{"title":"Building authentic partnerships across regions and disciplines to overcome global health threats.","authors":"Wendy Harrison, Margaret Gyapong","doi":"10.1093/inthealth/ihaf037","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf037","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008652","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":"Population and health system factors affecting the transferability of health kiosks in markets in Kenya.","authors":"Jarim Omogi, Lydia Kaduka, Grace Mbuthia, Anselimo Makokha","doi":"10.1093/inthealth/ihaf051","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf051","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the population and health system factors affecting the transferability of health kiosks in markets in Kenya.</p><p><strong>Methods: </strong>A cross-sectional study with a partially mixed concurrent dominant status design was conducted among 843 households, policy actors, market chairpersons and champions, community health promoters and health workers. A χ2 test was used to test for independence with variables with a statistical significance (p<0.05) subjected to logistic regression. Qualitative data were transcribed verbatim to form nodes and themes.</p><p><strong>Results: </strong>Level of income, knowledge, awareness and perception of cardiovascular disease (CVD) risk factors were associated with 27.5% of Nyeri respondents earning ≥Ksh 10 000 monthly compared with Vihiga respondents (17.3%). Vihiga respondents were likely to identify excessive alcohol consumption as a cause of CVD. Vihiga had fair (40%) and good (26.6%) awareness levels towards CVDs compared with Nyeri respondents (36.3% and 19.7%, respectively). Vihiga respondents had a higher positive perception towards health services at the local facility compared with Nyeri respondents.</p><p><strong>Conclusions: </strong>CVD burden, low awareness levels, low health insurance cover and the poor attitude of health workers have the potential to affect the transferability of a health intervention such as a health market kiosk.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058285","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}
Mariam L Barabara, Melissa H Watt, Virginie Marchand, Linda M Minja, Maya J Stephens, Gileard G Masenga, Blandina T Mmbaga, Susanna R Cohen
{"title":"Childbirth experiences for women living with HIV in Kilimanjaro, Tanzania: a mixed method study on respectful maternity care.","authors":"Mariam L Barabara, Melissa H Watt, Virginie Marchand, Linda M Minja, Maya J Stephens, Gileard G Masenga, Blandina T Mmbaga, Susanna R Cohen","doi":"10.1093/inthealth/ihaf049","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf049","url":null,"abstract":"<p><strong>Background: </strong>Respectful maternity care (RMC) is important for women living with human immunodeficiency virus (WLHIV) to promote their well-being and long-term healthcare engagement. This descriptive mixed-methods study explored the experiences of RMC during childbirth among WLHIV in Tanzania.</p><p><strong>Methods: </strong>We conducted a mixed-methods study and recruited 103 WLHIV from six healthcare facilities within 48 h of giving birth. Participants completed a survey using audio computer-assisted self-interview survey technology. In-depth interviews were conducted with 12 pregnant WLHIV and 12 postpartum WLHIV.</p><p><strong>Results: </strong>In the survey, self-reported RMC was overall high. The median score on the full RMC scale (possible range 0-100) was 74.4, with the highest scores in the subscale of dignity and respect (83.3), followed by supportive care (77.8) and communication and autonomy (62.9). Qualitative data suggested a general appreciation of the care received, but some participants reported that providers neglected them, avoided physical contact or did not seek their consent for procedures.</p><p><strong>Conclusions: </strong>These data suggest an opportunity for additional provider training in clinical empathy and patient-centred practices to address the unique needs of WLHIV and enhance their overall maternity care satisfaction and health outcomes. There is also a need for investments in clinical infrastructure to support the delivery of RMC.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992268","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}
Wenceslaus Sseguya, Silver Bahendeka, Nimesh Mody, Sara MacLennan, Aravinda M Guntupalli
{"title":"Prevalence and correlates of diagnosed and undiagnosed diabetes mellitus among adults in rural Uganda during the COVID-19 pandemic: an evaluation of a community-based screening programme.","authors":"Wenceslaus Sseguya, Silver Bahendeka, Nimesh Mody, Sara MacLennan, Aravinda M Guntupalli","doi":"10.1093/inthealth/ihaf050","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf050","url":null,"abstract":"<p><strong>Background: </strong>One in two people with diabetes in sub-Saharan Africa remains undiagnosed, which has contributed to the region's high rates of diabetes-related morbidity and mortality. While the COVID-19 pandemic likely exacerbated diabetes prevalence, limited data from the region, including Uganda, hampers our understanding of this impact. To address this gap, we analysed the diabetes prevalence and correlates among adults from three rural districts of Uganda using data from a community-based screening programme conducted by community health workers (CHWs) during the pandemic.</p><p><strong>Methods: </strong>We used anonymised data of 2587 records to analyse the prevalence and correlates of diagnosed and undiagnosed diabetes. Prevalence was presented as proportions with 95% CIs. Correlates of diabetes and undiagnosed diabetes prevalence were analysed using logistic regression and presented as ORs.</p><p><strong>Results: </strong>The overall prevalence of diabetes was 11.3% (95% CI 10.2 to 12.5%), with a 7.2% (95% CI 6.2 to 8.1%) prevalence for diagnosed diabetes. A high proportion (36.4%) of diabetes cases were undiagnosed. Older age, high body mass index and pre-existing hypertension were associated with high diabetes prevalence.</p><p><strong>Conclusions: </strong>There was a high proportion of undiagnosed diabetes among rural adults during the pandemic. Engaging CHWs in routine diabetes screening and awareness programmes can reduce the burden of undiagnosed diabetes.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036260","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}
Oluseyi Adegoke, Ifedayo A Odeniyi, Oluwadamilola O Ojo, Obianuju B Ozoh, Ayesha O Akinkugbe, Njideka U Okubadejo
{"title":"Sociodemographic and lifestyle determinants of blood pressure in adult Nigerians.","authors":"Oluseyi Adegoke, Ifedayo A Odeniyi, Oluwadamilola O Ojo, Obianuju B Ozoh, Ayesha O Akinkugbe, Njideka U Okubadejo","doi":"10.1093/inthealth/ihaf048","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf048","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure (BP) trends are influenced by genetic, sociodemographic and lifestyle factors, with notable population-specific variations. This study assessed the impact of these determinants on BP in urban Nigerians to identify high-risk subgroups and inform targeted interventions.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 5076 adults ages 18-92 y (51.1% female) from Lagos, Nigeria. Data were collected using a modified World Health Organization STEPS protocol, including standardized BP measurements. Multiple linear regression models evaluated the effects of sociodemographic (age, sex, education, marital status and occupation) and lifestyle factors (tobacco/alcohol use, physical activity and fruit/vegetable consumption) on systolic BP (SBP) and diastolic BP (DBP) trends.</p><p><strong>Results: </strong>Age and marital status (married/cohabiting) significantly predicted higher SBP and DBP. Male sex, previously married, low physical activity and current tobacco use independently predicted elevated SBP, while alcohol consumption and employment type (salaried and self-employment) predicted higher DBP. The impacts of these factors on SBP and DBP ranged from β=0.03 to 0.28. Low fruit/vegetable consumption was not a significant independent predictor.</p><p><strong>Conclusions: </strong>Sociodemographic and lifestyle factors exhibit unique patterns in influencing BP among urban Nigerians. Tailored public health strategies, including alcohol/tobacco risk awareness, access to health screening and socio-economic/marital support, are essential for effective hypertension prevention in this population.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018432","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}
Augustus Osborne, Alhaji Mustapha Abu, Hassan S Rogers, Florence Gyembuzie Wongnaah, Bright Opoku Ahinkorah
{"title":"Provincial distribution and factors associated with high completed fertility among married and cohabiting women aged 40-49 years in Sierra Leone: a cross-sectional study.","authors":"Augustus Osborne, Alhaji Mustapha Abu, Hassan S Rogers, Florence Gyembuzie Wongnaah, Bright Opoku Ahinkorah","doi":"10.1093/inthealth/ihae058","DOIUrl":"10.1093/inthealth/ihae058","url":null,"abstract":"<p><strong>Background: </strong>High completed fertility among married and cohabiting women has significant implications, such as burden on resources, exacerbating healthcare issues and educational and gender disparities. This study examined the provincial distribution and factors associated with high completed fertility among married and cohabiting women aged 40-49 y in Sierra Leone.</p><p><strong>Methods: </strong>Data for the study were sourced from the 2019 Sierra Leone Demographic and Health Survey. Our study comprised 2253 married and cohabiting women aged 40-49 y in Sierra Leone. Geographic variations in high fertility were presented using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to identify the factors associated with high completed fertility. The findings were presented as adjusted ORs (aOR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The national prevalence of high completed fertility among married and cohabiting women in Sierra Leone was 61.7% (58.9-64.5). Women whose partners had secondary/higher education (aOR=0.54, 95% CI 0.33 to 0.89) had lower odds of high completed fertility than those with no formal education. Women in the Northern province (aOR=0.39, 95% CI 0.17 to 0.87) had lower odds of high completed fertility than those in the Eastern province. Women who indicated ≥6 as their ideal number of children had a higher (aOR=8.10, 95% CI 4.58 to 14.35) likelihood of experiencing high completed fertility compared with those whose ideal number of children was 0-3. Those who were using contraceptives at the time of the survey had a higher (aOR=2.09, 95% CI 1.28 to 3.41) likelihood of having high completed fertility compared with those who were not using contraceptives. Women in the poorer (aOR=1.70, 95% CI 1.07 to 2.72) and middle wealth index quintiles (aOR=2.09, 95% CI 1.29 to 3.41) had higher odds of high completed fertility than those in the poorest wealth index quintile.</p><p><strong>Conclusions: </strong>A significant proportion (>60%) of married and cohabiting women aged 40-49 y in Sierra Leone have high completed fertility. Partner's education, province, ideal number of children, use of contraceptives and wealth index were the factors associated with high completed fertility among women in Sierra Leone. Policymakers in Sierra Leone should increase access to and education on family planning methods to empower women to make informed choices about their fertility. The government and policymakers should support educational opportunities, particularly for men, because they are usually the heads of households and can influence fertility decisions. In-depth interviews should be conducted with women who use contraception to understand their motivations and experiences.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"282-291"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine E Igben-Pender, Peter Omemo, Gideon Ng'wena
{"title":"Training in the symptothermal method to ameliorate unmet need for family planning: knowledge, attitudes and satisfaction.","authors":"Catherine E Igben-Pender, Peter Omemo, Gideon Ng'wena","doi":"10.1093/inthealth/ihae063","DOIUrl":"10.1093/inthealth/ihae063","url":null,"abstract":"<p><strong>Background: </strong>Addressing the unmet need for family planning to prevent unintended pregnancies is a high priority for women's health, and training as an element of the symptothermal method (STM) is deemed to be an effective strategy. This study assessed training on knowledge, attitudes and satisfaction with STM to ameliorate the unmet need for family planning.</p><p><strong>Methods: </strong>The study adopted a pre-post study design. A total of 136 women participated in this study. Knowledge and attitudes were assessed pre- and post-training as well as the level of satisfaction, using cycle charts and questionnaires. The χ2 test (p<0.05) was used to analyse data on sociodemographics, attitudinal characteristics and satisfaction. Paired samples t-test (p<0.05) was used to establish the mean difference of the two groups (knowledge and attitudes pre- and post-training).</p><p><strong>Results: </strong>The paired samples t-test established that women have significant (t=-058.716, p=0.001) knowledge post-training (1.0000±0.00000) compared with pre-training (0.0682±0.01587) on STM. There was no significant (t=-1.419, p=0.158) difference in attitudes towards STM pre- and post-training. There was a significant level of satisfaction (p=0.001).</p><p><strong>Conclusions: </strong>Our interventional study has enabled women to acquire robust knowledge, positive attitudes and satisfaction with the utilization of STM. This has ameliorated unmet need for family planning among participants.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"304-312"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382138","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":"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":"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":"259-269"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045088/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ayano Miyashita, Keiko Nakamura, Stephen M Kibusi, Eugene Benjamin Meshi, Anderson Bendera, Hideko Sato, Saber Al-Sobaihi, Yuri Tashiro, Kaushik L Ramaiya, Bruno F Sunguya, Kaoruko Seino
{"title":"Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.","authors":"Ayano Miyashita, Keiko Nakamura, Stephen M Kibusi, Eugene Benjamin Meshi, Anderson Bendera, Hideko Sato, Saber Al-Sobaihi, Yuri Tashiro, Kaushik L Ramaiya, Bruno F Sunguya, Kaoruko Seino","doi":"10.1093/inthealth/ihae070","DOIUrl":"10.1093/inthealth/ihae070","url":null,"abstract":"<p><strong>Background: </strong>The rise of hypertension (HTN) and diabetes mellitus (DM) in Tanzania underscores the importance of self-care practices (SCP) for disease management. Despite the proven effectiveness of SCP, financial barriers in resource-limited rural areas hinder continuous care. Health insurance (HI) emerges as a critical solution to alleviate financial constraints and support SCP.</p><p><strong>Methods: </strong>This study examined an association between HI and SCP by generalised linear and ordinal logistic regressions, adjusted for sociodemographic factors. Mediation analysis highlighted the role of disease management behaviours (hospital visits and medication adherence) in the association. Data were collected through individual interviews with 909 patients.</p><p><strong>Results: </strong>Better SCP for HTN and DM were associated with the National Health Insurance Fund (HTN: coefficient=0.571; DM: coefficient=0.567, p<0.001) and the improved Community Health Fund (iCHF) or CHF (HTN: coefficient=0.330; DM: coefficient=0.472, p<0.05), after adjustment for sociodemographic variables. Mediation analysis showed that disease management behaviours partially or fully mediated the relationship between HI and SCP.</p><p><strong>Conclusions: </strong>Enrolment in HI by patients in rural Tanzania exhibited better disease management behaviours and SCP. Efforts should focus on leveraging the HI schemes to expand their coverage in rural areas, which could benefit patients with non-communicable diseases.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"342-350"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830650","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}
Rebecca E Harrison, Volha Shyleika, Raman Vishneuski, Olga Leonovich, Dmitri Vetushko, Alena Skrahina, Htay Thet Mar, Ekaterine Garsevanidze, Christian Falkenstein, Öznur Sayakci, Antonio Isidro Carrion Martin, Cecilio Tan, Norman Sitali, Kerri Viney, Knut Lonnroth, Beverley Stringer, Cono Ariti, Animesh Sinha
{"title":"Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care.","authors":"Rebecca E Harrison, Volha Shyleika, Raman Vishneuski, Olga Leonovich, Dmitri Vetushko, Alena Skrahina, Htay Thet Mar, Ekaterine Garsevanidze, Christian Falkenstein, Öznur Sayakci, Antonio Isidro Carrion Martin, Cecilio Tan, Norman Sitali, Kerri Viney, Knut Lonnroth, Beverley Stringer, Cono Ariti, Animesh Sinha","doi":"10.1093/inthealth/ihae066","DOIUrl":"10.1093/inthealth/ihae066","url":null,"abstract":"<p><strong>Background: </strong>TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use.</p><p><strong>Methods: </strong>An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019-November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted.</p><p><strong>Results: </strong>There were 89 participants enrolled in the intervention, with a median follow-up of 12.2 (IQR: 8.1-20.5) mo. The majority (n=80; 89.9%) of participants had AUD, 11 (12.4%) also had a dependence on other substances, six (6.7%) a dependence on opioids and three (3.4%) a personality disorder. Fifty-eight had a history of past incarceration (65.2%), homelessness (n=9; 10.1%) or unemployment (n=55; 61.8%). Median adherence was 95.4% (IQR: 90.4-99.6%) and outpatient adherence was 91.2% (IQR: 65.1-97.0%). Lower adherence was associated with hepatitis C, alcohol plus other substance use and outpatient facility-based treatment, rather than video-observed treatment, home-based or inpatient treatment support.</p><p><strong>Conclusions: </strong>This intervention led to good adherence to MDR/RR-TB treatment in people with harmful use of alcohol, a group usually at risk of poor outcomes. Poor outcomes were associated with hepatitis C, other substance misuse and outpatient facility-based treatment support.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"313-323"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584818","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}