International Health最新文献

Accelerating Nigeria towards malaria elimination requires moving away from business as usual: insights from a political economy analysis. 加快尼日利亚消除疟疾的进程需要摆脱一切照旧的做法：这是来自政治经济分析的见解。

IF 2.2 4区医学

International Health Pub Date : 2025-10-07 DOI: 10.1093/inthealth/ihaf113

Elisabeth G Chestnutt, Stefanie Meredith, Babatunde Ipaye, Dawit Getachew, James K Tibenderana, Ebere Anyachukwu, Timothy Obot, Kolawole Maxwell

{"title":"Accelerating Nigeria towards malaria elimination requires moving away from business as usual: insights from a political economy analysis.","authors":"Elisabeth G Chestnutt, Stefanie Meredith, Babatunde Ipaye, Dawit Getachew, James K Tibenderana, Ebere Anyachukwu, Timothy Obot, Kolawole Maxwell","doi":"10.1093/inthealth/ihaf113","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf113","url":null,"abstract":"Background: Despite global efforts to eliminate malaria, progress in Nigeria has been slow. Political economy analysis (PEA) is increasingly being used to identify how political economy influences effective program implementation. Here we apply PEA to the malaria program in Nigeria to understand the contextual factors that have hindered progress.Methods: A desk review and stakeholder mapping were carried out to identify the relevant actors in the malaria sector. Semi-structured, open-ended interviews were conducted with key influencers and high-level managers. Data were analysed and grouped thematically into factors affecting resource allocation and factors affecting the use of allocated resources.Results: Factors affecting resource allocation included malaria receiving limited attention and resources due to low prioritisation by federal, state and local governments; weak advocacy from citizens, which means malaria elimination is not an electable issue for politicians; and no direct communication channels between the malaria program and key decision-makers. Factors affecting the use of allocated resources included poor coordination between multiple partners working on malaria.Conclusions: Achieving meaningful progress in malaria elimination in Nigeria requires predictable financing from sustained political will. Demand from citizens is essential to encourage political prioritisation. Programs and partners must also be better coordinated to maximise impact with limited resources. Establishing high-level malaria advocacy groups and integrating malaria priorities into the national development plan would support these efforts.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of the COVID-19 pandemic on quality of life of adults with diabetes in rural Uganda: a cross-sectional survey. COVID-19大流行对乌干达农村成人糖尿病患者生活质量的影响：一项横断面调查

IF 2.2 4区医学

International Health Pub Date : 2025-10-07 DOI: 10.1093/inthealth/ihaf112

Wenceslaus Sseguya, Silver Bahendeka, Sara MacLennan, Aravinda Meera Guntupalli

{"title":"Impact of the COVID-19 pandemic on quality of life of adults with diabetes in rural Uganda: a cross-sectional survey.","authors":"Wenceslaus Sseguya, Silver Bahendeka, Sara MacLennan, Aravinda Meera Guntupalli","doi":"10.1093/inthealth/ihaf112","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf112","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic was associated with unprecedented healthcare, economic and social disruptions that impacted persons with diabetes mellitus (PWDM). We aimed to establish how the quality of life (QoL) of persons with diabetes in rural Uganda was impacted by the COVID-19 pandemic, using the pre-pandemic, pandemic and post-pandemic self-reported QoL scores.Methods: We surveyed 410 PWDM ≥30 y of age from three rural districts in south-western Uganda. Median QoL scores were computed and variations across the three time periods were analysed using the Friedman analysis of variance and McNemar tests as appropriate. Logistic regression was used to identify factors associated with QoL. A p-value <0.05 indicated statistical significance.Results: The overall median QoL scores were 67.2 (pre-pandemic), 62.4 (pandemic) and 68.8 (post-pandemic) (p<0.001). There was a 75% increase in the proportion of participants with unsatisfactory QoL during the pandemic (p<0.001). Having diabetes complications (p<0.001), chronic comorbidity (p=0.012), no formal education (p<0.003) and travelling for healthcare using non-motorised transport (<0.001) were all independently associated with post-pandemic unsatisfactory QoL.Conclusions: The COVID-19 pandemic caused significant deterioration in QoL among rural PWDM, raising the need for policies to prioritise the consideration of their evolving needs while designing measures for future similar widespread emergencies.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rethinking expertise in artificial intelligence ethics for global health. 重新思考全球健康人工智能伦理方面的专业知识。

IF 2.2 4区医学

International Health Pub Date : 2025-10-06 DOI: 10.1093/inthealth/ihaf114

Bilal Irfan, Roberto Sirvent

引用次数: 0

Corrigendum to: Antibiotic prescription sources and use among under-5 children with fever/cough in sub-Saharan Africa. 撒哈拉以南非洲5岁以下发烧/咳嗽儿童抗生素处方来源和使用情况的勘误表。

IF 2.2 4区医学

International Health Pub Date : 2025-10-06 DOI: 10.1093/inthealth/ihaf118

引用次数: 0

Integrating community efforts, innovative government interventions and data in the fight against kala-azar: lessons from Dumka, India. 将社区努力、创新的政府干预措施和数据整合到防治黑热病的斗争中：来自印度Dumka的经验教训。

IF 2.2 4区医学

International Health Pub Date : 2025-09-24 DOI: 10.1093/inthealth/ihaf083

Neha Arora, Ravi Shankar Shukla, Dhruv Pandey, Abhishek Paul

引用次数: 0

The cost of dengue shock and septic shock in Vietnam: a patient-centred economic analysis. 越南登革热休克和败血性休克的成本：以患者为中心的经济分析。

IF 2.2 4区医学

International Health Pub Date : 2025-09-23 DOI: 10.1093/inthealth/ihaf105

Angela McBride, Nguyen Van Hao, Phan Vinh Tho, Luong Thi Hue Tai, Nguyen Thanh Phong, Nguyen Thanh Ngoc, Nguyen Anh Huyen, Trinh Manh Hung, Martin J Llewelyn, Sophie Yacoub, Louise Thwaites, Hugo C Turner

{"title":"The cost of dengue shock and septic shock in Vietnam: a patient-centred economic analysis.","authors":"Angela McBride, Nguyen Van Hao, Phan Vinh Tho, Luong Thi Hue Tai, Nguyen Thanh Phong, Nguyen Thanh Ngoc, Nguyen Anh Huyen, Trinh Manh Hung, Martin J Llewelyn, Sophie Yacoub, Louise Thwaites, Hugo C Turner","doi":"10.1093/inthealth/ihaf105","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf105","url":null,"abstract":"Background: Dengue shock (DS) and septic shock (SS) are the most common infectious causes of shock in Vietnam. Little is known about the cost of an episode of DS or SS from the patient perspective. We aimed to describe the direct medical, non-medical and productivity costs associated with DS and SS.Methods: We recruited adults with DS and SS to a prospective observational study at the Hospital for Tropical Diseases, Ho Chi Minh City, from 2019 to 2021. We collected hospital bills, insurance status and out of pocket payments, and conducted an economic questionnaire at discharge, 1, 3 and 6 mo later. We calculated the proportion incurring catastrophic health expenditure (CHE) and catastrophic costs.Results: We recruited 127 adults with DS, of whom 118 survived, and 35 with SS, of whom 24 survived; 18.9% and 71.4% with DS and SS, respectively, incurred CHE. When non-medical and productivity costs were considered, the true cost of illness was 6.3 and 6.7 times higher than the hospital bill for DS and SS, respectively.Conclusions: Productivity costs must be counted when assessing the cost of critical illness in low- and lower-middle income countries. It is vital that financial protection systems are extended to cover patients requiring high-cost critical care in Vietnam.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac output measurement in Malawian children ages 2 months-12 years hospitalised with severe anaemia (COM-TRACT). 马拉维2个月至12岁严重贫血住院儿童的心输出量测量。

IF 2.2 4区医学

International Health Pub Date : 2025-09-22 DOI: 10.1093/inthealth/ihaf103

Elizabeth Chintolo, Roisin Connon, Elizabeth C George, George Chagaluka, Bridon M'baya, A Sarah Walker, Neil Kennedy, Kathryn Maitland

{"title":"Cardiac output measurement in Malawian children ages 2 months-12 years hospitalised with severe anaemia (COM-TRACT).","authors":"Elizabeth Chintolo, Roisin Connon, Elizabeth C George, George Chagaluka, Bridon M'baya, A Sarah Walker, Neil Kennedy, Kathryn Maitland","doi":"10.1093/inthealth/ihaf103","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf103","url":null,"abstract":"Background: Little is known about myocardial perturbations in African children hospitalised with severe anaemia.Methods: An observational study nested within a clinical trial of blood transfusion was conducted on the paediatric ward in Blantyre, Malawi. Children were ages 2 months-12 years hospitalized with uncomplicated severe anaemia (haemoglobin 4-6 g/dl). By randomisation, 13 children received 30 ml/kg whole blood, 13 received 20 ml/kg whole blood and 26 had no immediate transfusion (usual care). We measured standard parameters of cardiac function using ultrasonic cardiac output monitoring (USCOM) at enrolment, 8 and 24 hours and discharge.Results: Fifty-two children, median age 39 months (interquartile range [IQR] 25-58) and median haemoglobin 5.1 g/dl (IQR 4.8-5.6) were studied. Severe tachycardia and tachypnoea over time corrected faster in the transfused arms than the controls. At enrolment, the stroke volume index was within the normal range and 26/52 (50%) had a cardiac output index (COI) >97.5% the standard centile. The COI decreased in all arms by discharge but was greatest in the transfusion arms (p=0.05 for 20 ml/kg and p=0.009 for 30 ml/kg). A higher volume or receipt of whole blood did not worsen cardiac function. No child required diuretics.Conclusions: The data generated by this small but granular study of haemodynamic and cardiac function provide reassuring physiological evidence showing the safety of higher doses of blood transfusion than currently recommended. It also supports the findings of a secondary analysis of the Transfusion and Treatment of Severe Anaemia in African Children trial indicating that whole blood transfusions are safe. These data support the new evidence-based paediatric transfusion algorithm for anaemic African children and its recommendation for safe use.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Livestock farmers' knowledge, attitudes and practices relating to zoonoses in the Coastal Savannah zone of Ghana. 加纳沿海萨凡纳地区畜牧农民对人畜共患病的知识、态度和做法。

IF 2.2 4区医学

International Health Pub Date : 2025-09-17 DOI: 10.1093/inthealth/ihaf101

Sylvia Afriyie Squire, Godwin Yao Ameleke, Edmund Tei Sottie, Hilda Ohene-Asa, Nancy Mensah, Dorothy Takyiakwaa

{"title":"Livestock farmers' knowledge, attitudes and practices relating to zoonoses in the Coastal Savannah zone of Ghana.","authors":"Sylvia Afriyie Squire, Godwin Yao Ameleke, Edmund Tei Sottie, Hilda Ohene-Asa, Nancy Mensah, Dorothy Takyiakwaa","doi":"10.1093/inthealth/ihaf101","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf101","url":null,"abstract":"Background: Zoonoses pose a significant health challenge globally, with livestock playing a major role in disease transmission. Understanding livestock farmers' knowledge, attitudes and practices (KAP) is crucial for prevention and control.Methods: A cross-sectional survey was conducted among 150 livestock farmers in Ghana's Coastal Savannah agroecological zone. Odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression analysis assessed the association between farmers' KAP and socio-economic and farm characteristics.Results: While 66.0% of farmers had satisfactory knowledge of specific zoonoses and 74.0% perceived preventive practices as protective, only 49.0% perceived the diseases as zoonotic and 39.3% practiced prevention satisfactorily. Farmers with fewer disease encounters (adjusted OR [aOR] 0.499 [95% CI 0.347 to 0.717]), males (aOR 3.238 [95% CI 1.213 to 8.648]) and intensive farmers (aOR 5.396 [95% CI 1.276 to 22.808]) have higher odds of having satisfactory knowledge. Conversely, males (aOR 0.261 [95% CI 0.077 to 0.885]) and farmers with more disease encounters (aOR 0.664 [95% CI 0.490 to 0.898]) have lower odds of having satisfactory perception.Conclusions: This study highlights a knowledge-practice gap among livestock farmers regarding zoonoses, influenced by factors like gender, production systems and disease encounters. Targeted training is recommended for women, extensive systems and disease-prone farms.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strengthening antimicrobial resistance surveillance across African military settings. 在整个非洲军事环境中加强抗菌素耐药性监测。

IF 2.2 4区医学

International Health Pub Date : 2025-09-12 DOI: 10.1093/inthealth/ihaf102

Yusuff Adebayo Adebisi

{"title":"Strengthening antimicrobial resistance surveillance across African military settings.","authors":"Yusuff Adebayo Adebisi","doi":"10.1093/inthealth/ihaf102","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf102","url":null,"abstract":"While antimicrobial resistance (AMR) surveillance within civilian health systems has progressed, military health systems remain under-represented in related research and policy frameworks. Military personnel, particularly during deployments, often operate in environments characterised by combat-related injuries, overcrowding and inadequate sanitation, which increase the risk of spread and emergence of drug-resistant infections. Despite these vulnerabilities, national AMR strategies in Africa largely prioritise civilian systems, with minimal integration of military health surveillance data or clinical insights from military medical facilities. As a result, AMR trends within military populations and conflict zones remain poorly documented. This paper examines the distinctive AMR challenges in African military settings and proposes strategies for incorporating military medical surveillance data into national AMR frameworks. Drawing on international models, such as the US Armed Forces Health Surveillance Division's Antimicrobial Resistance Monitoring and Research programme, it highlights the potential for military facilities to serve as sentinel sites for resistance monitoring. Integrating military medical surveillance data into national systems would enhance understanding of resistance patterns and support more inclusive and effective containment strategies, while strengthening antimicrobial stewardship within military health facilities to reduce inappropriate antimicrobial use.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surveys to substantiate elimination of trachoma as a public health problem in the Republic of the Union of Myanmar. 开展调查，以证实在缅甸联邦共和国消除沙眼是一个公共卫生问题。

IF 2.2 4区医学

International Health Pub Date : 2025-09-10 DOI: 10.1093/inthealth/ihaf038

Mg Mg Myo Wynn, Ye Win, Ye Lin, San San Win, Thapa Badri, Jamsheed Mohamed, Lin Zaw, Anthony W Solomon, Michael Dejene, Caleb Mpyet, Yilikal Adamu, Aemero Abateneh, Mohammed Shafi, Cristina Jimenez, Ana Bakhtiari, Sarah Boyd, Anna Harte, Emma M Harding-Esch, Jeremiah M Ngondi

{"title":"Surveys to substantiate elimination of trachoma as a public health problem in the Republic of the Union of Myanmar.","authors":"Mg Mg Myo Wynn, Ye Win, Ye Lin, San San Win, Thapa Badri, Jamsheed Mohamed, Lin Zaw, Anthony W Solomon, Michael Dejene, Caleb Mpyet, Yilikal Adamu, Aemero Abateneh, Mohammed Shafi, Cristina Jimenez, Ana Bakhtiari, Sarah Boyd, Anna Harte, Emma M Harding-Esch, Jeremiah M Ngondi","doi":"10.1093/inthealth/ihaf038","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf038","url":null,"abstract":"Background: To determine whether trachoma elimination thresholds have been met in Myanmar, surveys were undertaken in 2019 to estimate the prevalence of trachomatous inflammation-follicular (TF) in children ages 1-9 y and the prevalence of trachomatous trichiasis (TT) unknown to the health system in adults ≥15 y of age.Methods: Surveys were conducted in 14 townships (evaluation units [EUs]) that were considered formerly endemic for trachoma. A two-stage cluster survey design was applied, whereby 30 villages and 30 households per village were sampled. Consenting eligible participants ≥1 y of age were examined for trachoma using the World Health Organization (WHO) simplified trachoma grading system.Results: A total of 12 594 households were surveyed, with a total of 5901 children ages 1-9 y and 31 097 people ≥15 y of age examined. In all 14 EUs, the prevalences of TF and TT unknown to the health system were below the elimination thresholds of <5% and <0.2%, respectively.Conclusions: Surveys showed that trachoma was no longer a public health problem in Myanmar and trachoma elimination thresholds had been attained. Partly on the basis of these data, in September 2020, Myanmar was validated by WHO as having eliminated trachoma as a public health problem.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0