International Health最新文献

{"title":"Malawi newborn and child health national clinical practice guidelines: a landscape analysis.","authors":"Roselyn Chipojola, Gertrude Kunje, Suzgika Lakudzala, Mashudu Mthethwa, Nyanyiwe Masingi Mbeye","doi":"10.1093/inthealth/ihaf029","DOIUrl":"10.1093/inthealth/ihaf029","url":null,"abstract":"<p><strong>Background: </strong>Clinical practice guidelines (CPGs) are essential for standardizing healthcare, but their adoption, updating and adaptation remain inconsistent in Malawi. This review evaluated publicly available newborn and child health CPGs from 2017 to 2022, identifying relevant guidelines and assessing their quality using the Appraisal of Guidelines, Research and Evaluation (AGREE) II tool. Key gaps were found in stakeholder involvement and accessibility, highlighting the need to strengthen CPG development and dissemination to improve health outcomes.</p><p><strong>Methods: </strong>A total of 322 records were identified through Google Scholar, Google, the Ministry of Health (MOH) website and MOH offices using predetermined search terms. Hand searches were also conducted. The quality of reporting was appraised using the AGREE II tool.</p><p><strong>Results: </strong>Six CPGs met the eligibility criteria, five covering child health from the perinatal period onwards. CPGs targeted healthcare providers (n=6), program managers (n=2) and researchers (n=2). Topics included prevention, management and treatment. Reporting quality was generally poor, particularly regarding methodological rigour and editorial independence.</p><p><strong>Conclusions: </strong>A collaborative effort including the MOH, non-governmental organizations, professional associations and researchers in developing and adapting newborn and child health CPGs could yield large benefits in improving the quality of care of children in Malawi.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"661-668"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027414","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":"Does persistent active trachoma mandate antibiotic mass drug administration? A comparison of prevalence of trachomatous inflammation-follicular with that of conjunctival infection and anti-chlamydial antibodies, Western Province, Zambia.","authors":"Consity Mwale, Chileshe Mboni, Ngonda Saasa, Chummy S Sikasunge, Chisanga Chelu, Phyllis M Moonga, Grace Hameja, Levison Nkhoma, Frank Shamilimo, Namasiku S Kunda, Glenda Mulenga, Tabonga Naluonde, Nicholas Mutale, Sarah Boyd, Rosemary Pearson-Clarke, Ana Bakhtiari, Cristina Jimenez, Emma M Harding-Esch, Michael Dejene, Katherine Gass, Katrina Farber, Mohamed Bah, Caleb Mpyet, Freddie Masaninga, Nathan Nsubuga Bakyaita, Mwila Lundamo, Grace Chipalo Mutati, Sikufele Mubita, Davison J Kwendakwema, Paul Courtright, Anthony W Solomon, Kangwa I M Muma","doi":"10.1093/inthealth/ihaf092","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf092","url":null,"abstract":"<p><strong>Background: </strong>The evaluation unit comprising Kaoma, Luampa, and Nkeyema districts, Western Province, Zambia, has persistent active trachoma. In 2023, we sought to compare the evaluation unit-level prevalence of the active trachoma sign, trachomatous inflammation-follicular (TF), to that of conjunctival Chlamydia trachomatis (Ct) infection and anti-Chlamydia trachomatis (Ct) seropositivity.</p><p><strong>Methods: </strong>We conducted a cluster-sampled cross-sectional survey. In selected households, we examined all consenting residents ≥1 y of age for trachoma. We collected dried blood spots (DBSs) by finger-prick from children ages 1-9-y and conjunctival swabs from the left eyes of children ages 1-5-y. DBSs were tested for antibodies to the C. trachomatis antigen Pgp3 by lateral flow assay. We tested conjunctival swabs for C. trachomatis DNA by GeneXpert polymerase chain reaction (PCR).</p><p><strong>Results: </strong>The TF prevalence in children ages 1-9-y was 9.2%. In children ages 1-5-y, anti-Pgp3 seroprevalence was 1.7% and the seroconversion rate was 0.6 per 100 person-years. The prevalence of conjunctival C. trachomatis DNA in children ages 1-5-y was 0%.</p><p><strong>Conclusions: </strong>Based on TF prevalence, this population qualified for additional antibiotic mass drug administration rounds, but PCR and serology-more specific indicators of current or recent C. trachomatis infection than TF-confirmed an absence of significant current community C. trachomatis transmission, allowing a transition to surveillance. Adding these indicators is helpful in persistent active trachoma.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975411","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":"Mental health issues, risks and barriers to care for Bangladeshi children and adolescents: insights from lived experiences.","authors":"Md Omar Faruk, Kamal Uddin Ahmed Chowdhury, Sabiha Jahan, Erminia Colucci","doi":"10.1093/inthealth/ihaf091","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf091","url":null,"abstract":"<p><strong>Background: </strong>Mental health issues among Bangladeshi children and adolescents are increasing due to sociocultural factors. Despite its importance, in-depth research is scarce. This study addresses the gap by exploring mental health issues, risk factors and barriers to accessing care in rural and urban Bangladesh through qualitative methods.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 38 participants across both rural and urban areas, including 12 in-depth interviews with children and adolescents, 10 key informant interviews with caregivers and 2 focus group discussions with community representatives, educators and healthcare providers. All interviews were transcribed verbatim and a thematic analysis was employed to identify key themes. In addition to the interviews, we utilized observational data and yearly records from ADD International Bangladesh, a community-based mental health organization, to provide contextual depth and triangulate findings.</p><p><strong>Results: </strong>The findings revealed three themes: mental health issues such as anxiety, depression, suicidal ideation and substance abuse; risk factors including device overuse, family conflicts and substance availability; and barriers to care such as lack of services, low mental health literacy and stigma from religious and societal beliefs.</p><p><strong>Conclusions: </strong>The study provides an in-depth understanding of mental health issues, risk factors and barriers to care in rural and urban areas of Bangladesh. The findings enhance the understanding of the mental health status of young people and can inform policy development and the formation of suitable psychosocial interventions.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975449","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":"Examining wealth-related inequality in childhood vaccination in Fiji using the UNICEF Multiple Indicator Cluster Survey 2021.","authors":"Connie Lam, Md Irteja Islam, Rachel Devi, Meru Sheel, Alexandra Martiniuk","doi":"10.1093/inthealth/ihaf084","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf084","url":null,"abstract":"<p><strong>Background: </strong>Despite a 95% immunisation rate in Fiji, disparities exist in the distribution of immunisation in children from different socioeconomic backgrounds. We used data from the 2021 Fiji Multiple Indicator Cluster Survey (MICS) to determine socioeconomic inequalities contributing to differences in immunisation coverage.</p><p><strong>Methods: </strong>Data were extracted from the 'Household', 'Fertility/Birth history' and 'Children under 5' modules from the 2021 Fiji MICS to determine wealth quintiles and calculate vaccination rates for children aged 12-23 mo. Logistic regression was performed with factors of interest. Erreygers' corrected concentration index (ECI) was calculated and used to measure socioeconomic inequality.</p><p><strong>Results: </strong>Out of 417 children; 85.6% (357/417) were fully immunised, 12.0% (50/417) partially immunised and 2.4% (10/417) had no immunisations. Factors associated with increased probability of being fully immunised included being in the highest wealth quintile after adjusting for the number of children in the household. Children from larger households were more likely to be partially immunised after adjusting for household wealth. The ECI for fully vaccinated children was positive, whereas the ECI was negative for partially vaccinated children. Logistic regression also indicated a pro-rich inequality in vaccination.</p><p><strong>Conclusions: </strong>Our results help guides policy decisions on the delivery of immunisation services, enabling more equitable childhood immunisation in Fiji.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975423","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 and mortality rates for children co-infected with HIV and TB in Ethiopia: a systematic review and meta-analysis.","authors":"Fassikaw Kebede Bizuneh, Tsehay Kebede Bizuneh, Biruk Beletew Abate, Atitegeb Abera Kidie, Gataye Tizazu Biwota, Tilahun Gizaw Ayenew","doi":"10.1093/inthealth/ihaf085","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf085","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to identify risk factors and mortality rates in HIV and TB co-infected children in Ethiopia. An electronic literature search was conducted using multiple databases, including PubMed, Medline, Web of Science, African Journal Online, Google Scholar and university research repositories for gray literature. Weighted inverse variance random-effects meta-regression was employed to calculate pooled mortality rates, utilizing Stata/SE-17 for analysis. The meta-analysis included six eligible studies, encompassing a total of 2025 co-infected children. Among these, 238 deaths were reported over 1670.6 person-years. This made the crude mortality rate 11.74% (95% CI 11.49 to 16.12%) with an incidence of 1.5 deaths (95% CI 1.17 to 1.89) per 100 person-years. Factors including WHO stages III and IV (4.34, 95% CI 2.25 to 8.36), poor antiretroviral therapy (ART) adherence (3.11, 95% CI 2.04 to 4.15), missed isoniazid preventive therapy (IPT) (3.07, 95% CI 1.52 to 6.23) and low hemoglobin levels of ≤10 mg/dl (2.84, 95% CI 2.02 to 3.99) were predictors compared with their counterparts.This review reveals an unacceptably high pooled incidence of mortality among HIV and TB co-infected children in Ethiopia. Therefore, implementing systematic screenings for IPT, enhancing ART adherence counseling and addressing anemia through early treatment are critical for preventing premature deaths. Protocol registration in Prospero = CRD42024502038.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975761","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":"John Snow and the contaminated water of River Ganga at Kumbh Mela in India.","authors":"Sushila Tiwari, Rahul M Jindal, Dileep Mavalankar","doi":"10.1093/inthealth/ihaf081","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf081","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856863","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":"Oral cholera vaccine uptake, acceptance and confidence among residents of a high-risk township in Zambia: key insights for future vaccination programs.","authors":"Ernest Miti, Moses Mukosha, John Mwaba, Malala Mulavu, Johanna C Meyer, Steward Mudenda, Brian Godman, Chiluba Mwila, Audrey Hamachila, Aubrey C Kalungia","doi":"10.1093/inthealth/ihaf087","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf087","url":null,"abstract":"<p><strong>Background: </strong>Oral cholera vaccines (OCVs) prevent cholera and save lives. Given the recent 2024 country-wide cholera epidemic in Zambia, we determined self-reported OCV uptake, acceptance and confidence among adults living in a high-risk, cholera-prone township in Zambia.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted from April to August 2024, involving 385 randomly selected adult participants residing in the Kanyama township of Lusaka, Zambia. Data were collected using an interviewer-administered questionnaire and statistically analysed.</p><p><strong>Results: </strong>Self-reported uptake of at least one dose of the OCV was 18%, with the majority (315 [82%]) reporting being unvaccinated against cholera. Among those who were unvaccinated, vaccine acceptance was <10% (95% confidence interval [CI] 6.8 to 13.7), with higher rates reported among women than men (p=0.002). Despite this, the majority (210 [84.3%]) expressed confidence in the vaccination program. Those knowledgeable about the OCV were twice as likely to get vaccinated (adjusted odds ratio 2.60 [95% CI 1.19 to 5.68]). Knowledge, attitudes and perceptions were associated with OCV uptake.</p><p><strong>Conclusions: </strong>Self-reported OCV uptake and acceptance were low in a high-risk cholera-prone township in Zambia. Community education on the benefits of the vaccine is urgently needed to enhance confidence and attitudes towards the OCV and improve vaccination rates in the future.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838372","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":"Adaptation of Inuka coaching problem-solving therapy to support mental health and HIV medication adherence among status-neutral men who have sex with men in South Africa.","authors":"Lindiwe Tsope, Elise M van der Elst, Jacqueline Pienaar, Charlene Denousse, Mapaseka Mabena, Pontsho Komane, Boitumelo Ramashala, Ankiza Gakunu, Danielle Giovenco, Ruwenne Moodley, Don Operario, Eduard J Sanders","doi":"10.1093/inthealth/ihaf086","DOIUrl":"10.1093/inthealth/ihaf086","url":null,"abstract":"<p><strong>Background: </strong>Depression is prevalent among men who have sex with men (MSM) in South Africa and can impact their adherence to PrEP and ART. We developed the WeCare coaching intervention, adapted from the evidence-based Friendship Bench/Inuka problem-solving therapy program, to address their mental health challenges.</p><p><strong>Methods: </strong>Twenty MSM with symptoms of mild to moderate depression (Patient Health Questionnaire-9 scores 5-14) and using PrEP or ART were recruited from two clinics in Johannesburg and Pretoria. Participants received adapted Inuka coaching (four individual and up to four group sessions). Mental health outcomes were assessed preintervention and postintervention using the SRQ-20. Postintervention in-depth interviews and focus group discussions were conducted with participants and lay health workers (LHWs). Qualitative data evaluated utility. Data were analysed using thematic analysis.</p><p><strong>Results: </strong>Median SRQ-score improved from preintervention to post-intervention assessment (p<0.001). Participants found coaching acceptable, qualitatively highlighting the value of a safe space to discuss emotional well-being. Key themes included: (1) need for cultural and contextual adaptation of coaching content; (2) stigma-related stressors shaping mental health and perceived engagement with ART/PrEP; and (3) LHWs expressed enthusiasm for delivering support but requested strengthened ART/PrEP literacy training.</p><p><strong>Conclusion: </strong>Findings supported acceptability and feasibility and informed further development of the WeCare intervention.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838371","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":"Progress towards malaria elimination: insights from Cambodia's mobile malaria workers during the COVID-19 pandemic.","authors":"Emma K Manning, Rekol Huy, Sovannaroth Siv, Po Ly, James K Tibenderana, Lieven Vernaeve","doi":"10.1093/inthealth/ihaf080","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf080","url":null,"abstract":"<p><p>Significant progress has been made in Cambodia towards malaria control and the goal of achieving elimination of all species by 2025. These efforts require constant vigilance and agility in malaria programming to maintain forward momentum. During the COVID-19 pandemic, these achievements were threatened by restrictive pandemic control measures, necessitating swift action from the National Center for Parasitology, Entomology and Malaria Control and partners to safeguard critical malaria services, primarily case detection and treatment by mobile malaria workers (MMWs) among hard-to-reach populations. As malaria cases have declined in Cambodia, infections are increasingly focused among remote populations further from primary healthcare services. Thus, the greatest threat to malaria control during the pandemic consisted of the logistical and communication challenges faced by MMWs travelling to remote regions while movement was restricted. Through locally tailored implementation of these services and close communication with health authorities, Malaria Consortium's MMWs were able to minimise disruption of Cambodia's malaria control programme while ensuring staff and beneficiaries were protected.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838373","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":"Safer at school? Experiences of families on school closure during COVID-19 in an informal settlement in Nairobi, Kenya.","authors":"Elizabeth Echoka, Violet Wanjihia, Prisca Otambo, Lilian Nyandieka, Zipporah Bukania","doi":"10.1093/inthealth/ihaf082","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf082","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic led to widespread closures of learning institutions globally. In informal settlements, unique and multifaceted challenges were encountered. This article examines the specific challenges faced by families following school closures due to COVID-19 in an informal settlement in Nairobi, Kenya.</p><p><strong>Methods: </strong>Qualitative data were collected in December 2020. In-depth interviews with 30 household heads and 15 community representatives were conducted. Responses were recorded, transcribed and reviewed. Thematic analysis identified four major themes: strain on food and economic consequences, increased risk of teen pregnancy and exploitation, gaps in childcare and supervision and educational disruption and increased dropout risk.</p><p><strong>Results: </strong>School closures during COVID-19 not only disrupted education but also exacerbated food insecurity and economic strain, as families lost access to school feeding programs and experienced reduced incomes. Limited supervision of children increased their exposure to risky behaviours, while vulnerable groups, particularly girls, faced heightened risks of exploitation and teen pregnancy. Educational disruptions further worsened the situation, with many students, especially girls, at risk of permanently dropping out.</p><p><strong>Conclusions: </strong>The findings highlight the critical role of schools in marginalized communities and suggest the need for targeted support and inclusive educational policies that address the needs of informal settlement residents during periods of pandemic vulnerability.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776719","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}