BMC global and public health最新文献

{"title":"Disrupting antimicrobial resistance in food systems from a One Health perspective: a complex systems analysis in Canada, Senegal and the Netherlands.","authors":"Chloe Clifford Astbury, Catherine Hu, Mouhamadou Moustapha Sow, Mamadou Ciss, Michel Dückers, Caroline Schneeberger, Lotte van Heuvel, Cécile Aenishaenslin, Ria Benko, Marion Bordier, Valentina De Leon, Olivier Kambere Kavulikirwa, Éva Loboda, Arabi Rajan, Arne Ruckert, Sharon Villanueva, Mary Wiktorowicz, Tarra L Penney","doi":"10.1186/s44263-026-00322-6","DOIUrl":"10.1186/s44263-026-00322-6","url":null,"abstract":"<p><strong>Background: </strong>Food systems are a key contributor to antimicrobial resistance (AMR). Given the multi-sectoral nature of AMR, a One Health perspective has been advocated. Recent research situates AMR as an emerging property of a complex system, a perspective which can help identify root drivers of AMR and theorise the impacts of proposed solutions. This study aims to combine systems modelling and a One Health perspective to identify system-level dynamics and priority actions for addressing AMR in food systems.</p><p><strong>Methods: </strong>We used group model building, a participatory approach to systems modelling, in three countries: Canada, Senegal, and the Netherlands. Stakeholders from policy, research, civil society and industry developed qualitative systems models and identified priority actions for AMR mitigation. Workshop outputs were synthesised in the form of causal loop diagrams and iteratively refined with stakeholders to ensure they appropriately reflected their perspectives. Diagrams were analysed using systems archetypes, a conceptual tool for diagnosing recurring dynamics in complex systems, to identify common structural drivers of AMR and potential intervention points across countries. We then drew on systems theory and the priority actions identified by stakeholders to highlight potential paths to disrupting these archetypes, thereby reducing the contribution of food systems to AMR.</p><p><strong>Results: </strong>Across the countries, 39 stakeholders participated in workshops. The archetypes analysis highlighted how short-term exploitation of shared resources, reliance on antimicrobials at the expense of investing in alternative solutions, and dominance of antimicrobial-intensive production systems may contribute to AMR. Priority actions that were positioned to disrupt these archetypes included regulation, education, consumer engagement, and shift towards different production systems.</p><p><strong>Conclusions: </strong>AMR in food systems arises from recurring structural dynamics that require context-appropriate, systems-informed solutions. Countering short-term exploitation of shared antimicrobial resources calls for regulation, surveillance and education. Addressing overreliance on antimicrobials requires balanced strategies pairing judicious use with sustained investment in alternatives such as livestock management, infection prevention and vaccination. Disrupting the dominance of antimicrobial-intensive production systems calls for regulatory measures and consumer pressure to level the playing field with lower-use systems. Together, these findings point to solutions that employ a systems perspective on design, implementation and evaluation to enable long-term effectiveness in AMR mitigation.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083655","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 geostatistical survey for schistosomiasis and soil-transmitted helminths in Zimbabwe following interruption of preventive chemotherapy.","authors":"Nicholas Midzi, Masceline J Mutsaka-Makuvaza, Isaac Phiri, Rebecca Mwabvu, Kennedy Mubaiwa, Elyse Greenblatt, Alison Ower, Karen Palacio, Neerav Dhanani, Claudio Fronterre, Fiona M Fleming, Rachel L Pullan, Joseph Ws Timothy","doi":"10.1186/s44263-026-00301-x","DOIUrl":"10.1186/s44263-026-00301-x","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis and soil-transmitted helminthiases (STH) are targeted for elimination as public health problems (EPHP) in Zimbabwe by 2030. A 2018 impact survey demonstrated prevalence below EPHP thresholds following seven rounds of annual preventive chemotherapy (PC). However, the COVID-19 pandemic caused a three-year suspension of PC. We conducted a nationwide geostatistical impact assessment to estimate prevalence at ward-level and evaluated impact of PC interruption relative to 2018 results using a quasi-experimental design.</p><p><strong>Methods: </strong>The cross-sectional survey in 2021 targeted 11,600 school-aged children (SAC) and sub-sets of pre-SAC and adults. Sampling was optimised to achieve 90% correct classification of wards (N = 1,961) using geostatistical predictions from 2018 impact data. 200 schools were selected with inclusion proportional to predicted Schistosoma haematobium prevalence. All SAC provided urine and stool samples analysed by urine filtration and Kato-Katz. Geostatistical models incorporating environmental covariates were fitted and used to generate high-resolution prevalence predictions.</p><p><strong>Results: </strong>Data from 11,190 participants indicated a national schistosomiasis prevalence of 7.0% (95% CI 5.0-9.8%) including focal recrudescence of S. mansoni. Heavy-intensity infection recrudesced above 1% EPHP threshold (1.4%, 95% CI 0.9-2.0). STH prevalence increased though remained low (1.4%, 95% CI 1.0-2.1%), with few moderate-heavy infections (< 0.1%, 95% CI < 0.1-1.2). Geostatistical predictions delineated key spatial heterogeneity: 98.9% of wards exceeded 2% schistosomiasis prevalence (17,909,432 people), 37.2% required annual PC (≥ 10% prevalence; 6,473,455 people), and 33.4% wards exceeded 2% prevalence for STH (biennial PC).</p><p><strong>Conclusions: </strong>PC suspension led to recrudescence of schistosomiasis and smaller increases in STH prevalence. These findings emphasise the risk of pausing PC even in low or moderate prevalence settings. Continued surveillance and tailored PC are essential to achieve 2030 goals, with geostatistical outputs supporting precision interventions.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027338","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":"Financing of adolescent health and wellbeing in Bangladesh, Ethiopia and Nigeria: a case study of the Global Financing Facility.","authors":"Olivia Biermann, Emilia Lindquist, Khadija Mitu, Adesola Olumide, Oloruntomiwa Oyetunde, Workneh Yadete, Sara Bylund, Sara Luckenbill, Mariam Claeson, Sarah Baird","doi":"10.1186/s44263-026-00332-4","DOIUrl":"10.1186/s44263-026-00332-4","url":null,"abstract":"<p><strong>Background: </strong>Adolescent health and wellbeing (AHW) remains largely underfunded with uneven progress across countries. This study investigates the Global Financing Facility for Women, Children, and Adolescents (GFF) in-country approach to AHW financing - including investment case prioritization, multisectoral stakeholder platforms, program implementation, monitoring and evaluation, and co-financing - examining what these processes have achieved for AHW, and the barriers limiting their impact, across Bangladesh, Ethiopia, and Nigeria.</p><p><strong>Methods: </strong>This collective case study triangulates country data from document reviews, key-informant interviews with multisectoral stakeholders, focus group discussions with adolescents, teachers and healthcare workers, and a global review of GFF investment cases. Transcripts were analysed using content analysis. Document data were extracted in Excel, then triangulated with the qualitative data. Reporting follows the COREQ checklist.</p><p><strong>Results: </strong>We identified five themes: (1) Adolescents are less prioritised than other age groups in country investment cases, with the limited attention to adolescents typically directed at female reproductive health. (2) The GFF uses pre-existing multi-stakeholder platforms in Bangladesh, Ethiopia, and Nigeria with limited involvement of youth. (3) The GFF supports implementation of AHW through the health sector-wide approach in Bangladesh, while engagement of the education sector is limited. In Ethiopia, adolescent-friendly health services are included in the national financial plan, but implementation faces sociocultural barriers such as perceived stigmatisation and lack of privacy. Nigeria has a national adolescent-specific implementation plan, but a lack of coordination between federal and state levels hinders progress. (4) Monitoring and evaluation (M&E) is weak, despite agreement on adolescent health indicators. Only Nigeria has an adolescent M&E framework. (5) The GFF supports co-financing through donor alignment. Domestic resources are key to progress, although the actual amount of the budget allocation and impact on AHW specific outcomes remain unknown.</p><p><strong>Conclusions: </strong>The GFF co-financing model has increased attention to AHW and aligned investors, but progress is insufficient to drive transformative change. The GFF can be optimized by overcoming coordination and measurement challenges, increasing application of innovative financing instruments for AHW, and meaningfully engaging youth. Given the reduction in development financing globally, countries can draw useful lessons from the GFF model to reduce the gap in adolescent health funding.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027310","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 HIV risk across populations.","authors":"Ben Cranfield","doi":"10.1186/s44263-026-00328-0","DOIUrl":"10.1186/s44263-026-00328-0","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019325","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":"Formal and informal science-policy interaction during public health emergencies of international concern: a scoping review.","authors":"Sophie Meyer, Harvy Joy Liwanag, Kris Schürch, Beatrice Minder, Per von Groote, Caroline Schlaufer, Annika Frahsa","doi":"10.1186/s44263-026-00325-3","DOIUrl":"10.1186/s44263-026-00325-3","url":null,"abstract":"<p><strong>Background: </strong>Interaction between science and policy might be a crucial asset for policy decisions during public health emergencies. Much work has been published about processes and forms of science-policy interaction on the one hand and challenges of public health emergency contexts on the other. However, more knowledge is needed to understand the challenges that arise when these two issues intersect.</p><p><strong>Methods: </strong>We conducted a scoping review informed by the Johanna-Briggs-Institute protocol and searched seven databases to identify formal and informal approaches to organising science-policy interaction. The original search was conducted in April 2022 and updated in March 2026. The searches included Embase.com, Medline, the Cochrane Library, Web of Science Social Science Citation Index, ERIC, Global Health, and Google Scholar. Systematic reviews, articles related to endemic diseases, on clinical and hospital contexts, and impact evaluations of research evidence in decision-making processes were excluded. Information on defined procedures for science policy interaction, form of interaction, selection process of interaction participants, perception of interaction, and barriers and facilitators of the interaction was extracted. Inclusion criteria were a) describe interaction/s of researcher/s and policymaker/s, and b) describe the study setting of a public health emergency. Data analysis followed qualitative content analysis.</p><p><strong>Results: </strong>87 relevant studies were identified. Most included studies focused on the COVID-19 pandemic, with Scientific Advisory Committees (hereafter SACs) as the dominant mode of interaction. Informal mechanisms, such as committees without formal remit and unclear or undisclosed practices, were less frequently reported but played key roles. Common challenges included unclear roles, political interference, and limited communication. Key requirements are role transparency, formalisation, and institutionalisation of science-policy interaction.</p><p><strong>Conclusions: </strong>Science-policy interactions during public health emergencies are shaped by dominant formal structures and underexplored informal practices. Strengthening inclusive, transparent, and interdisciplinary advisory systems is key to improving preparedness for future crises.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984447","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":"The jingle jangle fallacy in digital well-being research is hindering scientific progress.","authors":"Christian Montag, Jon D Elhai","doi":"10.1186/s44263-026-00327-1","DOIUrl":"10.1186/s44263-026-00327-1","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984475","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":"The epidemiological impact, costs, and cost-effectiveness of implementing household contact investigation with tuberculosis preventive treatment in Nepal: a model-based analysis.","authors":"Rajan Paudel, Anchal Thapa, Suvesh Shrestha, Kunchok Dorjee, Raghu Dhital, David W Dowdy, Maxine Caws, Sourya Shrestha","doi":"10.1186/s44263-026-00324-4","DOIUrl":"10.1186/s44263-026-00324-4","url":null,"abstract":"<p><strong>Background: </strong>The burden of tuberculosis (TB) remains extremely high globally. It is increasingly recognized that contact investigation and preventive treatment are essential components of effective action to reduce TB. High-quality, local evidence of feasibility and impact is urgently needed to catalyse scale-up of preventive treatment in high-burden, resource-constrained settings.</p><p><strong>Methods: </strong>We collected data on the costs and yields of contact investigation and implementation of three months of isoniazid and rifapentine (3HP) to treat latent TB infection (LTBI), among adult household members of people diagnosed with TB, from a pilot conducted in two districts of Nepal (Chitwan and Pyuthan) from August 2022 to March 2023. We developed and calibrated mathematical models representing each district and estimated the number of TB episodes and deaths averted by the intervention during 2023-2042. By combining net discounted costs and discounted impact, we estimated the incremental cost-effectiveness of the intervention (compared to no intervention) from a health system perspective as costs (United States Dollars (USD) in 2022) per disability-adjusted life-year (DALY) averted.</p><p><strong>Results: </strong>The intervention screened 1,711 adult household contact persons for TB and LTBI, and treated 500 individuals for LTBI, achieving 98% 3HP acceptance and 95% completion at 150 USD per contact person treated (including drug and test procurement and implementation costs). Including the impact of treating TB disease, the intervention was projected to avert 141 (95% Uncertainty Interval (UI): 86-224) disease episodes and 24 (95% UI: 13-39) deaths during 2023-2042, or 8.2 episodes and 1.4 deaths averted per 100 contact persons screened. The incremental cost-effectiveness of the intervention was 119 USD (95% UI: 51-255) and 163 USD (95% UI: 76-328) per DALY averted in Chitwan and Pyuthan, respectively.</p><p><strong>Conclusions: </strong>Screening and treating household members of people with TB for both TB and LTBI can be successfully implemented in both rural and urban settings, is highly cost-effective and should be prioritized to reduce the TB burden in Nepal and similar high-burden countries.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979215","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":"Geographic variation and factors associated with home-based long-term care utilization across municipalities in Japan.","authors":"Jennifer Lisa Sakamoto","doi":"10.1186/s44263-026-00314-6","DOIUrl":"10.1186/s44263-026-00314-6","url":null,"abstract":"<p><strong>Background: </strong>Japan's universal long-term care insurance (LTCI) system promotes aging in place through home-based services (HBS). However, geographic disparities in HBS utilization may persist despite universal coverage. This study examines the following research questions: (1) How does the utilization of HBS vary across Japan? (2) Do HBS utilization rates exhibit spatial clustering or random spatial patterns? (3) What factors are associated with the regional variation in HBS utilization?</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 1,494 municipalities. Spatial autocorrelation analysis, including Global and Local Moran's I, was conducted to assess spatial clustering of HBS utilization. Non-spatial and spatial regression models were then estimated to examine regional factors associated with HBS utilization. Based on the Andersen-Newman Model of Health Services Utilization, these factors were categorized as need (older adults certified as having long-term care (LTC) needs), predisposing (sociodemographic characteristics), and enabling factors (municipality's system resources and LTC service supply). Stratified analyses were conducted to compare results between large urban, small urban, and rural municipalities.</p><p><strong>Results: </strong>HBS utilization varied widely across municipalities and showed significant spatial autocorrelation. Higher utilization clustered in western Japan, while lower utilization was observed in central and northern regions. The final spatial regression model explained 71.3% of the variance in HBS utilization. The need factor (certified as having LTC needs), predisposing factors (educational attainment), and enabling factors (financial strength of municipality, care manager availability, rurality, institutional care capacity, and non-institutional care provider density) were significantly associated with HBS utilization. Stratified analyses revealed that these associations varied by region type.</p><p><strong>Conclusions: </strong>Despite universal LTCI coverage, substantial geographic heterogeneity persists in HBS utilization across Japan, associated with underlying municipal characteristics. This variation may pose a challenge to the goal of aging in place. Addressing it will require locally sensitive policy approaches that account for differences in care needs, socioeconomic context, and local LTC service availability across municipalities.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932315","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":"Overcoming barriers to neurosurgical care with technology and innovation.","authors":"Jay J Park, Michael Lee, Evelyn Wong, Priya Bhanot, Audrey H Limb, Omar Ceesay, Alexandra Sakamoto, Andrew Lin, Vivek P Buch","doi":"10.1186/s44263-026-00310-w","DOIUrl":"10.1186/s44263-026-00310-w","url":null,"abstract":"<p><p>Technological advancements show great potential in transforming and advancing global surgery. Compared to general medicine, technology in neurosurgery has seen an explosive growth in recent years in ways that directly address accessibility. New, rapidly developing innovations pave the way for the expansion of neurosurgical care worldwide, particularly in areas with historically limited access to such facilities, personnel, clinical expertise, or financial means. Here, we present promising innovations like telemedicine, online collaborative platforms (OCPs), immersive technology (IT), and clinical artificial intelligence (AI) and their implementation in mitigating barriers to neurosurgical care. We argue how these tools enhance communications between providers and patients, streamline intraoperative workflows, and democratise access to neurosurgical education and training by reducing resource demands such as time, travel, and human labour. It is necessary, though, to identify how these technologies can be most successful in the context of global neurosurgery. In addition to reviewing these various technological avenues, we explore the nuances associated with the implementation and reported outcomes for each tool-highlighting challenges and opportunities for further innovation.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877132","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":"Estimation of the global burden of tungiasis in endemic countries using a disability adjusted life-years modelling approach.","authors":"Alistair Antonopoulos, Lynne Elson, Jürgen Krücken, Marlene Thielecke, Francis Mutebi, Richard B Yapi, Ulrike Fillinger, Hermann Feldmeier, Ruth Nyangacha, Nono-Raymond Swar Kuispond, Eddy Kakiese Laken, Renata Santiago Alberto Carlos, Johannes Charlier, Georg von Samson-Himmelstjerna","doi":"10.1186/s44263-026-00318-2","DOIUrl":"10.1186/s44263-026-00318-2","url":null,"abstract":"<p><strong>Background: </strong>Tungiasis is a neglected tropical zoonotic skin disease which is endemic to Sub-Saharan Africa and Latin America, caused by sand fleas of the genus Tunga, which burrow into the skin of affected humans and animals, most commonly when the feet come in contact with infested soil. Sand flea infection leads to inflammation, severe itching, and pain, with the potential for secondary bacterial or viral infections, gangrene, and disfigurement. Tungiasis disproportionately affects poor rural communities, and individuals living in unhygienic settlements. To date, the existing burden of tungiasis has never been estimated, despite being included in the World Health Organisation Neglected Tropical Diseases roadmap since 2021.</p><p><strong>Methods: </strong>We applied a prevalence-based Disability Adjusted Life Year (DALY) approach focusing on Years Lived with Disability (YLD) to model the burden of human tungiasis in endemic countries. Prevalence range estimates were derived using a Bayesian hierarchical Beta-Binomial model, with probability distributions applied to represent uncertainty in estimates based on highly heterogeneous local reports, capture local and regional variation, and reflect fluctuations in symptom severity among affected individuals. A discrete time point model was implemented over a 52-week period to estimate annual DALYs lost per country included in the analysis. Monte Carlo simulation with 1000 iterations was used to generate mean DALY estimates.</p><p><strong>Results: </strong>Globally, we estimate that up to 379,645 (95% UI 361,792-398,309) DALYs are lost annually, with the bulk of the burden in Sub-Saharan Africa. When comorbidities are included, this increases to 575,298 (95% UI 548,948-602,597). When adjusted for population size, we estimate that 24.2 DALYs (36.4 with comorbidities included) are lost annually per 100,000 people. In terms of DALYs lost, the disease burden is disproportionately concentrated in Sub-Saharan Africa, and Brazil.</p><p><strong>Conclusions: </strong>Our estimates suggest tungiasis exerts a substantial burden of disease in endemic countries, comparable in absolute terms to that of soil-transmitted helminths and echinococcosis, and greater than that of toxocariasis, fascioliasis. Furthermore, we observe marked regional concentration of disease burden within Sub-Saharan Africa, with the disease burden in this region driven by large at-risk rural, and urban slum-dwelling, populations living within the ecological zone of transmission.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868823","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}