International Health最新文献

{"title":"Uptake and challenges with daily oral pre-exposure prophylaxis among men who have sex with men and transgender women, suburban Yangon, Myanmar.","authors":"Ni Ni Tun, Frank Smithuis, Nyan Lynn Tun, Myo Min Min Hteik, Myat Ko Ko, Lutgarde Lynen, Tom Decroo, Eric Florence, Tinne Gils","doi":"10.1093/inthealth/ihae025","DOIUrl":"10.1093/inthealth/ihae025","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) is effective for human immunodeficiency virus (HIV) prevention in risk groups. We assessed PrEP uptake and 12-month retention among men who have sex with men (MSM) and transgender women (TGW) in Myanmar during the coronavirus disease 2019 pandemic and a political crisis.</p><p><strong>Methods: </strong>Using prospectively collected data, we assessed the proportion of persons eligible, initiated and retained 12 months on PrEP. We calculated HIV and syphilis incidence among those initiated on PrEP. Predictors of compliance to scheduled visits were assessed with fractional logistic regression.</p><p><strong>Results: </strong>Among 652 persons screened between July and December 2020, 85.3% were eligible and 38.8% initiated PrEP. The daily pill burden was the main reason (86.5%) for refusing PrEP. A history of HIV post-exposure prophylaxis (PEP) and having an HIV-positive partner not on anti-retroviral therapy (ART) was associated with PrEP uptake (p<0.05). The 12-month retention among those initiating PrEP was 43.0%. Age ≥25 y, a history of PEP and having an HIV-positive partner not on ART predicted better compliance with scheduled visits (p<0.05). HIV incidence among PrEP initiators was 3.1 per 100 person-years (95% confidence interval [CI] 1.3 to 7.4) and syphilis incidence was 17.6 per 100 person-years (95% CI 12.3 to 25.1).</p><p><strong>Conclusions: </strong>A PrEP program for MSM and TGW in Myanmar was implemented successfully under difficult circumstances. Alternative strategies are needed addressing PrEP uptake and retention.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"23-32"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319575","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":"Deployment of vaccine cold chain equipment in resource-limited settings: lessons from the Gavi Cold Chain Optimization Platform in Cameroon.","authors":"Jude Nkwain, Vouking Marius Zambou, Sangwe Clovis Nchinjoh, Valirie Ndip Agbor, Amani Adidja, Clarence Mbanga, Nnang Nadege Edwidge, Shalom Tchokfe Ndoula, Andreas Ateke Njoh, Demba Diack, Pietro Di Mattei, Owens Wiwa, Ousmane Diaby, Yauba Saidu","doi":"10.1093/inthealth/ihae010","DOIUrl":"10.1093/inthealth/ihae010","url":null,"abstract":"<p><strong>Background: </strong>Lack of or use of suboptimal cold chain equipment (CCE) is a major barrier to optimal immunization coverage and equity. Gavi established the CCE optimization platform (CCEOP) in 2015 to help eligible countries modernize their cold chain systems. However, there are limited data on CCE deployment at country level. We present lessons learnt from deploying CCE from the Gavi CCEOP in Cameroon.</p><p><strong>Methods: </strong>This cross-sectional study collected data on the number of days items of CCE spent at each point on their trajectory from the entry port to 62 randomly selected health facilities in Cameroon.</p><p><strong>Results: </strong>Once equipment arrived at the entry port, it took 10 d for customs clearance, 2 d from customs clearance to warehousing and 257 d (>9 mo) from the warehouse to facilities. Upon arrival at the facilities, it took a median of 53 (range 0-395) d from installation to final commissioning: most of the days (median=210) were spent between installation and final commissioning. The major causes of delays included insufficient coordination and communication across all levels, poor documentation and final commissioning.</p><p><strong>Conclusion: </strong>Early engagement on customs clearance, strengthening coordination and communication, ensuring proper documentation, as well as eliminating final commissioning, could significantly improve implementation of the program.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"33-40"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708304","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":"Corrigendum to: Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviour.","authors":"","doi":"10.1093/inthealth/ihae093","DOIUrl":"https://doi.org/10.1093/inthealth/ihae093","url":null,"abstract":"","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899380","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":"Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.","authors":"Ayano Miyashita, Keiko Nakamura, Stephen M Kibusi, Eugene Benjamin Meshi, Anderson Bendera, Hideko Sato, Saber Al-Sobaihi, Yuri Tashiro, Kaushik L Ramaiya, Bruno F Sunguya, Kaoruko Seino","doi":"10.1093/inthealth/ihae070","DOIUrl":"10.1093/inthealth/ihae070","url":null,"abstract":"<p><strong>Background: </strong>The rise of hypertension (HTN) and diabetes mellitus (DM) in Tanzania underscores the importance of self-care practices (SCP) for disease management. Despite the proven effectiveness of SCP, financial barriers in resource-limited rural areas hinder continuous care. Health insurance (HI) emerges as a critical solution to alleviate financial constraints and support SCP.</p><p><strong>Methods: </strong>This study examined an association between HI and SCP by generalised linear and ordinal logistic regressions, adjusted for sociodemographic factors. Mediation analysis highlighted the role of disease management behaviours (hospital visits and medication adherence) in the association. Data were collected through individual interviews with 909 patients.</p><p><strong>Results: </strong>Better SCP for HTN and DM were associated with the National Health Insurance Fund (HTN: coefficient=0.571; DM: coefficient=0.567, p<0.001) and the improved Community Health Fund (iCHF) or CHF (HTN: coefficient=0.330; DM: coefficient=0.472, p<0.05), after adjustment for sociodemographic variables. Mediation analysis showed that disease management behaviours partially or fully mediated the relationship between HI and SCP.</p><p><strong>Conclusions: </strong>Enrolment in HI by patients in rural Tanzania exhibited better disease management behaviours and SCP. Efforts should focus on leveraging the HI schemes to expand their coverage in rural areas, which could benefit patients with non-communicable diseases.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of joint external evaluation to COVID-19 and other infectious diseases mortality outcomes in 96 countries.","authors":"Yuri Lee, Siwoo Kim, Sieun Lee, Min Kyung Kim, Lawrence O Gostin, Juhwan Oh","doi":"10.1093/inthealth/ihae077","DOIUrl":"https://doi.org/10.1093/inthealth/ihae077","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effectiveness of Joint External Evaluation (JEE) scores with regard to coronavirus disease 2019 (COVID-19) and other infectious diseases performance in 96 countries. To propose a revised JEE tool, potential JEE indicators were also examined.</p><p><strong>Methods: </strong>JEE data from 2016-2019 were linked with outcomes such as COVID-19 fatality rates and infections, as well as mortality rates for other infectious diseases. We also examined potential indicators such as the Sustainable Development Goals (SDGs) and Universal Health Coverage index to propose enhancements to the JEE tool. Multiple regression analysis was used to assess these associations.</p><p><strong>Results: </strong>The average JEE score was 2.70 (SD=0.92) in 96 countries. Detection capabilities received the highest average score (3.23), while the other areas (2.30) section received the lowest scores. However, the analysis revealed that the JEE tool had limited predictive accuracy for COVID-19 outcomes. By contrast, the JEE scores showed a negative association with the performance of other infectious diseases. Notably, SDGs 2 (zero hunger), 4 (quality education) and 8 (decent work and economic growth) were strongly associated with better COVID-19 outcomes.</p><p><strong>Conclusion: </strong>The JEE scores showed limited predictive value for COVID-19 mortality outcomes in 96 countries. The tool offers insights into health security, but needs revision to better handle future pandemics.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830647","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception, practice and associated factors of labour pain management among obstetric care providers in public health facilities in Harari Region, Ethiopia: a multicentre cross-sectional study.","authors":"Loza Wondimu, Miressa Bekana, Abera Kenay Tura, Tamirat Getachew","doi":"10.1093/inthealth/ihae084","DOIUrl":"https://doi.org/10.1093/inthealth/ihae084","url":null,"abstract":"<p><strong>Background: </strong>Although providing relief from labour pain can improve the mother's satisfaction with the birthing process and lead to better reproductive outcomes. This study aims to evaluate the perceptions, practices and related aspects of labour pain management among obstetric care providers in public health institutions in the Harari Region of Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the labour and delivery wards of public health facilities in the Harari Region. Data were collected using a semi-structured and pretested self-administered questionnaire among systematically selected obstetrics care providers (OCPs). A multivariate logistic regression model was used to identify factors associated with the practice of labour pain management. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to determine the strength of associations and a p-value <0.05 was considered significantly associated.</p><p><strong>Results: </strong>Data from 234 OCPs were employed for analysis. A total of 70.9% of OCPs have positive perceptions and 69.7% practiced labour pain management in the past 4 weeks. Being a female (adjusted OR [aOR] 2.33 [95% CI 1.06 to 5.15]), having a positive perception (aOR 7.76 [95% CI 3.21 to 18.72]), being a physician (aOR 6.35 [95% CI 1.94 to 20.82]), being a midwife (aOR 5.28 [95% CI 1.78 to 15.63]) and being a highly qualified OCP (aOR 17.89 [95% CI 5.22 to 61.30]) were associated with being more likely to practice labour pain management. Positive attitude (aOR 2.77 [95% CI 1.51 to 8.72]), being a physician (aOR 6.01 [95% CI 1.23 to 29.35]) and practicing labour pain management (aOR 12.89 [95% CI 4.57 to 36.38]) were associated with labour pain management perceptions.</p><p><strong>Conclusions: </strong>Seven of ten OCPs practiced labour pain relief methods and had a positive perception of managing labour pain. Therefore, facilitating training and improving the perceptions and attitudes of OCPs towards labour pain management should be encouraged.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683098","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":"Study on the influence of levels of physical activity and socio-economic conditions on body mass index of adolescents.","authors":"Li Liu, Yongsen Liu, Tingran Zhang, Jiong Luo","doi":"10.1093/inthealth/ihae083","DOIUrl":"https://doi.org/10.1093/inthealth/ihae083","url":null,"abstract":"<p><strong>Background: </strong>We explored the relationship between adolescent physical activity levels, socio-economic conditions and body mass index (BMI) in order to gain a deeper understanding of the relevant factors affecting adolescent obesity.</p><p><strong>Methods: </strong>A stratified random sampling method was used to conduct a questionnaire survey of middle school students in the Chengdu-Chongqing Economic Zone. Multiple linear and logistic regression analysis methods were used to statistically analyse the data obtained.</p><p><strong>Results: </strong>The level of moderate to vigorous physical activity (MVPA) not only significantly reduces the incidence of obesity in adolescents, it also has a positive effect on avoiding underweight in adolescents. The impact of a father's BMI on a son's weight is higher than that of a daughter, while the impact of a mother's BMI on a child's weight is the opposite. High monthly income has a positive effect on reducing the BMI of male and female adolescents, but full-time working mothers actually increase the risk of obesity in their children. Teenagers who have exercise habits or view exercise as a form of enjoyment have a significantly reduced risk of obesity.</p><p><strong>Conclusions: </strong>The level of MVPA and exercise habits are important factors in inhibiting the development of obesity in adolescent students.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683109","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}