International Health最新文献_第2页

Challenges faced by adolescents and lung function technicians in Anuradhapura district, Sri Lanka, during spirometry: a qualitative study. 斯里兰卡阿努拉德普勒地区青少年和肺功能技术人员在肺活量测定中面临的挑战：一项定性研究。

IF 2.2 4区医学

International Health Pub Date : 2025-09-04 DOI: 10.1093/inthealth/ihaf097

Devanji Perera, Gajaba Nayakarathne, Parami Chandrasiri, Kasuni Ananda, Hasara Nuwangi, Shashanka Rajapakse

{"title":"Challenges faced by adolescents and lung function technicians in Anuradhapura district, Sri Lanka, during spirometry: a qualitative study.","authors":"Devanji Perera, Gajaba Nayakarathne, Parami Chandrasiri, Kasuni Ananda, Hasara Nuwangi, Shashanka Rajapakse","doi":"10.1093/inthealth/ihaf097","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf097","url":null,"abstract":"Background: Spirometry is the gold standard test for diagnosing airway disease. However, conducting spirometry in adolescents (13-14 y of age) is challenging because technicians should build a good rapport and maintain the technical rigour required in adult testing. This study investigated the challenges in spirometry assessment of adolescents with severe asthma.Methods: This was a qualitative descriptive study conducted in the Anuradhapura district, Sri Lanka from February to April 2023. Spirometry was conducted according to standard American Thoracic Society/European Respiratory Society guidelines. Three instructors with adequate knowledge but no prior experience conducted spirometry in adolescents, while two independent researchers observed the participants, followed by in-depth interviews. Data were collected until data saturation was achieved. Thematic analysis was used to analyse the experiences and perspectives of lung function technicians and participants.Results: Data saturation was achieved with 15 adolescents (7 male, 8 female). Two (13.3%) participants showed airway obstruction, while one (6.67%) had significant reversibility. Demonstration and simultaneous execution to train the respiratory manoeuvres improved the responses, but the test was tiring for the trainee instructor. Most adolescents found the procedure exhausting, and the trainee instructor's self-confidence improved the adolescents' performance.Conclusions: The study underscores the need for specialized training required to conduct spirometry in adolescents and better awareness for adolescents and parents of lung function testing.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994012","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

Building authentic partnerships across regions and disciplines to overcome global health threats. 建立跨区域和跨学科的真正伙伴关系，以克服全球卫生威胁。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihaf037

Wendy Harrison, Margaret Gyapong

引用次数: 0

Association between the Survey-based Women's Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa. 基于调查的妇女赋权指数与撒哈拉以南非洲保健障碍之间的关系。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihaf023

Richard Gyan Aboagye, Mainprice Akuoko Essuman, Tarif Salihu, Abdul-Aziz Seidu, John Elvis Hagan, Frank Baiden, Bright Opoku Ahinkorah

{"title":"Association between the Survey-based Women's Empowerment (SWPER) index and barriers to healthcare in sub-Saharan Africa.","authors":"Richard Gyan Aboagye, Mainprice Akuoko Essuman, Tarif Salihu, Abdul-Aziz Seidu, John Elvis Hagan, Frank Baiden, Bright Opoku Ahinkorah","doi":"10.1093/inthealth/ihaf023","DOIUrl":"10.1093/inthealth/ihaf023","url":null,"abstract":"Background: Women's health is an essential component of the Sustainable Development Goals. We examined how women's empowerment influences barriers to healthcare access in sub-Saharan Africa.Methods: The study included a weighted sample of 188 572 women's data from the Demographic and Health Surveys of 21 countries. A multilevel binary logistic regression analysis was used to examine the association between women's empowerment and barriers to accessing healthcare.Results: Women in the medium and high categories of attitude towards violence, social independence and autonomy were less likely to experience problems in getting permission to go for treatment. Women who had high attitudes towards violence were less likely to experience problems in getting money for treatment. Women with high social independence were less likely to face problems getting money for treatment. Women with high scores for attitudes towards violence, social independence and decision-making had the lowest likelihood of experiencing difficulty with distance to a health facility. Similarly, those in the high categories for attitude towards violence, social independence and decision-making had the lowest odds of experiencing problems not wanting to go alone.Conclusions: Women's empowerment decreases the barriers to accessing healthcare in sub-Saharan Africa. Designing healthcare intervention programs for women should consider the contribution that women make to household decision-making, social independence and attitudes towards violence.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"734-744"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103217","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}

引用次数: 0

The time to care is now: a multidisciplinary call to action for addressing paediatric burn injuries globally. 现在是护理的时候：多学科行动呼吁，在全球范围内解决儿科烧伤问题。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihaf035

Kajsa Vlasic, Theresia Mwakyembe, Irma Fleming, Giavonni Lewis, Sudha Jayaraman, Catherine A Staton, Melissa H Watt, Blandina T Mmbaga, Elizabeth M Keating

引用次数: 0

Large multimodal models: boon or burden for low- and middle-income countries. 大型多式联运模式：低收入和中等收入国家的福利或负担。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihae073

Rohit Malpani, Keymanthri Moodley

引用次数: 0

The sky's the limit: improving satellite imagery data literacy to address non-communicable diseases. 天空是极限：提高卫星图像数据素养，以应对非传染性疾病。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihae076

M Courtney Hughes, Elizabeth J Folkmann

引用次数: 0

Mortality risk stratification based on comorbidity status among cervical cancer patients in Lagos, Nigeria. 基于尼日利亚拉各斯宫颈癌患者合并症状况的死亡风险分层

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihaf008

Idris O Ola, Adeyemi A Okunowo, Muhammad Y Habeebu

{"title":"Mortality risk stratification based on comorbidity status among cervical cancer patients in Lagos, Nigeria.","authors":"Idris O Ola, Adeyemi A Okunowo, Muhammad Y Habeebu","doi":"10.1093/inthealth/ihaf008","DOIUrl":"10.1093/inthealth/ihaf008","url":null,"abstract":"Background: Comorbidity amplifies mortality risk by approximately sixfold in cancer patients and affects about 26% of cervical cancer (CC) patients in Nigeria. However, its impact on CC outcomes has yet to be fully explored.Methods: We analysed data from the Lagos University Teaching Hospital and the NSIA-LUTH Cancer Center in Lagos, Nigeria, between January 2015 and December 2021. Based on the hypertension-augmented Charlson comorbidity index (hCCI), the hazard ratios (HRs) associated with CC mortality were estimated using Cox proportional hazards model.Results: Our results showed a mortality rate of 30.1/100 women-years with a mean age at death of 59.8 years. Women with hCCI 2-6 had a significant increase in mortality risk in unadjusted (HR 1.68 [95% confidence interval {CI} 1.10 to 2.57]) and age-adjusted models (adjusted HR 1.57 [95% CI 1.02 to 2.42]) compared with those with hCCI 0. When CC stage was considered, the mortality risk gradient by hCCI was pronounced for late-metastatic CC with hCCI 2-6 (HR 2.32 [95% CI 1.23 to 4.39], increasing to 4.15 (95% CI 1.69 to 10.18) in the adjusted model compared with hCCI 0.Conclusions: Cervical cancer mortality risk increases with an increasing comorbidity score. Routine incorporation of comorbidity scoring in the clinical assessment of CC patients as well as the use of multidisciplinary cancer care teams may positively impact their clinical and psychosocial management.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"669-677"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374821","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}

引用次数: 0

Antibiotic resistance pattern of multidrug-resistant Enterobacterales from a rectal surveillance study in northern Nigeria. 尼日利亚北部直肠监测研究中多重耐药肠杆菌的抗生素耐药模式。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihaf026

Yahaya Yaqub, Joan Ejembi, Aliyu Aminu, Zainab Rabilu Daninna, Zainab Lamido Tanko, Nasiru Usman Ibrahim, Oduma Audu, Bawa Ega

{"title":"Antibiotic resistance pattern of multidrug-resistant Enterobacterales from a rectal surveillance study in northern Nigeria.","authors":"Yahaya Yaqub, Joan Ejembi, Aliyu Aminu, Zainab Rabilu Daninna, Zainab Lamido Tanko, Nasiru Usman Ibrahim, Oduma Audu, Bawa Ega","doi":"10.1093/inthealth/ihaf026","DOIUrl":"10.1093/inthealth/ihaf026","url":null,"abstract":"Background: Multidrug-resistant organisms (MDROs) are important in clinical practice worldwide. As whole genome sequencing (WGS) technologies are adopted, it is key to understand the nature of MDROs before the introduction of WGS in resource-poor settings.Methods: A hospital-based surveillance study was conducted in the largest referral health facility in northern Nigeria. A rectal swab sample was collected from each patient and samples were investigated for extended spectrum beta-lactamases and carbapenemase-resistant Enterobacterales (i.e. ESBL-PE and CRE, respectively). These MDROs were subjected to antimicrobial susceptibility testing and multiplex PCR. Statistical analyses were used to identify any associations between MDROs and selected antibiotics.Results: The prevalence of MDROs among participants (N=168) was 87.5% (n=147) for ESBL-PE and 4.2% (n=7) for CRE. All isolates were resistant to tetracycline and co-trimoxazole; however, most MDROs were susceptible to meropenem, ceftazidime-avibactam and fosfomycin (≥70%). blaSHV (33.3%; n=49) was the predominant ESBL gene carried by the isolates, followed by combinations of blaSHV, blaCTX and blaTEM. Although no carbapenemase genes were found, all CRE isolates had the blaOXA-48 gene, which may not be associated with phenotypic carbapenem resistance observed (χ2=0.056, p=0.81).Conclusions: Research utilising WGS and bioinformatics will elucidate more of the molecular landscape of MDROs in resource-poor settings.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"769-777"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702025","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}

引用次数: 0

Variability of interobserver interpretation of selected helminth ova in the development of a training image set. 在训练图像集的开发中，选定的蠕虫卵的观察者间解释的可变性。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihae085

Rupert Stephen Charles S Chua, Kiersten A Henderson, Lorenzo Maria C de Guzman, Vicki Foss, Nathaniel Schub, Cameron Bell, John Robert C Medina, Taggart G Siao, Myra S Mistica, Maria Luz B Belleza, Marie Cris R Modequillo, Nadine Joyce C Torres, Vicente Y Belizario

{"title":"Variability of interobserver interpretation of selected helminth ova in the development of a training image set.","authors":"Rupert Stephen Charles S Chua, Kiersten A Henderson, Lorenzo Maria C de Guzman, Vicki Foss, Nathaniel Schub, Cameron Bell, John Robert C Medina, Taggart G Siao, Myra S Mistica, Maria Luz B Belleza, Marie Cris R Modequillo, Nadine Joyce C Torres, Vicente Y Belizario","doi":"10.1093/inthealth/ihae085","DOIUrl":"10.1093/inthealth/ihae085","url":null,"abstract":"Background: Diagnosis of soil-transmitted helminthiasis and schistosomiasis for surveillance relies on microscopic detection of ova in Kato-Katz (KK) prepared slides. Artificial intelligence (AI)-based platforms for parasitic eggs may be developed using a robust image set with defined labels by reference microscopists. This study aimed to determine interobserver variability among reference microscopists in identifying parasite ova.Methods: Images of parasite ova taken from KK prepared slides were labelled according to species by two reference microscopists (M1 and M2). A third reference microscopist (M3) labelled images when the first two did not agree. Frequency, percent agreement, κ statistics and variability score (VS) were generated for analysis.Results: M1 and M2 agreed on 89.24% of the labelled images (κ=0.86, p<0.001). M3 had agreement with M1 and M2 (κ=0.30, p<0.001 and κ=0.28, p<0.001), resolving 89.29% of disagreement between them. The labelling of Schistosoma japonicum had the highest VS (κ=0.487, p=0.101) among the targeted ova. Reference microscopists were able to reliably reach consensus in 99.0% of the dataset.Conclusions: Training AI using this image set may provide more objective and reliable readings compared with that of reference microscopists.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"836-842"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957128","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}

引用次数: 0

Development and validation of supervised machine learning multivariable prediction models for the diagnosis of Pneumocystis jirovecii pneumonia using nasopharyngeal swab PCR in adults in a low-HIV prevalence setting. 利用鼻咽拭子聚合酶链式反应（PCR）对低艾滋病毒感染率环境中的成人进行肺孢子虫肺炎诊断的监督机器学习多变量预测模型的开发与验证。

IF 2.2 4区医学

International Health Pub Date : 2025-09-03 DOI: 10.1093/inthealth/ihae052

Rusheng Chew, Marion L Woods, David L Paterson

{"title":"Development and validation of supervised machine learning multivariable prediction models for the diagnosis of Pneumocystis jirovecii pneumonia using nasopharyngeal swab PCR in adults in a low-HIV prevalence setting.","authors":"Rusheng Chew, Marion L Woods, David L Paterson","doi":"10.1093/inthealth/ihae052","DOIUrl":"10.1093/inthealth/ihae052","url":null,"abstract":"Background: The global burden of the opportunistic fungal disease Pneumocystis jirovecii pneumonia (PJP) remains substantial. Polymerase chain reaction (PCR) on nasopharyngeal swabs (NPS) has high specificity and may be a viable alternative to the gold standard diagnostic of PCR on invasively collected lower respiratory tract specimens, but has low sensitivity. Sensitivity may be improved by incorporating NPS PCR results into machine learning models.Methods: Three supervised multivariable diagnostic models (random forest, logistic regression and extreme gradient boosting) were constructed and validated using a 111-person Australian dataset. The predictors were age, gender, immunosuppression type and NPS PCR result. Model performance metrics such as accuracy, sensitivity, specificity and predictive values were compared to select the best-performing model.Results: The logistic regression model performed best, with 80% accuracy, improving sensitivity to 86% and maintaining acceptable specificity of 70%. Using this model, positive and negative NPS PCR results indicated post-test probabilities of 84% (likely PJP) and 26% (unlikely PJP), respectively.Conclusions: The logistic regression model should be externally validated in a wider range of settings. As the predictors are simple, routinely collected patient variables, this model may represent a diagnostic advance suitable for settings where collection of lower respiratory tract specimens is difficult but PCR is available.","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"804-808"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113916","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}

引用次数: 0