysis were performed using PAST software version 5. <b>Results:</b> A statistically significant trend was identified for 20 out of 21 search terms (<i>p</i> < 0.05). The majority of terms showed decreasing trends over the study period. In contrast, dietary supplements (BAD) demonstrated the strongest increasing trend (S = +1275, Z = +7.93, <i>p</i> < 0.001). Search interest for the general term \"liver\" was the highest of all 21 terms (mean RSV 84.30), while specific DILI symptoms such as dark urine (mean 1.28) and skin itching (mean 0.07) showed minimal search activity. Strong positive correlations were found between paracetamol and antibiotic searches (rs = 0.812, <i>p</i> < 0.001), consistent with self-medication patterns. Dietary supplements showed significant negative correlations with all detox-related terms (rs = -0.650, <i>p</i> < 0.001). <b>Conclusions:</b> This is the first infodemiology study on DILI in Central Asia. The significant increase in dietary supplement searches, combined with the low public awareness of specific DILI symptoms, highlights a critical public health concern. These findings underscore the need for enhanced regulation of dietary supplements, targeted public health education, and the integration of digital surveillance tools into pharmacovigilance systems in Kazakhstan.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13513398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833592","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":"Tuberculosis- and Diabetes Mellitus-Associated Knowledge, Stigma, and Health-Seeking Behaviour in Ghana.","authors":"Edmond Kwaku Ocloo, Adwoa Asante-Poku, Ishaque Mintah Siam, Nii Arku Laryea, Emmanuel Frimpong Gyekye, Emmanuel Afreh Kyei, Stephen Osei-Wusu, Michelle Yeboah-Manu, Eric Koka, Richard Adjei Akuffo, Daniel Okyere, Prince Asare, Augustine Asare Boadu, Emelia Konadu Danso, Phillip Tetteh, Kenneth Mawuta Hayibor, Theophilus Afum, Isaac Darko Otchere, Nelly Arthur, Sylvester Owusu Amoako, Yaw Adusi-Poku, Charlotte-Alberta Cato, Abraham Adjei, Jane Afriyie-Mensah, Dorothy Yeboah-Manu","doi":"10.3390/ijerph23081050","DOIUrl":"10.3390/ijerph23081050","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis [TB] and diabetes mellitus (DM) remain major public health concerns worldwide. TB negatively affects an individual's glucose tolerance, increasing the risk of developing DM. Similarly, DM reduces the host's ability to fight TB infection and increases the likelihood of developing TB and poor response to TB medication. This study analysed stigma and health-seeking behaviour in a sub-district of Accra Metropolis.</p><p><strong>Methods: </strong>We used a mixed-methods research approach involving a cross-sectional survey and in-depth interviews to explore community knowledge, stigma, and health-seeking behaviour related to TB and DM. A total of 437 individuals were selected for a survey using a simple random sampling technique, while 22 participants, including three TB patients, four nurses, one medical doctor, four students from a nursing and midwifery school, five students from a school of hygiene, and five community members, were involved in the study. Healthcare providers and patients were purposively selected, while students and community members were recruited through convenience sampling. Descriptive and logistic regression analyses were performed on the quantitative data using STATA, while the qualitative data were thematically analysed using the MAXQDA software.</p><p><strong>Results: </strong>Participants' age, sex, and educational levels were significantly associated with their knowledge of TB and DM. Males were 0.600 times as likely as females to be knowledgeable about DM (95% CI: 0.386-0.934, <i>p</i> = 0.024). Social determinants of health, such as poverty, local beliefs, stigma, and negative attitudes from healthcare workers, may influence TB patients' preference for traditional remedies over biomedical treatment.</p><p><strong>Conclusion: </strong>Therefore, we observed that addressing cultural barriers, stigma, and financial costs related to TB and diabetes care will help increase patients' willingness for biomedical treatment.</p>","PeriodicalId":49056,"journal":{"name":"International Journal of Environmental Research and Public Health","volume":"23 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834217","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}