International Health最新文献

{"title":"Risk factors and circulation pattern of respiratory syncytial virus in children under 2 years in Maputo, Mozambique.","authors":"Mirela Pale, Almiro Tivane, Tinne Gils, Adilson Bauhofer, Neuza Nguenha, Loira Machalele, Félix Gundane, Aunésia Marrurele, Judite Salência, Délcio Muteto, Josina Chalufo-Chilundo, Marilda Siqueira, Tufária Mussá","doi":"10.1093/inthealth/ihae033","DOIUrl":"10.1093/inthealth/ihae033","url":null,"abstract":"<p><strong>Background: </strong>Evidence on risk factors for respiratory syncytial virus (RSV) in low-resource settings is limited. In Mozambican children <2 y of age with severe acute respiratory infection (SARI), we explored risk factors for RSV, described its seasonal variation and assessed associations between RSV and a life-threatening condition.</p><p><strong>Methods: </strong>We retrospectively included participants presenting in 2017-2018 in two hospitals in Maputo. RSV was detected and subtyped using real-time quantitative reverse transcription polymerase chain reaction on nasopharyngeal swabs. We used logistic regression and χ2 tests to assess associations and Spearman's correlation coefficient to assess the correlation between weather measurement and RSV positivity.</p><p><strong>Results: </strong>RSV was detected in 23.1% (n=109) of 472 included children and in 50.0% (20/40) of those <3 months old. Being <3 months (vs >1 y) was associated with RSV (adjusted odds ratio 4.3 [95% confidence interval 2.1-8.5]). RSV status was not associated with experiencing a life-threatening condition. RSV A and B co-circulated during the study period, but one type predominated in each year. In 2017, the RSV positivity rate was correlated with monthly average temperature (r=0.793, p=0.002) and precipitation (r=0.596, p=0.041).</p><p><strong>Conclusions: </strong>In Mozambican children with SARI, RSV was prevalent, especially in neonates. However, RSV was not associated with a life-threatening condition.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"159-167"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877746","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":"Kala-azar elimination in India: reflections on success and sustainability.","authors":"Dhruv K Pandey, Jorge Alvar, Margriet den Boer, Saurabh Jain, Naresh Gill, Daniel Argaw, Subhash Salunke, Mobassir Hussain, Nupur Roy","doi":"10.1093/inthealth/ihaf013","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf013","url":null,"abstract":"<p><p>The incidence and mortality of kala-azar (KA, visceral leishmaniasis) in India have fallen drastically in the past few years, and in 2023 the reported KA incidence reached the threshold for elimination as a public health problem (<1 case/10 000 of population at subdistrict level). One of the strategies adopted by India's kala-azar elimination program (KAEP) was the regular independent assessment of the program implementation by teams of experts. We present the findings of assessments undertaken in 2019, 2021 and 2023, when the KAEP was in the last mile of elimination. Factors that contributed to its success were political commitment, intensified implementation, a strong network of KA partners and committed donors. Bottlenecks were observed in disease surveillance, data utilization, vector-control operations and program management at implementation. To sustain the gains and achieve validation of elimination, the KAEP should continue the following minimal essential services: optimized active and passive case detection and management of KA, post-KA dermal leishmaniasis, KA-HIV coinfection and relapse supported by vector-control interventions. Long-term measures that will sustain elimination are overall socioeconomic development, including improved living conditions, parallel with efficient surveillance and operational research that is aligned with the changing epidemiology of the disease.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558030","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":"Dengue and diabetes comorbidities: an emerging syndemic public health threat.","authors":"Inayat Ali, Merrill Singer","doi":"10.1093/inthealth/ihaf011","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf011","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557686","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for PrEP and ART medication adherence challenges in cis-gender South African men who have sex with men in Johannesburg and Pretoria.","authors":"Jacqueline Pienaar, Lindiwe Tsope, Mapaseka Mabena, Pontsho Komane, Maria Sibanyoni, Boitumelo Ramashala, Elizabeth Wahome, Charlene Denousse, Ankiza Gakunu, Elise M van der Elst, Danielle Giovenco, Don Operario, Eduard J Sanders","doi":"10.1093/inthealth/ihae090","DOIUrl":"https://doi.org/10.1093/inthealth/ihae090","url":null,"abstract":"<p><strong>Background: </strong>Mental health challenges are common among men who have sex with men (MSM) in South Africa and may impact medication adherence.</p><p><strong>Methods: </strong>We determined the prevalence and risk factors of medication adherence challenges among 160 pre-exposure prophylaxis (PrEP)- and 40 antiretroviral therapy (ART)-taking MSM registered at two key population clinics in Johannesburg and Pretoria in 2023. We used modified Poisson regression to estimate associations between participant characteristics and medication adherence challenges (missed dosage on ≥1 d in the last month).</p><p><strong>Results: </strong>A total of 106 (53.5%) participants (57.6% on PrEP, 37.5% on ART; p=0.02) had medication adherence challenges and 61 (30.5%) participants (31.2% on PrEP, 27.5% on ART; p=0.23) met criteria for moderate to severe symptoms of depression (score ≥10 on the 9-item Patient Health Questionnaire). In multivariable analysis, predictors included PrEP use (adjusted prevalence ratio [aPR]=1.81 [95% confidence interval {CI} 1.21 to 2.73), clinic in Pretoria (aPR 1.43 [95% CI 1.08 to 1.89]), transactional sex (aPR 1.81 [95% CI 1.34 to 2.44]), moderate to severe depression (aPR 1.50 [95% CI 1.19 to 1.89]) and use of social media (aPR 1.45 [95% CI 1.05 to 2.00]).</p><p><strong>Conclusions: </strong>Depression is common and may be an important risk factor for poor medication adherence among MSM in South Africa. Future research should leverage a longitudinal study design to inform potential interventions.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411348","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":"Effect of prenatal alcohol consumption on maternal anemia among pregnant women in Gondar town, Northwest Ethiopia: a retrospective cohort study.","authors":"Alemu Earsido Addila, Telake Azale, Mezgebu Yitayal","doi":"10.1093/inthealth/ihaf010","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf010","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption during pregnancy can lead to multiple health, social and behavioral problems for both the mother and the offspring. Anemia is one of the major public health concerns and causes of morbidity and mortality among pregnant women with poor maternal and fetal outcomes in developing countries. This study aimed to identify the link between prenatal alcohol consumption and anemia among pregnant women in Gondar town, Northwest Ethiopia.</p><p><strong>Methods: </strong>A facility-based retrospective cohort study was conducted among 1669 pregnant women who were booked in for antenatal care in Gondar town. We used a two-stage random sampling technique to recruit and include study participants in the cohort. Data were collected using an interviewer-administered questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and anemia in pregnancy using log-binomial regression modeling. The burden of anemia in pregnancy was reported using the adjusted risk ratio (ARR) and population-attributable risk.</p><p><strong>Results: </strong>The prevalence of anemia during pregnancy was 14.86% (95% CI 13.23 to 16.65%). Hazardous alcohol consumption during pregnancy was significantly associated with anemia in pregnancy (ARR=2.24; 95% CI 1.60, 3.15). The adjusted population-attributable risk of anemia in pregnancy related to hazardous alcohol consumption during pregnancy was 7.68%.</p><p><strong>Conclusions: </strong>This study revealed that anemia during pregnancy continues to be a public health concern. Regardless of timing, there is a clear association between prenatal alcohol consumption and anemia during pregnancy that suggests a need for targeted prenatal alcohol use screening, and ongoing intervention for alcoholic pregnant women.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374817","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":"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":"https://doi.org/10.1093/inthealth/ihaf008","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-designing the FOotpaths foR Adolescent MAternal Mental HeAlth (FOR MAMA) intervention for pregnant teens in Malawi.","authors":"Wezi Mhango, Daniel Michelson, Darya Gaysina","doi":"10.1093/inthealth/ihaf007","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf007","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to gain insights into stakeholders' priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi.</p><p><strong>Methods: </strong>Participatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8) and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the Template for Intervention Description and Replication checklist.</p><p><strong>Results: </strong>Participants emphasized the need for information on causes and symptoms of common mental problems and for developing coping strategies: a) those focused on external stressors-problem-solving, financial literacy and interpersonal skills-and b) emotion-focused approach behaviours-behavioural activation, relaxation and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. All stakeholder groups felt there was a need for follow-up to ensure that adolescents correctly engaged with the intervention material.</p><p><strong>Conclusions: </strong>Findings informed the design of a brief multicomponent guided intervention for adolescents in the antenatal period.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256895","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":"A commentary: what do Rebecca Cheptegei and Gisèle Pelicot have in common?","authors":"Safieh Shah","doi":"10.1093/inthealth/ihaf004","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf004","url":null,"abstract":"<p><p>This commentary accompanies a study that focuses on the profound impact of intimate partner violence (IPV) on women's health in Ethiopia. The study highlights the dose-response relationship between IPV and antenatal care uptake, emphasizing the need for nuanced, context-specific interventions. The commentary highlights the need for new, sustainable and reliable ways of collecting IPV data across countries over time to effectively monitor Sustainable Development Goal 5. It advocates for a multilayered approach, combining healthcare, legal reforms and community-based strategies, to address the social causes of IPV, thereby aiming to critically appraise previously established ways of seeing information and ideas.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191057","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":"Intimate partner violence and maternal antenatal care utilization: is there a dose-response relationship? Findings from the Ethiopian National Demographic and Health Survey.","authors":"Bazie Mekonnen, Abebe Gebremariam, Negussie Deyessa, John N Cranmer","doi":"10.1093/inthealth/ihaf003","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf003","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality in sub-Saharan Africa (SSA) is an enduring public health challenge. Adequate utilization of antenatal care (ANC) services is one strategy to mitigate the problem by identifying and managing pregnancy risks early. Yet, in SSA, uptake of ANC remains low. Intimate partner violence (IPV) may be a deterrent to ANC uptake. We measured the dose-response relationship between IPV and adequate ANC utilization (defined as four or more visits [ANC-4]) using data from the Ethiopia Demographic and Health Survey (EDHS) 2016.</p><p><strong>Methods: </strong>We used complex sample logistic regression to measure the impact of three IPV subscales (emotional, sexual and physical) on ANC-4 while controlling for sociodemographic, obstetric and women empowerment factors.</p><p><strong>Results: </strong>A total of 2599 (weighted) currently married or in-union women were included. There was a significant dose-response relationship between IPV and ANC utilization. Emotional (adjusted odds ratio [aOR] 0.78 [confidence interval {CI} 0.64 to 0.97]) and sexual (aOR 0.68 [CI 0.50 to 0.92]) violence decreased ANC-4 uptake while controlling for the covariates.</p><p><strong>Conclusions: </strong>IPV is common, yet often invisible, in Ethiopia. Health workers may begin directly screening pregnant women for IPV in order to increase targeted support of ANC uptake. This is the first known study to confirm IPV has a dose-response relationship with ANC-4 uptake.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191060","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}