International Health最新文献

{"title":"Understanding the primary healthcare context in rural South and Southeast Asia: a village profiling study.","authors":"Rusheng Chew, Sazid Ibna Zaman, Mst Asfat Ara Joly, Didar Uddin, Md Nurullah, James J Callery, Carlo Perrone, Thomas J Peto, Koukeo Phommasone, Aung Pyae Phyo, Wanlapa Roobsoong, Aninda Sen, Moul Vanna, Arjun Chandna, Tiengkham Pongvongsa, Lek Dysoley, Nicholas P J Day, Yoel Lubell, Richard J Maude","doi":"10.1093/inthealth/ihaf025","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf025","url":null,"abstract":"<p><strong>Background: </strong>Understanding contextual factors is critical to the success of health service planning and implementation. However, few contextual data are available at the village level in rural South and Southeast Asia. This study addressed the gap by profiling representative villages across seven sites in Thailand (n=3), Cambodia, Laos, Myanmar and Bangladesh.</p><p><strong>Methods: </strong>Key informant surveys supplemented by other information sources were used to collect data from 687 villages on four key indicators (literacy rate, and percentages of attended deliveries, fully immunised children and latrine coverage), as well as access to various services. Data were analysed descriptively.</p><p><strong>Results: </strong>Sites varied considerably. Five were highly diverse ethno-culturally and linguistically, and all relied on primary health centres and village health/malaria workers as the main providers of primary healthcare. These were generally bypassed by severely ill patients for urban first-level referral hospitals and private sector facilities. While >75% of villages were near primary schools, educational attainment was generally low. Over 70% of villages at each site had mobile phone coverage and availability of electricity was high (≥65% at all sites bar Myanmar).</p><p><strong>Conclusion: </strong>These results illustrate the similarities and differences of villages in this region that must be considered in public health research and policymaking.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665106","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}

{"title":"Ethical issues surrounding the implementation of long-acting injectable antiretroviral therapy in sub-Saharan Africa.","authors":"Deborah Ekusai-Sebatta, Ritah Shanice Namugenyi, Eva Laker, Erisa Mwaka, Rachel King, David S Lawrence, Janet Seeley","doi":"10.1093/inthealth/ihaf016","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf016","url":null,"abstract":"<p><strong>Background: </strong>This article discusses the ethical issues surrounding the integration of long-acting injectable antiretroviral therapy (LA-ART) in the programmatic management of human immunodeficiency virus (HIV). As the medical landscape evolves, implementing LA-ART introduces many ethical issues that should be considered for the success of scale-up in diverse settings.</p><p><strong>Methods: </strong>This article examines key issues such as bioethical concerns around the rollout of LA-ART, including regulatory requirements, a person's autonomy, informed consent, privacy and confidentiality; the societal implications of providing LA-ART, including the impact on stigma and discrimination; ethics around who receives LA-ART, financial accessibility, equitable access, inclusive decision-making and cultural sensitivity; and the ethics of providing an expensive intervention, including cost-effectiveness, supply chain sustainability and resource allocation. By critically analysing the ethical issues, we aim to guide policymakers and identify areas for further research.</p><p><strong>Conclusion: </strong>Our overarching aim is to ensure that the rights of people living with HIV are protected as implementors plan for the rollout of LA-ART with a focus on eastern and southern Africa. The utilization of LA-ART in resource-limited settings poses significant ethical challenges, necessitating careful consideration of autonomy, access and equity, stigma, discrimination, sustainability and treatment adherence.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617670","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}

{"title":"Assessment of compliance with tetracycline eye ointment treatment to accelerate the elimination of trachoma in Yobe State, Nigeria.","authors":"Juliana A Amanyi-Enegela, Rinpan Ishaya, Joseph Kumbur, Girija Sankar, William Enan Adamani, Christopher Ogoshi, Nicholas Olobio, Muhammad Babar Qureshi, Caleb Mpyet","doi":"10.1093/inthealth/ihaf014","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf014","url":null,"abstract":"<p><strong>Background: </strong>Trachoma, a neglected tropical disease, remains a significant public health concern in many regions, particularly in sub-Saharan Africa and in Yobe State, Nigeria. One approach for elimination involves administering tetracycline eye ointment (TEO) to children <6 months of age as part of annual mass drug administration (MDA), aligning with the World Health Organization's 'A' component of the SAFE (Surgery, Antibiotics, Facial hygiene and Environmental sanitation) strategy for elimination of trachoma as a public health problem. However, suboptimal compliance rates in affected populations pose challenges, potentially serving as a reservoir for reinfection and hindering progress toward trachoma elimination. This study focuses on assessing compliance with topical TEO during MDA and explores strategies to enhance adherence in trachoma-endemic areas of Yobe State, Nigeria.</p><p><strong>Methods: </strong>A mixed research approach was carried out involving interviews with households across 30 communities in five local government areas where TEO was administered during the 2022 round of MDA. Focus group discussions were conducted with subsets of the population who received TEO to gain insights into the underlying reasons for non-compliance and ways to improve compliance. Additionally, healthcare provider perspectives on treatment administration, compliance and community health education were explored.</p><p><strong>Results: </strong>Findings from this study show that there is already a high level of compliance with TEO usage, however, forgetfulness due to competing domestic chores, insufficient quantity of TEO given for 6-week applications, low awareness about the impact of trachoma infection on the eyes and the stinging feeling after application, especially in children <6 months of age, are some barriers that affect TEO usage compliance. Following up with TEO recipients would remind them to use the ointment as required, while incentivizing health workers and community drug distributors to conduct follow-up visits to households, increasing awareness on the impact of trachoma on the eyes. Increasing the quantity of TEO allocation would also improve compliance.</p><p><strong>Conclusions: </strong>Yobe State has made remarkable progress towards eliminating trachoma as a public health problem, as 12 local government areas no longer require MDA. Sustaining this momentum means ensuring high compliance among the population eligible to receive TEO to prevent any reservoir for reinfection in the state.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617663","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}

{"title":"Large language models for analyzing open text in global health surveys: why children are not accessing vaccine services in the Democratic Republic of the Congo.","authors":"Roy Burstein, Eric Mafuta, Joshua L Proctor","doi":"10.1093/inthealth/ihaf015","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf015","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the use of large language models (LLMs) to analyze free-text responses from large-scale global health surveys, using data from the Enquête de Couverture Vaccinale (ECV) household coverage surveys from 2020, 2021, 2022 and 2023 as a case study.</p><p><strong>Methods: </strong>We tested several LLM approaches consisting of zero-shot and few-shot prompting, fine-tuning, and a natural language processing approach using semantic embeddings, to analyze responses on the reasons caregivers did not vaccinate their children.</p><p><strong>Results: </strong>Performance ranged from 61.5% to 96% based on testing against a curated benchmarking dataset drawn from the ECV surveys, with accuracy improving when LLMs were fine-tuned or provided examples for few-shot learning. We show that even with as few as 20-100 examples, LLMs can achieve high accuracy in categorizing free-text responses.</p><p><strong>Conclusions: </strong>This approach offers significant opportunities for reanalyzing existing datasets and designing surveys with more open-ended questions, providing a scalable, cost-effective solution for global health organizations. Despite challenges with closed-source models and computational costs, the study underscores LLMs' potential to enhance data analysis and inform global health policy.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573775","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}

{"title":"Obesity, beverage consumption and sleep patterns in rural African women in relation to advertising of these beverages.","authors":"Merling Phaswana, Zandile June-Rose Mchiza, Sunday Olawale Onagbiye, Philippe Jean-Luc Gradidge","doi":"10.1093/inthealth/ihae031","DOIUrl":"10.1093/inthealth/ihae031","url":null,"abstract":"<p><strong>Background: </strong>The burden of obesity-related, non-communicable diseases in South Africa is persistent, with poor and black South African women particularly vulnerable. The purpose of the present study was to determine relationships between obesity, physical activity, sleep patterns and beverage consumption among black South African women in a rural village in the Limpopo province.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 200 rural-dwelling African women. Data were collected on beverage consumption, sociodemographic information, sleep patterns and anthropometry using self-reported questionnaires.</p><p><strong>Results: </strong>The mean body mass index (BMI) was 28.5±7.3 kg/m2, with 40% being classified as obese (BMI ≥30 kg/m2) and the mean sleep score was 4.68±2.51. Participants with very bad habitual sleeping patterns consumed significantly more sugar-sweetened beverages and alcohol than those with very good sleeping patterns. We also observed that when total coffee with sugar, fruit juice, total sugar-sweetened beverages and weight decreased the number of hours participants slept increased.</p><p><strong>Conclusions: </strong>The study identified significant associations between body weight, sleep duration and sugar-sweetened beverage consumption among rural black South African women. This underscores a need to address unhealthy lifestyle behaviours to lower incidences of non-communicable diseases in rural-dwelling women.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"153-158"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human papillomavirus vaccine coverage among immigrant adolescents in Alberta: a population-based cohort study.","authors":"Crystal Du, Don Voaklander, Salima Meherali, Yuba Raj Paudel, Shannon E MacDonald","doi":"10.1093/inthealth/ihae038","DOIUrl":"10.1093/inthealth/ihae038","url":null,"abstract":"<p><strong>Background: </strong>Little is known about human papillomavirus (HPV) vaccination among immigrant children in Canada. We conducted a study in Alberta, Canada to assess HPV vaccine coverage among school-aged immigrant children compared with non-immigrant children.</p><p><strong>Methods: </strong>This cohort study analysed population-based linked administrative health data to measure HPV vaccine coverage for 346 749 school-aged children, including 31 656 immigrants. Coverage was examined at 12 y of age from 2008 to 2018 for females, and from 2014 to 2018 for males and both sexes combined; vaccine series completion was considered receipt of three doses, with initiation (one or more dose) as a supplementary analysis. Multivariable logistic regression examined the association of vaccine coverage with migration status, adjusting for sociodemographic variables.</p><p><strong>Results: </strong>Between 2014 and 2018, HPV vaccination coverage among immigrant children at age 12 y was significantly higher (52.58%) compared with non-immigrant children (47.41%). After controlling for place of residence, income quintile, biological sex and year, immigrant children had 1.10 greater odds (95% confidence interval 1.07 to 1.14) of receiving three doses of HPV vaccine compared with non-immigrant children. Immigrants from Asia and Africa had the highest coverage (60.25-68.78%), while immigrants from North America, Oceania and South America had the lowest coverage (39.97-48.36%).</p><p><strong>Conclusions: </strong>It is encouraging that immigrant children had higher HPV vaccine coverage compared with non-immigrants. Among immigrants, routine immunization promotion strategies should be tailored based on the country of origin.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"179-185"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding male circumcision: insights from a peri-urban community in Maputo City, Mozambique.","authors":"Joelma Baduro, K Carter Mccabe, Nílzio Cavele, Américo José, Anchelda Mulimela, Mehol Jamnadas, Cremildo Manhiça, Celso Monjane, Sheila Nhachungue, Tom Decroo, Ivalda Macicame","doi":"10.1093/inthealth/ihae042","DOIUrl":"10.1093/inthealth/ihae042","url":null,"abstract":"<p><strong>Background: </strong>Circumcision is a protective measure against sexually transmitted infections (STIs), reducing the risk of HIV infection. This study reported coverage of male circumcision and assessed the factors associated with male uncircumcision in a peri-urban area in Maputo City, Mozambique.</p><p><strong>Methods: </strong>This cross-sectional study of the Health Demographic Surveillance System in the Polana Caniço neighborhood investigated the sociodemographic and behavioral factors associated with uncircumcised males aged 15-49 y from October 2019 to June 2021. Data were collected from an HIV risk factors questionnaire and descriptive analyses conducted comparing self-reported male circumcision status by sociodemographic factors and sexual behaviors. The association was assessed via χ2 tests, and a multivariable logistic regression model was constructed. Adjusted ORs and 95% CIs were reported for factors associated with uncircumcised status.</p><p><strong>Results: </strong>Of the 3481 males aged 15-49 y who responded to the questionnaire, 79.5% (2766) self-reported being circumcised. The percentage of uncircumcised men steadily increased with age, ranging from 12.4% (95) among males aged 15-19 y to 34.5% (148) of men aged 40-49 y. Men without education or with primary education, as well as those not practicing Islam, were 3-4 times more likely to be uncircumcised. Uncircumcised men were more likely to self-report an STI and a lack of condom use.</p><p><strong>Conclusions: </strong>Being uncircumcised was associated with not using condoms and having STIs, highlighting the need to further emphasize combination HIV-prevention programs and regular HIV/STI screening. Targeting males with lower education and across religions can help reach those with lower coverage of this effective prevention intervention.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"205-213"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200991","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}

{"title":"Addressing the risk factors for the prevention of cardiovascular diseases in the Philippines.","authors":"Dalmacito A Cordero","doi":"10.1093/inthealth/ihae049","DOIUrl":"10.1093/inthealth/ihae049","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"235-236"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating onchocerciasis elimination in humanitarian settings: lessons from South Sudan.","authors":"J N Siewe Fodjo, S R Jada, J Rovarini, Y Y Bol, J Y Carter, A Hadermann, T Lakwo, R Colebunders","doi":"10.1093/inthealth/ihae051","DOIUrl":"10.1093/inthealth/ihae051","url":null,"abstract":"<p><p>There is persistent meso- and hyperendemicity of onchocerciasis (river blindness) in South Sudan, a country that has endured armed conflict for many years. In 2018, Amref Health Africa, in collaboration with local communities, the South Sudan Ministry of Health and other stakeholders, initiated some interventions, among which was Innovative Approaches to Reduce the Burden of Disease Caused by Onchocerciasis (IARDO) project. This project implemented several strategies, including identifying areas where onchocerciasis elimination programs need strengthening, switching from annual to biannual community-directed treatment with ivermectin (CDTI), additional ivermectin administration to postpartum women and school children and a community-based 'slash and clear' vector control strategy. These measures resulted in increased CDTI coverage, fewer bites from blackfly vectors and decreased onchocerciasis-related morbidity. The feasibility of these interventions, low cost, national government support and community ownership suggest their long-term sustainability.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"128-132"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory capacity expansion: lessons from establishing molecular testing in regional referral laboratories in Ethiopia.","authors":"Leulseged Chekol, Ebba Waktola, Saira Nawaz, Lehageru Tadesse, Samuel Muluye, Zelalem Bonger, Addisu Bogale, Frehywot Eshetu, Desalegne Degefaw, Adamu Tayachew, Hulemenaw Delelegn, Sharon Daves, Eyasu Seyoum, Kyle Moon, Daniel Melese, Joan-Miquel Balada, Shu-Hua Wang, Desmond Williams, Wondwossen Gebreyes, Zelalem Mekuria","doi":"10.1093/inthealth/ihae046","DOIUrl":"10.1093/inthealth/ihae046","url":null,"abstract":"<p><p>Respiratory viruses contribute to high morbidity and mortality in Africa. In 2020, the Ohio State University's Global One Health Initiative, in collaboration with the Ethiopian Public Health Institute and the US Centers for Disease Control and Prevention, took action to strengthen Ethiopia's existing respiratory virus surveillance system through decentralization of laboratory testing and scale-up of national and regional capacity for detecting respiratory viruses. In August 2022, four regional laboratories were established, thereby raising the number of reference laboratories conducting respiratory virus surveillance to five. This article highlights lessons learned during implementation and outlines processes undertaken for laboratory scale-up and decentralization.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"123-127"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499383","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}