BMC global and public health最新文献

{"title":"Yellow fever outbreak potential in Djibouti, Somalia and Yemen: a mathematical modelling study.","authors":"Keith Fraser, Laurence Cibrelus, Jennifer Horton, Chiori Kodama, J Erin Staples, Katy A M Gaythorpe","doi":"10.1186/s44263-026-00284-9","DOIUrl":"10.1186/s44263-026-00284-9","url":null,"abstract":"<p><strong>Background: </strong>The importation of arbovirus diseases into new countries is a global concern. This risk is exacerbated by human movement and climate change effects. In the World Health Organization (WHO) Eastern Mediterranean regional office, three countries - Djibouti, Somalia, and Yemen - are currently classified as potential or moderate risk for yellow fever (YF) outbreaks.</p><p><strong>Methods: </strong>Here we present a quantitative assessment of the risk of introduction and propagation of yellow fever virus (YFV) transmission in Djibouti, Somalia and Yemen. This modelling has two components: i) projecting the risk of importation of infectious individuals into the countries of interest using a radiation model of human movement and ii) estimating the risk of onward transmission given importation using a dynamic compartmental model of yellow fever virus transmission. Both components are multiplicatively combined to give an overall relative outbreak risk combining both risk of importation and risk of an outbreak given importation.</p><p><strong>Results: </strong>We show that areas such as the western coast of Yemen, regions of Somalia bordering Ethiopia and Kenya, and Djibouti City have potential for YF outbreaks (where the estimated probability of an outbreak given an imported infectious case is over 50%). This is due to environmental suitability for transmission based on factors such as temperature and projected human mobility between endemic and at-risk regions.</p><p><strong>Conclusions: </strong>Countries bordering existing YF endemic regions are potentially vulnerable to both introduction of YF cases and subsequent outbreak spread. This promotes the awareness of YF importation potential when conducting clinical surveillance in at-risk countries.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207510","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":"Navigating healthcare for adults with intellectual disabilities in Singapore: a qualitative study of barriers and facilitators to healthcare system access and care-seeking.","authors":"Felicia Jia Hui Chan, Muhammad Azamuddin Bin Aman, Lucas Jia Rong Puah, Joy Sock Hui Teo, Shiling Chen, Shahmir H Ali, Alyssa Yenyi Chan, Zoe Jane-Lara Hildon","doi":"10.1186/s44263-026-00288-5","DOIUrl":"10.1186/s44263-026-00288-5","url":null,"abstract":"<p><strong>Background: </strong>Despite Singapore's robust healthcare infrastructure, adults with intellectual disabilities (AWIDs) and caregivers face insufficient support. Singapore's multicultural context, ageing population, and income inequality further complicate equitable care. These challenges underscore the need to reassess the healthcare system for this group. Therefore, this study aimed to: (1) catalogue barriers and facilitators affecting health system access and care-seeking for AWIDs, caregivers, and health professionals before intervention; and (2) provide recommendations to address the barriers and enhance facilitators.</p><p><strong>Methods: </strong>A qualitative study using focus groups with 19 sectoral professionals and life-event guided interviews with AWID-caregiver dyads or triads (16 AWIDs; 20 caregivers) was conducted to explore viewpoints on care-seeking and health system access. Applied thematic analysis was used in identifying individual or system-level barriers and facilitators through a social constructivist lens.</p><p><strong>Results: </strong>Barriers included individual-level challenges such as having problems when faced with sudden or accumulated changes and transitions and the struggle with insufficient financial resources, particularly affected low-income families and was compounded by insufficient subsidies. System-level challenges included the lack of specialised services for AWIDs, which contributed to mismatched care, while fragmented care and limited care provider capability complicated service delivery. Additionally, fear and distrust of the health system, exacerbated access to care-seeking. All barriers are expressed by both groups. Conversely, a facilitator that enhanced individual-level support, such as the usage of informal networks, helped connect AWID and caregivers to appropriate care. System-level support was stressed by both groups including intersectoral collaboration to address complex issues, while the availability of paid support services improved health outcomes and access. Furthermore, unpaid community support organisations, provided essential social care through organised activities. The facilitators highlighted the potential for improving the healthcare landscape through collective efforts and community engagement.</p><p><strong>Conclusions: </strong>This study highlights the need for individual-level support, including involving more family members in caregiving, and system-level reforms such as integrated, specialised care, and enhanced advocacy. Across all levels, co-created care plans and regular check-ins are important to identify emerging issues and build trust. Implementing these strategies can help Singapore progress towards a more inclusive and responsive healthcare system for AWIDs.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148159982","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":"Coordinated outcome-wide analytic methodology for multi-wave analyses of the global flourishing study.","authors":"R Noah Padgett, Chris Felton, Matt Bradshaw, Ying Chen, Richard G Cowden, Eric S Kim, Renae Wilkinson, Byron R Johnson, Tyler J VanderWeele","doi":"10.1186/s44263-026-00287-6","DOIUrl":"10.1186/s44263-026-00287-6","url":null,"abstract":"<p><p>In this article, we describe the analytic design of the coordinated set of outcome-wide analyses used for examining longitudinal associations using data from the Global Flourishing Study (GFS), involving a multinational and multidisciplinary group of scholars. We discuss the benefits of outcome-wide analyses and provide details on controlling for high-dimensional confounders using principal components, accounting for complex sampling designs, imputing missing data, conducting sensitivity analyses for unmeasured confounding, meta-analyzing estimates of associations from across countries, and reporting results. We provide a brief illustrative example of the outcome-wide approach by estimating the association of Wave 1 sense of mastery with a wide range of Wave 2 outcomes. The example illustrates how results can be sensitive to analytic decisions, such as different coding strategies for the predictor and the number of principal components included. We conclude by outlining the major strengths and limitations of the employed methodology.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145995","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":"Meta-analysis of 633,317 individuals shows associations between healthy diets and depression, anxiety and stress in 23 low- and middle-income countries.","authors":"Thalia M Sparling, Cesar Cornejo, Bryan Cheng, Lisa M Troy, Suneetha Kadiyala","doi":"10.1186/s44263-026-00283-w","DOIUrl":"10.1186/s44263-026-00283-w","url":null,"abstract":"<p><strong>Background: </strong>Poor diet quality related to common mental disorders contribute to global health syndemics. However, there is no synthesis quantifying associations specifically in Low- and Middle-Income Countries (LMIC) where these concomitant health burdens are most prevalent.</p><p><strong>Methods: </strong>We drew on a systematic Evidence and Gap Map (EGM) of > 3,000 records from Medline, CAB Global Health and PsycINFO (2000-2024). We selected LMIC studies quantifying healthy diets (validated dietary indices or factor-analytic methods) against validated screening measures of depression, anxiety, and stress, with a healthy versus unhealthy diet comparator. Effect sizes were standardised as mean differences from Hedges' g and pooled using three-level meta-analysis with robust variance estimation (RVE). Risk of bias was assessed, and sensitivity analyses showed robustness across study designs, dietary measures, and country income strata.</p><p><strong>Results: </strong>Eighty-three eligible studies from 23 countries (depression n = 69; anxiety n = 43; stress n = 26), and 65 LMIC sample populations, reported statistical measures for 633,317 unique individuals. The Standardized Mean Differences (SMD) comparing healthy diets to unhealthy diets were -0.29 for depression (95% CI -0.35 to -0.23), -0.25 for anxiety (95% CI -0.35 to -0.16), and -0.24 for stress (95% CI -0.33 to -0.14). Results remained robust when restricted to low Risk of Bias studies. Findings were similar in direction and magnitude across study designs, dietary measurements, diagnostic tools, country income levels, and estimates adjusted for socio-economic status. Methodological limitations (e.g., cross-sectional design) and few studies from low-income countries created evidence gaps.</p><p><strong>Conclusions: </strong>Healthy diets were consistently associated with lower depression, anxiety, and stress symptoms in LMIC. These findings call for integrated dietary and mental health programming in LMIC (and in any setting with disproportionate health vulnerabilities), and for longitudinal and intervention research across diverse low-income settings beyond Iran and China.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140506","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":"Inter-facility travel time and referral for emergency obstetric care in the 15 most populated cities of Nigeria: a spatial analysis.","authors":"Kerry L M Wong, Aduragbemi Banke-Thomas, Tope Olubodun, Uchenna Gwacham-Anisiobi, Abimbola Olaniran, Abiodun Amosu, Michael Ezeanochie, Bala Harri, Babagana Bako, Charlotte Stanton, Shravya Shetty, Gautam Prasad, Taiwo Amole, Daniel Achugo, Aminu Umar, Rosemary Ogu, Bosede B Afolabi","doi":"10.1186/s44263-026-00285-8","DOIUrl":"10.1186/s44263-026-00285-8","url":null,"abstract":"<p><strong>Background: </strong>Timely access to comprehensive emergency obstetric care (CEmOC) can be vital for ensuring maternal and newborn survival. However, pregnant women in need of CEmOC may not initially present at a CEmOC facility, thereby necessitating inter-facility referral. We assessed inter-facility travel time between potential referring non-CEmOC facilities and receiving CEmOC facilities in the 15 largest Nigerian cities.</p><p><strong>Methods: </strong>Data was sourced from the 2018 Nigeria Health Facility Registry, with additional facilities verified in 2022. We applied Google Maps Platform's internal Directions Application Programming Interface (API) to derive driving times from each 600m² S2 cell to their respective nearest CEmOC facilities. Geographic coordinates of non-CEmOC facilities were mapped to S2 cells to retrieve travel time to public CEmOC facilities. Travel times were estimated from each S2 cell to the nearest CEmOC facilities by ownership (public and private) under peak traffic scenario (weekdays 18-20 h) and off-peak traffic scenario (weekends 01-03 h). Based on the shortest inter-facility travel time, each non-CEmOC facility was paired with a public CEmOC facility. Median travel time and percentage of non-CEmOC facilities located > 30 and > 60 min to the nearest public CEmOC facility were estimated. Sensitivity analysis comparing the API's travel time estimates for randomly-selected 10% of non-CEmOC facilities with those from other methods was conducted.</p><p><strong>Results: </strong>Altogether, 4,563 and 1,963 non-CEmOC and CEmOC facilities were included, respectively. Percentage of non-CEmOC facilities located > 30 min to the nearest public CEmOC was highest in Port Harcourt (51%) and lowest in Maiduguri (6%). All non-CEmOC facilities were located ≤ 60 min from the nearest public CEmOC facility in Aba, Owerri, and Ilorin. Median number of non-CEmOC facilities connected to a public CEmOC facility was 27, with five public CEmOC facilities connected to > 100 non-CEmOC facilities. For some non-CEmOC facilities, the nearest public CEmOC facilities are in a contiguous city or state.</p><p><strong>Conclusions: </strong>Inter-facility referrals in large Nigerian cities show substantial variation in travel time and uneven referral loads, revealing critical pressure points that may delay timely access to CEmOC. Integrating travel time metrics into maternal health planning is essential for improving the efficiency, equity, and resilience of resource-constrained urban referral systems.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059422","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":"Quantifying the financial burden of heat-related hospital admissions in Switzerland under a changing climate: A scalable analytical framework.","authors":"Ario Saeid Vaghefi, Iris Bucher, Chiara Colesanti Senni, Veruska Muccione, Martina S Ragettli, Abbas Mirmashhouri, Christian Huggel, Markus Leippold","doi":"10.1186/s44263-026-00275-w","DOIUrl":"10.1186/s44263-026-00275-w","url":null,"abstract":"<p><strong>Background: </strong>While heat-related mortality is well-documented, the full economic burden of non-fatal illness remains underexplored. This gap hinders evidence-based health planning in a warming climate. We aimed to quantify the current and projected financial burden of heat-related hospital admissions in Switzerland.</p><p><strong>Methods: </strong>We linked daily hospital admissions (1998-2022) from six Swiss cantons, representing 60% of the national total, to temperature records using a Distributed Lag Non-Linear Model (DLNM) meta-analysis. Costs were estimated via the Swiss Diagnosis-Related Groups (SwissDRG) tariff system across different disease categories and age groups. Future climate projections were generated using CH2018 climate simulations with Shared Socioeconomic Pathway (SSP) scenarios (SSP1-Representative Concentration Pathway (RCP)2.6, SSP2-RCP4.5, SSP5-RCP8.5).</p><p><strong>Results: </strong>Historically, extreme heat significantly increased hospital admissions in major Swiss regions, with endocrine/metabolic disorders showing the highest relative risk (RR 2.02). The elderly (75+) and children were the most vulnerable populations. The average annual cost of these direct hospitalizations across the six cantons studied was Swiss Francs (CHF) 20.6 million (2013-2022), notably a conservative estimate representing only a fraction of the total economic burden. Future projections show this burden escalating sharply. Under a high-emissions pathway (SSP5-RCP8.5), these direct costs are projected to increase 2.5-fold by the 2060s, with costs for the elderly quintupling. Critically, even with aggressive mitigation (SSP1-RCP2.6), costs are still projected to triple compared to the baseline. This is driven primarily by demographic aging, with climate change acting as a significant amplifier, responsible for 15-30% of the projected cost increases for the elderly.</p><p><strong>Conclusions: </strong>Our findings from major Swiss regions reveal a substantial and growing financial burden on the healthcare system. Given that these figures represent a lower bound, the true costs are likely much higher. This evidence underscores the urgent need for nationally coordinated adaptation policies to protect public health and ensure healthcare sustainability, even as mitigation efforts continue.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045311","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 artificial intelligence-assisted retinal imaging devices operated by non-specialist workers in detecting diabetic retinopathy in Sri Lanka.","authors":"Nilmini Wijemunige, Moditha Madhuwanthi Dissanayake, Tanya Vimarshani Gamage, Hasitha Rajakaruna, Pavithra Maniyangamage, Niroshani Wisidagama, Malinda De Silva, Manjula D Nugawela, Mapa Prabhath Piyasena, Sobha Sivaprasad, Sarath Samarage, Shanti Dalpatadu, Ravindra Prasan Rannan-Eliya","doi":"10.1186/s44263-026-00279-6","DOIUrl":"10.1186/s44263-026-00279-6","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR), a microvascular complication of diabetes, is an important cause of preventable blindness and can cause a significant reduction in the quality of life of working-age adults. Sri Lanka has one of the highest prevalences of diabetes globally, and like many low- and middle-income countries, faces significant barriers to DR screening. Easy-to-use, relatively cheap handheld retinal fundus imaging devices with automatic interpretation using artificial intelligence (AI) presents a new avenue for DR screening by non-specialist healthcare workers. This study piloted the use of one such device by non-specialist healthcare workers in a low-resource setting and aimed to evaluate image gradability and the diagnostic test accuracy (DTA) of the AI interpretation in this context.</p><p><strong>Methods: </strong>Adults with and without diabetes were recruited from a research clinic. Non-specialist healthcare workers received brief training to capture macular- and optic-disc-centred retinal images using an AI-assisted handheld retinal imaging camera (Remidio FOP NM-10), before and after mydriasis. The device generated reports identifying referrable DR. Participants also had visual acuity assessed and underwent slit lamp biomicroscopy by an ophthalmologist. We evaluated image gradability of the captured images pre- and post-dilation, as well as the DTA of the AI reports using the ophthalmologist's findings as the gold-standard.</p><p><strong>Results: </strong>Retinal images were captured on both eyes of 119 participants, including 49 with diabetes. The proportion of participants that had ungradable images of at least one eye prior to mydriasis was 46.2%, and this fell to 15.1% after mydriasis. A higher percentage of older individuals (59% of those aged 55-64 years and 70% of those aged 65-74 years), 85% of those with cataracts and 58% of those with poor visual acuity had at least one eye with ungradable images pre-mydriasis, with these percentages reducing by 40-70% with mydriasis. The sensitivity and specificity for referral of patients compared to the gold-standard was 73.3% and 79.8% respectively, with image gradability a major driver of misclassification.</p><p><strong>Conclusions: </strong>The AI-assisted retinal imaging camera used by non-specialist healthcare workers after minimal training, in a low-resource setting shows promise as a feasible tool to identify DR in dilated eyes.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045401","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":"Lung cancer care pathways and journeys: insights from patients at the National Cancer Institute in Mexico.","authors":"Elysse Bautista-González, Cecilia Vindrola-Padros, Alejandro Mohar Betancourt, Alberto Monroy-Chargoy, Heber Tomás Reyes-García, Hynek Pikhart, Anne Peasey","doi":"10.1186/s44263-026-00278-7","DOIUrl":"10.1186/s44263-026-00278-7","url":null,"abstract":"<p><strong>Background: </strong>Delayed diagnosis and treatment remain major contributors to poor lung cancer outcomes in Mexico, where fragmented service delivery and weak referral coordination shape patient trajectories. Integrating patient narratives with measurable time intervals is critical to understanding how health system structures translate into lived delays and inequities.</p><p><strong>Methods: </strong>We conducted a convergent mixed-methods study using routinely collected electronic health record data and structured patient interviews at the National Cancer Institute of Mexico (INCAN). Relevant dates were extracted for all suspected lung cancer patients admitted between 2004 and 2021 (N = 2,645). Descriptive statistics, interval calculations, pathway classification, and temporal trends were drawn. In parallel, a purposive subsample of patients (N = 46) participated in structured interviews exploring symptom appraisal, help-seeking, travel, and interactions with health services. Quantitative and qualitative data were collected concurrently and analysed independently with equal priority. Open-ended interview data were analysed thematically, and structured electronic health record data were quantified. Integration then occurred through joint displays combining interview-derived data with medical record variables to link measured delays and clinical pathways with patients' contextual characteristics and reconstruct individual care journeys.</p><p><strong>Results: </strong>Four diagnostic pathways were identified, reflecting where and how diagnosis occurred in N = 2645 patients. Median time from first symptom to treatment ranged from 160 to 255 days, with substantial variation by pathway and year of admission. Interviews revealed N = 41 patients were symptomatic at the time of first appraisal. Recurrent patterns of delayed self-appraisal (N = 61 (median days to first encounter after first symptom), misdiagnosis (N = 24), fragmented referrals, financial insecurity, and long-distance travel to access specialised care. Patients commonly navigated multiple public and private providers before reaching INCAN with very few arriving solely from a public pathway, reaching a median of 3 medical encounters before diagnosis, and thus often incurring out-of-pocket costs and experiencing interruptions in care.</p><p><strong>Conclusions: </strong>Stratifying lung cancer outcomes by diagnostic pathway and linking interval-based metrics to patient experience reveals how health system fragmentation generates avoidable delays and inequities. Policy responses should prioritise coordinated referral pathways, strengthened regional diagnostic capacity, financial protection mechanisms, and early detection competencies across levels of care.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045330","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":"Navigating evidence-informed decision making for arboviral disease control in Pacific Island countries.","authors":"Anaseini Ratu, Katherine L Anders, Karin Leder","doi":"10.1186/s44263-026-00289-4","DOIUrl":"10.1186/s44263-026-00289-4","url":null,"abstract":"<p><p>Arboviral disease control is a priority for Pacific Island countries (PICs), where dengue outbreaks occur frequently. This perspective applies the World Health Organization (WHO)'s evidence-informed decision making (EIDM) framework to examine opportunities and challenges in generating, translating and using evidence to guide arboviral disease control in PICs, using the Wolbachia mosquito release intervention as a case study. The implementation of Wolbachia in several Pacific countries was achieved in the absence of a comprehensive evidence ecosystem, highlighting gaps in EIDM processes. In particular, limited local evidence on intervention effectiveness, combined with challenges in disease surveillance, data accessibility and entomological monitoring, has hindered robust evaluation of public health impact and decisions on scale-up and sustainability. Opportunities exist to strengthen EIDM through pragmatic use of existing surveillance data, time-series analysis and serological studies to assess impact. An untapped reservoir of tacit evidence can be harnessed through culturally appropriate methodologies, such as Talanoa, to contextualise scientific data and address gaps in qualitative research. Closer connections between evidence generators and users can facilitate more effective collective decision-making in Pacific settings. The WHO EIDM framework is useful for Pacific populations to chart pathways towards improved arboviral disease control, with pragmatic considerations of its application in Pacific contexts. Enhanced collaborations and transdisciplinary programs offer further opportunities to align interventions with regional health priorities for integrated EIDM. Policy dialogues using culturally appropriate approaches and leveraging the advantage of simpler systems can greatly improve the efficiency of knowledge translation pathways for EIDM in PICs.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148039057","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":"Robust estimation of the time-dependent reproduction number in the presence of weekend reporting effects.","authors":"Isaac Ogi-Gittins, Nicholas Steyn, Alexander R Kaye, Edward M Hill, Robin N Thompson","doi":"10.1186/s44263-026-00280-z","DOIUrl":"10.1186/s44263-026-00280-z","url":null,"abstract":"<p><strong>Background: </strong>During infectious disease outbreaks, changes in pathogen transmissibility are assessed through real-time inference of metrics such as the time-dependent reproduction number (R_t), which can be estimated from disease incidence data. However, such data are often subject to a \"day-of-the-week effect\" (DOWE), whereby the number of cases on certain days of the week is liable to being under-reported (due to administrative delays) or over-reported (as public health authorities \"catch-up\" on reporting delayed cases). For example, cases occurring at weekends may only be reported during the following week, leading to under-reporting at weekends and over-reporting on weekdays (a weekend reporting effect; WRE).</p><p><strong>Methods: </strong>We analyse simulated datasets, as well as case reports from San Francisco recorded during the 1918 influenza pandemic. We investigate the impacts of WREs on R_t estimates obtained using two approaches: i) the Cori method (a frequently applied method for estimating R_t from daily disease incidence time series data); ii) an alternative method, involving aggregating the daily incidence data into weekly values to remove the WRE and applying a previous method (the OG1 method) for inferring R_t from weekly data.</p><p><strong>Results: </strong>Our analyses indicate that R_t estimates obtained from standard approaches such as the Cori method can be affected negatively by WREs. In contrast, since weekly aggregation of daily data can eliminate WREs, the alternative approach generates robust R_t estimates in the presence of WREs. When aggregating the daily data into weekly values, some information is lost. However, in many scenarios, the negative impact of data aggregation on R_t inference is outweighed by the benefit of then using data that are not corrupted by a WRE.</p><p><strong>Conclusions: </strong>Our research highlights the importance of accounting for DOWEs, such as WREs, when estimating R_t during infectious disease outbreaks.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990728","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}