Global Health Action最新文献

{"title":"Women's exposure to intimate partner violence and its association with child stunting: findings from a population-based study in rural Rwanda.","authors":"Jean Nepo Utumatwishima, Ingrid Mogren, Kristina Elfving, Aline Umubyeyi, Ali Mansourian, Gunilla Krantz","doi":"10.1080/16549716.2024.2414527","DOIUrl":"https://doi.org/10.1080/16549716.2024.2414527","url":null,"abstract":"<p><strong>Background: </strong>Child stunting is a significant challenge for most districts in Rwanda and much of sub-Saharan Africa and persists despite multisectoral efforts. There is a notable lack of population-based studies examining the correlation between violence against women and child stunting in Rwanda.</p><p><strong>Objective: </strong>We aimed to investigate the association between Rwandan women's exposure to intimate partner violence (IPV) and child stunting in children under 3 years of age.</p><p><strong>Methods: </strong>In December 2021, a population-based cross-sectional study was conducted in the Northern Province of Rwanda, including 601 women and their children <3 years of age. The World Health Organization (WHO) Women's Health and Life Experiences Questionnaire for IPV research was utilized. Child stunting was assessed using the WHO criteria for low height for age. Multivariable logistic regression was used to examine the association between IPV and child stunting before and during pregnancy.</p><p><strong>Results: </strong>Of 601 women, 47.4% (<i>n</i> = 285) experienced any form of IPV during pregnancy. The prevalence rates of the types of IPV associated with child stunting varied: 33% for psychological, 31.4% for sexual, and 25.7% for physical violence. Exposure to physical violence before pregnancy and sexual violence during pregnancy was associated with higher odds of child stunting; the adjusted odds ratios were 1.29 (95% CI, 1.01-2.03) and 1.25 (95% CI, 1.04-2.01), respectively.</p><p><strong>Conclusion: </strong>Women's exposure to physical and psychological violence is associated with an increased risk of child stunting. Urgent targeted interventions and support systems are needed to address the complex relationship between women's exposure to IPV and adverse effects on child growth.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2414527"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contested and nervous spaces: exploring the environment of healthcare provision for international migrants in the Gauteng province of South Africa.","authors":"Janine A White, Laetitia C Rispel","doi":"10.1080/16549716.2024.2422192","DOIUrl":"10.1080/16549716.2024.2422192","url":null,"abstract":"<p><strong>Background: </strong>Notwithstanding the global goal of inclusive universal health coverage, and the notion of migrant-sensitive health systems, limited healthcare access or the exclusion of migrants from national health systems persists. South Africa has a rights-based constitution, but there is an inability or a failure of the health system to recognise and address the health needs of migrants.</p><p><strong>Objective: </strong>To explore the intersection of the environment of healthcare provision for migrants and the everyday practices and behaviours of health workers and patients in the Gauteng province of South Africa.</p><p><strong>Methods: </strong>The conceptual frameworks of health system responsiveness and social exclusion informed this institutional ethnographic study at 13 healthcare facilities in Gauteng province. We developed an observation guide to explore the intersection of culture and environment and its influence on healthcare provision to patients, especially migrants. Following ethics approval, we observed the facilities for 234 person-days. We used thematic analysis to analyse the data.</p><p><strong>Results: </strong>Busy, frantic or nervous spaces, and contestations between patients and health workers, and among health workers formed part of the social and cultural environment of healthcare provision. The presence of migrant patients during busy periods served as a detonator for rude or discriminatory remarks, exacerbated by staff shortages and language barriers. Simultaneously, migrants exercised their agency by rebutting or confronting rude health workers. We also observed encouraging examples of kindness, caring and professionalism of health workers.</p><p><strong>Conclusion: </strong>The study has implications for achieving a migrant-sensitive health system in South Africa.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2422192"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"China's policies: post-COVID-19 challenges for the older population.","authors":"Xuezhi Wei, Guoqing Han, Quansheng Wang","doi":"10.1080/16549716.2024.2345968","DOIUrl":"10.1080/16549716.2024.2345968","url":null,"abstract":"<p><p>On 7 December 2022, the State Council of China released 'Measures to Further Optimize the Implementation of the Prevention and Control of the New Coronavirus Epidemic'. The previous three-year dynamic zero epidemic prevention policy was then replaced with a full liberalization policy. On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a 'public health emergency of international concern.' However, given the ongoing prevalence of coronavirus, emerging mutations, and the liberalization of restrictions, there are increased risks of vulnerable people contracting new variants. Low vaccination coverage among older people with compromised immune systems, puts them at further risk. The policy shift will increase pressure on already stretched health infrastructure and medical resources. This short article adds to the current debate arguing that the Chinese government should take commensurate preventive measures, including strengthening medical facilities and equipment and targeting ongoing vaccination in older people.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2345968"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review.","authors":"Neema Kaseje, Meghna Ranganathan, Monica Magadi, Kevin Oria, Andy Haines","doi":"10.1080/16549716.2023.2292385","DOIUrl":"10.1080/16549716.2023.2292385","url":null,"abstract":"<p><strong>Background: </strong>Rural community health workers [CHWs] play a critical role in improving health outcomes during non-pandemic times, but evidence on their effectiveness during the COVID-19 pandemic is limited. There is a need to focus on rural CHWs and rural health systems as they have limited material and human resources rendering them more vulnerable than urban health systems to severe disruptions during pandemics.</p><p><strong>Objectives: </strong>This systematic review aims to describe and appraise the current evidence on the effectiveness of rural CHWs in improving access to health services and health outcomes during the COVID-19 pandemic in low-and middle-income countries [LMICs].</p><p><strong>Methods: </strong>We searched electronic databases for articles published from 2020 to 2023 describing rural CHW interventions during the COVID-19 pandemic in LMICs. We extracted data on study characteristics, interventions, outcome measures, and main results. We conducted a narrative synthesis of key results.</p><p><strong>Results: </strong>Fifteen studies from 10 countries met our inclusion criteria. Most of the studies were from Asia [10 of 15 studies]. Study designs varied and included descriptive and analytical studies. The evidence suggested that rural CHW interventions led to increased household access to health services and may be effective in improving COVID-19 and non-COVID-19 health outcomes. Overall, however, the quality of evidence was poor due to methodological limitations; 14 of 15 studies had a high risk of bias.</p><p><strong>Conclusion: </strong>Rural CHWs may have improved access to health services and health outcomes during the COVID-19 pandemic in LMICs but more rigorous studies are needed during future pandemics to evaluate their effectiveness in improving health outcomes in different settings and to assess appropriate support required to ensure their impact at scale.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2292385"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Despite antiretroviral therapy (ART) rollout, most cases of tuberculosis among people with HIV in Adama, Ethiopia, occur before ART initiation.","authors":"Patrik Bristedt, Meseker Fentie, Per Björkman, Anton Reepalu","doi":"10.1080/16549716.2024.2395073","DOIUrl":"10.1080/16549716.2024.2395073","url":null,"abstract":"<p><strong>Introduction: </strong>Although antiretroviral therapy (ART) leads to reduced tuberculosis (TB) incidence in people with HIV (PWH), ART recipients remain at higher risk of TB compared to HIV-seronegative people. With accelerated ART rollout in sub-Saharan Africa, increasing proportions of TB cases among PWH in people receiving long-term ART have been reported.</p><p><strong>Objective: </strong>To determine TB notifications among PWH by ART status in a mainly urban uptake area in Ethiopia during an 8-year period in connection to the introduction of the 'test-and-treat' strategy for HIV.</p><p><strong>Methods: </strong>PWH were identified from registers at health facilities providing ART in Adama and surrounding areas, Ethiopia 2015-2022. Annual TB notifications were compared over time. PWH within TB were categorized by ART status at the time of TB diagnosis (pre-ART TB: TB diagnosed before or ≤6 months after starting ART; ART-associated TB: TB diagnosed >6 months after starting ART).</p><p><strong>Results: </strong>Among a total of 8,926 PWH, 993 had been diagnosed with TB (11.1%); mean age 40.0 years [SD 11.8], 53.5% were men). Throughout the study period, most TB cases had been notified before ART initiation (617/993; 62.1%). ART-associated TB cases constituted a mean of 37.4% (range 23.8%-44.2%) of all TB cases among PWH annually. Median time from ART initiation to TB diagnosis among ART-associated TB was 6.0 years.</p><p><strong>Conclusion: </strong>TB notifications among PWH in this area did not decrease 2015-2022, implying persistently high risk of TB among PWH in this setting. Most TB cases occurred in ART-naïve persons, illustrating late HIV diagnosis in this population.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2395073"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11360637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic health record and primary care physician self-reported quality of care: a multilevel study in China.","authors":"Wenhua Wang, Mengyao Li, Katya Loban, Jinnan Zhang, Xiaolin Wei, Rebecca Mitchel","doi":"10.1080/16549716.2023.2301195","DOIUrl":"10.1080/16549716.2023.2301195","url":null,"abstract":"<p><strong>Background: </strong>Health information technology is one of the building blocks of a high-performing health system. However, the evidence regarding the influence of an electronic health record (EHR) on the quality of care remains mixed, especially in low- and middle-income countries.</p><p><strong>Objective: </strong>This study examines the association between greater EHR functionality and primary care physician self-reported quality of care.</p><p><strong>Methods: </strong>A total of 224 primary care physicians from 38 community health centres (CHCs) in four large Chinese cities participated in a cross-sectional survey to assess CHC care quality. Each CHC director scored their CHC's EHR functionality on the availability of ten typical features covering health information, data, results management, patient access, and clinical decision support. Data analysis utilised hierarchical linear modelling.</p><p><strong>Results: </strong>The availability of five EHR features was positively associated with physician self-reported clinical quality: share records online with providers outside the practice (β = 0.276, <i>p</i> = 0.04), access records online by the patient (β = 0.325, <i>p</i> = 0.04), alert provider of potential prescription problems (β = 0.353, <i>p</i> = 0.04), send the patient reminders for care (β = 0.419, <i>p</i> = 0.003), and list patients by diagnosis or health risk (β = 0.282, <i>p</i> = 0.04). However, no association was found between specific features availability or total features score and physician self-reported preventive quality.</p><p><strong>Conclusions: </strong>This study provides evidence that the availability of EHR systems, and specific features of these systems, was positively associated with physician self-reported quality of care in these 38 CHCs. Future longitudinal studies focused on standardised quality metrics, and designed to control known confounding variables, will further inform quality improvement efforts in primary care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2301195"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury mortality in South Africa: a 2009 and 2017 comparison to track progress to meeting sustainable development goal targets.","authors":"Megan Prinsloo, Shibe Mhlongo, Rifqah A Roomaney, Lea Marineau, Thakadu A Mamashela, Bianca Dekel, Debbie Bradshaw, Lorna J Martin, Carl Lombard, Rachel Jewkes, Naeemah Abrahams, Richard Matzopoulos","doi":"10.1080/16549716.2024.2377828","DOIUrl":"10.1080/16549716.2024.2377828","url":null,"abstract":"<p><strong>Background: </strong>Injuries, often preventable, prompted urgent action within the United Nations' 2030 Agenda for Sustainable Development Goals (SDGs) to improve global health. South Africa (SA) has high rates of injury mortality, but accurate reporting of official national data is hindered by death misclassification.</p><p><strong>Objective: </strong>Two nationally representative surveys for 2009 and 2017 are utilised to assess SA's progress towards SDG targets for violence and road traffic injuries, alongside changes in suicide and under-5 mortality rates for childhood injuries, and compare these estimates with those of the Global Burden of Disease for SA.</p><p><strong>Methods: </strong>The surveys utilised multi-stage, stratified cluster sampling from eight provinces, with mortuaries as primary sampling units. Post-mortem files for non-natural deaths were reviewed, with additional data from the Western Cape. Age-standardised rates, 95% confidence intervals (CIs), and incidence rate ratios (IRRs) were calculated for manner of death rate comparisons and for age groups.</p><p><strong>Results: </strong>The all-injury age-standardised mortality rate decreased significantly between 2009 and 2017. Homicide and transport remained the leading causes of injury deaths, with a significant 31% decrease in road traffic mortality (IRR = 0.69), from 36.1 to 25.0 per 100 000 population.</p><p><strong>Conclusions: </strong>Despite a reduction in SA's road traffic mortality rate, challenges to achieve targets related to young and novice drivers and male homicide persist. Achieving SA's injury mortality SDG targets requires comprehensive evaluations of programmes addressing road safety, violence reduction, and mental well-being. In the absence of reliable routine data, survey data allow to accurately assess the country's SDG progress through commitment to evidence-based policymaking.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2377828"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease burden comparison and associated risk factors of early- and late-onset neonatal sepsis in China and the USA, 1990-2019.","authors":"Chengyue Zhang, Lianfang Yu, Xiaoming Pan, Yuwei Lu, Kaiyu Pan","doi":"10.1080/16549716.2024.2396734","DOIUrl":"10.1080/16549716.2024.2396734","url":null,"abstract":"<p><strong>Background: </strong>The morbidity and mortality rates of neonatal sepsis are high, with significant differences in risk factors and disease burden observed between developing and developed countries.</p><p><strong>Objective: </strong>To provide evidence to support recommendations on improving public health policies using a comparative systematic analysis of the disease burden.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease Study 2019, the prevalence and incidence of early- and late-onset neonatal sepsis and the disability-adjusted life years (DALYs) due to both countries in both China and the United States of America (USA) were assessed. Furthermore, the DALYs and summary exposure values for the primary risk factors (short gestation and low birthweight) were analysed. Joinpoint regression models were used to analyse temporal trends in epidemiological indicators of neonatal sepsis.</p><p><strong>Results: </strong>Between 1990 and 2019, the incidence and prevalence of neonatal sepsis demonstrated a significant upwards trend in China, whereas both were largely stable in the USA. A decreasing trend in the DALYs due to neonatal sepsis caused by short gestation and low birthweight in both sexes was observed in both countries, whereas a fluctuating increasing trend in years lived with disability was observed in China.</p><p><strong>Conclusions: </strong>The aim of the Chinese public health policy should be to control risk factors, learning from the advanced health policy planning and perinatal management experiences of developed countries.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2396734"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Kenyan assistive technology ecosystem: a network analysis.","authors":"Emma M Smith, Stephanie Huff, Rose Bukania, Bernard Chiira, Catherine Holloway, Malcolm MacLachlan","doi":"10.1080/16549716.2024.2302208","DOIUrl":"10.1080/16549716.2024.2302208","url":null,"abstract":"<p><strong>Background: </strong>Assistive technology is central to the realization of the rights of persons with disabilities. However, there remains limited access to assistive technology throughout much of the world, with particularly poor access in lower- and middle-income countries. Evaluating stakeholder engagement in assistive technology networks has been used as a successful strategy to understand and address gaps in the assistive technology ecosystem.</p><p><strong>Objective: </strong>The objective of this research was to provide an overview of the Kenyan Assistive Technology Ecosystem, including available assistive products and related services, and an understanding of the nature and strength of relationships between stakeholders.</p><p><strong>Methods: </strong>In this study, we employed an online qualitative stakeholder survey (2021) with representatives of organizations involved in assistive technology in Kenya.</p><p><strong>Results: </strong>The assistive technology network in Kenya is distributed, with Government Ministries and Agencies and Organizations of persons with disabilities central to the network. The strength of relationships is concentrated on awareness and communication, with fewer organizations actively collaborating. Innovation training organizations are not yet well integrated into the network.</p><p><strong>Conclusions: </strong>Improving access to assistive technology in Kenya will benefit from greater collaboration amongst all assistive technology stakeholders.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2302208"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low body mass index as a predictor of sputum culture conversion and treatment outcomes among patients receiving treatment for multidrug-resistant tuberculosis in Lesotho.","authors":"Lawrence Oyewusi, Chengbo Zeng, K J Seung, Stephanie Mpinda, Mikanda Kunda, Carole D Mitnick, Makelele Kanu, Meseret Tamirat, Joalane Makaka, Mabatloung Mofolo, Refiloe Maime, Llang Maama, Ninza Senyo, Bamidele Oguntoyinbo, Lwayi Mayombo, Molly F Franke","doi":"10.1080/16549716.2024.2305930","DOIUrl":"10.1080/16549716.2024.2305930","url":null,"abstract":"<p><strong>Background: </strong>A low body mass index (BMI) at the start of treatment for rifampicin- or multidrug-resistant tuberculosis (MDR/RR-TB) is associated with poor treatment outcomes and may contribute to delayed sputum culture conversion, thereby prolonging the period of potential transmission to others. Whether the relative importance of low BMI in predicting treatment outcomes differs by HIV status is unclear.</p><p><strong>Objectives: </strong>We evaluated the association between low BMI and two dependent variables, sputum culture conversion and end-of-treatment outcome, among patients receiving treatment for MDR/RR-TB in Lesotho, a setting with a high prevalence of HIV infection.</p><p><strong>Methods: </strong>Secondary data from a prospective cohort of patients initiating a longer (18-20 months) treatment containing bedaquiline and/or delamanid under routine programmatic conditions in Lesotho were analysed. Risk ratios and differences were adjusted for potential confounders using multivariable logistic regression, and estimates were stratified by HIV status.</p><p><strong>Results: </strong>Of 264 patients, 105 and 250 were eligible for culture conversion and end-of-treatment analyses, respectively. Seventy-one per cent of patients (74/105) experienced culture conversion within six months, while 74% (184/250) experienced a favourable end-of-treatment outcome. Low BMI was associated with a lower frequency of culture conversion at six months among those who were not living with HIV (relative risk [RR]: 0.50 [95% CI: 0.21, 0.79]); this association was attenuated among those living with HIV (RR: 0.88 [95% CI: 0.68, 1.23]). A low BMI was moderately associated with a lower frequency of treatment success (RR = 0.89 [95% CI: 0.77, 1.03]), regardless of HIV status.</p><p><strong>Conclusions: </strong>Low BMI was common and associated with the frequency of six-month culture conversion and end-of-treatment outcomes. The association with culture conversion was more pronounced among those not living with HIV. Addressing the myriad factors that drive low BMI in this setting could hasten culture conversion and improve end-of-treatment outcomes. This will require a multipronged approach focused on alleviating food insecurity and enabling prompt diagnosis and treatment of HIV and TB.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2305930"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}