Johanna Kurscheid, Andrea Buhl, Erica Westenberg, Marta Sólveig Palmeirim, Andrea Sylvia Winkler, Peter Steinmann, Nora Monnier
{"title":"Considerations and expectations for the administration of dispersible arpraziquantel to young children: a landscape analysis.","authors":"Johanna Kurscheid, Andrea Buhl, Erica Westenberg, Marta Sólveig Palmeirim, Andrea Sylvia Winkler, Peter Steinmann, Nora Monnier","doi":"10.1093/inthealth/ihae092","DOIUrl":"10.1093/inthealth/ihae092","url":null,"abstract":"<p><p>Schistosomiasis is a serious public health problem in many African countries and beyond. Preventive chemotherapy with praziquantel is a successful public health intervention that is recommended for all communities at risk, commonly reached through large-scale mass drug administration campaigns. However, preschool-age children are currently not routinely targeted for treatment due to operational challenges related to dosing and administration with the standard drug formulation. In response to the need for a suitable, child-friendly treatment, the multistakeholder Pediatric Praziquantel Consortium has developed a novel dispersible tablet with improved taste and smaller size. To prepare the introduction and inform future uptake of the novel paediatric formulation in endemic countries, we conducted a landscape analysis to explore perspectives, opinions and experiences of key stakeholders on operational and practical issues in relation to drug dosing and administration. Our findings confirm that child-friendly drug formulations mitigate several operational constraints related to the dosing and administration in young children. The introduction of this novel child health intervention into routine platforms and programs requires solid training and careful communication by engaging with communities, caregivers, healthcare workers and decision-makers to ensure acceptance and future uptake of treatment.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"527-534"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030167","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}
Tsegaye Alemu, Dawit Seyum, Samson Tesfaye, Alemayehu Sisay, Andrew Wardle, Mende Mensa Sorato
{"title":"Lived experience and lessons learned from the support of two secondary eye care units to improve cataract surgery and refractive services in two regions of Ethiopia: health system-strengthening support.","authors":"Tsegaye Alemu, Dawit Seyum, Samson Tesfaye, Alemayehu Sisay, Andrew Wardle, Mende Mensa Sorato","doi":"10.1093/inthealth/ihae074","DOIUrl":"10.1093/inthealth/ihae074","url":null,"abstract":"<p><strong>Background: </strong>Blindness and poor eyesight are significant public health issues globally and specifically in Ethiopia. In Ethiopia, there is limited access to cataract surgery and refractive error treatment centers. Therefore, this study aimed to evaluate the role of health system support in improving access to eye care services, particularly cataract surgery and refractive error treatment services in two secondary eye care units (SECUs).</p><p><strong>Methods: </strong>A parallel mixed-lived experience study was conducted in two SECUs. A desk review of relevant project documents and health facility activity reports was performed for quantitative data. The study was conducted from 12 December 2022 to 30 January 2023. A total of 21 in-depth interview participants were included.</p><p><strong>Results: </strong>Overall, 14 106 cataract surgeries were performed during the pilot project implementation period. Assela Teaching and Referral Hospital Eye Care Unit performed cataract surgery 20-30 times per week. Similarly, Debre Tabor Comprehensive Hospital performed cataract surgery 18-24 times per week. The refractive service of the two SECUs was planned to range from 15-30 to 60 per week, and the refractive services were increased from 50-60 per week in both eye care units.</p><p><strong>Conclusions: </strong>This project has significantly helped the existing health system achieve the 2030 global target and has improved access to eye care services in selected SECUs. The use of cataract surgery and refractive error performance markedly increased from 0 to 100%.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"431-439"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576961","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}
Abdolreza Sotoodeh Jahromi, Mohammad Jokar, Arman Abdous, Mohammad Hasan Rabiee, Farzad Heydari Bahman Biglo, Vahid Rahmanian
{"title":"Prevalence and concentration of aflatoxin M1 in milk and dairy products: an umbrella review of meta-analyses.","authors":"Abdolreza Sotoodeh Jahromi, Mohammad Jokar, Arman Abdous, Mohammad Hasan Rabiee, Farzad Heydari Bahman Biglo, Vahid Rahmanian","doi":"10.1093/inthealth/ihaf002","DOIUrl":"10.1093/inthealth/ihaf002","url":null,"abstract":"<p><strong>Background: </strong>Aflatoxin M1 (AFM1) is a derivative of aflatoxin B1 and a significant contaminant of milk and dairy products. In this study, we implemented an umbrella review of all existing systematic reviews and meta-analyzing studies to apprise and summarize the worldwide prevalence and level of AFM1 in milk and dairy products.</p><p><strong>Methods: </strong>We conducted a systematic review of structured review and meta-analysis articles published in English until January 2024, with no time limit. Articles were sourced from reputable databases, including PubMed/MEDLINE, EMBASE, Scopus, Web of Science, CINAHL and the Cochrane Database of Systematic Reviews. Relevant studies from Google Scholar were also included.</p><p><strong>Results: </strong>The overall prevalence of AFM1 in all dairy products was 66.2% (95% CI 60.6 to 71.9%), with high heterogeneity (I²=99.7%, Q statistic=2221.03, p<0.0001). The prevalence for specific dairy products was as follows: raw milk, 64.8% (95% CI 60.9 to 68.7%); pasteurized milk, 88.7% (95% CI 81.6 to 95.7%); sterilized milk, 71.0% (95% CI 67.2 to 74.8%); ultra-high temperature processing (UHT) milk, 67.9% (95% CI 64.9 to 70.9%); yogurt, 58.8% (95% CI 42.5 to 75.1%); doogh, 17.2% (95% CI 13.9 to 20.5%); and cheese 49.8% (95% CI 47.8 to 51.9%). The overall mean concentration of AFM1 across all dairy products was 57.22 ng/kg (95% CI 46.95 to 67.49), with significant heterogeneity (I²=99.7%, Q statistic=2221.03, p<0.0001). Mean AFM1 levels (ng/kg) for each dairy product were as follows: raw milk, 52.51 (95% CI 40.96 to 64.05); pasteurized milk, 71.14 (95% CI 48.81 to 93.47); sterilized milk, 60.10 (95% CI 30.90 to 89.30); UHT milk, 82.57 (95% CI 35.30 to 129.85); yogurt, 46.74 (95% CI 24.27 to 69.21); and doogh, 41.60 (95% CI 32.60 to 50.60).</p><p><strong>Conclusions: </strong>In total, these results highlight the importance of increasing the regulation of animal feed, reducing aflatoxin B1 (AFB1) in animal feed, and monitoring AFM1 in dairy products, particularly raw and heated milk.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"403-415"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030091","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}
Bazie Mekonnen, Abebe Gebremariam, Negussie Deyessa, John N Cranmer
{"title":"Intimate partner violence and maternal antenatal care utilization: is there a dose-response relationship? Findings from the Ethiopian National Demographic and Health Survey.","authors":"Bazie Mekonnen, Abebe Gebremariam, Negussie Deyessa, John N Cranmer","doi":"10.1093/inthealth/ihaf003","DOIUrl":"10.1093/inthealth/ihaf003","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality in sub-Saharan Africa (SSA) is an enduring public health challenge. Adequate utilization of antenatal care (ANC) services is one strategy to mitigate the problem by identifying and managing pregnancy risks early. Yet, in SSA, uptake of ANC remains low. Intimate partner violence (IPV) may be a deterrent to ANC uptake. We measured the dose-response relationship between IPV and adequate ANC utilization (defined as four or more visits [ANC-4]) using data from the Ethiopia Demographic and Health Survey (EDHS) 2016.</p><p><strong>Methods: </strong>We used complex sample logistic regression to measure the impact of three IPV subscales (emotional, sexual and physical) on ANC-4 while controlling for sociodemographic, obstetric and women empowerment factors.</p><p><strong>Results: </strong>A total of 2599 (weighted) currently married or in-union women were included. There was a significant dose-response relationship between IPV and ANC utilization. Emotional (adjusted odds ratio [aOR] 0.78 [confidence interval {CI} 0.64 to 0.97]) and sexual (aOR 0.68 [CI 0.50 to 0.92]) violence decreased ANC-4 uptake while controlling for the covariates.</p><p><strong>Conclusions: </strong>IPV is common, yet often invisible, in Ethiopia. Health workers may begin directly screening pregnant women for IPV in order to increase targeted support of ANC uptake. This is the first known study to confirm IPV has a dose-response relationship with ANC-4 uptake.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":"542-551"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191060","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}
Catherine E Igben-Pender, Peter Omemo, Gideon Ng'wena
{"title":"Use effectiveness of the symptothermal method to ameliorate unmet need for family planning in Kisumu County, Kenya.","authors":"Catherine E Igben-Pender, Peter Omemo, Gideon Ng'wena","doi":"10.1093/inthealth/ihaf072","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf072","url":null,"abstract":"<p><strong>Background: </strong>This study assessed the use effectiveness of the symptothermal method (STM) to ameliorate the unmet need for family planning.</p><p><strong>Methods: </strong>The study adopted a quasi-experimental design. A total of 260 women, comprising 136 STM users (interventional group) and 124 oral contraceptive pill (OCP) users (control group), were recruited. Intervention was conducted for 3 months with longitudinal monitoring for 12 months. Questionnaires, cycle charts and thermometers were used for data collection and data were analysed using SPSS version 23 (IBM, Armonk, NY, USA). To estimate the use effectiveness of STM vs OCPs, survival analysis of the Life table and Kaplan-Meier with log rank, was performed at 95% confidence interval (CI). To estimate the hazard ratio based on the effects of its covariates, a Cox proportional hazards model with 95% CI was applied. The Cox proportional hazards assumption was checked and four categorical covariates were adjusted for in the Cox model analysis.</p><p><strong>Results: </strong>In the STM group, no pregnancy occurred. Use effectiveness of STM for 12 months was 100%. For OCPs, three pregnancies occurred. The use effectiveness was 97-99% with failure of 1-2%. The Cox proportional hazards model had a hazard ratio of 0.01 (p=0.058), indicating that the risk of unintended pregnancy was lowered by 99% in STM users compared with OCP users. A p-value >0.05 indicated no significant difference between the two groups.</p><p><strong>Conclusions: </strong>Our study demonstrated that STM, when used correctly, is very effective in ameliorating the unmet need for family planning based on the World Health Organization's algorithm on STM effectiveness as an alternative to artificial contraceptive methods.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530633","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":"Global, regional and national burden of skin and subcutaneous diseases: a systematic analysis of the Global Burden of Disease Study 2021.","authors":"Deng Li, Siqi Fan, Haochen Zhao, Jiayi Song, Wei Li, Xuewen Xu","doi":"10.1093/inthealth/ihaf070","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf070","url":null,"abstract":"<p><strong>Background: </strong>Skin and subcutaneous diseases (SSDs) represent a growing global health burden. This study aims to assess global, regional and national trends in the incidence, prevalence, mortality and disability-adjusted life years (DALYs) associated with 15 specific SSDs from 1990 to 2021, providing a comprehensive stratification by age, sex, sociodemographic index (SDI) and region.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease (GBD) Study 2021, covering 204 countries, were analysed for age-standardized rates of incidence, prevalence, mortality and DALYs. Temporal trends were assessed using annual percentage change, age-period-cohort modelling and compositional analysis by SDI and GBD region.</p><p><strong>Results: </strong>In 2021, SSDs accounted for 4.7 billion incident cases, 2.0 billion prevalent cases, 119 129 deaths and 41.9 million DALYs globally. Incidence and prevalence have increased by >35% since 1990, with a higher burden among females and older adults. Immune-mediated and inflammatory SSDs have overtaken infectious conditions in high- and middle-SDI regions, while infections still dominate in low-SDI regions. Sub-Saharan Africa and tropical Latin America had the highest incidence and mortality burdens, respectively. A marked epidemiological shift was observed across most regions, with notable compositional transitions in SSD types over time.</p><p><strong>Conclusions: </strong>SSDs are increasing globally, with significant regional and socio-economic disparities. Targeted interventions and improved access to dermatologic care are critical for addressing the growing burden, especially in resource-limited regions.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530630","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}
Man Thi Hue Vo, Keiko Nakamura, Dai Tri Han Tran, T J Robinson T Moncatar
{"title":"Is equitable access to health and social care possible for Vietnamese older adults? Care providers' perspectives.","authors":"Man Thi Hue Vo, Keiko Nakamura, Dai Tri Han Tran, T J Robinson T Moncatar","doi":"10.1093/inthealth/ihaf066","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf066","url":null,"abstract":"<p><strong>Background: </strong>Despite growing initiatives to support older adults, disparities in accessing health and social care services persist in developing countries such as Vietnam. Insufficient evidence exists on how to improve equitable access to these services. This study aimed to determine care workers' perceptions of disparities in service accessibility and potential solutions in facilitating equal access for older adults.</p><p><strong>Methods: </strong>A qualitative study included 27 focus group discussions and in-depth interviews conducted using a semi-structured questionnaire with 171 health and social care workers in Thua Thien Hue Province, Vietnam in 2019. Inductive thematic analysis was used to identify the perceived disparities and solutions.</p><p><strong>Results: </strong>Three main themes emerged concerning these disparities: socio-economic and geographic barriers, cultural stigma and access gaps for disadvantaged communities. To facilitate equitable access, it was perceived crucial to enhance social protection coverage and benefits, empower community-based care and localized programs and implement targeted interventions.</p><p><strong>Conclusions: </strong>The findings indicate persistent disparities. However, effective implementation of social health protection, fostering community engagement and targeted interventions can be beneficial in narrowing these gaps. The findings suggest that achieving equitable access for Vietnam's aging population is within reach through a more comprehensive social protection system.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486764","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":"Microbial foodborne outbreaks in Africa: a systematic review.","authors":"Famous K Sosah, Eric S Donkor","doi":"10.1093/inthealth/ihaf058","DOIUrl":"https://doi.org/10.1093/inthealth/ihaf058","url":null,"abstract":"<p><p>Microbial foodborne outbreaks are a severe public health challenge in Africa, which bears the highest global burden due to systemic vulnerabilities. Common microbial pathogens contaminate various foods, particularly raw and processed meats, leading to significant morbidity, mortality and economic losses. In this review, data from 31 studies encompassing 42 microbial foodborne outbreaks in Africa were synthesized, analyzed and visualized. Overall, 877 067 of infections and intoxications occurred, with 2064 hospitalizations and 2061 deaths. Salmonella enterica accounted for the most of infections and intoxication (53.6%), while Staphylococcus aureus caused the highest rate of outbreaks (21.4%). Clostridium botulinum was associated with the highest fatality (46.154%), followed by Listeria monocytogenes (20.323%). The implicated food vehicles in the outbreaks included processed meats (38.1%), cereals, legumes and tuber (21.43%), vegetables (9.52%) and seafood (7.14%). The key contributing factors were poor hygiene, inadequate food storage and limited compliance with food safety practices. Addressing critical deficiencies in food safety infrastructure, public awareness and hygiene practices requires enhanced surveillance systems, stricter regulatory frameworks, investment in infrastructure and public education campaigns. Efforts should prioritize the control of prevalent pathogens to mitigate the health and socioeconomic impacts of foodborne illnesses across the continent.</p>","PeriodicalId":49060,"journal":{"name":"International Health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530632","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}