BMC global and public health最新文献

{"title":"Public brain health: a framework for action to promote and safeguard brain health.","authors":"Timothy Daly, Dorothee Horstkötter, Harris Anthony Eyre, Emily Murphy, Seth Alan Gale, Lisa Cosgrove, Davide Bruno, Eoin Cotter, Andrea Slachevsky, James Rupert Fletcher, Lindsay Wallace, Abel Wajnerman-Paz, Jennifer Jaie Manly, Jonathan Fuller, Stella-Maria Paddick, Romain Manet, C Elizabeth Shaaban, Marcello Ienca, Andrea Sylvia Winkler, Eider Arenaza-Urquijo, Carol Brayne, Agustín Ibáñez, Steffi Riedel-Heller, Edo Richard, Sebastian Walsh, Carole Dufouil","doi":"10.1186/s44263-026-00340-4","DOIUrl":"10.1186/s44263-026-00340-4","url":null,"abstract":"<p><p>The promotion of brain health has generally been undertaken at the level of individuals, for instance, in the quest for precision treatments for persons with, or at high risk of, neurological disorders. But the growing global burden of neurological conditions and the increasing understanding of the brain's central role in all facets of human life have spurred interest in public health approaches to the brain that emphasise population-level strategies benefitting everyone as part of a \"brain health for all\" vision of society. This article defines the emerging concept of public brain health as intersectoral action to establish brain health priorities, empower communities, and reduce health inequities, with the ultimate goal of improving brain health at the population level across the lifetime. We propose a framework to promote and safeguard population brain health with the following key elements: co-defining priorities with communities, balancing prevention strategies, and reducing global gaps in brain health through ambitious policy-making. Public brain health calls for collective responsibility to maximise brain health equity across the life course.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV DNA testing and treatment strategies for cervical pre-cancer among women living with HIV in Papua New Guinea: a prospective clinical cohort study.","authors":"Joyce Sauk, Michaela A Riddell, Joy Tongela, Fredah Koluk, Hari Lialu, Grace Tan, Robert Jones, Arthur Elijah, Josephine Gabuzzi, Paulus Ripa, Pamela J Toliman, Heni Meke, Steven G Badman, Rebecca J Guy, Marion Saville, Angela Kelly-Hanku, Andrew Jb Vallely","doi":"10.1186/s44263-026-00336-0","DOIUrl":"10.1186/s44263-026-00336-0","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends human papillomavirus (HPV) testing and same-day treatment for cervical screening among women in the general population in low- and middle-income countries (LMIC). Among women living with HIV, additional triage is recommended due to lower specificity and predictive value of HPV testing alone in this population. We evaluated the performance of HPV DNA testing alone and in combination with alternative triage strategies for the early detection and treatment of cervical pre-cancer among women living with HIV in Papua New Guinea (PNG).</p><p><strong>Methods: </strong>We did a prospective clinical cohort study among women living with HIV aged 30-59 years attending an HIV treatment and care service. Eligible women self-collected a vaginal specimen for point-of-care HPV DNA testing on the GeneXpert platform. All women testing HPV-positive, and a random sample of HPV-negative women, had enhanced visualisation of the cervix with digital colposcopy (EVA) and provided a clinician-collected cervical specimen for off-site liquid-based cytology. The primary outcome was the clinical performance (sensitivity, specificity, positive and negative predictive value [PPV, NPV]) of HPV testing alone and in combination with alternative triage strategies (EVA, HPV type restriction, modified assay cut-off values) for detection of high-grade squamous intraepithelial lesion (HSIL) or worse.</p><p><strong>Results: </strong>Between May 3, 2024 and December 12, 2024, we recruited 404 women, of whom 168 (41.6%) tested positive for one or more of 14 oncogenic HPV types. Estimated sensitivity and NPV for HSIL or worse using manufacturer-defined cycle threshold cutoffs was >99%, specificity 63.3% (95%CI: 58.3%-68.3%), and PPV 18.6% (12.6%-24.6%). Restricting screen-positive to one or more of the 8 HPV types of greatest oncogenic potential had comparable sensitivity and NPV (>99%), with specificity 70.2% (65.5%-74.9%) and PPV 22.6% (15.6%-29.6%). HPV 8-type restriction with more stringent assay cut-offs (cycle threshold <33.99) had sensitivity 86.5% (75.3%-97.7%), specificity 80.1% (75.9%-84.3%), PPV 30.7% (21.7%-39.7%), and NPV 98.4% (96.9%-99.9%). EVA provided no additional benefits to HPV testing alone.</p><p><strong>Conclusions: </strong>Applying HPV 8-type restriction with or without modified manufacturer assay cut-off values to the WHO pre-qualified Xpert HPV test improved clinical performance for detection of HSIL or worse among women living with HIV in PNG.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priorities and opportunities for strengthening hygiene and One Health alignment in research, policy and practice.","authors":"Max T Eyre, Elizabeth D Thomas, Fanta D Gutema, Hongying Li, Kelly Baker","doi":"10.1186/s44263-026-00337-z","DOIUrl":"10.1186/s44263-026-00337-z","url":null,"abstract":"<p><p>Hygiene plays a critical yet under-recognized role in addressing One Health (OH) challenges, including zoonotic disease prevention, antimicrobial resistance (AMR) control, food safety and protection of ecosystem health. Likewise, hygiene research and interventionsgenerally lack an OH perspective, resulting in siloed efforts that inadequately address the human-animal-environment interface. We convened three sessions at global conferences well attended by health professionals working in hygiene or OH. Participants identified gaps and opportunities for hygiene-OH alignment across research, policy and practice at community, national, regional and global levels. An evidence gap identified was research on hygiene approaches to protect ecosystems in programs otherwise focused upon human or animal health. Methodological priorities included harmonizing tools and protocols for pathogen detection, fecal contamination measurement and hygiene behavior assessment; strengthening cross-sectoral data sharing; and developing integrated study designs. Intervention opportunities included engaging local stakeholders, balancing infrastructure and behavior change, adapting existing programs for cross-sectoral relevance and broadening evaluation to include animal and environmental outcomes. Implementation priorities included localized program design and decision-making, regional cooperation for cross-border threats and leveraging surveillance and preparedness infrastructure. Policy priorities included reducing institutional fragmentation, harmonizing standards, and strengthening the roles of hygiene and OH within existing regulatory frameworks. From our synthesis, we present cross-cutting recommendations for strengthening hygiene and OH alignment. Aligning hygiene and OH offers a pathway to more comprehensive and upstream prevention of disease and AMR, supporting coordinated, system-level management of health risks across human, animal and environmental domains and building resilience to emerging health threats.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best practices for engaging lived experience experts in dialogues about climate change and mental health: lessons learned from a global effort.","authors":"Britt Wray, Ans Vercammen, Lian Zeitz, Sacha Wright, Vashti-Eve Burrows, Jeannie Yamazaki, Suhailah Jasmin Ali, Kyle Hill, Jemaima Tiatia-Siau, Kezang Wangmo, John Jamir Benzon Aruta, Gail Co, Renzo R Guinto, Emma L Lawrance","doi":"10.1186/s44263-026-00321-7","DOIUrl":"10.1186/s44263-026-00321-7","url":null,"abstract":"<p><strong>Background: </strong>The Connecting Climate Minds global initiative sought to advance research and action at the intersection of climate change and mental health by centering the voices of people with lived experience.</p><p><strong>Methods: </strong>Through a series of regional and thematic dialogues, Connecting Climate Minds engaged nearly 1,200 participants across seven global regions, including Indigenous communities, smallholder farmers and fisher peoples, and youth. A Lived Experience Working Group guided the integration of lived experience throughout all project components, from co-designing research agendas to producing multimedia storytelling outputs. This perspective reflects on the methodologies, challenges, and lessons learned from Connecting Climate Minds' lived experience engagement, drawing on two global debriefing workshops and extensive project documentation.</p><p><strong>Results: </strong>Key principles that emerged include the importance of appropriately resourcing relationship building (\"moving at the speed of trust\"), reciprocity, cultural sensitivity, ethical storytelling, and the need for researcher training. The perspective also highlights systemic barriers to meaningful engagement, such as rigid funding structures and institutional resistance to, or inappropriate systems for, power-sharing with impacted communities. By documenting both successes and missteps, this perspective offers practical guidance for researchers, funders, and policymakers committed to inclusive, justice-oriented approaches in climate and mental health research. Ultimately, Connecting Climate Minds demonstrates that centering lived experience not only enriches research quality and relevance but also fosters more equitable and transformative outcomes.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Better data for better public health decision-making: perspectives on quantifying the intended and unintended impacts of public service modifications.","authors":"Sangeeta Bhatia, Yehya M S Althobaity, Lloyd A C Chapman, Josiline Chemutai, Carlo Delfin S Estadilla, Linda Gansberger, Eva Janoušková, Pauline Nyakairu Karega, Ruth McCabe, Rachel E Murray-Watson, Tristan M Naidoo, Mark Pritchard, Bingling She, Timothy B Hallett, Anna Petherick, Pierre Nouvellet, Anne Cori, Angelique Mavrodaris","doi":"10.1186/s44263-026-00333-3","DOIUrl":"https://doi.org/10.1186/s44263-026-00333-3","url":null,"abstract":"<p><p>Public services such as healthcare, schools, and transport constitute the infrastructure essential for a functioning and productive society. These services may undergo planned modifications because of interventions intended to manage societal challenges, or experience unplanned disruptions resulting from external shocks. For instance, schools might be closed to mitigate the spread of an infectious disease, or when an external shock, such as a heatwave, renders their continued operation infeasible. These modifications to public services, whether planned or unplanned, have both intended and unintended public health outcomes, as well as wider and longer-term societal consequences. To improve our response to various societal challenges, it is essential to assess the relation between the extent of modifications and the intended outcomes, and identify the full spectrum of unintended consequences, both beneficial and adverse. A central pillar of such an exercise would be timely and granular data on the modifications and outcomes - what was done, what happened, to whom, where, and when? However, these data are rarely, if ever, systematically collected. Instead, research into the evaluation of public service modifications relies on sporadic and bespoke data collection. In this perspective, we highlight a critical data gap in tracking public service availability, adaptations, and interventions, illustrating our arguments through two case studies. We examine the challenges in collecting and integrating such data and propose practical solutions to improve data infrastructure and cross-sectoral coordination.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national spatial prioritisation framework for the targeted expansion of essential sickle cell disease services across health-facility catchments in Uganda.","authors":"George Paasi, Grace Ndeezi, Ruth Namazzi, Ezekiel Mupere, Ian Guyton Munabi, Sarah Kiguli, Richard Idro, Peter Olupot-Olupot","doi":"10.1186/s44263-026-00338-y","DOIUrl":"10.1186/s44263-026-00338-y","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease causes substantial childhood morbidity and premature mortality in sub-Saharan Africa, while access to essential services remains uneven. In Uganda, geographic variation in inherited SCD risk supports spatially targeted service planning.</p><p><strong>Methods: </strong>We conducted a national facility-linked ecological spatial planning analysis using 280 eligible higher-level public facilities. Populated cells were assigned to the nearest eligible facility within a modelled 60-minute travel-time boundary. Epidemiological context was represented by a study-specific co-risk index combining standardised haemoglobin S (HbS) allele frequency and Plasmodium falciparum parasite rate among children aged 2 to 10 years (PfPR2-10). Reported availability was assessed for newborn screening, hydroxyurea, blood transfusion, and specialised SCD clinic care. We derived service-deficit, structural-vulnerability, programme-priority, service-specific priority, and coverage-to-need measures and assessed sensitivity to alternative weighting specifications.</p><p><strong>Results: </strong>Among 280 planning zones, 122 (43.6%) had none of the four reported services and 205 (73.2%) had no more than one. Co-risk ranged from 0.003 to 0.934 and service-mediated SCD structural vulnerability from 0.000 to 0.905. Higher programme-priority scores were concentrated mainly in northern, north-eastern, eastern, and parts of central Uganda, while lower-priority tiers were more common in the south-west. Newborn-screening and hydroxyurea priorities were closely aligned, transfusion priorities extended more broadly into northern and central Uganda, and specialised-clinic priorities were more spatially mixed. The overall coverage-to-need gap had a mean of 0.190 and median of 0.205. The 56 zones comprising the national top 20% of programme priority contained approximately 7.0 million people, representing 17.3% of the population within the analytic framework. Priority concentration was strongest in Lango, Teso, Acholi, Karamoja, and Busoga.</p><p><strong>Conclusions: </strong>The framework identified a concentrated set of candidate service-strengthening nodes under the specified assumptions, mainly in northern, north-eastern, and eastern Uganda. The findings can support further programme assessment and stakeholder review for phased, regionally coordinated, and service-specific expansion of SCD care.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative evidence synthesis on perinatal screening for sickle cell disease in high-burden countries.","authors":"Amelia Seabold, Alina Luchyshyn, Nia Roberts, Anna Schuh, Lulu Chirande, Helene-Mari van der Westhuizen","doi":"10.1186/s44263-026-00316-4","DOIUrl":"10.1186/s44263-026-00316-4","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) screening can improve lives and reduce mortality through prevention and targeted treatment, but screening programmes are not universally available in the settings which could most benefit from them. We aimed to understand the implementation considerations for prenatal and newborn SCD screening programmes in countries with a high livebirth prevalence of SCD using the socioecological model of health.</p><p><strong>Methods: </strong>We performed a systematic review of qualitative evidence relating to prenatal and newborn screening programmes for SCD in the thirty countries with the highest SCD case to livebirth ratio. We included 18 papers published between 2004 and 2024 that covered nine countries and performed the Critical Appraisal Skills Programme Qualitative Studies Checklist on each. Through recursive interaction with our data, we interpretively developed four themes using reflexive thematic analysis and used the GRADE-CERqual method to appraise our key findings.</p><p><strong>Results: </strong>We framed our results using the socioecological model of health which organizes influences on health into individual, community, and systems levels. From macro to micro levels, our themes are (1) sustainable SCD screening programmes require financial and political support from government and integration into existing healthcare infrastructure, (2) experiences of and knowledge-sharing about SCD fosters further acceptance and opportunity for newborn screening, (3), the decision to conduct a SCD test has extensive ramifications for both child and family, and (4) prenatal and newborn screening modalities offer parents of affected children different options for action. Our policy suggestions focus on planning for programme sustainability at the outset, leveraging existing community knowledge, alleviating stigma, and providing different testing options for families.</p><p><strong>Conclusions: </strong>We identified the need for more qualitative inquiry on systems-level implementation of SCD screening programmes and impact of external funding. We call for decreased stigmatization by supporting knowledge-sharing programmes grounded in local modes of understanding and recognize SCD screening decisions as both consequential to families and shaped by parents' experiences over time.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating tuberculosis service accessibility in Pakistan by analyzing population movement patterns from telecom mobility and survey data.","authors":"Christina Mergenthaler, Oluwafemi John Ifejube, Peter Stephens, Razi Syed, Yee Theng Ng, Umar Saif, Bilal Butt, Frank Cobelens, Ente Rood","doi":"10.1186/s44263-026-00329-z","DOIUrl":"10.1186/s44263-026-00329-z","url":null,"abstract":"<p><strong>Background: </strong>Geographical distance is an important dimension of access to healthcare and is considered in a wide range of settings to aid strategic planning and evaluation of healthcare interventions. Evidence has shown that in addition to geographic distance, multiple factors influence the travel behavior of people seeking health services. Yet most studies have largely framed the issue from the perspective of how far people should travel, while few have explained how far people actually travel, thereby overlooking potential insights into travel behaviors.</p><p><strong>Methods: </strong>In this research, we used in-person interviews, telecom mobility data, and spatial analysis to estimate peoples' accessibility to TB service points in Pakistan. Characteristics of TB service points, including sector (public versus private), urbanicity, socioeconomic class, and administrative province were further analyzed for their association with TB service accessibility. We constructed decay curves to compare the accessibility rates obtained from in-person interviews among people visiting TB service points with those derived from telecom mobility data. We applied generalized linear models to assess whether these measured population movements to TB service points differ by data source, and to explore associations with the TB service point characteristics.</p><p><strong>Results: </strong>Our results show that significant variations in TB service accessibility are associated with administrative provinces, and the density of TB service points. We found a significant difference between the geographic accessibility measured by the two data sources across distance bands. We also found that relative, and not absolute, TB service accessibility is similar across both data sources. However there is a steeper decay curve in the interview data, reflecting lower accessibility at each successively distal distance band relative to the telecom mobility data.</p><p><strong>Conclusions: </strong>While telecom mobility data and survey data capture different population movement patterns, both provide insights which may help to align service availability with population needs. These findings are highly relevant for the geoprioritization of TB case-finding services, the efficacy of which hinge on early and efficient screening and diagnosis.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with loneliness and social capital in a large volunteer sample of adults in England.","authors":"Austen El-Osta, Mahmoud Al-Ammouri, Aos Alaa, Sami Altalib, Agustin Tristán-López, Azeem Majeed","doi":"10.1186/s44263-026-00335-1","DOIUrl":"10.1186/s44263-026-00335-1","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a pressing public health concern with wide-ranging impacts on mental, physical and social wellbeing. Building on the Measuring Loneliness in England (INTERACT) Study which represents one of the largest volunteer-based studies of loneliness and social disconnection conducted in the United Kingdom (UK), we explore demographic, social and health-related factors associated with loneliness and social capital, using multiple validated measures.</p><p><strong>Methods: </strong>We analysed cross-sectional data from 135,725 community-dwelling adults across England. Loneliness was assessed using both the University of California, Los Angeles (UCLA) 3-item Loneliness Scale and the Office for National Statistics (ONS) Direct Measure of Loneliness (DMOL). Social capital was measured using a composite scale of neighbourhood trust, cohesion and reciprocity. Multivariable ordinal and binary logistic regression models were fitted to summarise mutually adjusted associations within the responding sample. The models were used as exploratory, sample-conditional descriptions and were not intended to estimate population parameters.</p><p><strong>Results: </strong>Younger age (particularly 16-25 years old), being single, unemployed or living with disability were consistently associated with higher loneliness across both scales. In contrast, respondents reporting nine or more friends had substantially lower odds of loneliness (UCLA: adjusted odds ratio (aOR) = 0.09, 95% model-based interval (MBI): 0.09-0.10; DMOL: aOR = 0.16, 95% MBI: 0.15-0.17). University education was associated with higher loneliness on the UCLA scale but lower loneliness on the DMOL. High social capital was more frequently reported among older, married and retired respondents. Respondents with long-term conditions or disability had reduced odds of high social capital (long-term conditions: aOR = 0.82, 95% MBI: 0.80-0.85; disability: aOR = 0.77, 95% MBI: 0.74-0.80).</p><p><strong>Conclusions: </strong>This study identified several sociodemographic, social and health-related factors associated with loneliness, although some associations varied according to the loneliness measure used. Because participants comprised a non-probability volunteer sample, the estimates should not be interpreted as population parameters, causal effects or confirmatory evidence. The findings are hypothesis-generating and require confirmation in representative, longitudinal and intervention-focused studies.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequitable nutritional impact of India's first COVID-19 lockdown: a national cross-sectional analysis.","authors":"Anushka Reddy Marri, Madolyn R Dauphinais, Leonardo Martinez, Meagan Karoly, Finn McQuaid, Pranay Sinha","doi":"10.1186/s44263-026-00326-2","DOIUrl":"10.1186/s44263-026-00326-2","url":null,"abstract":"<p><strong>Background: </strong>India's first nationwide COVID-19 lockdown in March 2020 disrupted food systems, healthcare access, and livelihoods, raising concerns about its impact on nutritional outcomes. While the effects of the pandemic on food security have been widely documented, national-level evidence on nutritional status, particularly across economic strata, remains limited.</p><p><strong>Methods: </strong>We analyzed data from India's fifth National Family Health Survey (NFHS-5), a national household survey conducted between 2019 and 2021, during which the COVID-19 lockdown occurred. We assessed underweight status (Body Mass Index (BMI) < 18.5 kg/m²) in adults, wasting (weight-for-height z-score < -2) in children under five, and anemia in men, women, and children under five. Outcomes were analyzed by wealth quintile (Q1-Q5). Adjusted prevalences were estimated by marginal standardization. Survey-weighted multivariable logistic regression models were used to examine associations between lockdown period and outcome prevalence, and concentration indices and curves were applied to assess changes in economic disparities.</p><p><strong>Results: </strong>After adjustment, underweight prevalence among men increased only in the near-poor second quintile (adjusted Odds Ratio (aOR) 1.25, 95% Confidence Interval (CI) 1.12-1.40) and declined in the wealthiest, while among women it declined in the wealthier quintiles and overall and was largely unchanged among the poorest. Wasting declined across all wealth quintiles in children, with smaller reductions among the poorest. Anemia declined across all groups. All outcomes remained concentrated in the poorest quintiles in both periods. Concentration indices and curves confirmed widening disparities in underweight and wasting, with smaller or less consistent shifts for anemia.</p><p><strong>Conclusions: </strong>Following India's first COVID-19 lockdown, undernutrition improved for most groups, but these gains were inequitably distributed: improvements were concentrated among wealthier households while the poorest improved least, and near-poor men experienced a rise in underweight. Anemia declined across all groups but remained highest in the lower wealth quintiles. These estimates should be interpreted with caution, as the cross-sectional design precludes causal inference and higher mortality among the most vulnerable during the lockdown may have rendered post-lockdown estimates conservative. These findings point to the need for equity-focused interventions and resilient nutrition systems to protect at-risk populations during and after crises.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}