International Health最新文献

{"title":"Global trends and projections of high BMI burden and its independent impact on atrial fibrillation and flutter.","authors":"YuBin He, YaPing Ren, YaYun Zhang, Zixiong Zhu, Xuewen Li","doi":"10.1093/inthealth/ihaf005","DOIUrl":"10.1093/inthealth/ihaf005","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates changes in the burden of high body mass index (BMI) and its impact on atrial fibrillation and flutter (AF/AFL) using the 2021 Global Burden of Disease database.</p><p><strong>Methods: </strong>Mortality and disability-adjusted life years rates were analysed globally, considering age, sex, geography and the Socio-demographic Index (SDI). Decomposition and frontier analyses assessed the impact of epidemiological drivers and SDI on the burden. The nordpred model validated the predictions.</p><p><strong>Results: </strong>The burden of high BMI is now 2.5 times greater than 30 y ago and will continue to increase over the next 20 y, heavily impacting cardiovascular and metabolic diseases. High BMI-related AF/AFL also poses a significant burden, especially in developed regions. Men's burden grows faster than women's. Decomposition analysis shows epidemiological changes mainly drive burden increases, while in women, population growth is more significant. Frontier analysis indicates that the gap between actual burden and theoretical optimal value has widened with increasing SDI, except in countries such as Bulgaria and the Czech Republic.</p><p><strong>Conclusions: </strong>Over the past 30 y, the overall burden of high BMI and its impact on AF/AFL have increased significantly, highlighting the need for targeted public health strategies.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"552-565"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123901","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":"Effect of prenatal alcohol consumption on maternal anemia among pregnant women in Gondar town, Northwest Ethiopia: a retrospective cohort study.","authors":"Alemu Earsido Addila, Telake Azale, Mezgebu Yitayal","doi":"10.1093/inthealth/ihaf010","DOIUrl":"10.1093/inthealth/ihaf010","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption during pregnancy can lead to multiple health, social and behavioral problems for both the mother and the offspring. Anemia is one of the major public health concerns and causes of morbidity and mortality among pregnant women with poor maternal and fetal outcomes in developing countries. This study aimed to identify the link between prenatal alcohol consumption and anemia among pregnant women in Gondar town, Northwest Ethiopia.</p><p><strong>Methods: </strong>A facility-based retrospective cohort study was conducted among 1669 pregnant women who were booked in for antenatal care in Gondar town. We used a two-stage random sampling technique to recruit and include study participants in the cohort. Data were collected using an interviewer-administered questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and anemia in pregnancy using log-binomial regression modeling. The burden of anemia in pregnancy was reported using the adjusted risk ratio (ARR) and population-attributable risk.</p><p><strong>Results: </strong>The prevalence of anemia during pregnancy was 14.86% (95% CI 13.23 to 16.65%). Hazardous alcohol consumption during pregnancy was significantly associated with anemia in pregnancy (ARR=2.24; 95% CI 1.60, 3.15). The adjusted population-attributable risk of anemia in pregnancy related to hazardous alcohol consumption during pregnancy was 7.68%.</p><p><strong>Conclusions: </strong>This study revealed that anemia during pregnancy continues to be a public health concern. Regardless of timing, there is a clear association between prenatal alcohol consumption and anemia during pregnancy that suggests a need for targeted prenatal alcohol use screening, and ongoing intervention for alcoholic pregnant women.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"583-593"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374817","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":"Co-designing the FOotpaths foR Adolescent MAternal Mental HeAlth (FOR MAMA) intervention for pregnant teens in Malawi.","authors":"Wezi Mhango, Daniel Michelson, Darya Gaysina","doi":"10.1093/inthealth/ihaf007","DOIUrl":"10.1093/inthealth/ihaf007","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to gain insights into stakeholders' priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi.</p><p><strong>Methods: </strong>Participatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8) and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the Template for Intervention Description and Replication checklist.</p><p><strong>Results: </strong>Participants emphasized the need for information on causes and symptoms of common mental problems and for developing coping strategies: a) those focused on external stressors-problem-solving, financial literacy and interpersonal skills-and b) emotion-focused approach behaviours-behavioural activation, relaxation and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. All stakeholder groups felt there was a need for follow-up to ensure that adolescents correctly engaged with the intervention material.</p><p><strong>Conclusions: </strong>Findings informed the design of a brief multicomponent guided intervention for adolescents in the antenatal period.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"573-582"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256895","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":"Longitudinal analysis of blood pressure control and influencing factors among 32 701 primary care hypertensive patients with or without diabetes: a prospective cohort study in Jianye District, China.","authors":"Xia Zhang, Na Jiang, Ming Zhang, Xiaoyan Ni, Lijun Fan, Wei Du, Hui Xue","doi":"10.1093/inthealth/ihae082","DOIUrl":"10.1093/inthealth/ihae082","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore the variation in blood pressure (BP) control in primary care hypertensive patients with or without diabetes, and investigate potential factors associated with inadequate BP control during follow-up.</p><p><strong>Methods: </strong>Primary care hypertensive patients with and without diabetes were recruited in 2020 from Jianye District of Nanjing and prospectively followed up until 2023. Effective BP control was measured in terms of consistent normal readings of systolic BP <140 mmHg and of diastolic BP <90 mmHg based on the most recent assessment during the follow-up period. We used the negative binomial model with total person-years as an offset to evaluate whether the study population would achieve BP control after the 3-y follow-up period in terms of rate ratio (RR) and 95% CI. We further conducted subgroup analysis based on the absence or presence of clinically confirmed diabetes and BP stability at baseline.</p><p><strong>Results: </strong>Of a total of 32 701 patients with hypertension, compared with those without comorbid diabetes and stable BP at baseline, patients with comorbid diabetes and unstable BP at baseline were less likely to have effective BP control at follow-up (adjusted RR=2.01, 95% CI 1.89 to 2.15). We observed an elevated risk of ineffective BP control at follow-up in those aged 60-70 y (1.69; 95% CI 1.56 to 1.83) or ≥70 y (1.73; 95% CI 1.59 to 1.88), females (1.09; 95% CI 1.03 to 1.16), those with a higher waist-to-height ratio (1.25; 95% CI 1.17 to 1.34), overweight/obese in terms of body mass index (1.16; 95% CI 1.09 to 1.23) or regularly consuming alcohol (1.26; 95% CI 1.16 to 1.37). Higher educational attainment indicated a reduced risk of ineffective BP control at follow-up (0.68; 95% CI 0.63 to 0.75).</p><p><strong>Conclusions: </strong>Achieving effective BP control remains a persistent challenge, especially for patients with comorbid hypertension and diabetes. In the absence of any novel strategies for hypertension care, the existing multidisciplinary care approaches could be repurposed and integrated for effective management of the aforementioned comorbid conditions in primary care settings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"461-469"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683090","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":"Bayesian analysis of non-communicable diseases risk factors: a focus on the lower-educated population in Bangladesh.","authors":"Md Ismail Hossain, Moumita Datta Gupta, Tahsina Fariha Ohi, Md Mahfuzur Rahman","doi":"10.1093/inthealth/ihae087","DOIUrl":"10.1093/inthealth/ihae087","url":null,"abstract":"<p><strong>Background: </strong>This study investigates non-communicable disease (NCD) risk factors, specifically hypertension and diabetes, among Bangladeshi adults with lower educational attainment. With an increasing global burden of NCDs, understanding the dynamics in lower-educated populations becomes crucial for targeted interventions and achieving Sustainable Development Goal 3.4-curtailing premature mortality from non-communicable diseases by one-third by 2030 through prevention and treatment.</p><p><strong>Methods: </strong>Utilizing data from the Bangladesh Demographic and Health Survey (2017-2018), a two-stage stratified sampling design identified 7287 lower-educated individuals. Bayesian logistic regression was applied for risk factor analysis.</p><p><strong>Results: </strong>The prevalence of hypertension and diabetes among lower-educated people was 31% and 9.3%, respectively. NCD prevalence (37.3%) underscored a significant health burden. Factors such as gender, age, wealth status, working status, residence and region showed significant associations with NCDs. Bayesian analysis revealed that females were 1.30 times more likely to develop NCDs, while older age groups demonstrated 4.30 times greater likelihood. Employed individuals exhibited a 43% lower risk. Wealthier households showed higher NCD likelihood and residence in the central region was associated with an 11% lower risk.</p><p><strong>Conclusions: </strong>This study highlights the high risk of developing NCDs among lower-educated females, particularly those ≥35 y of age in Bangladesh. Therefore, targeted interventions for this group are critical to reducing NCD risks, supporting national health objectives and advancing progress toward the Sustainable Development Goals.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"499-508"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808194","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":"Comment on: 'Disclosure of diagnosis by parents and caregivers to children infected with HIV in Hawassa, southern Ethiopia: a multicentre, cross-sectional study'.","authors":"John Patrick C Toledo","doi":"10.1093/inthealth/ihae061","DOIUrl":"10.1093/inthealth/ihae061","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"605-606"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382137","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":"Treatment-related characteristics of communities in districts characterized by persistent trachoma: an exploratory descriptive study.","authors":"Dawit Seyum Buda, Naomi Lorrain Nkoane, Thinavhuyo Robert Netangaheni","doi":"10.1093/inthealth/ihae086","DOIUrl":"10.1093/inthealth/ihae086","url":null,"abstract":"<p><strong>Background: </strong>Despite the implementation of surgery, antibiotics mass administration, facial cleanliness and environmental improvement, commonly known as the SAFE strategy for several years, the persistence and recrudescence of trachoma is a prevailing challenge in Ethiopia. This study explores the treatment-related characteristics of communities within districts characterized by persistent trachoma in southern Ethiopia.</p><p><strong>Methods: </strong>Nyangatom and Uba Debretsehay districts are predominantly inhabited by pastoralist and farming communities, respectively. A community-based, exploratory descriptive qualitative study was conducted from June to October 2023. A total of 11 key informant interviews and six focus group discussions were conducted. The interviews and discussions were digitally recorded, transcribed and thematically analysed using Atlas ti. 23.</p><p><strong>Results: </strong>Districts characterized by persistent trachoma are characterized by segments of populations that have never been treated or suboptimally treated. This is due to the competing priorities faced by providers, the nature of campaigns and the limited ability of logistics to reach the 'must reach' population. Other barriers include limited social support and terrain hindering full geographical and population coverage. Treatment slippage is of particular concern because of treatment fatigue, misinformation and the unavailability of treatments for routine care.</p><p><strong>Conclusions: </strong>Communities in districts characterized by persistent and recrudescent trachoma face various socioecological barriers that impact the outcome of SAFE strategy implementation. A mix of both random and systematic omissions of people who need treatment most, such as children and women, was evident.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"489-498"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649315","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":"Dengue and diabetes comorbidity: an emerging public health threat.","authors":"Donal Bisanzio, Cássia Fernanda Estofolete, Richard Reithinger","doi":"10.1093/inthealth/ihae089","DOIUrl":"10.1093/inthealth/ihae089","url":null,"abstract":"<p><p>Dengue is of growing global public health concern. Diabetes is a significant risk factor for severe dengue and dengue-related mortality. Countries with the highest number of reported dengue cases are projected to experience a substantial increase in diabetes by 2050. This likely will result in an increased incidence of dengue-diabetes comorbidity, and, hence, in severe dengue and dengue-related mortality. Countries that are or will be affected by a high burden for both diabetes and dengue should urgently design strategies to minimize the health and economic impact that a diabetes-dengue comorbidity could have on affected populations.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"597-599"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830644","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":"Trachoma prevalence surveys in 15 indigenous and non-indigenous evaluation units in Brazil, 2018-2023.","authors":"Célia Landmann Szwarcwald, Maria de Fátima Costa Lopes, Paulo Roberto Borges de Souza Junior, Daniela Vaz Ferreira Gómez, Expedito José de Albuquerque Luna, Wanessa da Silva de Almeida, Giseli Nogueira Damacena, Joana da Felicidade Ribeiro Favacho, Norma Helen Medina, Luciano Chaves Franco Filho, Aiara Cogo, Sarah Boyd, Ana Bakhtiari, Cristina Jimenez, Sandra L Talero, Martha Idalí Saboyá-Díaz, Anthony W Solomon, Emma Harding-Esch","doi":"10.1093/inthealth/ihaf067","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf067","url":null,"abstract":"<p><strong>Background: </strong>To provide the groundwork for a future declaration of elimination of trachoma as a public health problem in Brazil, we conducted house-to-house surveys following WHO methodological guidance.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted in 10 non-indigenous and five indigenous evaluation units (EUs) from 2018 to 2023; data on six EUs are reported here for the first time. Two-stage cluster sampling was used: 30 clusters per EU, and 30 households per cluster. We estimated the prevalence of trachomatous inflammation-follicular (TF) in 1-9-y-olds and trachomatous trichiasis (TT) unknown to the health system in those aged ≥15 y. Data on sanitary conditions were collected in household interviews.</p><p><strong>Results: </strong>In all EUs, TF prevalence was below the elimination threshold (5%). TT prevalence was lower than the 0.2% threshold in 14 EUs. In 'Noroeste Cearense' mesoregion, TT prevalence was 0.22% (95% CI 0.06 to 0.44%), but statistical analysis showed a 58% likelihood of TT elimination in this EU. In three indigenous EUs, >10% of households had no sanitary facilities and high percentages of open defecation.</p><p><strong>Conclusions: </strong>It is highly likely that trachoma has been eliminated as a public health problem in all the EUs surveyed. The findings on sanitary conditions mandate public policies to overcome socioenvironmental inequalities.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545754","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":"Schistosomiasis treatment in young children: a welcome step towards deployment of the paediatric praziquantel formulation.","authors":"J Russell Stothard","doi":"10.1093/inthealth/ihae094","DOIUrl":"10.1093/inthealth/ihae094","url":null,"abstract":"<p><p>It is an awkward fact that effective public health control of schistosomiasis in Africa has yet to deliver a fully comprehensive intervention for appropriate anthelmintic treatment of those preschool-age children and infants with active infection(s) and/or insidious disease. Over the last decade, despite the steady progress of the Pediatric Praziquantel Consortium in developing a monoenantiomeric oral dispersible tablet, future challenges remain in securing its deployment and implementation at scale. This commentary provides a forward-looking critique for the international community, reminding us of this unfortunate treatment gap, and seeks to encourage commensurate action on ameliorating this overlooked medical inequity.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"389-391"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030097","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}