Maarten Lambert, John Mmassy, Sungwa Kabissi, Cecilia Benizeth, Gasper Baltazary, Betty Allen Maganda, Katja Taxis
{"title":"Lessons from the field: implementing pharmacy services in the Tanzanian hospital setting.","authors":"Maarten Lambert, John Mmassy, Sungwa Kabissi, Cecilia Benizeth, Gasper Baltazary, Betty Allen Maganda, Katja Taxis","doi":"10.1093/inthealth/ihaf079","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf079","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745647","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}
Frederick Kungu, Samuel Nee-Amugie Yartey, Anastasia A Asantewaa, Eric S Donkor
{"title":"Cholera burden in Ghana: a systematic review and meta-analysis of prevalence, antimicrobial resistance and risk factors.","authors":"Frederick Kungu, Samuel Nee-Amugie Yartey, Anastasia A Asantewaa, Eric S Donkor","doi":"10.1093/inthealth/ihaf069","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf069","url":null,"abstract":"<p><p>Cholera persists in Ghana due to sanitation challenges. This systematic review aims to synthesize data on the prevalence, antimicrobial resistance, risk factors and community knowledge of cholera in Ghana. Extensive literature searches were conducted in PubMed, Scopus, ScienceDirect, Web of Science and African Journal Online. After screening, we included 33 studies, assessing their quality using the Joanna Briggs Institute checklist. Random effects meta-analysis and subgroup analysis were conducted using RStudio. The pooled prevalence of cholera was 18.42%. Based on subgroups, the highest prevalence was reported in studies that combined rectal swabs and stool samples (57.58%), involved human populations (31.79%) and were conducted in the Greater Accra-Ashanti region (64.52%). Cotrimoxazole had the highest resistance rates (75-100%) and gentamicin the lowest (1-11%). Multidrug resistance ranged between 68% and 100%. There were reports of individual resistance genes to some antibiotics (strA, floR and dfrA1). Case fatality and mortality rates were 3.40% and 2.7%, respectively. Risk factors such as eating street-vended food and proximity to refuse dumps were also reported. Cholera persists in Ghana with high drug resistance rates and regional prevalence variations. Strengthening surveillance, improving sanitation and regulating antibiotics are critical to mitigating outbreaks and resistance spread.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676265","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":"Prevalence of neonatal necrotizing enterocolitis and predictors in Ethiopia: a systematic review and meta-analysis.","authors":"Bikila Balis, Magarsa Lami, Ibsa Musa, Usmael Jibro, Abdi Birhanu, Tesfaye Assebe Yadeta","doi":"10.1093/inthealth/ihaf075","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf075","url":null,"abstract":"<p><p>Neonatal death in sub-Saharan African countries accounts for 80% of the global burden. An estimated 30 deaths per 1000 live births occurred in Ethiopia in 2019. Neonatal necrotizing enterocolitis (NEC) is the most common contributing factor to these deaths. Nevertheless, there is no strong evidence of neonatal NEC in Ethiopia. Therefore, this study aimed to determine the pooled prevalence of neonatal NEC and its predictors among neonates admitted to neonatal intensive care units in Ethiopia. Databases (Scopus, CINAHL, CAB Abstract, Embase, PubMed, Web of Science, Google and Google Scholar) and lists of references were used to search literature in Ethiopia. Stata version 17 (StataCorp, College Station, TX, USA) was used for analysis and the odds ratios (ORs) of the outcome variable were determined using the random-effects model. Heterogeneity among the studies was assessed by computing values for I2 and p-values. Also, sensitivity analysis and funnel plots were used to assess the stability of pooled values to outliers and publication bias. A total of 12 studies with a sample size of 7675 were included in this study. The overall prevalence of neonatal NEC was 16% (95% confidence interval 11 to 22). Meta-analyses and sensitivity analyses showed the stability of the pooled ORs and the funnel plots did not show publication bias. Preterm birth, very low birth weight and duration of stay in a neonatal intensive care unit (NICU) were identified as predictors of neonatal NEC. In Ethiopia, one in six (16%) neonates admitted to NICUs had NEC, with preterm birth, very low birth weight and duration of stay in the NICU identified as key predictors. Moreover, these findings imply the need for targeted interventions to reduce the risk of this condition in vulnerable neonates using large-scale prevention strategies through high-quality healthcare for mothers and children.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650921","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}
Kang-Kang Zhong, Rui Yang, Xue-Chun Liu, Jie He, Chuan-Ting Wen, Zhi-Wei Zhu, Ming-Xuan Fan, Teng Bao, Qi Zhong
{"title":"Susceptible window identification of the relationship between maternal ozone exposure and preterm birth.","authors":"Kang-Kang Zhong, Rui Yang, Xue-Chun Liu, Jie He, Chuan-Ting Wen, Zhi-Wei Zhu, Ming-Xuan Fan, Teng Bao, Qi Zhong","doi":"10.1093/inthealth/ihaf073","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf073","url":null,"abstract":"<p><p>Previous studies have focused on the effects of ozone (O3) exposure and preterm birth (PTB), but the findings are contentious and the susceptible window for O3 exposure during pregnancy remains inconclusive. Here, we pooled the current evidence to explore the relationship between maternal O3 exposure and PTB and further identified the susceptible exposure windows. We pooled a meta-analysis of 17 eligible studies by searching Embase, PubMed and Web of Science through 9 September 2024. The odds ratio (OR) and the corresponding 95% confidence intervals (CIs) were extracted for analysis. The tests for heterogeneity, sensitivity and publication bias between studies were performed using Stata 15.0 (StataCorp, College Station, TX, USA). The combined results showed a positive association between O3 exposure and PTB (n=13; OR 1.065 [95% CI 1.056 to 1.073]), and middle pregnancy (gestational weeks 13-27) may be a susceptible window of O3 exposure with PTB (n=11; OR 1.033 [95% CI 1.029 to 1.036]). This meta-analysis suggested that O3 exposure during pregnancy may independently increase the risk of PTB and gestational weeks the 13-27 is a critical window for preventing this risk. Reducing outdoor activity or a wearing protective mask and multiple micronutrients supplementation during pregnancy may reduce the risk of O3 exposure in PTB.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650922","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":"Cross-sectional study of maternal iodine nutrition and salt iodization in Kyrgyzstan: urban-rural and socioeconomic factors.","authors":"Iuliia Chyngyshpaeva, Zhyparkul Derbishalieva, Zhokhongir Dzhaliev, Don Eliseo Lucero-Prisno, Kenesh Dzhusupov","doi":"10.1093/inthealth/ihaf076","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf076","url":null,"abstract":"<p><strong>Background: </strong>Iodine deficiency remains a public health concern, especially among vulnerable populations such as pregnant women. Despite global efforts to address iodine deficiency disorders (IDDs) through universal salt iodization programs, gaps in coverage and effectiveness persist in countries like Kyrgyzstan. This study evaluated the iodine status of pregnant women and the effectiveness of Kyrgyzstan's national salt iodization program. We investigated sociodemographic factors associated with iodine deficiency.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Kyrgyzstan. Urine and salt samples were collected from a stratified random sample of 388 pregnant women to measure urinary iodine concentration (UIC) and iodine concentration in salt (ICS). Descriptive statistics, t tests and logistic regression were used.</p><p><strong>Results: </strong>Most salt samples had adequate ICS levels. Median UIC levels were adequate, but a significant share of insufficient UIC levels indicated widespread iodine deficiency. Urban residents showed higher UIC and ICS levels. Higher education and income levels were associated with better iodine status. Ethnic differences in UIC and ICS levels were observed.</p><p><strong>Conclusions: </strong>Despite Kyrgyzstan's salt iodization program's success, iodine deficiency remains prevalent among pregnant women, particularly in rural and lower-income groups. Targeted public health interventions, monitoring and tailored strategies are essential to improve iodine intake and reduce IDDs in these populations.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643956","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}
Emma K Manning, Olusola Oresanya, James K Tibenderana, Kolawole Maxwell
{"title":"Delivery of malaria services during a pandemic: lessons from COVID-19 in Nigeria.","authors":"Emma K Manning, Olusola Oresanya, James K Tibenderana, Kolawole Maxwell","doi":"10.1093/inthealth/ihaf074","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf074","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic posed significant threats to maintaining malaria services in Nigeria and threatened to reverse global progress towards elimination of the disease. During the COVID-19 pandemic, we worked in collaboration with the National Malaria Elimination Programme in Nigeria across 11 states to ensure that malaria campaigns and routine services continued. Here, we share the challenges and experiences from developing and implementing operational guidelines that enabled programmes to be adapted during unpredictable situations. The modifications made to long-lasting insecticide-treated net distribution and seasonal malaria chemoprevention campaign strategies enabled wide coverage of these interventions, despite limitations imposed by lockdowns. Strong partnerships were essential for the continued delivery of malaria services during lockdowns, which also highlighted the importance of community health workers during emergencies.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585459","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}
Justina Seyi-Olajide, Abdelbasit Ali, William F Powell, Lubna Samad, Tahmina Banu, Hafeez Abdelhafeez, Salome Maswime, Alizeh Abbas, Adesoji Ademuyiwa, Emmanuel A Ameh, Simone Abib, Tasmiah Aziz, Stephen Bickler, Donald Bundy, Tanvir K Chowdhury, Maria A Echeto, Faye Evans, Zipporah Gathuya, Rebecca Gray, Sarah Hodges, Dean Jamison, Greg Klazura, Kokila Lakhoo, Benjamin Martin, John Meara, Mary Nabukenya, Mark Newton, Doruk Ozgediz, Ekta Rai, Godfrey S Philipo, Alicia Sykes, Ava Yap
{"title":"Surgery and the first 8000 days of life: a review.","authors":"Justina Seyi-Olajide, Abdelbasit Ali, William F Powell, Lubna Samad, Tahmina Banu, Hafeez Abdelhafeez, Salome Maswime, Alizeh Abbas, Adesoji Ademuyiwa, Emmanuel A Ameh, Simone Abib, Tasmiah Aziz, Stephen Bickler, Donald Bundy, Tanvir K Chowdhury, Maria A Echeto, Faye Evans, Zipporah Gathuya, Rebecca Gray, Sarah Hodges, Dean Jamison, Greg Klazura, Kokila Lakhoo, Benjamin Martin, John Meara, Mary Nabukenya, Mark Newton, Doruk Ozgediz, Ekta Rai, Godfrey S Philipo, Alicia Sykes, Ava Yap","doi":"10.1093/inthealth/ihae078","DOIUrl":"10.1093/inthealth/ihae078","url":null,"abstract":"<p><p>The first 8000 days of life, from birth to adulthood, encompasses critical phases that shape a child's health and development. While global health efforts have focused on the first 1000 days, the next 7000 days (ages 2-21) are equally vital, especially concerning the unmet burden of surgical conditions in low- and middle-income countries (LMICs). Approximately 1.7 billion children globally lack access to essential surgical care, with LMICs accounting for 85% of these unmet needs. Common surgical conditions, including congenital anomalies, injuries, infections, and pediatric cancers, often go untreated, contributing to significant mortality and disability. Despite the substantial need, LMICs face severe workforce and infrastructure shortages, with most pediatric surgical conditions requiring specialized skills, equipment, and tailored healthcare systems. Economic analyses have shown that pediatric surgical interventions are cost-effective, with substantial societal benefits. Expanding surgical care for children in LMICs demands investments in workforce training, infrastructure, and health systems integration, complemented by innovative funding and equitable global partnerships. Prioritizing surgical care within national health policies and scaling up children's surgery through initiatives like the Optimal Resources for Children's Surgical Care can improve health outcomes, align with Sustainable Development Goals, and foster equity in global health. Addressing the surgical care gap in LMICs will reduce preventable mortality, enhance quality of life, and drive sustainable growth, emphasizing surgery as an essential component of universal health coverage for children.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"392-402"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649311","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}
Dhruv K Pandey, Jorge Alvar, Margriet den Boer, Saurabh Jain, Naresh Gill, Daniel Argaw, Subhash Salunke, Mobassir Hussain, Nupur Roy
{"title":"Kala-azar elimination in India: reflections on success and sustainability.","authors":"Dhruv K Pandey, Jorge Alvar, Margriet den Boer, Saurabh Jain, Naresh Gill, Daniel Argaw, Subhash Salunke, Mobassir Hussain, Nupur Roy","doi":"10.1093/inthealth/ihaf013","DOIUrl":"10.1093/inthealth/ihaf013","url":null,"abstract":"<p><p>The incidence and mortality of kala-azar (KA, visceral leishmaniasis) in India have fallen drastically in the past few years, and in 2023 the reported KA incidence reached the threshold for elimination as a public health problem (<1 case/10 000 of population at subdistrict level). One of the strategies adopted by India's kala-azar elimination program (KAEP) was the regular independent assessment of the program implementation by teams of experts. We present the findings of assessments undertaken in 2019, 2021 and 2023, when the KAEP was in the last mile of elimination. Factors that contributed to its success were political commitment, intensified implementation, a strong network of KA partners and committed donors. Bottlenecks were observed in disease surveillance, data utilization, vector-control operations and program management at implementation. To sustain the gains and achieve validation of elimination, the KAEP should continue the following minimal essential services: optimized active and passive case detection and management of KA, post-KA dermal leishmaniasis, KA-HIV coinfection and relapse supported by vector-control interventions. Long-term measures that will sustain elimination are overall socioeconomic development, including improved living conditions, parallel with efficient surveillance and operational research that is aligned with the changing epidemiology of the disease.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"416-422"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558030","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}
Jacqueline Pienaar, Lindiwe Tsope, Mapaseka Mabena, Pontsho Komane, Maria Sibanyoni, Boitumelo Ramashala, Elizabeth Wahome, Charlene Denousse, Ankiza Gakunu, Elise M van der Elst, Danielle Giovenco, Don Operario, Eduard J Sanders
{"title":"Risk factors for PrEP and ART medication adherence challenges in cis-gender South African men who have sex with men in Johannesburg and Pretoria.","authors":"Jacqueline Pienaar, Lindiwe Tsope, Mapaseka Mabena, Pontsho Komane, Maria Sibanyoni, Boitumelo Ramashala, Elizabeth Wahome, Charlene Denousse, Ankiza Gakunu, Elise M van der Elst, Danielle Giovenco, Don Operario, Eduard J Sanders","doi":"10.1093/inthealth/ihae090","DOIUrl":"10.1093/inthealth/ihae090","url":null,"abstract":"<p><strong>Background: </strong>Mental health challenges are common among men who have sex with men (MSM) in South Africa and may impact medication adherence.</p><p><strong>Methods: </strong>We determined the prevalence and risk factors of medication adherence challenges among 160 pre-exposure prophylaxis (PrEP)- and 40 antiretroviral therapy (ART)-taking MSM registered at two key population clinics in Johannesburg and Pretoria in 2023. We used modified Poisson regression to estimate associations between participant characteristics and medication adherence challenges (missed dosage on ≥1 d in the last month).</p><p><strong>Results: </strong>A total of 106 (53.5%) participants (57.6% on PrEP, 37.5% on ART; p=0.02) had medication adherence challenges and 61 (30.5%) participants (31.2% on PrEP, 27.5% on ART; p=0.23) met criteria for moderate to severe symptoms of depression (score ≥10 on the 9-item Patient Health Questionnaire). In multivariable analysis, predictors included PrEP use (adjusted prevalence ratio [aPR]=1.81 [95% confidence interval {CI} 1.21 to 2.73), clinic in Pretoria (aPR 1.43 [95% CI 1.08 to 1.89]), transactional sex (aPR 1.81 [95% CI 1.34 to 2.44]), moderate to severe depression (aPR 1.50 [95% CI 1.19 to 1.89]) and use of social media (aPR 1.45 [95% CI 1.05 to 2.00]).</p><p><strong>Conclusions: </strong>Depression is common and may be an important risk factor for poor medication adherence among MSM in South Africa. Future research should leverage a longitudinal study design to inform potential interventions.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"509-516"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411348","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":"A commentary: what do Rebecca Cheptegei and Gisèle Pelicot have in common?","authors":"Safieh Shah","doi":"10.1093/inthealth/ihaf004","DOIUrl":"10.1093/inthealth/ihaf004","url":null,"abstract":"<p><p>This commentary accompanies a study that focuses on the profound impact of intimate partner violence (IPV) on women's health in Ethiopia. The study highlights the dose-response relationship between IPV and antenatal care uptake, emphasizing the need for nuanced, context-specific interventions. The commentary highlights the need for new, sustainable and reliable ways of collecting IPV data across countries over time to effectively monitor Sustainable Development Goal 5. It advocates for a multilayered approach, combining healthcare, legal reforms and community-based strategies, to address the social causes of IPV, thereby aiming to critically appraise previously established ways of seeing information and ideas.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"600-601"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191057","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}