International Health最新文献

{"title":"Consumption of vitamin A-rich foods among 6-23-month-old children in Jigjiga town: a community-based cross-sectional study.","authors":"Biruk Fantahun, Sinetibeb Mesfin, Dawit Abebe, Adisu Birhanu, Berhe Gebremichael","doi":"10.1093/inthealth/ihaf128","DOIUrl":"10.1093/inthealth/ihaf128","url":null,"abstract":"<p><strong>Background: </strong>Vitamin A is a fat-soluble vitamin that has several vital functions in the body. Its deficiency causes several eye disorders. The Somali region of Ethiopia has the lowest vitamin A consumption among children under two years, yet few studies have explored related factors.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among 522 households in Jijiga town. A multi-stage sampling method was used, and data was analyzed using bivariable and multivariable logistic regression.</p><p><strong>Results: </strong>Overall, 49.8% (95% CI: 45.3-54.3) of children aged 6-23 months consumed VARF in the 24 hours preceding the survey. VARF consumption was higher among children aged 12-17 months (AOR=2.71; 95% CI: 1.49-4.95) and 18-23 months (AOR=2.02; 95% CI: 1.01-4.03), mothers with secondary or higher education (AOR=2.28-3.48), those exposed to media (AOR=2.98; 95% CI: 1.80-4.92), households with food security (AOR=2.36; 95% CI: 1.30-4.30), and Protestant families (AOR = 6.28; 95% CI: 1.50-26.95).</p><p><strong>Conclusions: </strong>About half of the children had good intake of vitamin A-rich foods. Educating mothers, promoting nutrition through media, ensuring food security, and promoting age-appropriate feeding practices are key to increasing vitamin A intake.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"650-657"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402231","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":"Antimicrobial stewardship interventions currently implemented at primary healthcare settings across low- and lower-middle-income countries (LLMICS).","authors":"Abdulhammed O Babatunde, Abdulmumin Damilola Ibrahim, Oluwaseyi M Egbewande, Wuraola Olabode, Nabeelah Aroyehun, Warittha Tieosapjaroen, Yusuf Babatunde, Eneyi Kpokiri","doi":"10.1093/inthealth/ihaf136","DOIUrl":"10.1093/inthealth/ihaf136","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a top global public health and development threat. Antimicrobial stewardship programs (AMSPs) are one of the most cost-effective interventions to optimize the use of antimicrobials. This study reviews AMSPs that have been implemented in low- and lower middle-income countries.</p><p><strong>Methods: </strong>A systematic search was conducted on electronic databases including MEDLINE, PubMed, Embase, OVID, Web of Science and Cochrane Library on 18 July 2024 for published papers from 2014 to 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Relevant published literature was then selected based on the established inclusion/exclusion criteria. Each article was screened by two independent reviewers. Data were extracted and synthesized in the review.</p><p><strong>Results: </strong>Of the 425 articles screened, only 13 were eligible for review and included in this study. Two studies were multinationals. Five studies were randomized controlled trials. Among the three key focuses of AMSPs, most of the interventions focused on optimizing antibiotic use (n=8), followed by improving diagnostics and monitoring (n=3) and education and training (n=2). The most commonly reported barriers to implementing AMSPs was a lack of resources (n=9). Facilitators reported included knowledge of AMS (n=8), availability of educational and training resources (n=8), adequate funding (n=6), accountable and transparent procedures (n=5) and positive communication within healthcare facilities (n=4).</p><p><strong>Conclusions: </strong>All included studies show improvement in AMS through innovative programs. However, only a few have been adopted nationwide and influence policy formulation in the country. We recommend adoption of effective AMSPs into the national strategic planning and implementation across primary health settings.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"557-569"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020217","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":"Crowding-out effect of out-of-pocket expenditure on non-communicable diseases in sub-Saharan Africa: a Nigerian case study.","authors":"Adelakun Odunyemi, Hamid Sohrabi, Khurshid Alam","doi":"10.1093/inthealth/ihaf117","DOIUrl":"10.1093/inthealth/ihaf117","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the crowding-out effect of out-of-pocket (OOP) health expenditures for non-communicable diseases (NCDs) on household consumption in Nigeria, a critical issue in sub-Saharan Africa (SSA) given the escalating prevalence of NCDs and associated high care costs.</p><p><strong>Methods: </strong>Using data from the 2018/2019 Nigerian Living Standard Survey, we employ a Generalised Method of Moments estimator and conditional Engel curve equations derived from the Quadratic Almost Ideal Demand System to analyse the impact of NCD and non-NCD OOP expenditures on 13 household consumption categories.</p><p><strong>Results: </strong>Despite representing <2% of household budgets, NCD OOP expenditures significantly crowded out essential spending, particularly on healthier food options (fruits, vegetables, protein) and cooking energy sources, disproportionately affecting lower-income households. Intriguingly, discretionary spending on sugar, alcoholic/sugary beverages, entertainment (including tobacco) and meals outside the home remained unaffected, possibly indicating reliance on these fast meal alternatives due to limited cooking fuel access. Middle-income households also experienced crowding out of staples and education expenditures.</p><p><strong>Conclusions: </strong>These findings highlight the urgent need for universal health coverage to reduce OOP burdens, alongside targeted interventions addressing NCD burden, dietary quality, the energy crisis and health inequities in Nigeria and, by extension, SSA.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"629-640"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558224","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":"Reframing climate disasters through the lens of a climate necropolitics of health.","authors":"Anushka Ataullahjan, Lesley Gittings","doi":"10.1093/inthealth/ihaf157","DOIUrl":"10.1093/inthealth/ihaf157","url":null,"abstract":"<p><p>A climate necropolitics of health offers a critical framework that illuminates how climate change disproportionately harms marginalized populations by highlighting how the lives of certain individuals are protected and whose lives are expendable. We demonstrate how entrenched gender inequity, colonial legacies and systemic underinvestment in health and education have had negative health impacts for women and girls in the Swat Valley in Pakistan. We propose that a climate necropolitics of health asks us to move beyond seeing climate disasters as an isolated event, instead locating them in broader histories of environmental injustice, structural violence and social exclusion.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"538-539"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858766","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":"Drought and armed conflict as drivers of overcrowding in Sudan's refugee camps.","authors":"Safa Abdalrhim, Gorashey Ahmed, Moayad Mudawi, Abobakr Abdulbagi Omer Mohamed, Omaima Mohamed, Iyas Dawood, Rawa Badri","doi":"10.1093/inthealth/ihag002","DOIUrl":"10.1093/inthealth/ihag002","url":null,"abstract":"<p><p>Forced migration is a result of variable changes, including human-made factors, environmental factors or both. Climate change has been a significant cause of increased forced migration in Sudan. The prolonged drought attributed to climate change affects Sudanese citizens, with 80% of the population relying on agriculture and pastoralism as their main source of income. Since April 2023, the conflict has displaced over 14.5 million people. Four million have sought safety in neighbouring countries. The refugee camps lack essential resources, and the displaced people face a health crisis, with outbreaks of cholera, 30% of children facing malnutrition and widespread mental health issues. Access to sustainable WASH (water, sanitation and hygiene) systems, improved healthcare, mass vaccinations and climate-sensitive interventions are key to mitigation efforts. The ongoing conflict in Sudan demands a coordinated response from the Sudanese government, humanitarian agencies and international partners to prevent further catastrophe.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"549-551"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094748","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":"'He who knows it, feels it.' Stepping stones towards fulfilling a peer-advocate role among people with chronic stigmatising conditions in Liberia.","authors":"Hannah Berrian, Rosalind McCollum, Wede Seekey, Tiawanlyn G Godwin-Akpan, Zeela Zaizay, Sally Theobald, Laura Dean","doi":"10.1093/inthealth/ihaf126","DOIUrl":"10.1093/inthealth/ihaf126","url":null,"abstract":"<p><strong>Background: </strong>People affected by skin neglected tropical diseases (NTDs) are often stigmatised, experiencing discrimination in consequence of their condition. Peer advocates can help progress a person-centred agenda for people affected by NTDs, however, evidence gaps in the steps to becoming an advocate persist.</p><p><strong>Methods: </strong>We wanted to understand the steps towards a peer advocacy role for skin NTDs. We used the participatory Stepping Stones method to identify steps on the journey to becoming an advocate with 48 participants, followed by three in-depth life histories with peer advocates for other stigmatising chronic conditions (e.g. disability, mental health, Ebola survivors).</p><p><strong>Results: </strong>We found study participants frequently experience stigma and discrimination in consequence of their condition. The peer advocate role includes awareness raising and advocacy and providing mutual peer support. Among peer advocates, personal acceptance of their condition, vocational training and family support are important steps along the pathway to becoming a peer advocate. Outcomes of the role include personal determination and increased confidence for peer advocates, provision of help and support for others with similar conditions and broader change in understanding, attitudes and policy within the community and country.</p><p><strong>Conclusions: </strong>We find that when appropriately enabled, peer advocates can themselves be empowered and play a key role in person-centred care.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"641-649"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7618586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477198","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":"Social ties, employment and mental health in people with disabilities in Korea: evidence from a 2016-2018 panel survey.","authors":"Jae-Hyun Kim, Hyun Jun Lee, Gyeong Min Lee, Youngsoo Kim","doi":"10.1093/inthealth/ihaf078","DOIUrl":"10.1093/inthealth/ihaf078","url":null,"abstract":"<p><strong>Background: </strong>Social connectedness is a critical factor influencing health outcomes, particularly among people with disabilities, who face increased risks of social isolation and poor mental health. This study aimed to examine the effects of interpersonal relationships on subjective health and mental health among individuals with disabilities.</p><p><strong>Methods: </strong>We analysed nationally representative panel data of economically active individuals with disabilities in South Korea. Generalized estimating equation models were applied to assess the associations between interpersonal relationship scores and health outcomes, adjusting for sociodemographic and behavioural factors.</p><p><strong>Results: </strong>Compared with participants with the highest interpersonal relationship scores (≥25 points), those with the lowest scores (≤14 points) had significantly higher odds of reporting poor subjective health (odds ratio [OR] 1.986 [95% confidence interval {CI} 1.392 to 2.832], p<0.0001), lower happiness (-0.913 points [95% CI 0.840 to 0.993], p=0.034) and greater odds of experiencing depression (OR 1.959 [95% CI 1.179 to 3.255], p=0.009).</p><p><strong>Conclusions: </strong>These findings highlight the importance of social connectedness as a key determinant of mental and subjective health among people with disabilities in Korea.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"591-599"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309639","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":"Air pollution and lung cancer in India: an escalating public health crisis.","authors":"Tarun Kumar Suvvari, Nithya Arigapudi, Shreya Veggalam","doi":"10.1093/inthealth/ihaf154","DOIUrl":"10.1093/inthealth/ihaf154","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"555-556"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806329","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":"Impact of the COVID-19 pandemic on quality of life of adults with diabetes in rural Uganda: a cross-sectional survey.","authors":"Wenceslaus Sseguya, Silver Bahendeka, Sara MacLennan, Aravinda Meera Guntupalli","doi":"10.1093/inthealth/ihaf112","DOIUrl":"10.1093/inthealth/ihaf112","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic was associated with unprecedented healthcare, economic and social disruptions that impacted persons with diabetes mellitus (PWDM). We aimed to establish how the quality of life (QoL) of persons with diabetes in rural Uganda was impacted by the COVID-19 pandemic, using the pre-pandemic, pandemic and post-pandemic self-reported QoL scores.</p><p><strong>Methods: </strong>We surveyed 410 PWDM ≥30 y of age from three rural districts in south-western Uganda. Median QoL scores were computed and variations across the three time periods were analysed using the Friedman analysis of variance and McNemar tests as appropriate. Logistic regression was used to identify factors associated with QoL. A p-value <0.05 indicated statistical significance.</p><p><strong>Results: </strong>The overall median QoL scores were 67.2 (pre-pandemic), 62.4 (pandemic) and 68.8 (post-pandemic) (p<0.001). There was a 75% increase in the proportion of participants with unsatisfactory QoL during the pandemic (p<0.001). Having diabetes complications (p<0.001), chronic comorbidity (p=0.012), no formal education (p<0.003) and travelling for healthcare using non-motorised transport (<0.001) were all independently associated with post-pandemic unsatisfactory QoL.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic caused significant deterioration in QoL among rural PWDM, raising the need for policies to prioritise the consideration of their evolving needs while designing measures for future similar widespread emergencies.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"610-620"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240222","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":"Cardiac output measurement in Malawian children ages 2 months-12 years hospitalised with severe anaemia (COM-TRACT).","authors":"Elizabeth Chintolo, Roisin Connon, Elizabeth C George, George Chagaluka, Bridon M'baya, A Sarah Walker, Neil Kennedy, Kathryn Maitland","doi":"10.1093/inthealth/ihaf103","DOIUrl":"10.1093/inthealth/ihaf103","url":null,"abstract":"<p><strong>Background: </strong>Little is known about myocardial perturbations in African children hospitalised with severe anaemia.</p><p><strong>Methods: </strong>An observational study nested within a clinical trial of blood transfusion was conducted on the paediatric ward in Blantyre, Malawi. Children were ages 2 months-12 years hospitalized with uncomplicated severe anaemia (haemoglobin 4-6 g/dl). By randomisation, 13 children received 30 ml/kg whole blood, 13 received 20 ml/kg whole blood and 26 had no immediate transfusion (usual care). We measured standard parameters of cardiac function using ultrasonic cardiac output monitoring (USCOM) at enrolment, 8 and 24 hours and discharge.</p><p><strong>Results: </strong>Fifty-two children, median age 39 months (interquartile range [IQR] 25-58) and median haemoglobin 5.1 g/dl (IQR 4.8-5.6) were studied. Severe tachycardia and tachypnoea over time corrected faster in the transfused arms than the controls. At enrolment, the stroke volume index was within the normal range and 26/52 (50%) had a cardiac output index (COI) >97.5% the standard centile. The COI decreased in all arms by discharge but was greatest in the transfusion arms (p=0.05 for 20 ml/kg and p=0.009 for 30 ml/kg). A higher volume or receipt of whole blood did not worsen cardiac function. No child required diuretics.</p><p><strong>Conclusions: </strong>The data generated by this small but granular study of haemodynamic and cardiac function provide reassuring physiological evidence showing the safety of higher doses of blood transfusion than currently recommended. It also supports the findings of a secondary analysis of the Transfusion and Treatment of Severe Anaemia in African Children trial indicating that whole blood transfusions are safe. These data support the new evidence-based paediatric transfusion algorithm for anaemic African children and its recommendation for safe use.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"600-609"},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7618878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114965","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}