BMC global and public health最新文献

{"title":"Monitoring for advanced disease in the universal test and treat era: trends in CD4 count testing in South Africa.","authors":"Cornelius Nattey, Dorina Onoya, Khumbo Shumba, Dickman Gareta, William Macleod, Matthew P Fox, Adrian Puren, Koleka Mlisana, Jacob Bor","doi":"10.1186/s44263-024-00118-6","DOIUrl":"10.1186/s44263-024-00118-6","url":null,"abstract":"<p><strong>Background: </strong>Under South Africa's Universal Test and Treat (UTT) policy, CD4 counts are no longer required to determine HIV treatment eligibility. However, CD4 count at presentation remains an important marker of disease progression. We assessed whether CD4 testing declined in the UTT era and, if so, by how much.</p><p><strong>Methods: </strong>We analysed CD4 count data from the National Health Laboratory Service (NHLS) National HIV Cohort and TIER.Net database for individuals in HIV care across five South African provinces. \"First CD4 count\" was defined as the first CD4 test recorded for each patient. In TIER.Net, \"date of presentation\" was the earliest date of HIV testing, CD4 measurement, or clinic visit. Trends in first CD4 testing volumes (2004-2018) were analyzed, with interrupted time-series analyses assessing the impact of UTT (September 2016).</p><p><strong>Results: </strong>Data included 5,274,218 (NHLS) and 2,265,557 (TIER.Net) individuals with a first CD4 count. In NHLS, first CD4 counts increased from 47,604 in 2004 to 383,705 in 2010 and then declined. Lower volumes were recorded in TIER.Net. Adjusting for prior trends, first CD4 counts increased slightly after UTT, by 32 individuals/day in NHLS (95% CI: - 6 to 61) and 88 individuals/day in TIER.Net (95% CI: 30 to 148). Among TIER.Net patients, the percentage with a CD4 count decreased by 4.3% (95% CI: - 5.2 to - 3.0%).</p><p><strong>Conclusions: </strong>We found no major decline in CD4 testing at presentation following UTT, contrasting findings from resource-constrained settings with greater reliance on external donors.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924336","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":"Criminal legal penalties, substance use, and overdose: a concept mapping study examining Colorado's criminal legal penalties.","authors":"Katherine LeMasters, Samantha K Nall, Cole Jurecka, Betsy Craft, Paul J Christine, Ryan Goodman, Jessie Henderson, Robert Haywood-James, Angela Williams, Grace Wittner, Joshua A Barocas","doi":"10.1186/s44263-024-00117-7","DOIUrl":"10.1186/s44263-024-00117-7","url":null,"abstract":"<p><strong>Background: </strong>In the USA, many states, including Colorado, have increased criminal penalties for illicit opioid possession, which may alter overdose risk. We aimed to evaluate the relationship between Colorado's increased drug-related criminal legal penalties, risk of overdose, and substance use patterns.</p><p><strong>Methods: </strong>We used concept mapping - a mixed-methods approach used to develop a conceptual understanding of an issue from a community lens - to engage with people with living and/or lived experience with the criminal legal system, substance use, and/or overdose, their loved ones, and service providers. In facilitated discussion, we used the prompt: \"Do you see overdose and substance use, in Colorado, being impacted by an individual's involvement with the criminal legal system?\" Participants - recruited from community-based organizations - identified, rated, sorted, and categorized factors affecting criminal legal involvement, substance use, and/or overdose in their community. We used groupwisdom to develop concept maps and to analyze findings.</p><p><strong>Results: </strong>Twenty-four individuals (ages 18-70) participated; most had living and/or lived experience. Participants identified 100 distinct factors, which were sorted into 9 clusters: societal impacts of criminal legal involvement, lifesaving benefits to decreased criminal legal penalties, environmental barriers of criminal legal involvement, structural barriers to recovery services, essential culturally aware community-based services, strategic allocation of funding, strategies to improve law enforcement's impact, changing policies to keep law enforcement accountable and better educate law enforcement on community culture, and community issues with law enforcement to prioritize. Of the 40 most influential and common factors, most related to structural impacts of criminal legal involvement and barriers to recovery (e.g., long waitlists, job loss).</p><p><strong>Conclusions: </strong>Using concept mapping, we worked with community members to identify and prioritize factors associated with substance use and overdose amidst increasing drug-related criminal legal penalties. These insights (e.g., law enforcement's role should be acting as a bridge to mental health and recovery services) are critical for policymakers and service providers, as they speak to the need for investing in re-entry services, harm reduction services, and co-responder models for behavioral health crises.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"3 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924333","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":"2024 at BMC Global and Public Health: a year in review.","authors":"Ben Cranfield, Gen Li, Gerrit John-Schuster","doi":"10.1186/s44263-024-00119-5","DOIUrl":"10.1186/s44263-024-00119-5","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"86"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884020","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":"Unveiling pandemic patterns: a detailed analysis of transmission and severity parameters across four COVID-19 waves in Bogotá, Colombia.","authors":"David Santiago Quevedo, Nicolás T Domínguez, Diego Fernando Perez, Maria Alejandra Cabrera Polanía, Juan David Serrano Medina, Felipe Segundo Abril-Bermúdez, Diane Moyano Romero, Diana Sofia Rios Oliveros, Manuel Alfredo González Mayorga, Charles Whittaker, Zulma M Cucunubá","doi":"10.1186/s44263-024-00105-x","DOIUrl":"10.1186/s44263-024-00105-x","url":null,"abstract":"<p><strong>Background: </strong>Despite a wealth of data from high-income countries, there is limited information on the distinct epidemiological patterns observed in diverse, densely populated regions within Latin America. This retrospective analysis of COVID-19's four major waves in Bogotá, Colombia, evaluates 1.77 million cases in detail.</p><p><strong>Methods: </strong>A comprehensive suite of statistical methods was employed. Transmission dynamics were assessed by estimating the instantaneous reproduction number <math><mrow><mi>R</mi> <mo>(</mo> <mi>t</mi> <mo>)</mo></mrow> </math> , while variant-specific transmission advantages were estimated using multinomial logistic regression models. Disease severity was assessed through a suite of indicators: Hospitalisation Case Ratio (HCR), intensive care unit case ratio (ICU-CR), case fatality ratio (CFR), hospitalisation fatality ratio (HFR), and ICU fatality ratio (ICU-FR). Additionally, we analysed the distribution of hospitalisations, ICU admissions, and fatalities by age group and wave. We employed a Bayesian hierarchical model to capture epidemiological delays-such as onset-to-death, hospitalisation, and ICU admission durations to estimate hospital and ICU stay durations.</p><p><strong>Results: </strong>Our findings reveal substantial variation in <math><mrow><mi>R</mi> <mo>(</mo> <mi>t</mi> <mo>)</mo></mrow> </math> , with peaks exceeding 2.5 during the ancestral and Omicron waves. Over the course of the pandemic, we observed a 78% reduction in CFR, underscoring shifts in clinical severity. The third wave, associated with the Mu variant, recorded the highest case and death counts, alongside a decreased CFR, an elevated HFR, and a shift in the most affected age group towards younger populations. In contrast, the fourth wave, driven by the Omicron variant, exhibited the highest reproduction number and the lowest overall severity. This wave was characterised by a significant increase in pediatric hospitalisations. The study reveals a continued decline in the mean durations of hospital and ICU stays across the four waves, with hospital stays decreasing from 10.84 to 7.85 days and ICU stays dropping from 16.2 to 12.4 days.</p><p><strong>Conclusions: </strong>This study reveals significant shifts in transmission and severity metrics-including mortality, hospitalisation, and ICU rates and stays-across age groups during Bogotá's four COVID-19 waves. These insights underscore the value of retrospective analyses to understand the pandemic's varied impact and inform public health strategies in diverse urban settings.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840178","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":"Patterns and drivers of excess mortality during the COVID-19 pandemic in 13 Western European countries.","authors":"Simon Galmiche, Camille Coustaury, Kelly Charniga, Rebecca Grant, Simon Cauchemez, Arnaud Fontanet","doi":"10.1186/s44263-024-00103-z","DOIUrl":"10.1186/s44263-024-00103-z","url":null,"abstract":"<p><strong>Background: </strong>Important differences in excess mortality between European countries during the COVID-19 pandemic have been reported. Understanding the drivers of these differences is essential to pandemic preparedness.</p><p><strong>Methods: </strong>We examined patterns in age- and sex-standardized cumulative excess mortality in 13 Western European countries during the first 30 months of the COVID-19 pandemic and the correlation of country-level characteristics of interest with excess mortality.</p><p><strong>Results: </strong>In a timeline analysis, we identified notable differences in seeding events, particularly in early 2020 and when the Alpha variant emerged, likely contributing to notable differences in excess mortality between countries (lowest in Denmark during that period). These differences were more limited from July 2021 onwards. Lower excess mortality was associated with implementing stringent non-pharmaceutical interventions (NPIs) when hospital admissions were still low in 2020 (correlation coefficient rho = 0.65, p = 0.03) and rapid rollout of vaccines in the elderly in early 2021 (rho =  - 0.76, p = 0.002). Countries which implemented NPIs while hospital admissions were low tended to experience lower gross domestic product (GDP) losses in 2020 (rho =  - 0.55, p = 0.08). Structural factors, such as high trust in the national government (rho =  - 0.77, p = 0.002) and low ratio of population at risk of poverty (rho = 0.55, p = 0.05), were also associated with lower excess mortality.</p><p><strong>Conclusions: </strong>These results suggest the benefit of early implementation of NPIs and swift rollout of vaccines to the most vulnerable. Further analyses are required at a more granular level to better understand how these factors impacted excess mortality and help guide pandemic preparedness plans.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840656","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":"Common criteria for evaluating cross-disciplinary research in global health: a scoping review.","authors":"Yan Ding, Jessica Hooper, Imelda Bates","doi":"10.1186/s44263-024-00113-x","DOIUrl":"10.1186/s44263-024-00113-x","url":null,"abstract":"<p><strong>Background: </strong>Solutions to global health challenges depend on nations' capacity for cross-disciplinary research in global health. Despite longstanding demands for practical guidelines, published guidance and frameworks for evaluating cross-disciplinary research are scarce and scattered among disciplines. We aimed to bring together information on how cross-disciplinary research has been evaluated and collate the frameworks and tools that have been used to advance knowledge and practice about the design and evaluation of cross-disciplinary research in global health.</p><p><strong>Methods: </strong>We conducted a systematic scoping review by searching five databases (MEDLINE, CINAHL COMPLETE, Global Health, PubMed, Web of Science) for publications relevant for our objectives. These were to understand the characteristics of frameworks used to evaluate cross-disciplinary research, to describe how they had been used in practice, and to identify underlying common underpinning criteria. Our inclusion criteria were that the publications (a) focus on frameworks for cross-disciplinary research and (b) include aspects of evaluation or monitoring. The last search was conducted in July 2023.</p><p><strong>Results: </strong>Thirty-one of 2718 screened publications met our inclusion criteria. The intended users of the frameworks were cross-disciplinary researchers (31; 97%), funders (15; 48%), evaluators/reviewers (15; 48%) and practitioners/stakeholders (10; 32%). Eight frameworks (26%) were bespoke for a particular project and used a 'context-process-outcome' approach to incorporate the whole research pathway. Four frameworks (13%) focused on evaluating outcome/impact. Nineteen (61%) focused on other specific aspects of cross-disciplinary research. Seventeen frameworks (55%) provided evaluation tools and 14 (45%) included guidance about their use in practice. Twenty-four (77%) provided examples of how their frameworks were used in practice, and 21 (68%) stated that their frameworks were generalizable in different contexts. The criteria used for the evaluations across the publications fell into four categories: appropriate cross-disciplinary research approaches for the project goal; shared learning and integration; meeting disciplinary standards; and effective synthesis.</p><p><strong>Conclusions: </strong>Our collation and description of the heterogenous published guidance and frameworks for evaluating cross-disciplinary research, and our practical lessons for how to improve the robustness of such evaluations, will help funders, researchers and evaluators to make evidence-informed choices when they commission, design and evaluate cross-disciplinary research programmes in global health.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840638","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":"Investigating inconsistencies regarding health equity in select World Health Organization texts: a critical discourse analysis of health promotion, social determinants of health, and urban health texts, 2008-2016.","authors":"Michelle Amri, Theresa Enright, Patricia O'Campo, Erica Di Ruggiero, Arjumand Siddiqi, Jesse B Bump","doi":"10.1186/s44263-024-00106-w","DOIUrl":"10.1186/s44263-024-00106-w","url":null,"abstract":"<p><strong>Background: </strong>Scholarly critiques have demonstrated that the World Health Organization (WHO) approaches the concept of health equity inconsistently. For example, inconsistencies center around measuring health inequity across individuals versus groups; in approaches and goals sought in striving for health equity; and whether considerations around health equity prioritize socioeconomic status or also consider other social determinants of health. However, the significance of these contrasting approaches has yet to be assessed empirically.</p><p><strong>Methods: </strong>This study employs critical discourse analysis to assess the WHO's approaches to health equity in select health promotion, social determinants of health, and urban health texts from 2008 to 2016.</p><p><strong>Results: </strong>We find that the WHO: (i) usually measures health equity by comparing groups; (ii) explicitly specifies three approaches to health equity (although we identified additional implicit approaches in our analysis of WHO discourses); and (iii) considers health equity inconsistently both in terms of socioeconomic status and other social determinants of health, but socioeconomic status was given substantially more attention than other individual social determinants of health.</p><p><strong>Conclusions: </strong>There is misalignment with the WHO's stated approaches to tackle health inequity and its discourses around health equity. This incongruence increases the likelihood of pursuing short-term solutions and not sustainably addressing the root causes of health inequity. Critical discourse analysis' focus on power allows for understanding why 'radical' approaches are not explicitly expressed to ensure that governments will be agreeable to addressing health inequity.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"81"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840650","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":"Cautiously optimistic: paediatric critical care nurses' perspectives on data-driven algorithms in low-resource settings-a human-centred design study in Malawi.","authors":"Margot Rakers, Daniel Mwale, Lieke de Mare, Lezzie Chirambo, Bart Bierling, Alice Likumbo, Josephine Langton, Niels Chavannes, Hendrikus van Os, Job Calis, Kiran Dellimore, María Villalobos-Quesada","doi":"10.1186/s44263-024-00108-8","DOIUrl":"10.1186/s44263-024-00108-8","url":null,"abstract":"<p><strong>Background: </strong>Paediatric critical care nurses face challenges in promptly detecting patient deterioration and delivering high-quality care, especially in low-resource settings (LRS). Patient monitors equipped with data-driven algorithms that monitor and integrate clinical data can optimise scarce resources (e.g. trained staff) offering solutions to these challenges. Poor algorithm output design and workflow integration, however, are important factors hindering successful implementation. This study aims to explore nurses' perspectives to inform the development of a data-driven algorithm and user-friendly interface for future integration into a continuous vital signs monitoring system for critical care in LRS.</p><p><strong>Methods: </strong>Human-centred design methods, including contextual inquiry, semi-structured interviews, prototyping and co-design sessions, were carried out at the high-dependency units of Queen Elizabeth Central Hospital and Zomba Central Hospital in Malawi between March and July 2023. Triangulating these methods, we identified what algorithm could assist nurses and used co-creation methods to design a user interface prototype. Data were analysed using qualitative content analysis.</p><p><strong>Results: </strong>Workflow observations demonstrated the effects of personnel shortages and limited monitor equipment for vital signs monitoring. Interviews identified four themes: workload and workflow, patient prioritisation, interaction with guardians, and perspectives on data-driven algorithms. The interviews emphasised the advantages of predictive algorithms in anticipating patient deterioration, underlining the need to integrate the algorithm's output, the (constant) monitoring data, and the patient's present clinical condition. Nurses preferred a scoring system represented with familiar scales and colour codes. During co-design sessions, trust, usability and context specificity were emphasised as requirements for these algorithms. Four prototype components were examined, with nurses favouring scores represented by colour codes and visual representations of score changes.</p><p><strong>Conclusions: </strong>Nurses in the LRS studied, perceived that data-driven algorithms, especially for predicting patient deterioration, could improve the provision of critical care. This can be achieved by translating nurses' perspectives into design strategies, as has been carried out in this study. The lessons learned were summarised as actionable pre-implementation recommendations for the development and implementation of data-driven algorithms in LRS.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"80"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840634","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":"Strengthening the relationship between community resilience and health emergency communication: a systematic review.","authors":"Tushna Vandrevala, Elizabeth Morrow, Tracey Coates, Richard Boulton, Alison F Crawshaw, Emma O'Dwyer, Carrie Heitmeyer","doi":"10.1186/s44263-024-00112-y","DOIUrl":"10.1186/s44263-024-00112-y","url":null,"abstract":"<p><strong>Background: </strong>Community resilience and health emergency communication are both crucial in promoting a community's ability to endure crises and recover from emergency events. Yet, a notable gap in theory and evidence exists in the relationship between them. We aim to explore the relationship between community resilience and health emergency communication and to identify strategies and interventions to strengthen their usefulness to each other. Based on the results, a secondary aim was to develop a model of community-centred resilience and health emergency communication.</p><p><strong>Methods: </strong>A systematic review of literature published between January 1990 and February 2024 was undertaken following Joanna Briggs Institute guidelines. Electronic databases (Web of Science, Social Science Citation Index, PubMed/MEDLINE) were searched using key terms. Eligibility criteria were developed from the literature and the knowledge of the multidisciplinary team. Inductive thematic analysis generated key themes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to present the findings.</p><p><strong>Results: </strong>The searches identified 300 articles, of which 86 met the inclusion criteria. Two main themes were identified from the literature: (i) the relationship between emergency communication and community resilience, including subthemes: building trust and collaboration within communities, identifying resources and their distribution, tailoring communication strategies, considering inclusion and equity, and community engagement and feedback and (ii) strategies and interventions, including subthemes: facilitating community structures as channels for communication, respecting personal and private boundaries in health communication, targeting outreach for effective crisis communication, building resilience through training and communication initiatives, and demonstrating commitment to equity and inclusion.</p><p><strong>Conclusions: </strong>There is a small, yet valuable, body of evidence to demonstrate the value of bolstering community-centred resilience for emergency preparedness, response and recovery. The model of community-centred resilience and health emergency communication developed can inform policy, research and practice. Further research is required to develop and test community-centred approaches to enhance inclusive risk communication and equitable recovery.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"79"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840664","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":"Subnational burden estimates to find missing people with tuberculosis: wrong but useful?","authors":"Sandra Alba, Christina Mergenthaler, Mirjam I Bakker, Ente Rood","doi":"10.1186/s44263-024-00110-0","DOIUrl":"10.1186/s44263-024-00110-0","url":null,"abstract":"<p><p>Efforts to combat tuberculosis (TB) require reliable national and subnational data for planning, monitoring and evaluation. Yet, reliable subnational estimates of TB burden are hard to come by-especially at the lower levels of disaggregation such as district, community, or ward level. Several approaches have been proposed to generate subnational estimates of TB burden. However, ascertaining the accuracy of modelled estimates and ensuring their use for TB program planning remains a challenge, thereby raising questions about their usefulness. In this perspective article, we review several subnational TB models to gain insights into their accuracy, purpose and use as a starting point to reflect on their usefulness in finding the missing people with TB. We argue that despite concerns about their accuracy, subnational TB models can help pinpoint areas that deserve more programmatic attention (spatial targeting) and better understand the effectiveness of interventions (programmatic learning). Furthermore, increasing the use of these models can help improve both their accuracy and usefulness in the long run-if estimates are systematically compared against programmatic data and models are improved to better capture reality on the ground. As such, we conclude that subnational TB models represent an essential evidence-based learning tool to guide the search for the missing people with TB.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"2 1","pages":"77"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840665","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}