Jack T Gardner, Vincent Dusabejambo, Steve P Bensen
{"title":"Using disruptive innovation to design endoscopic ligators for resource-challenged health settings.","authors":"Jack T Gardner, Vincent Dusabejambo, Steve P Bensen","doi":"10.1093/inthealth/ihae067","DOIUrl":"10.1093/inthealth/ihae067","url":null,"abstract":"<p><strong>Background: </strong>Commercial single-use endoscopic multiband ligators, used for esophageal variceal band ligation (EVL), are prohibitively expensive. To enable greater access to EVL, we used disruptive innovation to develop a novel endoscopic multiband ligator.</p><p><strong>Methods: </strong>We designed and tested a prototype handle 'ENDOhandle' using computer-aided design modeling and exported a cap, trigger cord and latex to form a functional banding unit.</p><p><strong>Results: </strong>The cost of the banding unit was US$4.80 compared with several hundred US dollars for commercially available devices in the USA.</p><p><strong>Conclusions: </strong>Disruptive innovation technology developed an inexpensive ligator for resource-challenged health settings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"385-387"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478651","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}
Abdirahman Saeed Mohamed, Espen Bjertness, Aung Soe Htet, Win Thuzar Aye, Ahmed Ali Madar
{"title":"Attitudes towards wife-beating justification and its association with female genital mutilation - analysis of ever-married Somali women in the 2020 Somali Health and Demographic Survey.","authors":"Abdirahman Saeed Mohamed, Espen Bjertness, Aung Soe Htet, Win Thuzar Aye, Ahmed Ali Madar","doi":"10.1093/inthealth/ihae047","DOIUrl":"10.1093/inthealth/ihae047","url":null,"abstract":"<p><strong>Background: </strong>In Somalia, despite its prohibition, female circumcision persists alongside significant intimate partner violence. This study examines the prevalence of wife-beating justification among Somali women and its link to the perception that female genital mutilation/cutting (FGM/C) is a religious obligation.</p><p><strong>Methods: </strong>We studied 7726 married Somali women 15-49 y of age from the 2020 Somali Health and Demographic Survey. Using χ2 tests and logistic regression, we examined wife-beating justification by covariates and its connection to the perception that FGM/C is a religious obligation.</p><p><strong>Results: </strong>The prevalence of women justifying wife-beating for any of six reasons was 56.5% (95% confidence interval [CI] 55.3 to 57.6). A higher prevalence of wife-beating justification was found among women 35-49 y of age (59.9% [95% CI 57.8 to 61.9]), without education (57.7% [95% CI 56.5 to 59.0]), rural residents (57.8% [95% CI 56.3 to 59.2]), with lower socio-economic status (60.4% [95% CI 58.7 to 62.1]) and married before age 18 y (58.4% [95% CI 56.7 to 60.1]). Adjusted for covariates, logistic regression analyses indicated a significant association between wife-beating justification and the belief that FGM/C is mandated by religion (adjusted odds ratio 1.40 [95% CI 1.17 to 1.68], p<0.001).</p><p><strong>Conclusions: </strong>Wife-beating justification is alarmingly common among Somali women and significantly associated with the belief that FGM/C is mandated by religion. Further research is necessary to investigate the drivers behind the acceptance of domestic violence, its impact on women's mental health and well-being and its association with FGM/C acceptance.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"251-258"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332332","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}
Jasantha Odayar, Tamsin K Phillips, Claudine Hennessey, Landon Myer
{"title":"Guidelines for the transfer of people living with HIV attending primary healthcare facilities in South Africa: a scoping review.","authors":"Jasantha Odayar, Tamsin K Phillips, Claudine Hennessey, Landon Myer","doi":"10.1093/inthealth/ihae057","DOIUrl":"10.1093/inthealth/ihae057","url":null,"abstract":"<p><p>People living with HIV may move between health facilities: this is called 'transfer', and includes up- and down-referral based on clinical condition and lateral transfer (e.g. between primary healthcare [PHC] facilities for reasons such as geographic mobility or stigma). Transfers involving PHC facilities occur frequently and are associated with viraemia and disengagement. We reviewed the South African National Department of Health (NDOH) and Southern African HIV Clinicians Society websites and contacted NDOH officials to identify national guidelines applicable to HIV care in South Africa for recommendations on transfers involving PHC facilities. In total, 21/24 (88%) documents mentioned transfer, using the terms 'referral', 'linkage', 'transfer', 'transition' and 'handover'. Guidelines defined 'linkage to care' as connecting individuals to care after HIV testing, but other terms were not well defined. Documents emphasised transfers between different levels of the health system, and transfers between PHC facilities received limited attention. The transfer process was delineated for linkage to care, up- and down-referrals, but not for transfers between PHC facilities. Clinical management of patients transferring between PHC facilities and tracing of patients who requested transfers and missed their visits were not specified. Overall, transfers between PHC facilities were not well addressed and require attention to improve HIV treatment outcomes.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"237-244"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511313","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}
Michael Matte, Natsumi Koyama, Dana Giandomenico, Emmanuel Baguma, Georget Kibaba, Moses Ntaro, Raquel Reyes, Edgar M Mulogo, Ross M Boyce, Emily J Ciccone
{"title":"A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda.","authors":"Michael Matte, Natsumi Koyama, Dana Giandomenico, Emmanuel Baguma, Georget Kibaba, Moses Ntaro, Raquel Reyes, Edgar M Mulogo, Ross M Boyce, Emily J Ciccone","doi":"10.1093/inthealth/ihae075","DOIUrl":"10.1093/inthealth/ihae075","url":null,"abstract":"<p><strong>Background: </strong>Integrated community case management (iCCM) programs leverage lay village health workers (VHWs) to carry out the initial evaluation of children with common conditions including malaria, pneumonia and diarrhea. Therefore, it is imperative that VHWs are able to identify children who are critically ill and require referral to a health facility. Elevated venous lactate levels have been associated with severe illness and adverse health outcomes, including death. However, lactic acidosis may not be recognized in rural settings because it is not routinely measured outside of hospitals and research studies. Point-of-care lactate tests may help identify patients in need of a higher level of care and improve VHWs' ability to make timely and appropriate referrals.</p><p><strong>Methods: </strong>The study was a cross-sectional evaluation of children aged <5 y presenting to VHWs in rural southwestern Uganda with complaints of fever and cough. Demographics, clinical presentation, evaluation, management and disposition were recorded. VHWs were trained and instructed to perform lactate testing using a point-of-care assay in eligible participants.</p><p><strong>Results: </strong>During the study period, 238 children were enrolled and completed an initial assessment. Of the 204 participants included in the analysis, 113 (55.4%) were female, and the median (IQR) age was 23 (9-36) months. Most participants, 139/200 (69.5%), had negative results on the malaria rapid diagnostic test. The median lactate level was 2.1 mmol/L; 12% (24/204) had a lactate ≥3.5 mmol/L and only nine participants (4.4%) had a lactate ≥5 mmol/L. Having a lactate level above either cut-off was not associated with the presence of danger signs at presentation.</p><p><strong>Conclusions: </strong>Few children presenting with fever and cough to VHWs in western Uganda had elevated lactate levels. However, most of the children with elevated lactate levels did not otherwise satisfy established iCCM criteria based on physical examination findings for referral to a health facility. Therefore, while elevated lactate was not associated with danger signs in this small study, it is possible that there is under-recognition of severe illness using current iCCM guidelines.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"377-384"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631072","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":"Self-reported prevalence of tuberculosis: unveiling spatial representation in the districts of Tamil Nadu.","authors":"Malaisamy Muniyandi, Kavi Mathiyazhagan, Nagarajan Karikalan","doi":"10.1093/inthealth/ihae072","DOIUrl":"10.1093/inthealth/ihae072","url":null,"abstract":"<p><strong>Background: </strong>The objective of the current study was to estimate the self-reported individual-level crude prevalence and cluster-level adjusted prevalence of TB for the districts of Tamil Nadu and to understand the spatial distribution of TB cases through spatial autocorrelation and hotspot analysis.</p><p><strong>Methods: </strong>National Family Health Survey (NFHS) data, gathered during 2014-2015 (NFHS-4) and 2019-2021 (NFHS-5), were used in the current study to estimate district-wise, individual-level crude and cluster-level adjusted TB prevalence per 100 000 population in Tamil Nadu. This was illustrated with the help of spatial geographic representation for various districts of Tamil Nadu using SPSS and QGIS software. The spatial autocorrelation and hotspot analysis were performed using Geoda software.</p><p><strong>Results: </strong>The overall self-reported individual-level crude prevalence of TB was 337 (95% CI 302 to 375) and 169 (95% CI 144 to 197) per 100 000 population, whereas the cluster-level adjusted prevalence of TB was 356 (95% CI 311 to 405) and 184 (95% CI 154 to 219) per 100 000 population in NFHS-4 and NFHS-5, respectively.</p><p><strong>Conclusions: </strong>This study highlights those geographical areas with high rates of TB prevalence. This information would be useful for the state and district programme managers to identify areas of high TB prevalence where interventions can be focused.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"366-376"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478650","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":"Sputum culture conversion and its predictors among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia.","authors":"Mulugeta Gamachu, Alemayehu Deressa, Lemma Demissei Regassa, Miesso Bayu, Ibsa Mussa, Fekede Asefa Kumsa, Tariku Dingeta","doi":"10.1093/inthealth/ihae059","DOIUrl":"10.1093/inthealth/ihae059","url":null,"abstract":"<p><strong>Background: </strong>Evidence of time to culture conversion is used to predict the time of cure from the disease and the overall drug-resistant tuberculosis (TB) treatment duration. Even though evidence about sputum culture conversion is enormous in TB treatment, no study has yet been done in our areas, where cases are common. The study aimed to assess the time to sputum conversion and its predictors among drug-resistant TB patients from October 2013 to September 2021 in eastern Ethiopia.</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted in eastern Ethiopia among 273 drug-resistant TB patients who were treated from October 2013 to September 2021 at Dire Dawa City and Harari regional treatment centres. The Kaplan-Meier method was used to estimate the median time of sputum culture conversion. Cox proportional hazards regression was employed to detect the predictors of sputum culture conversion. An adjusted hazard ratio (aHR) with 95% confidence interval (CI) was used to determine the strength and significance of the association.</p><p><strong>Results: </strong>Of the 273 drug-resistant TB patients, the sputum culture of 216 (79.12%) patients became negative in a median time of 3 months (interquartile range 2-7). The time to sputum culture conversion was negatively associated with underweight (aHR 0.65 [95% CI 0.49 to 0.90]) and poor adherence (aHR 0.41 [95% CI 0.24 to 0.69]). The time to sputum culture conversion was also positively associated with patients resistant to two or more drugs (aHR 1.58 [95% CI 1.07 to 2.32]) and patients receiving a short treatment regimen (aHR 2.24 [95% CI 1.10 to 2.55]).</p><p><strong>Conclusions: </strong>A shorter culture conversion rate was observed compared with the median time recommended by the World Health Organization. Being underweight, poor adherence to treatment, resistance to two or more drugs and receiving a short treatment regimen were found to be predictors of time to sputum culture conversion. Implementing nutrition assessment, counselling and support of drug adherence may improve sputum culture conversion.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"292-303"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Admission and outcomes of COVID-19 among chronic obstructive pulmonary diseases patients in Africa: protocol for a systematic review and meta-analysis.","authors":"Guesh Mebrahtom, Abrha Hailay, Woldu Aberhe, Kidane Zereabruk, Teklehaimanot Gereziher Haile, Degena Bahrey Tadesse","doi":"10.1093/inthealth/ihae062","DOIUrl":"10.1093/inthealth/ihae062","url":null,"abstract":"<p><p>When the coronavirus case was originally reported in Wuhan, China, in December 2019, it quickly spread throughout the world and became a global public health problem. Evidence of the admission and outcomes of coronavirus disease among patients with chronic obstructive pulmonary disease (COPD) has not been reported in Africa. Consequently, this research protocol uses a systematic review and meta-analysis of the admission and outcomes of COVID-19 in patients with COPD in Africa. All observational studies published in the English language and reporting on the prevalence, admission and outcomes of COVID-19 among patients with COPD in Africa will be included. A search strategy will be implemented using electronic databases and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol recommendations. The findings of this review will be reported to health program designers, decision-makers and healthcare providers.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"245-250"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pregnant women and healthcare workers' perceptions on tuberculosis and screening: a cross-sectional study in Indonesia.","authors":"Dzerlina Syanaiscara Rahari, Detty Siti Nurdiati, Jarir At Thobari, Suyanto Suyanto, Tippawan Liabsuetrakul","doi":"10.1093/inthealth/ihae069","DOIUrl":"10.1093/inthealth/ihae069","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of studies regarding the obstacles in tuberculosis (TB) screening in pregnant women. This study aimed to assess the perceptions of TB as a disease and TB screening among pregnant women and healthcare workers, describe pregnant women's perceptions on specific TB screening methods and explore associations between the perceptions of TB with the intention to have TB screening by pregnant women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at six primary healthcare centres in Yogyakarta Municipality, Indonesia among 240 pregnant women and 126 healthcare workers interviewed with a structured questionnaire about their perceptions. Perceptions were analysed as percentages and associated factors were tested by multivariable logistic regression.</p><p><strong>Results: </strong>Most pregnant women and healthcare workers supported TB screening in pregnant women based on their perceptions of the susceptibility to or severity of TB and the benefits and risks of TB screening. Women who perceived the high susceptibility of TB disease and the benefits of TB screening were significantly more likely to have high intentions to accept TB screening in the future.</p><p><strong>Conclusions: </strong>Pregnant women's perceptions of TB and TB screening influenced their intention to be screened; however, appropriate testing methods for universal TB screening in pregnant women in areas with a high prevalence of TB require further studies.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"334-341"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth Oluwamayowa Oloruntola, Chioma J Eze, Gloria O Alao, Mercy Opateye, Oluwaseun T Gbadebo, Precious E Akinbote, Ruth D Adesina, Oluwadamilare Akingbade
{"title":"Experiences and needs of persons who have undergone limb amputation in Saki West, Oyo State, Nigeria.","authors":"Elizabeth Oluwamayowa Oloruntola, Chioma J Eze, Gloria O Alao, Mercy Opateye, Oluwaseun T Gbadebo, Precious E Akinbote, Ruth D Adesina, Oluwadamilare Akingbade","doi":"10.1093/inthealth/ihae068","DOIUrl":"10.1093/inthealth/ihae068","url":null,"abstract":"<p><strong>Background: </strong>Amputation is a life-changing experience involving the surgical removal of a body part. However, little is known about the experiences of persons who have undergone limb amputation in the Saki West Local Government Area (LGA), which prompted this study.</p><p><strong>Methods: </strong>An exploratory qualitative study design was used. Thirty participants were interviewed using face-to-face focus group discussions. Five sessions were conducted, with six participants in each session. Data were analysed using the thematic analysis framework of Braun and Clarke.</p><p><strong>Results: </strong>A total of 76.3% of the participants were males and 73.3% were married. Their ages ranged from 22 and 69 y, with a mean age of 48.0 y and a monthly income of 20 000 naira (US$12). Three major themes emerged from the study: the needs and challenges of those who have undergone amputation, coping strategies of those who have undergone amputation and recommendations by persons who have undergone amputation. The study revealed that people who have undergone amputation experienced psychological pain, such as a loss of self-worth and stigmatization from friends and loved ones. Coping strategies identified were accepting the situation and emotional support from family. Participants recommended providing financial support, empowerment programs, employment opportunities and fostering a community of amputees in the Saki West LGA.</p><p><strong>Conclusions: </strong>Amputees undergo psychological and psychosocial problems that can affect their health and recovery. They need emotional and financial support, rehabilitation services and provision of prostheses from family, society and the government. These services should be adequately provided in the Saki West LGA, the largest among the 10 suburban local governments in Oyo State, with numerous commercial activities and a high risk for road traffic accidents.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"324-333"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Quality of life and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders attending public hospitals in Addis Ababa, Ethiopia: a cross-sectional study.","authors":"Jerman Dereje, Abenet Kassaye, Abiy Mulugeta, Girmaw Medfu, Shegaye Shumet, Tilahun Kassew","doi":"10.1093/inthealth/ihae055","DOIUrl":"10.1093/inthealth/ihae055","url":null,"abstract":"<p><strong>Background: </strong>Neurodevelopmental disorders are a set of disorders that negatively affect the acquisition of skills in a variety of developmental domains, including motor function, learning, socialization, language and cognition. However, there is no information available on the standard of living of Ethiopian primary caregivers of children and adolescents with neurodevelopmental disorders. Therefore, this study aimed to assess the quality of life (QOL) and associated factors among primary caregivers of children and adolescents with neurodevelopmental disorders in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted during 1-30 May 2022. Systematic random sampling was used to obtain 352 samples. QOL was measured using the WHO Quality of Life Brief. The gathered information was coded, entered into EpiData 4.6.0.2 and analyzed with SPSS version 26. Multiple linear regression analysis was used to identify the correlates of QOL and the strength of the correlation was measured by β coefficient with 95% CI.</p><p><strong>Results: </strong>The mean score of the overall QOL was 62.61 with a SD of 5.17. The mean (±SD) scores for the physical health, psychological, environmental and social relationship domains of primary caregivers were 57.36±9.98, 66.98±9.39, 66.06±12.91 and 60.02±9.14, respectively. Age was significantly associated with physical domain (β=-0.25, 95% CI -0.43 to -0.07) and with environmental domain (β=-4.57, 95% CI -9.06 to -0.09). Being divorced/widowed was negatively associated with psychological health (β=-2.99, 95% CI -5.82 to -0.17) and social health (β=-0.62, 95% CI -1.33 to -0.10). The presence of medical illness was negatively associated with the physical health domain (β=-4.32, 95% CI -7.64 to -2.91) and the environmental domain (β=-3.11, 95% CI -5.71 to -0.51). Poor social support was negatively associated with psychological health (β=-3.25, 95% CI -5.89 to -0.61) and the social health domain (β=-3.39, 95% CI -11.3 to 4.6), and moderate social support (β=8.62, 95% CI 3.15 to 14.09) was positively associated with physical health. Depression (β=-6.32, 95% CI -11.96 to -0.67) and anxiety (β =-3.07, 95% CI -5.80 to -0.34) were negatively associated with physical health and the psychological health domain, respectively.</p><p><strong>Conclusions: </strong>The findings from this study indicate that all dimensions of QOL of primary caregivers of children and adolescents with neurodevelopmental disorders in this study setting were compromised. Being divorced or widowed, lack of formal education, age, average monthly income, poor social support, depression, anxiety and the presence of medical illness were factors associated with QOL in all domains. This requires integrating a bio-psychosocial perspective, a positive mental health strategy and pharmaceutical therapies to enhance QOL for caregivers of children and adolescents with neurodevelopmental disorders.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"270-281"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}