BMC global and public health最新文献

{"title":"Social isolation, social exclusion, and access to mental and tangible resources: mapping the gendered impact of tuberculosis-related stigma among men and women living with tuberculosis in Eastern Cape Province, South Africa.","authors":"Andrew Medina-Marino, Lindsey de Vos, Joseph Daniels","doi":"10.1186/s44263-025-00166-6","DOIUrl":"10.1186/s44263-025-00166-6","url":null,"abstract":"<p><strong>Background: </strong>In 2022, an estimated 10.6 million people developed tuberculosis (TB) globally, with men bearing a greater burden of disease compared to women. In South Africa specifically, men experience higher risks of poor outcomes and TB-related mortality than women. Stigma and isolation among people living with tuberculosis (PLWTB) are well documented. The gendered pathways through which TB-related stigma leads to isolation or impacts access to resources during one's illness-to-health journey are poorly understood.</p><p><strong>Methods: </strong>We interviewed PLWTB receiving treatment at government clinics in Buffalo City Metro Health District, Eastern Cape Province, South Africa. Semi-structured guides explored TB symptom experiences, access to care, treatment motivation, key supporters, and access to mental and tangible resources (MTRs) during illness. Open coding was done inductively, with MTR domains informed by the Network-Individual-Resource Model. Findings were analyzed through a cyclic, iterative, and deductive process using social isolation and exclusion as interpretive lenses. Memos and pathway mapping examined gendered differences in stigma, isolation, and access to networked MTRs.</p><p><strong>Results: </strong>One hundred forty-two PLWTB (men = 86; women = 56) were interviewed. PLWTB described pervasive TB stigma and isolation. Women described self-isolating in response to enacted and anticipated stigma. Men described active exclusion by friends and family. Women's maintenance of familial ties facilitated access to MTRs while ill. Men's systematic exclusion (e.g., deliberate or forced by peers or family) reduced their agency to access resources. Men and women described regaining physical strength and recovery of social networks through treatment, but also the sustained impacts of post-treatment stigma.</p><p><strong>Conclusions: </strong>We identified gendered pathways through which TB stigma and isolation affect access to MTRs. For women, stigma led to social isolation, but familial networks helped maintain access to MTRs, fostering resilience. Men experienced social exclusion, reduced agency to access MTRs, and increased vulnerability during illness. Findings can guide gender-responsive interventions to reduce the impact of TB stigma on health outcomes.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"50"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236438","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":"Spatial variation in time to diagnosis of visceral leishmaniasis in Bihar, India.","authors":"Emily S Nightingale, Joy Bindroo, Pushkar Dubey, Khushbu Priyamvada, Aritra Das, Caryn Bern, Sridhar Srikantiah, Ashok Kumar, Mary M Cameron, Tim C D Lucas, Sadhana Sharma, Graham F Medley, Oliver J Brady","doi":"10.1186/s44263-025-00169-3","DOIUrl":"10.1186/s44263-025-00169-3","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis (VL) is a debilitating and-without treatment-fatal parasitic disease which burdens the most impoverished communities in northeastern India. Control and ultimately, elimination of VL depends heavily on prompt case detection. However, a proportion of VL cases remain undiagnosed many months after symptom onset. Delay to diagnosis increases the chance of onward transmission, and poses a risk of resurgence in populations with waning immunity. We analysed the spatial variation of delayed diagnosis of VL in Bihar, India and aimed to understand the potential driving factors of these delays.</p><p><strong>Methods: </strong>The spatial distribution of time to diagnosis was explored using a Bayesian hierarchical model fit to 4270 geo-located cases notified between January 2018 and July 2019 through routine surveillance. Days between symptoms meeting clinical criteria (14-day fever) and diagnosis were assumed to be Poisson-distributed, adjusting for individual- and village-level characteristics. Residual variance was modelled with an explicit spatial structure. Cumulative delays were estimated under different scenarios of active case detection coverage.</p><p><strong>Results: </strong>The 4270 cases analysed were found to be prone to excessive delays in areas outside existing endemic 'hot spots'. After accounting for differences associated with age, HIV status and mode of detection (active versus passive surveillance), cases diagnosed within recently affected (≥ 1 case reported in the previous year) blocks and villages experienced shorter delays on average (by 13% [2.9-21.7%] (95% credible interval) and 7% [1.3-13.1%], respectively) than those in non-recently-affected areas.</p><p><strong>Conclusions: </strong>Delays to VL diagnosis when incidence is low could influence whether transmission of the disease could be interrupted or resurges. Prioritising and narrowing surveillance to high-burden areas may increase the likelihood of excessive delays in diagnosis in peripheral areas. Active surveillance driven by observed incidence may lead to missing the risk posed by as-yet-undiagnosed cases in low-endemic areas, and such surveillance could be insufficient for achieving and sustaining elimination.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"51"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236439","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":"Effectiveness of a community health advisor colorectal cancer screening educational intervention on stool test completion in an African American primary care patient population: a pragmatic randomized controlled trial.","authors":"John S Luque, Gebre-Egziabher Kiros, Matthew A Vargas, Askal Ali, Rima Tawk, Deloria R Jackson, Sabrina L Dickey, Cynthia M Harris, Temple Robinson, Bessie Duncan, Jeanne' Freeman, Clement K Gwede, Kristin Wallace","doi":"10.1186/s44263-025-00168-4","DOIUrl":"10.1186/s44263-025-00168-4","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) disparities in incidence and mortality for African Americans compared to white Americans are explained by socioeconomic, behavioral, biological, and cultural factors in addition to lower screening rates and lower stage-specific survival. The behavioral clinical trial, \"Test Up Now Education Program\" (TUNE-UP) tested a community health advisor (CHA) intervention to increase stool-based screening in African American patients of community health centers (CHC) in Florida.</p><p><strong>Methods: </strong>Participants who were not up to date with CRC screening were randomized to two study arms after completing a baseline survey. The two experimental arms were (1) an intervention group which received adapted \"Screen to Save\" CRC education, a tailored brochure, and CHA education; and (2) a control group which received the brochure only. Participants were surveyed at baseline, 3 months, and 12 months follow-up. The primary outcome was completion of the stool test within the last year, measured by self-report. The secondary outcomes were CRC knowledge, CRC perceived susceptibility, and CRC screening self-efficacy. For each arm, the proportion of participants who received CRC screening by 12 months was calculated. McNemar's chi-square test was used to test changes in dichotomous outcomes related to CRC screening. For outcome variables measured on a continuous scale, a paired t-test was applied to compare changes in mean values. Generalized estimating equations (GEE) models were used to compare effects of the intervention on secondary outcomes, adjusting for covariates and confounding factors.</p><p><strong>Results: </strong>At 12 months (n = 93), completion of the stool test increased significantly among participants in both study arms, showing no difference; 27 out of 45 (60%) participants in the intervention group and 28 out of 48 (58%) participants in the control group (p = 0.87).The intervention had a significant effect on the two secondary outcomes of CRC knowledge (p = 0.03) and CRC perceived susceptibility (p < 0.001) after adjusting for the covariates and confounders included in the model.</p><p><strong>Conclusions: </strong>The trial demonstrated CHCs can increase CRC screening among African Americans who were not up to date in receiving recommended screening.</p><p><strong>Trial registration: </strong>The clinical trial was registered on March 11, 2020 under the identifier https://clinicaltrials.gov/study/NCT04304001 .</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192645","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":"Understanding the impact of covariates for trachoma prevalence prediction using geostatistical methods.","authors":"Misaki Sasanami, Ibrahim Almou, Adam Nouhou Diori, Ana Bakhtiari, Nassirou Beidou, Donal Bisanzio, Sarah Boyd, Clara R Burgert-Brucker, Abdou Amza, Katherine Gass, Boubacar Kadri, Fikreab Kebede, Michael P Masika, Nicholas P Olobio, Fikre Seife, Abdoul Salam Youssoufou Souley, Amsayaw Tefera, Amir B Kello, Anthony W Solomon, Emma M Harding-Esch, Emanuele Giorgi","doi":"10.1186/s44263-025-00161-x","DOIUrl":"10.1186/s44263-025-00161-x","url":null,"abstract":"<p><strong>Background: </strong>Model-based geostatistics (MBG) is increasingly used for estimating the prevalence of neglected tropical diseases, including trachoma, in low- and middle-income countries. We sought to investigate the impact of spatially referenced covariates to improve spatial predictions for trachomatous inflammation-follicular (TF) prevalence generated by MBG. To this end, we assessed the ability of spatial covariates to explain the spatial variation of TF prevalence and to reduce uncertainty in the assessment of TF elimination for pre-defined evaluation units (EUs).</p><p><strong>Methods: </strong>We used data from Tropical Data-supported population-based trachoma prevalence surveys conducted in EUs in Ethiopia, Malawi, Niger, and Nigeria between 2016 and 2023. We then compared two models: a model that used only age, a variable required for the standardization of prevalence as used in the routine, standard prevalence estimation, and a model that included spatial covariates in addition to age. For each fitted model, we reported estimates of the parameters that quantify the strength of residual spatial correlation and 95% prediction intervals as the measure of uncertainty.</p><p><strong>Results: </strong>The strength of the association between covariates and TF prevalence varied within and across countries. For some EUs, spatially referenced covariates explained most of the spatial variation and thus allowed us to generate predictive inferences for TF prevalence with a substantially reduced uncertainty, compared with models without the spatial covariates. For example, the prediction interval for TF prevalence in the areas with the lowest TF prevalence in Nigeria narrowed substantially, from a width of 2.9 to 0.7. This reduction occurred as the inclusion of spatial covariates significantly decreased the variance of the spatial Gaussian process in the geostatistical model. In other cases, spatial covariates only led to minor gains, with slightly smaller prediction intervals for the EU-level TF prevalence or even a wider prediction interval.</p><p><strong>Conclusions: </strong>Although spatially referenced covariates could help reduce prediction uncertainty in some cases, the gain could be very minor, or uncertainty could even increase. When considering the routine, standardized use of MBG methods to support national trachoma programs worldwide, we recommend that spatial covariate use be avoided.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192646","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":"Access to medicines and continuity of non-communicable diseases care for forcibly displaced populations: a call for rights-based, comprehensive responses.","authors":"Saleh Aljadeeah, Houssynatou Sy, Joris Michielsen, Cecile Van De Konijnenburg, Jean Défi Ebadu, Fanny Procureur, Martin Heine","doi":"10.1186/s44263-025-00172-8","DOIUrl":"10.1186/s44263-025-00172-8","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"49"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188717","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":"Using an implementation research approach to assess the birth outcomes associated with the 2016 World Health Organization antenatal care policy across states in Nigeria: multilevel analysis of national survey data.","authors":"Christiana Ikemeh, Adedayo O Adeyemi, Leah M Frerichs, Christopher M Shea, Justin G Trogdon","doi":"10.1186/s44263-025-00164-8","DOIUrl":"10.1186/s44263-025-00164-8","url":null,"abstract":"<p><strong>Background: </strong>In 2017, the Nigerian Federal Ministry of Health adopted and implemented the 2016 World Health Organization (WHO) antenatal care (ANC) policy, including the eight-visit ANC (8vANC) recommendation, to improve ANC uptake and reduce perinatal deaths. This study aimed to examine the impact of the 2016 WHO ANC policy implementation on selected birth outcomes in Nigeria.</p><p><strong>Methods: </strong>This research applied an implementation research approach to assess cesarean births, low birth weight (LBW), and perinatal death outcomes associated with the 2016 WHO ANC policy implementation across states in Nigeria. We used multilevel mixed-effects logistic regression model to perform secondary analyses on a matched sample of mothers and children, n = 10,864. A main fixed effect variable was generated from maternal adherence as penetration-fidelity and categorized as \" < 8vANC and partial/non-concordant,\" \" < 8vANC and concordant,\" \"8vANC and partial/non-concordant,\" and \"8vANC and concordant.\" We measured \"concordant\" as maternal self-reported adherence to five selected ANC components (timing of first ANC visit, blood pressure measurement, tetanus vaccinations, urinalysis, and blood sample test), whereas partial/non-concordant was defined as the receipt of fewer components.</p><p><strong>Results: </strong>There was no significant association between penetration-fidelity and cesarean births. Compared with children born to mothers who were categorized as \" < 8vANC and partial/non-concordant,\" the final adjusted models indicated that penetration-fidelity was significantly associated with reduced odds of LBW among children of mothers who were categorized as \"8vANC and concordant\" (OR: 0.38, 95% CI: 0.20-0.71, p = 0.003) but with increased odds of perinatal death among children birthed to mothers categorized as \"8vANC and concordant\" (OR: 1.85, 95% CI: 1.05-3.26, p = 0.032). There was no statistically significant between-state residual variation associated with birth outcomes. Overall, multiparity was associated with increased odds of LBW and perinatal death, whereas advanced maternal age was associated with reduced odds.</p><p><strong>Conclusions: </strong>Our findings suggest the need for more nuanced ANC promotion campaigns that would target the varied maternal age and parous spectrum along the maternal and child health continuum. Further research is needed to evaluate the degree to which the state-level implementation of the policy may have also influenced adherence to the 2016 WHO ANC recommendations.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129286","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":"From pilot project to toolkit: using lessons learned from a comprehensive university campus sexual violence activity in Kenya.","authors":"Paula Tavrow, Nicole M Maderas, Humphries Evelia, Glory Kathambi, Albert Obbuyi","doi":"10.1186/s44263-025-00165-7","DOIUrl":"10.1186/s44263-025-00165-7","url":null,"abstract":"<p><p>Sexual- and gender-based violence (SGBV) is a widespread and under-reported international human rights violation. It is more pernicious than other forms of societal violence because it stigmatizes and marginalizes people. Efforts to address SGBV at African universities have been limited and not comprehensive. Like other campuses, Moi University in Kenya has a serious problem of sexual misconduct. With support from a Kenyan nongovernmental organization and an American university, Moi University launched a pilot project, End Violence on Campus (EVOC), to test a comprehensive and low-cost intervention which was mainly student-led. Activities included establishing an EVOC Club to prevent SGBV, setting up support services, surveying second-year students, and holding student-staff policy dialogues. Although the EVOC Club won a university award and achieved gender equality in membership, the project had numerous challenges. Key lessons learned were as follows: (1) Student organizations need structured tools and support; (2) offering active bystander training and warnings to incoming students are essential; (3) while male students were the main perpetrators, food-insecure students are the most vulnerable to harassment from adults, such as lecturers; (4) monitoring via extensive annual surveys was cumbersome; and (5) achieving lasting change in survivor services required oversight and integration into existing structures. These lessons and other best practices informed the development of the Reduce-to-End Violence on Campus (REVOC) Multimedia Toolkit for use at universities in Kenya and elsewhere. The toolkit, a free downloadable resource, provides a step-by-step framework for SGBV project implementation that includes short videos, training curricula, and brief survey instruments.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081904","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":"Hypertension and diabetes screening uptake in adults aged 40-70 in Indonesia: a knowledge, attitudes, and practices study.","authors":"Maja E Marcus, Anna Reuter, Lisa Rogge, Farah Diba, Marthoenis, Sebastian Vollmer","doi":"10.1186/s44263-025-00157-7","DOIUrl":"10.1186/s44263-025-00157-7","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and hypertension are major global health crises, yet Indonesia is lagging behind in achieving care outcomes compared to other middle-income countries. We examined barriers to screening uptake, a key care entry point, in 40-70-year-old adults in Aceh, Indonesia.</p><p><strong>Methods: </strong>We assessed individual-level data on diabetes and hypertension screenings in Banda Aceh and Aceh Besar in 2019. Using two-stage random sampling, we collected survey data on 2080 adults that are indicated for, but had not undergone diabetes screening as per World Health Organization's Package of Essential Noncommunicable Disease Intervention guidelines. Using this, we adjusted the data for complex survey design to describe (1) the share of respondents with screening indication and presence of risk factors; (2) disease-related knowledge, attitude, and practices, as well as (3) estimate associations of screening with socioeconomic characteristics, knowledge, and attitudes using multivariable linear and logistic regression.</p><p><strong>Results: </strong>We found that while respondents were aware of diabetes and hypertension, a majority lacked knowledge about leading risk factors, the conditions' potentially asymptomatic nature, and screening needs. About 41% of respondents never had any blood pressure or glucose check, the primary reason reported being not feeling ill. Blood glucose checks were rarely conducted. We found rural location and lower education to be associated with lower disease-related knowledge, and lower wealth with lower knowledge and screening uptake.</p><p><strong>Conclusions: </strong>Barriers to screening uptake in Aceh, Indonesia, include misconceptions around hypertension and diabetes, provider-specific challenges especially around the provision of glucose testing, and socioeconomic gradients.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"44"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061070","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":"Incidence of Rodentolepis nana infection within people seeking asylum and refugees attending health screening at an integrated refugee health service.","authors":"Kieran Killington, Nicky Longley, Katherine Bowers, Humayra Chowdhury, Paola Cinardo, Laura Nabarro, Sarah Eisen","doi":"10.1186/s44263-025-00159-5","DOIUrl":"10.1186/s44263-025-00159-5","url":null,"abstract":"<p><strong>Background: </strong>Rodentolepis (Hymenolepis) nana (R. nana) is the most common cestode to infect humans, and whilst most infections are asymptomatic, those with a high burden of infection can present with abdominal pain, diarrhoea, or growth stunting. The Respond service, London, offers screening and treatment for common infections to people seeking asylum and refugees (PSAR), including testing for gastrointestinal parasites such as R. nana.</p><p><strong>Methods: </strong>We present a retrospective observational analysis of all positive R. nana results in patients screened by the Respond service between April 2016 and July 2023. A positive result was defined by the presence of R. nana ova on stool microscopy for ova, cysts and parasites (OCP) or R. nana DNA detection using the Novodiag® Stool Parasite assay (NSP), a cartridge based multiplex molecular assay. We explore incidence of R. nana infection and efficacy of treatment in PSAR presenting to an integrated refugee health service.</p><p><strong>Results: </strong>R. nana was identified in 54/1797 (3%) of patients who had a stool sample collected in the Respond service. Median age of patients was 15 years (interquartile range [IQR] 9-17), and 38/54 (70%) were male, reflecting the sex demographic of the cohort. Coinfection with other parasites occurred in 28/54 (52%) of the cohort. Of the 27 patients who tested positive for R. nana where their family members were also tested, 11 patients (41%) had family members who were also infected with R. nana. Treatment failure (defined as failure to clear R. nana detected by OCP/NSP after treatment with praziquantel) occurred in 43% of the patients for whom a clearance sample was returned.</p><p><strong>Conclusions: </strong>We show a significant prevalence of R. nana in people seeking asylum screened within the Respond cohort. We show significant clustering within family units and a relatively high treatment failure rate. We propose prompt treatment of positive cases to prevent transmission within families, and consideration of treatment of family units simultaneously to prevent re-infection.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047603","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":"Pre-sleep screen time and screen time addiction as shared determinants of poor sleep and obesity in adolescents aged 11-14 years in Scotland.","authors":"Emma Louise Gale, Andrew James Williams, Joanne E Cecil","doi":"10.1186/s44263-025-00160-y","DOIUrl":"https://doi.org/10.1186/s44263-025-00160-y","url":null,"abstract":"<p><strong>Background: </strong>The overall quantity of screen time has been associated with short sleep duration and increasingly sedentary lifestyles, leading to adiposity. The aim of this research was to explore which components of screen time usage are shared determinants of poor sleep and higher adiposity in adolescents, using data from the Teen Sleep Well Study.</p><p><strong>Methods: </strong>A cross-sectional study of adolescents aged 11-14 years in Fife, Scotland was conducted. Sleep was measured objectively using the Actigraph GT3X-BT and subjectively using validated questionnaires. Adiposity was assessed using body fat percentage (BF%) and obesity was measured using body mass index percentile (BMIp). Four components of screen time were addressed using questionnaires: the timing of screen time, quantity of screen time, location of screen time, and screen time addiction. Descriptive statistics and statistical tests such as Pearson correlation tables, and adjusted regression analyses were used. Mediation analyses explored wellbeing as a factor in the association between screen time and sleep and obesity.</p><p><strong>Results: </strong>Sixty-two participants (33 female/29 male, mean age 12.2 ± 1.1 years, mean BMIp 60.3 ± 32.1) completed the study. Excessive screen time pre-sleep (30 min before sleep) and post-sleep (first 30 min after waking), excessive screen time on a weekend, and screen time addiction were shared determinants of higher adiposity, a later chronotype (evening-preference) and poor sleep outcomes: poor sleep habits, increased insomnia symptoms (IS) and increased sleep onset variability. Mediation analyses confirmed that adolescent wellbeing mediated the association between pre-sleep screen time and IS (36.3%) and BF% (21.9%), post-sleep screen time and IS (37.7%) and BF% (30.4%), videogaming addiction and IS (31.9%) and BF% (34.6%), social media addiction and IS (35.0%) and BF% (17.4%), mobile phone addiction and IS (34.0%) and BF% (10.6%), weekday screen time and IS (58.1%) and BF% (39.8%), and weekend screen time and IS (51.4%) and BF% (38.0%).</p><p><strong>Conclusions: </strong>These screen time behaviours, alongside wellbeing should be considered in multi-component health-promoting interventions aimed at improving adolescent sleep and reducing obesity risk. Future research should employ longitudinal designs to clarify the directionality of these associations and determine the effectiveness of interventions that target both screen time behaviours and wellbeing.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003743","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}