International Health最新文献

{"title":"High prevalence of soil-transmitted helminths and schistosomiasis among primary schoolchildren in Southwest Ethiopia: the need for health strategies alongside mass drug administration.","authors":"Asrat Meleko, Dorin Brener Turgeman, Naomi Caplan, Sarit Baum, Nisan K Zerai, Willemijn Zaadnoordijk, Michal Bruck, Galia Sabar, Zvi Bentwich, Rachel Golan","doi":"10.1093/inthealth/ihad083","DOIUrl":"10.1093/inthealth/ihad083","url":null,"abstract":"<p><strong>Background: </strong>Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected.</p><p><strong>Results: </strong>Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly.</p><p><strong>Conclusions: </strong>Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"529-533"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487893","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":"Chronic obstructive pulmonary disease in East Africa: a systematic review and meta-analysis.","authors":"Guesh Mebrahtom, Abrha Hailay, Teklewoini Mariye, Teklehaimanot Gereziher Haile, Goitom Girmay, Kidane Zereabruk, Woldu Aberhe, Degena Bahrey Tadesse","doi":"10.1093/inthealth/ihae011","DOIUrl":"10.1093/inthealth/ihae011","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a common lung disease that causes restricted airflow and breathing problems. Globally, COPD is the third leading cause of death and low- and middle-income countries account for the majority of these deaths. There is limited information on COPD's prevalence in East Africa. Thus the purpose of this systematic review and meta-analysis is to estimate the pooled prevalence of COPD in East Africa.A computerized systematic search using multiple databases was performed in search of relevant English articles from the inception of the databases to August 2023. All the authors independently extracted the data. R and RStudio software were used for statistical analysis. Forest plots and tables were used to represent the data. The statistical heterogeneity was evaluated using I2 statistics. There was heterogeneity between the included articles. Therefore, a meta-analysis of random effects models was used to estimate the overall pooled prevalence of COPD in East Africa. A funnel plot test was used to examine possible publication bias.The database search produced 512 papers. After checking for inclusion and exclusion criteria, 43 full-text observational studies with 68 553 total participants were found suitable for the review. The overall pooled prevalence of COPD in East Africa was 13.322%. The subgroup analysis found the COPD pooled prevalence in the different countries was 18.994%, 7%, 15.745%, 9.032%, 15.026% and 11.266% in Ethiopia, Uganda, Tanzania, Malawi, Sudan, and Kenya, respectively. Additionally, the subgroup analysis of COPD by study setting among community-based studies was 12.132% and 13.575% for hospital-based studies.According to the study's findings, approximately one of every seven individuals in East Africa has COPD, indicating a notably high prevalence of the disease. Thus governments and other stakeholders working on non-communicable disease control should place an emphasis on preventive measures to minimize the burden of COPD.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"499-511"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703862","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":"Influence of the new dispersible fixed-dose combination anti-Tuberculosis drug on treatment adherence among children with Tuberculosis in Osun State, Nigeria.","authors":"Obioma Chijioke-Akaniro, Patrick A Akinyemi, Sunday Asuke, Chukwuma Anyaike, Ndubuisi A Uwaezuoke, Urhioke Ochuko, Emperor Ubochioma, Amos Omoniyi, Corinne S Merle, Soji Daniel","doi":"10.1093/inthealth/ihad104","DOIUrl":"10.1093/inthealth/ihad104","url":null,"abstract":"<p><strong>Background: </strong>The dispersible fixed-dose combination drug has been recommended as the mainstay of treatment for TB in children. However, more needs to be known about its effect on treatment. This study aimed to assess the effectiveness of the formulation on treatment adherence among children with TB.</p><p><strong>Methods: </strong>A historical cohort design was used to assess and compare adherences of old loose non-dispersible and new dispersible fixed-dose anti-TB drugs, using a convergent parallel mixed-method approach for data collection. Determinants of treatment adherence were assessed using binary logistic regression.</p><p><strong>Results: </strong>The proportion of children with good treatment adherence was higher in the new dispersible formulation group (82 [64.6%]) relative to the proportion among the loose non-dispersible formulation group (29 [23.4%]). Reports of forgetfulness, travelling and pill burden were significantly higher among those with poor adherence in the loose non-dispersible formulation group. Significant predictors of treatment adherence were acceptability (adjusted OR [AOR]=4.1, p=0.013, 95% CI 1.342 to 12.756), travelling from treatment areas (AOR=8.9, p=0.002, 95% CI 2.211 to 35.771) and forgetfulness (AOR=74.0, p<0.001, 95% CI 23.319 to 234.725).</p><p><strong>Conclusions: </strong>The determinants of treatment adherence are multifactorial. In addition to ensuring universal access to the drug, flexible referral in case of travelling and ensuring treatment partners' participation to minimise forgetfulness to take pills, are essential.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"534-543"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399987","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":"In our own eyes: ethical dilemmas and insights encountered by researchers conducting qualitative research in high ambient temperatures in Kilifi, Kenya.","authors":"A Lusambili, S Chabeda, P Khaemba","doi":"10.1093/inthealth/ihad115","DOIUrl":"10.1093/inthealth/ihad115","url":null,"abstract":"<p><p>We reflect on our fieldwork experience from the Climate Heat Maternal and Neonatal Health Africa (CHAMNHA) project in Kilifi, Kenya, which focused on studying the effects of extreme heat on women during pregnancy, delivery and the post-partum period. We describe the ethical and practical challenges encountered, highlighting valuable lessons learned. We propose potential solutions to address issues concerning the reciprocity of vulnerable participants and the provision of childcare and food for accompanying children. Further, we address challenges related to engaging specific participants, interview cancellations attributed to extreme temperatures and discuss the perpetuation of inequalities by ethics and academic institutions. With the anticipated increase in research at the intersection of climate change-induced heat exposure and its impacts on human populations, research institutions and ethics committees in low- and middle-income countries are responsible for instituting guidelines that account for the risks for the subjects under study and the field researchers.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"475-478"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040773","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":"Erratum to: deployment of vaccine cold chain equipment in resource-limited settings: lessons from the Gavi Cold Chain Optimization Platform in Cameroon.","authors":"","doi":"10.1093/inthealth/ihae027","DOIUrl":"10.1093/inthealth/ihae027","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"571"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102730","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":"Is the African Vaccine Manufacturing Accelerator a decoupling mechanism?","authors":"Abiodun E Awosusi","doi":"10.1093/inthealth/ihae032","DOIUrl":"10.1093/inthealth/ihae032","url":null,"abstract":"<p><p>This article explores how the African Vaccine Manufacturing Accelerator can support the sustainable production of vaccines in Africa. It highlights the value of the accelerator in relation to the Regional Vaccine Manufacturing Collaborative. The author proposes that this novel financing instrument should be well-designed and implemented in line with the targets of the Partnerships for African Vaccine Manufacturing. It should not be a decoupling tool to appease the institutional environment of the global vaccine market, but a sustainable demonstration of the goodwill and commitment of political and technical leaders to ensure equitable access to routine and epidemic-related vaccines in Africa.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"568-570"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868943","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":"Stigma associated with cutaneous leishmaniasis in rural Sri Lanka: development of a conceptual framework.","authors":"Hasara Nuwangi, Lisa Dikomitis, Kosala G Weerakoon, Chandani Liyanage, Thilini C Agampodi, Suneth B Agampodi","doi":"10.1093/inthealth/ihae021","DOIUrl":"10.1093/inthealth/ihae021","url":null,"abstract":"<p><strong>Background: </strong>There is limited knowledge about the stigma associated with cutaneous leishmaniasis (CL) in Sri Lanka. To ensure that leishmaniasis researchers focus on CL-associated stigma, we provide an evidence-based framework that can be used in future research.</p><p><strong>Methods: </strong>We conducted a systematic review on CL-associated stigma using international evidence and carried out a multimethod qualitative study in the Anuradhapura district in Sri Lanka. Based on that, we identified manifestations of stigma, drivers and facilitators that we synthesised to develop a conceptual framework on CL-associated stigma.</p><p><strong>Results: </strong>Our framework consists of drivers, facilitators and self-stigma experienced by people with CL. Stigma drivers included fear, misbeliefs and misconceptions about CL; the belief that wounds are disfiguring; the treatment burden and implied blame. Facilitators that reduced stigma included knowledge of the curability of CL and awareness that CL is not contagious. The nature of social interactions in rural communities enhanced stigma formation. We identified various enacted, felt and internalised stigma experiences of people with CL.</p><p><strong>Conclusions: </strong>We developed a conceptual framework of the stigma associated with CL that can be used to develop targeted interventions to increase CL awareness, address stigma and improve the quality of life for CL patients.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"553-561"},"PeriodicalIF":2.3,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133062","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":"Development and validation of supervised machine learning multivariable prediction models for the diagnosis of Pneumocystis jirovecii pneumonia using nasopharyngeal swab PCR in adults in a low-HIV prevalence setting.","authors":"Rusheng Chew, Marion L Woods, David L Paterson","doi":"10.1093/inthealth/ihae052","DOIUrl":"https://doi.org/10.1093/inthealth/ihae052","url":null,"abstract":"<p><strong>Background: </strong>The global burden of the opportunistic fungal disease Pneumocystis jirovecii pneumonia (PJP) remains substantial. Polymerase chain reaction (PCR) on nasopharyngeal swabs (NPS) has high specificity and may be a viable alternative to the gold standard diagnostic of PCR on invasively collected lower respiratory tract specimens, but has low sensitivity. Sensitivity may be improved by incorporating NPS PCR results into machine learning models.</p><p><strong>Methods: </strong>Three supervised multivariable diagnostic models (random forest, logistic regression and extreme gradient boosting) were constructed and validated using a 111-person Australian dataset. The predictors were age, gender, immunosuppression type and NPS PCR result. Model performance metrics such as accuracy, sensitivity, specificity and predictive values were compared to select the best-performing model.</p><p><strong>Results: </strong>The logistic regression model performed best, with 80% accuracy, improving sensitivity to 86% and maintaining acceptable specificity of 70%. Using this model, positive and negative NPS PCR results indicated post-test probabilities of 84% (likely PJP) and 26% (unlikely PJP), respectively.</p><p><strong>Conclusions: </strong>The logistic regression model should be externally validated in a wider range of settings. As the predictors are simple, routinely collected patient variables, this model may represent a diagnostic advance suitable for settings where collection of lower respiratory tract specimens is difficult but PCR is available.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113916","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":"RE: 'Laboratory capacity expansion: lessons from establishing molecular testing in regional referral laboratories in Ethiopia'.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/inthealth/ihae054","DOIUrl":"https://doi.org/10.1093/inthealth/ihae054","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113917","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}