International Health最新文献

{"title":"Response to \"Are microsporidia infections really increasing in HIV/AIDS patients or is it increased awareness?\"","authors":"Ali Asghari","doi":"10.1093/inthealth/ihag080","DOIUrl":"https://doi.org/10.1093/inthealth/ihag080","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680450","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":"Post-intervention outcomes 4 years after a nationwide postpartum haemorrhage mortality reduction project in Niger's health facilities: a retrospective analysis.","authors":"Anders Seim, Zeidou Alassoum, Nassirou Ousmane, Oumoulkair Hamidou, Aïda Mounkaila, Luai A Ahmed","doi":"10.1093/inthealth/ihag075","DOIUrl":"https://doi.org/10.1093/inthealth/ihag075","url":null,"abstract":"<p><strong>Objectives: </strong>Niger in West Africa reduced maternal mortality by 34.5% among 1 380 799 health-facility births over 72 months through 2020 by more than halving postpartum haemorrhage (PPH) mortality in health facilities nationwide, using low-cost obstetrics technologies and 11 public health disease-eradication tools. Monthly support ended in December 2020 because of a lack of funding. Sustainability of innovations is important, given declining external funding and expectations that even very poor countries fund health from domestic taxes. Therefore, the current study assessed for PPH mortality rebound, also because 2015-20 results had been better than expected.</p><p><strong>Methods: </strong>Routinely collected government maternal mortality data during the 2015-20 project period and the 2021-4 post-project period were tested using Poisson regression models, and the Cochran-Armitage test for trend.</p><p><strong>Results: </strong>Among 2 158 021 health-facility births from 2021 to 2024, no significant change was seen in the proportion of maternal deaths caused by PPH, PPH case fatality, PPH cases per 100 000 births, or PPH deaths/1000 births compared with the preceding 4 years.</p><p><strong>Conclusions: </strong>Niger's >50% PPH mortality reduction was sustained for 4 years without external attention to its implementation. Given sustained success emanating from capacity-strengthening, the strategy should be tested in other settings where maternal mortality remains high.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671012","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":"Lessons from Niger and from a multicountry randomized study on reducing postpartum haemorrhage (PPH) mortality in resource-constrained settings: perspectives for scaling-up across continents, with expansion to eclampsia and other major causes of maternal mortality.","authors":"Zeidou Alassoum, Anders Seim","doi":"10.1093/inthealth/ihag081","DOIUrl":"https://doi.org/10.1093/inthealth/ihag081","url":null,"abstract":"<p><p>Two large studies published in 2023 report more rapid reductions in postpartum haemorrhage (PPH) mortality after health-facility births than many would think possible in a low- or middle-income country, using very different study designs yet broadly similar interventions. In this commentary and the accompanying study, we report on how Niger is sustaining its nationwide results through four subsequent years among over 2 million health-facility births with little external support. In an era of greatly reduced external funding for health, these studies provide strong justification for testing elsewhere too, to determine whether these approaches should be scaled globally.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671014","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":"Tobacco smoking prevalence and associated factors in Duhok City, Kurdistan Region of Iraq: a cross-sectional study.","authors":"Nawfal R Hussein, Dildar H Musa, Halder J Abozait, Ibrahim A Naqid, Waleed M Mohammed, Zana S M Saleem, Nashwan M R Ibrahim, Alind Y Mustafa, Ahmed A Mosa","doi":"10.1093/inthealth/ihag077","DOIUrl":"https://doi.org/10.1093/inthealth/ihag077","url":null,"abstract":"<p><strong>Objectives: </strong>Smoking is a major cause of preventable morbidity and mortality worldwide. Despite global tobacco control efforts, smoking prevalence remains high in many regions. This study aimed to determine the prevalence of smoking and its associated factors in the Kurdistan Region of Iraq.</p><p><strong>Methods: </strong>A community-based, cross-sectional study was conducted in 2025, consisting of 1132 individuals aged ≥18 years selected through multistage random sampling from 12 districts of Duhok City. Data were collected using a structured questionnaire and anthropometric measurements. Descriptive statistics and logistic regression analyses were performed to identify factors associated with smoking.</p><p><strong>Results: </strong>The mean age of participants was 37.5 ± 14.8 years. The overall prevalence of smoking was 33.6%, with a marked gender disparity (50.9% in men vs 5.7% in women). In univariate analysis, smoking was significantly associated with gender, education, marital status, employment status, physical activity, hypertension, waist circumference, and body mass index. Multivariate logistic regression showed that gender, education level, and employment status remained independently associated with smoking.</p><p><strong>Conclusions: </strong>Smoking prevalence in the Kurdistan Region of Iraq is alarmingly high, particularly among men, individuals with lower education, and employed adults. These findings highlight the urgent need for strengthened tobacco control policies and targeted public health interventions in the region.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664809","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":"Benefit incidence analysis of HIV services in Enugu State, southeast Nigeria: do the poor preferentially benefit?","authors":"Ifeyinwa Arize, Wenhui Mao, Eric Obikeze, Uchenna Ezenwaka, Osondu Ogbuoji, Obinna Onwujekwe","doi":"10.1093/inthealth/ihag063","DOIUrl":"https://doi.org/10.1093/inthealth/ihag063","url":null,"abstract":"<p><strong>Background: </strong>Nigeria ranks fourth globally in human immunodeficiency virus (HIV) prevalence, with an estimated 1.9 million people living with HIV. HIV response in Nigeria has been largely funded by development partners providing free treatment services at designated health facilities. This study aims to examine the benefit incidence of subsidized HIV services and the distribution of benefits across population groups with different socio-economic status (SES).</p><p><strong>Methods: </strong>A survey of patients (n=212) accessing antiretroviral therapy clinics in six purposively selected urban and rural facilities in Enugu State. Principal components analysis was used to create an SES index. The concentration index was used to measure the level of equity in spending across the socio-economic quintiles.</p><p><strong>Results: </strong>The majority (60%) of respondents visited facilities every 2 months. All respondents received HIV drugs for free. The total monthly gross and net benefits of HIV services were US$2143 and US$1755, respectively. Surveyed respondents obtained the largest benefit through using HIV drugs, which accounted for >56% of gross benefit and almost 70% of net benefit of total HIV services. The concentration indices for gross (-0.03) and net (-0.06) benefits indicate a pro-poor distribution of HIV services.</p><p><strong>Conclusion: </strong>Subsidized HIV services in Enugu State disproportionately benefited poorer populations, with free HIV drugs constituting the largest share of benefits, indicating equitable access to HIV services in Enugu State.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632443","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 smartphone-based semiquantitative system for chlorpyrifos detection via digital image analysis of enzymatic paper microfluidic cards: proof of concept for organophosphate screening.","authors":"Sheriff Jombla Senesie, Mabinty Serry, Mariama Deborah Kamara, Augusta Fasia Palmer, Abdul Cham, Morlai Sesay","doi":"10.1093/inthealth/ihag079","DOIUrl":"https://doi.org/10.1093/inthealth/ihag079","url":null,"abstract":"<p><strong>Objectives: </strong>The need for rapid, point-of-need screening of pesticide residues in resource-limited settings requires moving beyond subjective visual interpretation of colorimetric tests. Organophosphate pesticides pose significant public health risks, especially in low- and middle-income countries, where laboratory-based detection methods are often inaccessible.</p><p><strong>Methods: </strong>We developed an integrated system combining paper-based microfluidics, smartphone imaging, and chemometric modeling. A three-zone paper microfluidic card was engineered to incorporate an acetylcholinesterase inhibition assay, along with internal positive and negative controls. A 3D-printed imaging enclosure with controlled LED lighting standardizes smartphone image capture. Images were processed via an automated pipeline to extract CIELAB color features, and a partial least squares regression (PLSR) model was calibrated to predict chlorpyrifos concentration.</p><p><strong>Results: </strong>The system achieved a limit of detection of 0.35 mg/L and a limit of quantification of 1.06 mg/L. Validation on an independent set yielded a root-mean-square error of prediction of 0.82 mg/L and a mean absolute error of 12.7%. Recovery rates in spiked lettuce extract ranged from 89% to 110%. The a* channel in CIELAB space showed the strongest correlation with concentration, and the PLSR model performed robustly for semiquantitative screening.</p><p><strong>Conclusions: </strong>This smartphone-based system transforms a qualitative enzymatic assay into a reliable, semiquantitative screening of organophosphate (chlorpyrifos) residues in resource-limited settings such as Sierra Leone. As a laboratory-validated prototype, it requires future field testing before operational deployment and validated system performance in terms of detection limits, accuracy, precision, and robustness against matrix effects in a representative vegetable matrix (lettuce extract).</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594107","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":"Comment on: Global burden and cross-country inequality of infectious skin diseases in children: the Global Burden of Disease Study 2021.","authors":"Mohammad Reza Mohammadi","doi":"10.1093/inthealth/ihag059","DOIUrl":"https://doi.org/10.1093/inthealth/ihag059","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537472","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":"Association between husband involvement and dietary diversity among pregnant women in Hargeisa City, Somaliland.","authors":"Hamse Khalif Hassan, Hsin-Jen Chen","doi":"10.1093/inthealth/ihag074","DOIUrl":"https://doi.org/10.1093/inthealth/ihag074","url":null,"abstract":"<p><strong>Background: </strong>Adequate dietary diversity is crucial for maternal nutrition, yet many pregnant women in Somaliland suffer from poor nutrient intake. However, evidence of influencing factors of pregnant women's dietary diversity, particularly the role of husband involvement in maternal dietary practices, remains limited in Somaliland. Therefore, this study examines the association between husband involvement and dietary diversity among pregnant women attending maternal and child health centres (MCHCs) in Hargeisa, Somaliland.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted from November to December 2024 in five MCHCs in Hargeisa. Data on sociodemographics, antenatal care (ANC), husband involvement and supplementation were collected via interviewer-administered questionnaires. SPSS version 29.0 was used for data cleaning and analysis, with bivariate and multivariable logistic regression (p<0.05 significance).</p><p><strong>Results: </strong>The overall prevalence of adequate dietary diversity was 64%. Significant predictors of adequate dietary diversity include greater husband involvement, higher maternal education, multigravidity, attending ANC for four or more visits and participation in nutrition counselling sessions. In contrast, logistic barriers, limited healthcare access and insufficient healthcare professionals were negatively associated with adequate dietary diversity among pregnant women attending MCHCs.</p><p><strong>Conclusions: </strong>Pregnant women's dietary diversity is suboptimal in Hargeisa. Strengthening husband involvement in care, maternal education and access to care in integrating nutrition counselling into ANC services were recommended.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521257","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":"Use of complementary indicators in trachoma surveys in Nigeria: results of impact surveys in two local government areas.","authors":"Caleb Mpyet, Sunday Isiyaku, Joy Shu'aibu, Teyil Wamyil-Mshelia, Grace Ajege, Suzie Madaki, Fatai Oyediran, Laura Senyonjo, Cristina Jimenez, E Michelle Taylor, Michael K Kamuyu, Mohamed Bah, Katherine Gass, Diana L Martin, Jennifer Hsieh, Sarah Gwyn, Zachary Reynolds, Ana Bakhtiari, Sarah Boyd, Ado Abubakar, Oluwaseun Akinmulero, Temitope Olaleye, Olumide Okunoye, McPaul I Okoye, Nnaemeka C Iriemenam, Anthony W Solomon, Emma M Harding-Esch, Nicholas Olobio","doi":"10.1093/inthealth/ihag071","DOIUrl":"https://doi.org/10.1093/inthealth/ihag071","url":null,"abstract":"<p><strong>Objectives: </strong>Trachoma elimination progress is hampered in some districts by persistent or recrudescent trachomatous inflammation-follicular (TF). In Sokoto State, Nigeria, two local government areas (LGAs) have been classified as having persistent TF. We aimed to determine whether there was ongoing, programmatically significant conjunctival Chlamydia trachomatis (Ct) community transmission in these LGAs.</p><p><strong>Methods: </strong>In addition to examination for trachoma clinical signs, we took conjunctival swabs (for Ct nucleic acid amplification testing) from children aged 1-5 years, and dried blood spots [for estimation of anti-chlamydial plasmid gene protein 3 seroconversion rates (SCRs)] from children aged 1-9 years.</p><p><strong>Results: </strong>In Binji LGA, TF prevalence (4.1%) was below the elimination threshold, SCR was 1.1 per 100 child years in 1-5-year-olds, and Ct infection prevalence was 0.1%. In Silame LGA, TF prevalence (5.6%) was above the elimination threshold, but SCR was 1.6, and Ct infection prevalence was 0.2%.</p><p><strong>Conclusion: </strong>Binji has attained the active trachoma elimination threshold, thus transitioning to surveillance. In Silame, despite the TF prevalence remaining slightly above threshold, the low Ct infection prevalence and low SCR suggest Ct transmission is minimal, and mass drug administration will not be conducted. Silame can therefore also transition to the surveillance phase. Complementary trachoma survey indicators help ensure appropriate and cost-efficient programmatic decisions.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521305","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":"Occurrence and motivations for referral and data reporting among informal healthcare providers in urban informal settlements in Southeast Nigeria.","authors":"Ifeyinwa Arize, Pamela Adaobi Ogbozor, Chinelo Obi, Divine N Obodoechi, Benard Chibuike Okechi, Chinyere Mbachu, Obinna Onwujekwe, Helen Elsey","doi":"10.1093/inthealth/ihag073","DOIUrl":"https://doi.org/10.1093/inthealth/ihag073","url":null,"abstract":"<p><strong>Objectives: </strong>Establishing effective systems that enable informal healthcare providers (IHPs) to refer complicated cases and share service data with the formal health system is essential for improving quality services and coordination.</p><p><strong>Methods: </strong>This qualitative study explored the motivations of IHPs to refer patients and share health information in eight urban informal settlements in two eastern states, Enugu and Anambra in Nigeria. Data were collected through 32 in-depth interviews with purposively selected IHPs.</p><p><strong>Results: </strong>Findings revealed that IHPs refer patients and share some patient information. However, the recording and sharing of patients' data was uncommon among most IHPs. Altruism was reported by IHPs as a motivator for improving care and linking with the formal sector to save lives. However, there are ad hoc and unsystematic links between formal and informal providers.</p><p><strong>Conclusion: </strong>Understanding these motivations is vital for designing strategies to strengthen collaboration and establish sustainable referral and data-sharing systems within Nigeria's mixed health system.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450165","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}