International Health最新文献

{"title":"Provincial distribution and factors associated with high completed fertility among married and cohabiting women aged 40-49 years in Sierra Leone: a cross-sectional study.","authors":"Augustus Osborne, Alhaji Mustapha Abu, Hassan S Rogers, Florence Gyembuzie Wongnaah, Bright Opoku Ahinkorah","doi":"10.1093/inthealth/ihae058","DOIUrl":"10.1093/inthealth/ihae058","url":null,"abstract":"<p><strong>Background: </strong>High completed fertility among married and cohabiting women has significant implications, such as burden on resources, exacerbating healthcare issues and educational and gender disparities. This study examined the provincial distribution and factors associated with high completed fertility among married and cohabiting women aged 40-49 y in Sierra Leone.</p><p><strong>Methods: </strong>Data for the study were sourced from the 2019 Sierra Leone Demographic and Health Survey. Our study comprised 2253 married and cohabiting women aged 40-49 y in Sierra Leone. Geographic variations in high fertility were presented using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to identify the factors associated with high completed fertility. The findings were presented as adjusted ORs (aOR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The national prevalence of high completed fertility among married and cohabiting women in Sierra Leone was 61.7% (58.9-64.5). Women whose partners had secondary/higher education (aOR=0.54, 95% CI 0.33 to 0.89) had lower odds of high completed fertility than those with no formal education. Women in the Northern province (aOR=0.39, 95% CI 0.17 to 0.87) had lower odds of high completed fertility than those in the Eastern province. Women who indicated ≥6 as their ideal number of children had a higher (aOR=8.10, 95% CI 4.58 to 14.35) likelihood of experiencing high completed fertility compared with those whose ideal number of children was 0-3. Those who were using contraceptives at the time of the survey had a higher (aOR=2.09, 95% CI 1.28 to 3.41) likelihood of having high completed fertility compared with those who were not using contraceptives. Women in the poorer (aOR=1.70, 95% CI 1.07 to 2.72) and middle wealth index quintiles (aOR=2.09, 95% CI 1.29 to 3.41) had higher odds of high completed fertility than those in the poorest wealth index quintile.</p><p><strong>Conclusions: </strong>A significant proportion (>60%) of married and cohabiting women aged 40-49 y in Sierra Leone have high completed fertility. Partner's education, province, ideal number of children, use of contraceptives and wealth index were the factors associated with high completed fertility among women in Sierra Leone. Policymakers in Sierra Leone should increase access to and education on family planning methods to empower women to make informed choices about their fertility. The government and policymakers should support educational opportunities, particularly for men, because they are usually the heads of households and can influence fertility decisions. In-depth interviews should be conducted with women who use contraception to understand their motivations and experiences.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"282-291"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433722","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":"Training in the symptothermal method to ameliorate unmet need for family planning: knowledge, attitudes and satisfaction.","authors":"Catherine E Igben-Pender, Peter Omemo, Gideon Ng'wena","doi":"10.1093/inthealth/ihae063","DOIUrl":"10.1093/inthealth/ihae063","url":null,"abstract":"<p><strong>Background: </strong>Addressing the unmet need for family planning to prevent unintended pregnancies is a high priority for women's health, and training as an element of the symptothermal method (STM) is deemed to be an effective strategy. This study assessed training on knowledge, attitudes and satisfaction with STM to ameliorate the unmet need for family planning.</p><p><strong>Methods: </strong>The study adopted a pre-post study design. A total of 136 women participated in this study. Knowledge and attitudes were assessed pre- and post-training as well as the level of satisfaction, using cycle charts and questionnaires. The χ2 test (p<0.05) was used to analyse data on sociodemographics, attitudinal characteristics and satisfaction. Paired samples t-test (p<0.05) was used to establish the mean difference of the two groups (knowledge and attitudes pre- and post-training).</p><p><strong>Results: </strong>The paired samples t-test established that women have significant (t=-058.716, p=0.001) knowledge post-training (1.0000±0.00000) compared with pre-training (0.0682±0.01587) on STM. There was no significant (t=-1.419, p=0.158) difference in attitudes towards STM pre- and post-training. There was a significant level of satisfaction (p=0.001).</p><p><strong>Conclusions: </strong>Our interventional study has enabled women to acquire robust knowledge, positive attitudes and satisfaction with the utilization of STM. This has ameliorated unmet need for family planning among participants.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"304-312"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382138","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":"Evaluating the cost-effectiveness of Cy-Tb for LTBI in India: a comprehensive economic modelling analysis.","authors":"Malaisamy Muniyandi, Karikalan Nagarajan, Kavi Mathiyazhagan, Kirti Tyagi, Kavitha Rajsekar, Chandrasekaran Padmapriyadarsini","doi":"10.1093/inthealth/ihae048","DOIUrl":"10.1093/inthealth/ihae048","url":null,"abstract":"<p><strong>Background: </strong>Latent tuberculosis infection (LTBI) remains a significant challenge, as there is no gold standard diagnostic test. Current methods used for identifying LTBI are the interferon-γ release assay (IGRA), which is based on a blood test, and the tuberculin skin test (TST), which has low sensitivity. Both these tests are inadequate, primarily because they have limitations with the low bacterial burden characteristic of LTBI. This highlights the need for the development and adoption of more specific and accurate diagnostic tests to effectively identify LTBI. Herein we estimate the cost-effectiveness of the Cy-Tb test as compared with the TST for LTBI diagnosis.</p><p><strong>Methods: </strong>An economic modelling study was conducted from a health system perspective using decision tree analysis, which is most widely used for cost-effectiveness analysis using transition probabilities. Our goal was to estimate the incremental cost and number of TB cases prevented from LTBI using the Cy-Tb diagnostic test along with TB preventive therapy (TPT). Secondary data such as demographic characteristics, treatment outcome, diagnostic test results and cost data for the TST and Cy-Tb tests were collected from the published literature. The incremental cost-effectiveness ratio was calculated for the Cy-Tb test as compared with the TST. The uncertainty in the model was evaluated using one-way sensitivity analysis and probability sensitivity analysis.</p><p><strong>Results: </strong>The study findings indicate that for diagnosing an additional LTBI case with the Cy-Tb test and to prevent a TB case by providing TPT prophylaxis, an additional cost of 18 658 Indian rupees (US$223.5) is required. The probabilistic sensitivity analysis indicated that using the Cy-Tb test for diagnosing LTBI was cost-effective as compared with TST testing. If the cost of the Cy-Tb test is reduced, it becomes a cost-saving strategy.</p><p><strong>Conclusions: </strong>The Cy-Tb test for diagnosing LTBI is cost-effective at the current price, and price negotiations could further change it into a cost-saving strategy. This finding emphasizes the need for healthcare providers and policymakers to consider implementing the Cy-Tb test to maximize economic benefits. Bulk procurements can also be considered to further reduce costs and increase savings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"259-269"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879734","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":"Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.","authors":"Ayano Miyashita, Keiko Nakamura, Stephen M Kibusi, Eugene Benjamin Meshi, Anderson Bendera, Hideko Sato, Saber Al-Sobaihi, Yuri Tashiro, Kaushik L Ramaiya, Bruno F Sunguya, Kaoruko Seino","doi":"10.1093/inthealth/ihae070","DOIUrl":"10.1093/inthealth/ihae070","url":null,"abstract":"<p><strong>Background: </strong>The rise of hypertension (HTN) and diabetes mellitus (DM) in Tanzania underscores the importance of self-care practices (SCP) for disease management. Despite the proven effectiveness of SCP, financial barriers in resource-limited rural areas hinder continuous care. Health insurance (HI) emerges as a critical solution to alleviate financial constraints and support SCP.</p><p><strong>Methods: </strong>This study examined an association between HI and SCP by generalised linear and ordinal logistic regressions, adjusted for sociodemographic factors. Mediation analysis highlighted the role of disease management behaviours (hospital visits and medication adherence) in the association. Data were collected through individual interviews with 909 patients.</p><p><strong>Results: </strong>Better SCP for HTN and DM were associated with the National Health Insurance Fund (HTN: coefficient=0.571; DM: coefficient=0.567, p<0.001) and the improved Community Health Fund (iCHF) or CHF (HTN: coefficient=0.330; DM: coefficient=0.472, p<0.05), after adjustment for sociodemographic variables. Mediation analysis showed that disease management behaviours partially or fully mediated the relationship between HI and SCP.</p><p><strong>Conclusions: </strong>Enrolment in HI by patients in rural Tanzania exhibited better disease management behaviours and SCP. Efforts should focus on leveraging the HI schemes to expand their coverage in rural areas, which could benefit patients with non-communicable diseases.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"342-350"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830650","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":"Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care.","authors":"Rebecca E Harrison, Volha Shyleika, Raman Vishneuski, Olga Leonovich, Dmitri Vetushko, Alena Skrahina, Htay Thet Mar, Ekaterine Garsevanidze, Christian Falkenstein, Öznur Sayakci, Antonio Isidro Carrion Martin, Cecilio Tan, Norman Sitali, Kerri Viney, Knut Lonnroth, Beverley Stringer, Cono Ariti, Animesh Sinha","doi":"10.1093/inthealth/ihae066","DOIUrl":"10.1093/inthealth/ihae066","url":null,"abstract":"<p><strong>Background: </strong>TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use.</p><p><strong>Methods: </strong>An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019-November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted.</p><p><strong>Results: </strong>There were 89 participants enrolled in the intervention, with a median follow-up of 12.2 (IQR: 8.1-20.5) mo. The majority (n=80; 89.9%) of participants had AUD, 11 (12.4%) also had a dependence on other substances, six (6.7%) a dependence on opioids and three (3.4%) a personality disorder. Fifty-eight had a history of past incarceration (65.2%), homelessness (n=9; 10.1%) or unemployment (n=55; 61.8%). Median adherence was 95.4% (IQR: 90.4-99.6%) and outpatient adherence was 91.2% (IQR: 65.1-97.0%). Lower adherence was associated with hepatitis C, alcohol plus other substance use and outpatient facility-based treatment, rather than video-observed treatment, home-based or inpatient treatment support.</p><p><strong>Conclusions: </strong>This intervention led to good adherence to MDR/RR-TB treatment in people with harmful use of alcohol, a group usually at risk of poor outcomes. Poor outcomes were associated with hepatitis C, other substance misuse and outpatient facility-based treatment support.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"313-323"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584818","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":"Using disruptive innovation to design endoscopic ligators for resource-challenged health settings.","authors":"Jack T Gardner, Vincent Dusabejambo, Steve P Bensen","doi":"10.1093/inthealth/ihae067","DOIUrl":"10.1093/inthealth/ihae067","url":null,"abstract":"<p><strong>Background: </strong>Commercial single-use endoscopic multiband ligators, used for esophageal variceal band ligation (EVL), are prohibitively expensive. To enable greater access to EVL, we used disruptive innovation to develop a novel endoscopic multiband ligator.</p><p><strong>Methods: </strong>We designed and tested a prototype handle 'ENDOhandle' using computer-aided design modeling and exported a cap, trigger cord and latex to form a functional banding unit.</p><p><strong>Results: </strong>The cost of the banding unit was US$4.80 compared with several hundred US dollars for commercially available devices in the USA.</p><p><strong>Conclusions: </strong>Disruptive innovation technology developed an inexpensive ligator for resource-challenged health settings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"385-387"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478651","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":"Attitudes towards wife-beating justification and its association with female genital mutilation - analysis of ever-married Somali women in the 2020 Somali Health and Demographic Survey.","authors":"Abdirahman Saeed Mohamed, Espen Bjertness, Aung Soe Htet, Win Thuzar Aye, Ahmed Ali Madar","doi":"10.1093/inthealth/ihae047","DOIUrl":"10.1093/inthealth/ihae047","url":null,"abstract":"<p><strong>Background: </strong>In Somalia, despite its prohibition, female circumcision persists alongside significant intimate partner violence. This study examines the prevalence of wife-beating justification among Somali women and its link to the perception that female genital mutilation/cutting (FGM/C) is a religious obligation.</p><p><strong>Methods: </strong>We studied 7726 married Somali women 15-49 y of age from the 2020 Somali Health and Demographic Survey. Using χ2 tests and logistic regression, we examined wife-beating justification by covariates and its connection to the perception that FGM/C is a religious obligation.</p><p><strong>Results: </strong>The prevalence of women justifying wife-beating for any of six reasons was 56.5% (95% confidence interval [CI] 55.3 to 57.6). A higher prevalence of wife-beating justification was found among women 35-49 y of age (59.9% [95% CI 57.8 to 61.9]), without education (57.7% [95% CI 56.5 to 59.0]), rural residents (57.8% [95% CI 56.3 to 59.2]), with lower socio-economic status (60.4% [95% CI 58.7 to 62.1]) and married before age 18 y (58.4% [95% CI 56.7 to 60.1]). Adjusted for covariates, logistic regression analyses indicated a significant association between wife-beating justification and the belief that FGM/C is mandated by religion (adjusted odds ratio 1.40 [95% CI 1.17 to 1.68], p<0.001).</p><p><strong>Conclusions: </strong>Wife-beating justification is alarmingly common among Somali women and significantly associated with the belief that FGM/C is mandated by religion. Further research is necessary to investigate the drivers behind the acceptance of domestic violence, its impact on women's mental health and well-being and its association with FGM/C acceptance.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"251-258"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332332","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":"Guidelines for the transfer of people living with HIV attending primary healthcare facilities in South Africa: a scoping review.","authors":"Jasantha Odayar, Tamsin K Phillips, Claudine Hennessey, Landon Myer","doi":"10.1093/inthealth/ihae057","DOIUrl":"10.1093/inthealth/ihae057","url":null,"abstract":"<p><p>People living with HIV may move between health facilities: this is called 'transfer', and includes up- and down-referral based on clinical condition and lateral transfer (e.g. between primary healthcare [PHC] facilities for reasons such as geographic mobility or stigma). Transfers involving PHC facilities occur frequently and are associated with viraemia and disengagement. We reviewed the South African National Department of Health (NDOH) and Southern African HIV Clinicians Society websites and contacted NDOH officials to identify national guidelines applicable to HIV care in South Africa for recommendations on transfers involving PHC facilities. In total, 21/24 (88%) documents mentioned transfer, using the terms 'referral', 'linkage', 'transfer', 'transition' and 'handover'. Guidelines defined 'linkage to care' as connecting individuals to care after HIV testing, but other terms were not well defined. Documents emphasised transfers between different levels of the health system, and transfers between PHC facilities received limited attention. The transfer process was delineated for linkage to care, up- and down-referrals, but not for transfers between PHC facilities. Clinical management of patients transferring between PHC facilities and tracing of patients who requested transfers and missed their visits were not specified. Overall, transfers between PHC facilities were not well addressed and require attention to improve HIV treatment outcomes.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"237-244"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511313","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":"A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda.","authors":"Michael Matte, Natsumi Koyama, Dana Giandomenico, Emmanuel Baguma, Georget Kibaba, Moses Ntaro, Raquel Reyes, Edgar M Mulogo, Ross M Boyce, Emily J Ciccone","doi":"10.1093/inthealth/ihae075","DOIUrl":"10.1093/inthealth/ihae075","url":null,"abstract":"<p><strong>Background: </strong>Integrated community case management (iCCM) programs leverage lay village health workers (VHWs) to carry out the initial evaluation of children with common conditions including malaria, pneumonia and diarrhea. Therefore, it is imperative that VHWs are able to identify children who are critically ill and require referral to a health facility. Elevated venous lactate levels have been associated with severe illness and adverse health outcomes, including death. However, lactic acidosis may not be recognized in rural settings because it is not routinely measured outside of hospitals and research studies. Point-of-care lactate tests may help identify patients in need of a higher level of care and improve VHWs' ability to make timely and appropriate referrals.</p><p><strong>Methods: </strong>The study was a cross-sectional evaluation of children aged <5 y presenting to VHWs in rural southwestern Uganda with complaints of fever and cough. Demographics, clinical presentation, evaluation, management and disposition were recorded. VHWs were trained and instructed to perform lactate testing using a point-of-care assay in eligible participants.</p><p><strong>Results: </strong>During the study period, 238 children were enrolled and completed an initial assessment. Of the 204 participants included in the analysis, 113 (55.4%) were female, and the median (IQR) age was 23 (9-36) months. Most participants, 139/200 (69.5%), had negative results on the malaria rapid diagnostic test. The median lactate level was 2.1 mmol/L; 12% (24/204) had a lactate ≥3.5 mmol/L and only nine participants (4.4%) had a lactate ≥5 mmol/L. Having a lactate level above either cut-off was not associated with the presence of danger signs at presentation.</p><p><strong>Conclusions: </strong>Few children presenting with fever and cough to VHWs in western Uganda had elevated lactate levels. However, most of the children with elevated lactate levels did not otherwise satisfy established iCCM criteria based on physical examination findings for referral to a health facility. Therefore, while elevated lactate was not associated with danger signs in this small study, it is possible that there is under-recognition of severe illness using current iCCM guidelines.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"377-384"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631072","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":"Self-reported prevalence of tuberculosis: unveiling spatial representation in the districts of Tamil Nadu.","authors":"Malaisamy Muniyandi, Kavi Mathiyazhagan, Nagarajan Karikalan","doi":"10.1093/inthealth/ihae072","DOIUrl":"10.1093/inthealth/ihae072","url":null,"abstract":"<p><strong>Background: </strong>The objective of the current study was to estimate the self-reported individual-level crude prevalence and cluster-level adjusted prevalence of TB for the districts of Tamil Nadu and to understand the spatial distribution of TB cases through spatial autocorrelation and hotspot analysis.</p><p><strong>Methods: </strong>National Family Health Survey (NFHS) data, gathered during 2014-2015 (NFHS-4) and 2019-2021 (NFHS-5), were used in the current study to estimate district-wise, individual-level crude and cluster-level adjusted TB prevalence per 100 000 population in Tamil Nadu. This was illustrated with the help of spatial geographic representation for various districts of Tamil Nadu using SPSS and QGIS software. The spatial autocorrelation and hotspot analysis were performed using Geoda software.</p><p><strong>Results: </strong>The overall self-reported individual-level crude prevalence of TB was 337 (95% CI 302 to 375) and 169 (95% CI 144 to 197) per 100 000 population, whereas the cluster-level adjusted prevalence of TB was 356 (95% CI 311 to 405) and 184 (95% CI 154 to 219) per 100 000 population in NFHS-4 and NFHS-5, respectively.</p><p><strong>Conclusions: </strong>This study highlights those geographical areas with high rates of TB prevalence. This information would be useful for the state and district programme managers to identify areas of high TB prevalence where interventions can be focused.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"366-376"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478650","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}