{"title":"Sputum culture conversion and its predictors among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia.","authors":"Mulugeta Gamachu, Alemayehu Deressa, Lemma Demissei Regassa, Miesso Bayu, Ibsa Mussa, Fekede Asefa Kumsa, Tariku Dingeta","doi":"10.1093/inthealth/ihae059","DOIUrl":"10.1093/inthealth/ihae059","url":null,"abstract":"<p><strong>Background: </strong>Evidence of time to culture conversion is used to predict the time of cure from the disease and the overall drug-resistant tuberculosis (TB) treatment duration. Even though evidence about sputum culture conversion is enormous in TB treatment, no study has yet been done in our areas, where cases are common. The study aimed to assess the time to sputum conversion and its predictors among drug-resistant TB patients from October 2013 to September 2021 in eastern Ethiopia.</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted in eastern Ethiopia among 273 drug-resistant TB patients who were treated from October 2013 to September 2021 at Dire Dawa City and Harari regional treatment centres. The Kaplan-Meier method was used to estimate the median time of sputum culture conversion. Cox proportional hazards regression was employed to detect the predictors of sputum culture conversion. An adjusted hazard ratio (aHR) with 95% confidence interval (CI) was used to determine the strength and significance of the association.</p><p><strong>Results: </strong>Of the 273 drug-resistant TB patients, the sputum culture of 216 (79.12%) patients became negative in a median time of 3 months (interquartile range 2-7). The time to sputum culture conversion was negatively associated with underweight (aHR 0.65 [95% CI 0.49 to 0.90]) and poor adherence (aHR 0.41 [95% CI 0.24 to 0.69]). The time to sputum culture conversion was also positively associated with patients resistant to two or more drugs (aHR 1.58 [95% CI 1.07 to 2.32]) and patients receiving a short treatment regimen (aHR 2.24 [95% CI 1.10 to 2.55]).</p><p><strong>Conclusions: </strong>A shorter culture conversion rate was observed compared with the median time recommended by the World Health Organization. Being underweight, poor adherence to treatment, resistance to two or more drugs and receiving a short treatment regimen were found to be predictors of time to sputum culture conversion. Implementing nutrition assessment, counselling and support of drug adherence may improve sputum culture conversion.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"292-303"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330718","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":"Admission and outcomes of COVID-19 among chronic obstructive pulmonary diseases patients in Africa: protocol for a systematic review and meta-analysis.","authors":"Guesh Mebrahtom, Abrha Hailay, Woldu Aberhe, Kidane Zereabruk, Teklehaimanot Gereziher Haile, Degena Bahrey Tadesse","doi":"10.1093/inthealth/ihae062","DOIUrl":"10.1093/inthealth/ihae062","url":null,"abstract":"<p><p>When the coronavirus case was originally reported in Wuhan, China, in December 2019, it quickly spread throughout the world and became a global public health problem. Evidence of the admission and outcomes of coronavirus disease among patients with chronic obstructive pulmonary disease (COPD) has not been reported in Africa. Consequently, this research protocol uses a systematic review and meta-analysis of the admission and outcomes of COVID-19 in patients with COPD in Africa. All observational studies published in the English language and reporting on the prevalence, admission and outcomes of COVID-19 among patients with COPD in Africa will be included. A search strategy will be implemented using electronic databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol recommendations. The findings of this review will be reported to health program designers, decision-makers and healthcare providers.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"245-250"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367137","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":"Pregnant women and healthcare workers' perceptions on tuberculosis and screening: a cross-sectional study in Indonesia.","authors":"Dzerlina Syanaiscara Rahari, Detty Siti Nurdiati, Jarir At Thobari, Suyanto Suyanto, Tippawan Liabsuetrakul","doi":"10.1093/inthealth/ihae069","DOIUrl":"10.1093/inthealth/ihae069","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies regarding the obstacles in tuberculosis (TB) screening in pregnant women. This study aimed to assess the perceptions of TB as a disease and TB screening among pregnant women and healthcare workers, describe pregnant women's perceptions on specific TB screening methods and explore associations between the perceptions of TB with the intention to have TB screening by pregnant women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at six primary healthcare centres in Yogyakarta Municipality, Indonesia among 240 pregnant women and 126 healthcare workers interviewed with a structured questionnaire about their perceptions. Perceptions were analysed as percentages and associated factors were tested by multivariable logistic regression.</p><p><strong>Results: </strong>Most pregnant women and healthcare workers supported TB screening in pregnant women based on their perceptions of the susceptibility to or severity of TB and the benefits and risks of TB screening. Women who perceived the high susceptibility of TB disease and the benefits of TB screening were significantly more likely to have high intentions to accept TB screening in the future.</p><p><strong>Conclusions: </strong>Pregnant women's perceptions of TB and TB screening influenced their intention to be screened; however, appropriate testing methods for universal TB screening in pregnant women in areas with a high prevalence of TB require further studies.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"334-341"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631081","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}
Elizabeth Oluwamayowa Oloruntola, Chioma J Eze, Gloria O Alao, Mercy Opateye, Oluwaseun T Gbadebo, Precious E Akinbote, Ruth D Adesina, Oluwadamilare Akingbade
{"title":"Experiences and needs of persons who have undergone limb amputation in Saki West, Oyo State, Nigeria.","authors":"Elizabeth Oluwamayowa Oloruntola, Chioma J Eze, Gloria O Alao, Mercy Opateye, Oluwaseun T Gbadebo, Precious E Akinbote, Ruth D Adesina, Oluwadamilare Akingbade","doi":"10.1093/inthealth/ihae068","DOIUrl":"10.1093/inthealth/ihae068","url":null,"abstract":"<p><strong>Background: </strong>Amputation is a life-changing experience involving the surgical removal of a body part. However, little is known about the experiences of persons who have undergone limb amputation in the Saki West Local Government Area (LGA), which prompted this study.</p><p><strong>Methods: </strong>An exploratory qualitative study design was used. Thirty participants were interviewed using face-to-face focus group discussions. Five sessions were conducted, with six participants in each session. Data were analysed using the thematic analysis framework of Braun and Clarke.</p><p><strong>Results: </strong>A total of 76.3% of the participants were males and 73.3% were married. Their ages ranged from 22 and 69 y, with a mean age of 48.0 y and a monthly income of 20 000 naira (US$12). Three major themes emerged from the study: the needs and challenges of those who have undergone amputation, coping strategies of those who have undergone amputation and recommendations by persons who have undergone amputation. The study revealed that people who have undergone amputation experienced psychological pain, such as a loss of self-worth and stigmatization from friends and loved ones. Coping strategies identified were accepting the situation and emotional support from family. Participants recommended providing financial support, empowerment programs, employment opportunities and fostering a community of amputees in the Saki West LGA.</p><p><strong>Conclusions: </strong>Amputees undergo psychological and psychosocial problems that can affect their health and recovery. They need emotional and financial support, rehabilitation services and provision of prostheses from family, society and the government. These services should be adequately provided in the Saki West LGA, the largest among the 10 suburban local governments in Oyo State, with numerous commercial activities and a high risk for road traffic accidents.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"324-333"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631078","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":"Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study.","authors":"Jerman Dereje, Abenet Kassaye, Abiy Mulugeta, Girmaw Medfu, Shegaye Shumet, Tilahun Kassew","doi":"10.1093/inthealth/ihae055","DOIUrl":"10.1093/inthealth/ihae055","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI.</p><p><strong>Results: </strong>The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively.</p><p><strong>Conclusions: </strong>The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"270-281"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308879","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}
Emilienne Epee, Carine Fokam Tagne, Ana Bakhtiari, Sarah Boyd, Rebecca Willis, Anna J Harte, Cristina Jimenez, Clara Burgert-Brucker, Whitney Goldman, Amir B Kello, Stephanie Palmer, Patricia Houck, Steven Reid, Emily Toubali, Yaobi Zhang, Daniel A Cohn, Fatou Gueye, Jeremiah M Ngondi, Ismael Teta, Emma M Harding-Esch, Anthony W Solomon, Sidi M Coulibaly, Jean Claude Noah Noah, Georges Nko'ayissi, Alain Georges Etoundi Mballa, André Omgbwa Eballé, Assumpta Bella
{"title":"Assessing the prevalence of trachoma in the East, North, Far North and Adamaoua regions of Cameroon, 2016-2022.","authors":"Emilienne Epee, Carine Fokam Tagne, Ana Bakhtiari, Sarah Boyd, Rebecca Willis, Anna J Harte, Cristina Jimenez, Clara Burgert-Brucker, Whitney Goldman, Amir B Kello, Stephanie Palmer, Patricia Houck, Steven Reid, Emily Toubali, Yaobi Zhang, Daniel A Cohn, Fatou Gueye, Jeremiah M Ngondi, Ismael Teta, Emma M Harding-Esch, Anthony W Solomon, Sidi M Coulibaly, Jean Claude Noah Noah, Georges Nko'ayissi, Alain Georges Etoundi Mballa, André Omgbwa Eballé, Assumpta Bella","doi":"10.1093/inthealth/ihae071","DOIUrl":"10.1093/inthealth/ihae071","url":null,"abstract":"<p><strong>Background: </strong>Baseline prevalence surveys in Cameroon in 2010-2012 showed that trachoma was endemic primarily in the north of the country, with 23 evaluation units (EUs) requiring interventions against active (inflammatory) trachoma. This study presents data from prevalence surveys conducted in 2016-2022 following interventions against trachoma in the East, North, Far North and Adamaoua regions of Cameroon.</p><p><strong>Methods: </strong>EUs were created based on health district boundaries. Within each EU, clusters were selected using probability of selection proportional to population size. Participants were examined for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT).</p><p><strong>Results: </strong>A total of 151 800 people were examined in 45 surveys across 35 EUs. Based on the most recent survey results, TF prevalence was greater than the 5% TF elimination threshold in two EUs. Ten EUs had TT prevalence estimates greater than the 0.2% elimination threshold.</p><p><strong>Conclusions: </strong>Trachoma remains a public health problem in Cameroon. Continued interventions are needed in EUs with prevalence estimates greater than elimination thresholds, including antibiotic mass drug administration and improved access to TT surgery. Future surveys will be needed to determine when national elimination of trachoma as a public health problem has been achieved.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"351-365"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631075","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":"Systolic hypertension, caesarean duration and prenatal visits as predictors of maternal near miss in Peru.","authors":"Estefany Alejandra Cutipa Vásquez Melgar, Rodrigo Jesús Flores Palacios","doi":"10.1093/inthealth/ihaf045","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf045","url":null,"abstract":"<p><strong>Background: </strong>To identify the predictive factors of maternal near miss in caesarean patients in the obstetrics and gynaecology service at Hospital III Daniel Alcides Carrión, Tacna, Peru.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from 1 January 2022 to 31 December 2023. Preoperative, intraoperative and postoperative clinical and laboratory characteristics of caesarean patients hospitalized in the obstetrics and gynaecology service were analysed. Cox proportional hazards regression was used to identify predictors.</p><p><strong>Results: </strong>We identified 264 caesarean patients, of which 49 experienced maternal near miss. The mean age was 32.81±5.13 y, the median number of prenatal visits was 7 (interquartile range [IQR] 6-9) and the median gestational age was 39 weeks (IQR 37.5-40). Identified predictive factors for maternal near miss were systolic blood pressure ≥140 mmHg before caesarean (adjusted hazard ratio [aHR] 2.20), duration of the caesarean (aHR 1.02) and number of prenatal visits (aHR 0.90).</p><p><strong>Conclusions: </strong>The findings suggest that systolic hypertension before caesarean delivery, caesarean duration and number of prenatal visits are significant predictors of maternal near miss. These results underscore the importance of early prenatal care, monitoring blood pressure levels and optimizing surgical duration to improve maternal outcomes. Future research should focus on the implementation of targeted interventions based on these predictors to reduce maternal morbidity and improve health policies in low-resource settings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022456","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}
Gerami D Seitzman, Khumbo Kalua, Esther S Misanjo, Cindi Chen, Kevin Ouimette, Lina Zhong, YuHeng Liu, Danny Yu, Thomas Abraham, Nathaniel Wu, Daisy Yan, Thomas M Lietman, Armin Hinterwirth, Thuy Doan
{"title":"Comparison of antimicrobial resistance genes on the ocular surface of patients with corneal infections in California and Malawi.","authors":"Gerami D Seitzman, Khumbo Kalua, Esther S Misanjo, Cindi Chen, Kevin Ouimette, Lina Zhong, YuHeng Liu, Danny Yu, Thomas Abraham, Nathaniel Wu, Daisy Yan, Thomas M Lietman, Armin Hinterwirth, Thuy Doan","doi":"10.1093/inthealth/ihaf042","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf042","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) determinants on the ocular surface may contribute to poor treatment responses.</p><p><strong>Methods: </strong>An exploratory comparative analysis of ocular surface AMR determinants, as determined by RNA-sequencing (RNA-seq), on patients presenting with corneal infections at the Proctor Medical Clinic at the University of California San Francisco in San Francisco, CA, USA, and the Queen Elizabeth Central Hospital at the Department of Ophthalmology of Kamuzu College of Health Sciences in Blantyre, Malawi, was conducted. All patients underwent swabbing of three sites on the ocular surface: cornea, ipsilateral conjunctiva, and contralateral conjunctiva.</p><p><strong>Results: </strong>Mutations conferring macrolide resistance were present on the ocular surface in 58% (95% CI 44 to 71%) of the participants in Malawi and 32% (95% CI 20 to 46%) of the participants in San Francisco. Aminoglycosides resistance genes were also common on the ocular surface with 58% (95% CI 44 to 71%) prevalence in Malawi and 21% (95% CI 12 to 35%) in San Francisco. AMR was associated with poorer visual outcomes in a subset of patients.</p><p><strong>Conclusions: </strong>As determined by RNA-seq, ocular surface AMR gene mutations are common in patients with infectious keratitis. Surveillance may be important for infectious keratitis treatment selection as well as providing guidance for antibiotic stewardship.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056111","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}
Consity Mwale, Chileshe Mboni, Ngonda Saasa, Chummy S Sikasunge, Chisanga Chelu, Tina Chisenga, Lubasi Sundano, Namasiku Siyumbwa Kunda, Phyllis M Moonga, Kaluba Lombe, Tabonga Naluonde, Sarah Boyd, Ana Bakhtiari, Cristina Jimenez, Emma M Harding-Esch, Michael Dejene, Freddie Masaninga, Nathan N Bakyaita, Davison Kwendakwema, Anthony W Solomon, Kangwa I M Muma
{"title":"Assessing trachoma elimination progress in districts with persistent trachoma, Western Province, Zambia.","authors":"Consity Mwale, Chileshe Mboni, Ngonda Saasa, Chummy S Sikasunge, Chisanga Chelu, Tina Chisenga, Lubasi Sundano, Namasiku Siyumbwa Kunda, Phyllis M Moonga, Kaluba Lombe, Tabonga Naluonde, Sarah Boyd, Ana Bakhtiari, Cristina Jimenez, Emma M Harding-Esch, Michael Dejene, Freddie Masaninga, Nathan N Bakyaita, Davison Kwendakwema, Anthony W Solomon, Kangwa I M Muma","doi":"10.1093/inthealth/ihaf041","DOIUrl":"10.1093/inthealth/ihaf041","url":null,"abstract":"<p><strong>Background: </strong>Trachoma is a public health problem in Zambia. We aimed to estimate the prevalence of trachomatous inflammation-follicular (TF) in 1-9-y-olds and of trachomatous trichiasis (TT) in ≥15-y-olds after the implementation of trachoma elimination interventions to determine if the trachoma elimination thresholds had been achieved: <5% for TF in 1-9-y-olds and <0.2% TT for ≥15-y-olds.</p><p><strong>Methods: </strong>Two rounds of impact prevalence surveys in two evaluation units (EUs) comprising four districts of Western Province were conducted; the first in 2018, the second in 2023. All individuals aged ≥1 year from 30 households of 24 clusters in each EU were examined for trachoma. Data were captured electronically.</p><p><strong>Results: </strong>In 2018, TF prevalence in 1-9-y-olds was 13.9% in Kalabo/Sikongo and 17.9% in Shang'ombo/Sioma. Following further interventions, TF prevalence among 1-9-y-olds in 2023 was 7.7% and 12.5%, respectively. TT prevalences in ≥15-y-olds were 0.10% and 0.79% in 2018, and 0.4% and 0.2% in 2023, respectively.</p><p><strong>Conclusions: </strong>These EUs did not attain trachoma elimination thresholds as a public health problem. They fulfilled the WHO definition for persistent trachoma. Therefore, they warrant further investigation, including collection of Chlamydia trachomatis infection data, to inform future programmatic decision-making. Further TT surgical services are also needed.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022352","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}
Veronica Njaramba, Peter Mwaura, Samuel Mungai, Bernard N Kanoi, David Kamau, Jesse Gitaka
{"title":"Impact of home-based follow-up care on hypertension control among patients attending Thika Level Five Hospital, Kiambu County, Kenya: A randomized control study.","authors":"Veronica Njaramba, Peter Mwaura, Samuel Mungai, Bernard N Kanoi, David Kamau, Jesse Gitaka","doi":"10.1093/inthealth/ihaf044","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf044","url":null,"abstract":"<p><strong>Background: </strong>Hypertension contributes to a large burden of cardiovascular diseases, with a higher prevalence in low- and middle-income countries. Hypertension management is mainly hospital-based, but it faces low retention rates in facilities, non-adherence and subsequent suboptimal blood pressure (BP) control. This study aimed to implement home-based follow-up care and assess its impact on controlling BP.</p><p><strong>Methods: </strong>An open-label randomized controlled study was conducted on 200 participants with uncontrolled BP selected using a systematic random sampling technique and randomly assigned into home-based follow-up care (intervention group) and hospital-based follow-up care (control group). Data were collected using a structured questionnaire containing the 8-item Morisky Medication Adherence Scale and Hypertension Self-Care Activity Level Effect (H-SCALE). Data were analysed using SPSS version 29.0.</p><p><strong>Results: </strong>Hypertension control was 52.0% and 92.2% in the control and intervention groups, respectively. In the interventional group, drug adherence increased from 38.2% to 94.1% compared with a reduction in the control group from 45.9% to 33.7%. Dietary Approaches to Stop Hypertension diet adherence rose from 2.9% to 76.5% compared with a control group from 1% to 2%.</p><p><strong>Conclusions: </strong>Home-based care follow-up has a significant impact on the control of hypertension.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039088","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}